Manel Cervantes: "Survival to covid-19 has doubled in all age groups"
Head of the Infectious Diseases Service at the Parc Taulí Hospital
Santa Coloma de GramenetAs head of the infectious disease service at the Parc Taulí Hospital since 2015, Manel Cervantes has been at the forefront of caring for patients with coronavirus. And he has done so in a hospital serving the more than 400,000 inhabitants of Vallès Occidental. The doctor assures that the second wave has nothing to do with the first in terms of the impact of the disease, and the fact that there are more positive, he insists, has not translated into an increase in mortality. In fact, at his centre, covid survival has almost doubled in all age groups, including those over 80.
Mortality figures in Parc Taulí have improved.
Very much so. Between March 15 and April 15 we had about sixty deaths a week; one week we had 72. In just four weeks we accumulated 200 deaths. However, in the second wave we never went above 13 in a week.
So there are now fewer deaths due to covid-19 in Vallès Occidental?
Unfortunately there still are, because this virus does a lot of damage to the over-65s. But we think it is important to point out that we have not had any deaths in under-50s in this second wave. In the first wave, the dead under 65 were only eight. I don't want to be triumphalist, but pneumonia in general kills young people, and this is not happening. But yes, from 65 onwards Covid really does a lot of damage.
Has survival increased in all age groups?
Yes. We've been comparing the survival data from September to March and April and we see that the figure is almost double that of the first wave. In July and August we started getting an increase in cases and then we didn't register any deaths because most of them were young patients. And I thought: "You'll see when the grandparents start coming back to us as everything changes".
But it wasn't like that.
Since the increase in admissions in October, the average age of those admitted has risen to 72, but our mortality has not risen again, it has halved in all age groups. Well, not in the under-50s, because we no longer had any.
Do you think this is a global trend?
Maybe it's not representative of the whole country, but we work in an area of 400,000 inhabitants and we are the only hospital in the area. Furthermore, we have attended patients from Mollet, Granollers and Terrassa and, in fact, a third of those attended in this second wave in the ICUs were not residents of Sabadell. And this is happening in all health centres, because we work as a single hospital.
Patients aged 80 and over, whose recovery is the most complex, are surviving 40% longer.
Yes, and in any other disease this would be considered a success. The mortality in these patients used to be 30% and now it's around 12%. It's really an improvement. We don't give up when the patient is recoverable, no matter how old, if we can, we put him on assisted ventilation, which is less invasive and aggressive than intubation. We have elderly people who improve their prognosis in four days and manage to save themselves.
What about the other age groups?
Under 70, the mortality rate of all patients admitted is 3%. That means people are dying, but far from the numbers left by pneumococcal pneumonia, the most common. And the most complex people are those with other pathologies, of course. It is also true that we have not finished the second wave and that these are not definitive data, but for the moment they are holding up. And they also encourage us: it was our feeling and the data have confirmed it.
What are the reasons for these changes?
We can't be proud and say that it's because we treat them better now. I think it's a mixture of factors. The sick arrive earlier and knowing that they have covid because they have been tested in primary school, and in an orderly manner: now we do not admit patients by the hundreds, but by the tens. We are doing better.
Knowledge also has an influence.
Of course it does. We have learned which treatments work best and must be administered from the beginning to increase their effectiveness, such as steroids. And we have also learned not to give drugs that are useless. That may seem silly, but we do patients less harm.