Explosion of infections among young people suffocates primary healthcare centres

BarcelonaThe explosion of covid infections among young people is putting primary care centres (PCCs) on the ropes. With a large part of the vulnerable population vaccinated, hospitals and especially ICUs have been decongesting and now it is mainly the burden of unvaccinated patients between 15 and 30 years of age with mild infections that is stifling the outpatient clinics. The data are shocking: in fifteen days the number of positives that are diagnosed in Catalonia with antigen tests - the test that primary healthcare centres perform when they come across a possible case - has increased tenfold and only this week 8,354 infections have been detected. Some of the new cases also correspond to tourists and the forecast is that the incidence continues to rise.

Health professionals consulted by the ARA warn that the immediate future looks unsustainable and call for citizen responsibility while calling for help to the authorities: more hands and more spaces are needed to deal with the rise in infections, they say. "The priority is the vaccination campaign because we are convinced that it is the only way out of the pandemic. But those who vaccinate, those who diagnose and those who care for chronic patients are the same. If cases continue to increase we will not be able to reach everyone", regrets the secretary of the Catalan Society of Family Medicine (Camfic) and doctor in the Servei d'Atenció Primària (SAP) Muntanya - Dreta de Barcelona, Iris Alarcón. In fact, Barcelona is the main focus of infection in the country, especially the districts of Sarrià-Sant Gervasi and Eixample.

According to the Public Health Agency of Barcelona (ASPB), in two weeks the number of covid cases in the city have almost tripled: if on 13 June 832 positive cases were identified, on Wednesday the figure already reached 2,235. These data are similar to those of December and February, when vaccination was not yet fully deployed. "Some days ago we started to see more cases, but this week is crazy", says Antonia Raya, a nurse at the CAP Raval Nord, who regrets that, now that they were returning to resume face-to-face visits and that primary healthcare was "recovering its essence", this avalanche has "knocked down the mood".

The increase in cases coincides with San Juan, although it is still too early to attribute it to the festivities. "And we did not expect such a spectacular increase, not even because the restrictions were relaxed. We have all taken care of ourselves for many months, including young people, and now there was hope. We did not expect it", adds Alarcón, who suggests that it could be due to the delta variant, which is more contagious.

In practically all the CAPs in Barcelona, hundreds of people are tested daily and approximately 10% are positive. Catalan Health minister Josep Maria Argimon admitted during his first commission in Parliament that the situation is "worrying". On Wednesday, he exemplified, patients queuing at the CAP Gòtic had to be sent to other clinics because the waiting time exceeded two hours.

Tracking problems

Most of those who end up in primary healthcare have mild symptoms, but Raya recalls that testing and monitoring those who fear they may have complications is a slow job. And if more and more people are catching the virus every day, there is also a greater risk of young patients entering hospitals. "What we are experiencing is a full-fledged wave", she warns. Alarcón agrees with her, who says that no one is exempt from acute covid: "Of the ten people under 40 years I visited yesterday, two had pneumonia".

Health professionals, especially nurses, have been working double shifts for months to vaccinate and now fear that primary healthcare will die out during the weeks it takes for the vaccines to take effect among young people. "Since it doesn't seem serious and the patients we get are young and healthy, there is a feeling that we can hold our own. And no, we need resources like those that were put in hospitals when they suffered avalanches", says Raya, who insists: "The fire that needs to be put out burns in primary care and if we don't cut the chains we will see young people in the ICU".

In fact, another major obstacle primary healthcare now faces is that there are now many more contacts per positive than before. "We are seeing up to five contacts and this is a lot of work in terms of follow-up, checks and tests", says Alarcón. "And on top of that we have tracking problems: the positives don't give us the contacts until after five days, the avalanche of tests is congesting the laboratories and the Public Health services are collapsed", says Raya.