Society 24/07/2021

Covid hospitals and primary healthcare centres are back, as in March 2020

Health deprogrammes non-urgent healthcare activity for three months in public and private centres to preserve the holidays of health workers and maintain the system

3 min
Cues at the door of the CABEZA de Huerta in Barcelona in an archive image

BarcelonaThe health system returns to focus exclusively on treating covid-19 patients. As in March 2020, when the high incidence of the coronavirus collapsed the capacity of the system, the Health Department has given the order to deprogramme all deferrable activity in primary healthcare and hospitals to be able to devote itself to the pandemic and to the urgent cases that cannot be postponed. The order is valid for three months -that is, until the end of October, in autumn- although it can be corrected downward or upward depending on the evolution of infections. This resolution also includes private healthcare centres, as was done during the first wave in spring last year.

Although epidemiological data point to a slight slowdown of new positive cases as a sign that the peak of this fifth wave is being reached, the decongestion is far from being close, today, to health centers. The reason is none other than the incidence, which is the highest of all the infection, so that the easing of restrictions will be gradual and slow in the steps of care. The number of patients admitted to the ward has already exceeded 2,000, a figure that has not been recorded since February, and this weekend the number of ICU beds is expected to exceed 500, as it was at the end of April, at the height of the post-Easter peak. Under the same pressure are the professionals who answer the calls on the 061 telephone.

Postpone everything that is not urgent

The Health minister, Josep Maria Argimon, had referred this week to a "critical, very critical" situation in terms of pressure on hospitals, and admitted that some centres were already canceling non-urgent appointments. The truth is that when he said it there was already a circular signed by CatSalut, the body responsible for the benefits of the public system, which agreed to "condition the activity" of the centres "so that only urgent, emergent and clinically unpostponable activity is attended", as the ACN has advanced. Primary care centres that have not yet officially received the document have been forced by the lack of staff to take this decision to move forward.

In addition to the seriousness of the situation in primary care and hospitals, which the health authorities have highlighted in recent days by raising the level of concern, it coincides with the summer, and the department has set itself the "red line" of not having to cancel holidays for exhausted staff after a year and a half of disproportionate activity. 

Save the holidays

Health sources insist that the goal is to preserve "above all the rest of the health collective and at the same time, ensure that it can cope with a very important demand". Requests for one-day leave have been rejected, but the department does not want to go beyond this, after the summer of 2020 there was a resurgence in the middle of the holidays and many of the professionals had to postpone their rest plans. For Health, there is no alternative if it wants to ensure the care of covid patients and emergency or unpostponable patients, the reorganisation of teams of professionals and the optimisation of all the necessary resources.

The tense situation is well illustrated by a case of a primary healthcare centre that usually has six family doctors. A week ago, it was left with only one. The rest had either already left for their summer holidays or had been infected by covid. Not even the fact that some of the professionals decided to suspend their holidays allowed to guarantee the schedule, and therefore the management decided to cancel a few days ago those patients who had to make routine or minor pathologies and control visits. The primary care department has always pointed out that the main victims of these reductions in routine care are chronic patients, who need check-ups to keep their illness at bay. 

At the gates of the second weekend with night-time curfew, the seven-day cumulative incidence - the value guiding the restriction - is below 600 cases per 100,000 inhabitants, but the safety level of the Ministry of Health stands at 200. Health predicts that there are 10 more days to notice the easing of restrictions in the ICUs of a fifth wave that, despite the vaccine, looks like the first.