Society 01/12/2021

Visits to primary care double in a fortnight

Health Department recommends limiting unnecessary visits to hospitals to avoid outbreaks

3 min
A large man receiving both the flu vaccine and the third dose against covid to the HEAD Rio de Janeiro of Barcelona.

Santa Coloma de GramenetThe curve of the sixth wave of covid grows progressively, without causing the explosion of new infections of last summer, when 50,000 cases a week were detected, and without saturating the health system. Or at least hospitals, because the primary care centres are noticing the pressure of this increase in positive. They now receive twice as many visits related to covid than fifteen days ago, and only in the last week visits for suspected infection or moderate symptoms have grown by 38%. Health Secretary Carmen Cabezas has described this increase as "very serious and important", because primary care already carries virtually the entire burden of the pandemic: vaccines (both flu and covid), care for respiratory problems and screening tests. At the same time, it s trying to recover face-to-face consultations to treat other diseases.

The president of the Catalan Society of Family Medicine (Camfic), Antoni Sisó, says that the growth in cases in recent weeks is undeniable, but "not necessarily alarming." "The incidence is growing slowly and progressively, very differently from how it did during the fifth wave, when it skyrocketed in a few days. But the evolution of the pandemic is uncertain, not only because of the omicron variant, but because the virus often behaves unpredictably," the doctor explains. According to Sisó, the difference is made by the vaccines: the virus is passed on mainly by the unvaccinated, as well as some outbreaks in schools.

On the other hand, the hospital impact can still "be contained", in Cabezas's words, thanks to the high vaccination rate. Catalonia has vaccinated 75% population (84.2% if you only take into account those over 12) and the authorities say that for every 20 positives, there is a hospitalisation. Now, 682 people have been admitted to hospital for covid, and 145 of them are in ICUs. This means that in conventional plants there are 30% more patients compared to last week and 42% more in intensive care. "We hope to be able to slow the increase and avoid the impact of other waves," Cabezas said. Unvaccinated over-50s are 6.2 times more likely to end up in ICU than those who are, she recalled.

Sisó stresses that there are more and more professionals that take time off work for emotional reasons. He argues that the health system should be more "permeable" to provide coverage when necessary to the areas that need it most. "We have a virus that presumably causes more mild illness than hospitalisations. If primary care needs human resources from other areas such as hospitals to cope with the demand, it should be able to get them", raises. The doctor says that while primary care lacks hands to administer vaccines or do PCRs and activity has grown by 7.5% in a year, hospitals have seen a 10% reduction. "Either we get help from other areas or we will be overrun," he warns.

In addition, the workload will increase even further in primary care centres in the coming weeks, as more population groups become eligible to receive a booster jab. It will now be the over-60s turn, who can already get their booster if six months have passed since they received the second dose of Moderna or Pfizer or three months if they received AstraZeneca or Janssen. Since last week about 20,000 people received the injection. Appointments had been managed by health centres, but the Department will now also make it possible to book a slot online for the 65 to 69-year-olds.

Outbreaks in hospitals

The Health Department has declared 11,612 infections in the last seven days, more than twice as many as a fortnight ago, and, although admissions have not gone up as much (proportionally fewer sick people enter thanks to vaccines), this rise in infections in the community begins to make a dent in hospitals. The director of the Servei Català de la Salut (CatSalut), Gemma Craywinckel, lamented that the virus is generating outbreaks among staff and users, which can have a "very relevant and negative" impact for patients and professionals.

For this reason, the Department recommended centres make changes in the management of patient flows, visits and schedules, and, although it has clarified that they will not ask to force people to attend appointments unaccompanied, they do ask that, unless it is "essential", people visit health centres alone. Excluded from this indication are dependents, such as the very elderly, people with disabilities or children.

The Hospital del Mar has been the first centre to announced the temporary suspension of visits to patients admitted to the ER "due to an exceptional situation of high pressure on care," except in end of life situations. Before this, however, the Hospital Verge de la Cinta in Tortosa had restricted visits due to a covid outbreak. It is carrying out a mass screening to contain it.

Covid passes at vaccination points

To fight against the digital divide, which affects users wishing to download their covid pass on the Health Department's app, La Meva Salut, the director of the Catalan Health Service (Catsalut), Gemma Craywinckel, has announced that the Department of Health will allow those who "cannot obtain it any other way" to get a printed copy from mass vaccination points. The aim is to avoid overcrowding at health centres. Craywinckel also asked people to help their relatives download the QR code if possible.