Thursday, May 26

Argentina transits the second wave of coronavirus with a healthcare system on the edge and exhausted doctors | Society

More than twenty people with mild symptoms of covid-19 line up to swab themselves in front of a tent installed in the garden adjacent to the Mariano y Luciano de la Vega de Moreno hospital, 36 kilometers west of Buenos Aires. The average age is around 40, but there are also a couple of children accompanied by their mothers. The tests begin at 07:30 in the morning and three hours later the 180 available daily shifts have already been distributed. “There are no more supplies, they will have to come back tomorrow,” repeats the nurse in charge of the swab to those who come to ask. “When the cold arrives, this is going to collapse,” predicts one of those who are rejected.

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In this centennial hospital, which before the pandemic was the only one for a population of about 600,000 people, two new rooms have just been fitted out to receive severe coronavirus patients. Intensive care bed occupancy is 80%, a critical limit. In the modular hospital opened last June only for covid cases, the occupancy is 50%. Signs are hanging at the emergency door asking to keep a distance, wear a mask and remind that since April 16 visits from family members have been suspended – except for authorized exceptional cases – due to the rapid increase in cases registered in this second wave in Argentina.

In the last week, the average number of new infections in the country is around 20,000 a day. They are below the 23,000 that were three weeks ago, when the night curfew and other measures decreed by the Alberto Fernández Government began to take effect, but still above the peak of the first wave, registered last southern winter. The restrictions have divided the Argentine population and have confronted the national Executive with the opposition due to educational presence, but among medical personnel there is consensus: there is a real risk of sanitary collapse and the movement of people must be further restricted to avoid it.

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“The new wave is much more contagious and much more deadly. The circulation of the Manaus and British vines in the AMBA [Área Metropolitana de Buenos Aires] It is a fact and it is statistically proven that the Brazilian strain, for example, has killed in its region in three months what before in a year. We see it every day, more aggressive cases, in young people, many of them without known risk factors ”, wrote the director of the Moreno hospital, Emmanuel Álvarez, in a public letter that went viral.

Exhausted doctors

Days later, sitting in his office, Álvarez confirms his concern about the increase in cases that an exhausted team of professionals has to deal with. “The health personnel, from last year to this one, have never stopped and are very tired. We are working with a large workload because, as there is a greater need for human resources, people work in different places or add hours. We have reached the point where no more human resources can be added. As much as we wanted to add three more hospitals, there are no people, ”he explains.

“Doctors have a workload of 36 hours a week. But there are those who are working 48, 72 or even 96 hours. That is the limit. Likewise, nursing is a very scarce resource and they usually work in two or three places in order to make ends meet, ”Álvarez continues. In the first year of the pandemic, more than 78,000 health professionals were infected with COVID-19 in Argentina and almost 500 died.

AME2657.  BUENOS AIRES (ARGENTINA), 04/26/2021.- A health worker stands guard in an emergency area for covid-19 of a clinic in Buenos Aires, on April 26.
AME2657. BUENOS AIRES (ARGENTINA), 04/26/2021.- A health worker stands guard in an emergency area for covid-19 of a clinic in Buenos Aires, on April 26.Juan Ignacio Roncoroni / EFE

The vaccination campaign has drastically decreased the cases, but even so, those who are on the front lines of the battle against the coronavirus are despairing at the lack of compliance with the measures decreed by the Government. “A month ago I took a step to the side of the hospitals and stayed in a vaccination center, because the pandemic affected me a lot physically and emotionally. It is very hard to see how people die. When you go out to the street after working so many hours and you see that nobody takes care of themselves, you think if it makes sense to risk your life, “says Juan, who became a nurse three years ago and prefers not to give his last name.

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“An admitted nurse charges about 30,000 pesos ($ 300) and the rent for a small apartment is 25,000 ($ 250). You can’t live with just one job, ”explains Juan. A colleague began to cry after the death of a 39-year-old patient who orphaned two babies and another said he wanted to leave everything and go to live in the country. “The new strains are killing much younger people. Last year, I saw older adults who were at risk group die, but today we are all at risk group and the time in which the virus kills is much shorter. Sometimes they don’t even go to therapy, ”adds Juan.

The harsh isolation in force during the first months of the pandemic in Argentina gave time to strengthen the Argentine health system and avoid its generalized collapse. In the province of Buenos Aires, the most populated in the country, they went from 883 intensive care beds in the public sector to 2,279. However, the closure was lethal for the economy: in 2020 the Argentine GDP plummeted by 9.9%. Today the government has much less social and economic margin than a year ago to impose such strict isolation. From the health sector they ask that, at least, a closure be contemplated for short periods to prevent a health tragedy this winter. To date, 3.1 million people have been infected with coronavirus in Argentina and 67,821 have died.

“The majority of the population has a relaxed and unacceptable behavior and the only thing left to us to reduce the damage is immediate restrictive measures,” warns Arnaldo Dubin, head of intensive care at the Otamendi sanatorium in Buenos Aires. “Fortunately, oxygen has not been lacking, the government has applied measures in time, but the situation is serious. There are patients who spend hours wandering in ambulances or in their homes before being admitted and some are treated outside intensive care, by personnel who are not the ideal. Respirators and beds are easily bought, but training an intensivist doctor takes four years ”, he emphasizes.

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The coronavirus is the greatest concern of Argentine health personnel, but not the only one, because as circulation increased, the emergency rooms were once again filled with injuries from traffic accidents and clashes. With the arrival of the cold, an increase is also expected in respiratory infections that were almost not present last year, such as bronchiolitis and pneumonia, which generate a greater occupation of beds. “Vaccination is going to have a positive impact in the most serious cases and in the population over 70 years of age, but it is not enough. The national average of vaccinated is 14% and in those under 60 it is even lower ”, warns the infectologist Javier Fariña, one of the government advisers. The new, more contagious variants are worrying and a shift towards younger people is observed. This situation can generate a perfect storm if it is associated with low temperatures ”, he concludes.

A relative of a patient waits outside a hospital in Buenos Aires, on April 29, 2021.
A relative of a patient waits outside a hospital in Buenos Aires, on April 29, 2021. Juan Ignacio RONCORONI / EFE

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