Alberto Fernandez and Axel Kitsilaf are very concerned about the saturation of hospitals in the suburbs of Buenos Aires
A sharp increase in the number of hospitalizations of patients with COVID-19 in hospitals in the suburbs of Buenos Aires increased medical oxygen consumption by 300 percent. This is due to the fact that one of the main resources used in the treatment and clinical management of complications arising in patients is enriched gas.
For this reason, the supply of oxygen in major medical centers is increasing at the request of the Ministry of Health and the mayors, who are anxiously watching the decline of this critical resource.
Lack of therapeutic oxygen has already been felt in some health centers near Moscow. Last Monday, the medical director of a hospital in the western suburbs sent an alarming message to the district chief:
«Dear all: In the absence of kilombs, another one is added … called the parent company, which provides oxygen to 50% of the country (XXX), breaks down and breaks when delivered in about 2-3 days. That means there is a chance of that there will be a lack of oxygen everywhere. Includes us. For this reason, and even to be sure, I ask you maximum cooperation regarding consumption and be very careful and limited with liters / hour / patient Initially this was done within 24 hours as we do not know when (XXX) will refill the tanks of intermediate companies. That’s why I ask you to talk to doctors, especially medical staff and coordinators minimize excessive oxygen loss in masks and reduce consumption to acceptable minimums. Thank you very much and I inform you. “
(Photo: Franco Fafasuli)
The decision came 48 hours later, but there were moments of crisis during that period. The hospital will not escape the reality experienced by other municipalities: In the last seven days, three times more patients with COVID-19 were admitted to the intensive care unit than in the previous week.
Last Friday the governor Axel Kitsilaf and the president Alberta Fernandez they met for two and a half hours. The unscheduled meeting was motivated by an explosive combination of: an increase in the number of reported cases of coronavirus; a record number of deaths and a report received by the president of Buenos Aires taking into account the projected “tsunami” – the saturation of the health care system, which reached an extreme when in some reference centers and areas with fewer health opportunities there were no places for beds.
In these cases, the occupancy of places in therapy exceeded 93 percent. The situation in clinics and sanatoriums is worse – from 95 to 100 percent.
The attention of Kichilaf and Fernandez is focused primarily on the second and third cardboard suburbs. In addition to the fact that municipalities have a large number of settlements, the health care system is far from strong, there is a significant concentration of poverty and destitution, and the delivery of bags of food needs to be strengthened.
Axel Kitsilaf’s government, faced with increasing demand for therapeutic oxygen, has acquired 300 concentrators to provide patients with oxygen therapy
In the second cardboard there are areas like Ituzaingó where they were almost non-existent 2 of the 29 available beds for resuscitation. How could he know Infobae, from this area patients have already been referred to La Plata.
Vital for treatment
To avoid tragedy due to lack of beds and oxygen, Kicillof along with Daniel Golan, his health minister, has already begun boosting medical oxygen supply in major health centers.
Last weekend in Ensenada the installation was completed mobile oxygen plant “Put hospitals that are in high demand at this critical time and do not allow hospitals The people of Buenos Aires have been left without this vital resource, as has happened in various countries in Europe and the region, ”Golan said.
For example, in Peru on April 10, 15 people died of coronavirus due to lack of oxygen in the city of Talara.
The World Health Organization (WHO) estimates that approximately one in five patients with COVID-19 requires oxygen at concentrations higher than in the environment. “Without such therapy, the disease can be fatal,” said the emergency expert. Priyanka relan, to the WHO Bulletin, as referenced France 24.
“The mobile installation installed in Ensenada is an oxygen generation system specially designed for urgent transfer to the institution, which requires it to provide this resource,” Golan explained. Infobae.
The province has also purchased 300 concentrators “to provide patients with oxygen therapy and keep blood oxygen levels stable,” he said, adding that ” El Dike Hospital, Region XI Health, which will be distributed according to the needs of medical centers ”. The mobile plant was located in the Ensenada Municipal Sports Center.
In this city next week the Kichilaf government will establish one of seven Alternative outpatient health centers, to increase the possibility of hospitalization of patients of mild to moderate severity with COVID-19.
The idea is to prevent saturation of hospitals in the zones, and patients spend hours in the ambulance waiting for referral. Also, avoid complicating the shots, as it is very difficult to add therapeutic beds not so much because of the consumables – 1,200 new respirators have already been purchased, but because of the lack of trained professionals.
The new spaces will add 303 beds to the system. The other municipalities that will be strengthened by the overcrowding of the hospitals they suffer from are La Plata, Pilar, Almirante Brown, Florence Varela and Moreno.
A mobile oxygen plant located in Ensenada
They explained from Golan’s portfolio Infobae what “He seeks to avoid the destruction of health due to lack of beds in the midst of the” tsunami ” cases crossing the metropolitan area of Buenos Aires (AMBA), and they clarified that “at the moment this sector of the province occupies 78.96 percent of employment in the intensive care unit of the public subsector.”
In some municipalities, the occupancy of places in intensive care units is even higher. Areas like Merlot and Tigre have been exposing their health systems for three weeks. In the first case, internees already occupy 82.21% of the detention center beds. In the second – 81.48 percent.
La Matanza, the most populous municipality in the province, is home to more than 22 million people. 75,65%but there are institutions like Agudas Paroussian Hospital, located in Isidro Casanova, which has almost one hundred percent therapy.
Due to this population density, La Matanza registers the largest number of patients with COVID-19 since the beginning of the pandemic – 108,041. The death toll is 3,087, 10% of all coronavirus deaths in Buenos Aires. Only for the last days the mayor’s office registered 987 new cases.
In San Isidro and Vicente Lopez the power of their intensive care is at its limit. In the first case it reaches 90%; in the second to 85.51 percent.
(Photo: Franco Fafasuli)
Within three weeks, several mayors had taken the initiative to increase the oxygen capacity of referral hospitals in their municipalities.
How he was able to check Infobae, at Harry Hospital, the municipality of Escobar, which he manages Ariel Suyarchuk, the oxygen bubble was increased to three times. That is, 300% more, the same increase in consumption of this gas that Golan acknowledged.
A similar decision was made Julio Zamora, Mayor of Tigre. There, they tripled the capacity of medicinal oxygen in three early diagnosis units located in the center of the municipality, in Don Tarquato and Benavides.
The oxygen bubble at Harry Hospital, Escabar Municipality, has been tripled
Communal Chief Jose Paso, Mario Ishi, He has already provided a budget for the installation of his own shop for the production of medicinal oxygen. Approximate investment – 28 million pesos. He confirmed as confirmed by the quartermaster. “given the certainty that this important material for the treatment of patients with COVID-19 is lacking ″.
According to the latest reports received by Governor Kichilof, In the Tigers, the occupancy rate of intensive care beds in hospitals is 81.49%; in Jose K. Pass – almost 65%, one of the lowest; and in Escobar 87.80%.
The lack of hospital beds and the specter of oxygen deficiency have sparked controversy in public hospitals about how to act in the event that two or more patients have to go to intensive care at the same time and have, for example, a single bed.
In these extreme cases, hospitals must resolve this moral dilemma through their Ethics Committee which patient will be admitted to the intensive care unit and who will be expelled.
In the municipality of Tiger, the oxygen capacity has tripled
This has already happened in other countries, such as Italy and Spain, where experience shows that health professionals need to determine exactly who is being given scarce therapeutic resources that can save their lives and who is not.
«The problem is not in choosing which patient to save, but in not being to blame. This is the limit of ethics“Regrettably said the prestigious intensivist, who with suffering notices the only of the 10 beds he left in the intensive care unit, which he managed for 12 years.
«Over the past month, oxygen demand has increased between 40 and 50 percent. In mid-March, we had 3,100 patients in intensive care, the number on Sunday was 4,858. This forces the need for oxygen to exceed forecasts and we believe the peak will continue to grow“- he says Infobae doctor Claudio Santa Maria, rector of the Higher Institute of Health Sciences, who explains: “Coronavirus is an air virus that creates a storm of cytokines that affects various organs. At the level of the lungs, they cause inflammation that slows down what is called hematosis, a metabolism carried out by red blood cells that take in oxygen and release carbon dioxide. Because the inflammation is so great in the beginning, the saturation deficiency needs to be compensated by masks or mustaches. As the condition progresses and becomes much more severe, the patient needs to be intubated, and thus, using a respirator we provide oxygen under pressure. Lack of oxygen causes cell and tissue death. ”
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Coronavirus: three times more patients with COVID-19 were admitted to the intensive care unit in the last seven days than in the previous week
