Another collapse of health centers: more than a week for a PCR

The extraordinary plenary session of the Interterritorial Council of the National Health System, of which the Ministry and the autonomous communities are part, approved this week the Action Plan for Primary and Community Care 2022-2023, which, among others, aims to improve in procedures and in diagnostic capacity for health centers. For now, it is just a document that, on the ground, is alien to the day-to-day life of health workers who, like Noguerol, have for years denounced that Primary drowns with its usual patients and, since the outbreak of a pandemic that seems to have no end, with the assistance of suspects and positives of covid.

The surfing of this sixth wave, with a incidence of cases that does not stop growing at breakneck speed, it is plunging healthcare facilities into a umpteenth collapse due to the growing demand for PCR or antigen testing. In a doubly worrisome scenario: Christmas Eve. Mar Noguerol, a doctor at the Cuzco health center (Fuenlabrada, Madrid, spokesperson for the AP Se Mueve Platform, signs it. In the region, he details, there are already waits of up to a week to carry out diagnostic tests through centralized points , which depend on Primary Care.

The physician specifies that these points are the so-called specific units of Primary Care Covid Care (UACov). Since they were established, a year ago, as a new resource of the Ministry of Health to face the pandemic, care for people with mild symptoms or asymptomatic who, before, have contacted the coronavirus telephone number to undergo a PCR or a antigenic test. For example, if you have previously done a self-diagnostic test that is bought in pharmacies -and now there is an absolute shortage- and need to confirm or rule out infection.

"Every day we are finding more positive cases and life continues the same and the centers look like the Plaza Mayor", says doctor Mar Noguerol

"When in a health center we detect a new case, because it has come when presenting symptoms, we refer them to that unit so that they can identify and summon their cohabitating contacts for the test. In the centers We only serve people who have symptoms", says Noguerol. The problem they are finding in recent days, he adds, is that, in order to be treated in the outpatient clinics," people say they have snot or a headache and we can't cope. "In addition, they complain, every day more positive cases are being found "and life goes on the same and the centers look like the Plaza Mayor."

No permits at Christmas

"The situation is not good. Very worrying. And what can happen in the face of Christmas, catastrophic. In fact, here it is already beginning to talk about denial of permits during the holidays ", Javier Alberdi, president of the Principality of Asturias Medical Union (Simpa), advances to this newspaper. In the Principality, he indicates, there are health centers that carry months with a 50% staff that, in addition, "it is aged".

"The average number of daily patients exceeds 50 per doctor and, the other day, a colleague came to see 98 in a single day," they complain from Asturias

The growth of the new wave of coronavirus has only made the situation worse, according to Alberdi because 90% of health care for covid patients is currently provided through Primary. Antigen tests are carried out in health centers and suspected cases go to autocovid for PCR. "The situation is very complicated and the level of work stress is very high. The average number of daily patients exceeds 50 per doctor and, the other day, a colleague attended 98 in a single day. It is anecdotal, but it gives an idea of ​​how Primary is doing, "adds the doctor.

Maximum capacity and without separation

From Seville, the president of the Medical Union, Rafael Ojeda, explains to The newspaper of Spain that the problems that are being found in Primary Care are, on the one hand, capacity: in health centers "many patients" are entering the waiting list because they are covid suspects and mixed with those who are not. In addition, he complains that each center in the province acts with different criteria regarding the diagnostic tests available to them.

"There is an important variability in the availability of antigen tests in the emergency rooms of health centers; in some it is done to the patient who arrives with suspected covid; in others, it is not done, but is referred to that same center in the morning or to the Primary School doctor to request a PCR in the autocovid of the Emergency Hospital (dependent on the Virgen del Rocío), "he explains. As this first option of performing a rapid antigen test is not available in all health centers, Ojeda continues, the patient is referred to the aforementioned autocovid, which sometimes implies waiting for days to confirm your diagnosis. "This implies an uncertainty for patients and doctors and a delay in the diagnosis," he asserts.

In addition, the Sevillian doctor alludes to the traffic jam that is being generated in the centers due to the arrival of patients who come to receive the third dose of the vaccine and, from now on, of the children who, in this community, will also receive their first doses, among other devices, in outpatient clinics and by appointment. "The pressure is higher", assures the representative of the medical union.

Days to a PCR

In Navarra, the community with the highest rate of infections of Spain, the Medical Union also denounces waits of up to four days in the realization of the diagnostic tests, also in the information of the results and, in addition, they point out that the health authorities now consider only doing tracking of cases to relatives of the positives and at vulnerable people. The first thing, they emphasize, would be to improve services: diagnostic speed or accessibility to health care because, they also criticize, it is being difficult to access health centers.

It is, precisely, one of the complaints that patients repeat the most: the delay in face-to-face appointments, with waiting lists of up to ten days to see family doctors or the impossibility of contacting health centers where they do not take the telephone. Also, again, health workers complain, the sixth wave is bringing the suspension of non-urgent consultations and operations. In Navarra, there is also talk of the possibility of suspending the Christmas holidays for professionals, an aspect that, for the moment, no one has communicated to them, Jesús Soria, deputy secretary general of the Medical Union in the Autonomous Community, tells this newspaper.

From Aragon, the same union indicates to The newspaper of Spain that they are finding themselves with a lack of personnel to carry out PCRs on suspected cases and the average wait is two days. An average that drops notably in Galicia, indicates from this community Matilde Maceira, family doctor in Narón (Ferrol) and regional delegate of Primary of the State Confederation of Medical Unions (CESM). At least in his health area, he indicates, the PCRs are being carried out within 24 hours.