The professionals of the Canary Health Service (SCS) and the Canary Emergency Service (SUC) who were actively involved in the quarantine for 14 days of almost a thousand people at the Hotel del Sur de Tenerife, and in which seven positive cases of coronavirus were confirmed, have published an article in the scientific journal ‘Emergencies’, in which they attribute the success of the confinement measures adopted to the good coordination of the multiprofessional team that worked in the operation and to the availability of the necessary human and material resources.
In the article, which is titled First public health measures to contain the Covid-19: hotel quarantine and that it is accessible on the website of the Spanish Society of Emergency Medicine, editor of the magazine, its authors point out that “the main objective of containing the contagion was reached”, because only seven positives of Covid-19 among the 893 guests, 263 workers and the 71 members of the operation.
They are Clara Gironés-Bredy, medical director of the Tenerife Primary Care Management and associate professor at the Faculty of Health Sciences of the University of La Laguna; Marcela Posca-Maina, territorial director of the SUC from the province of Santa Cruz de Tenerife; Ramón Pinto-Plasencia, Director of Nursing of the aforementioned Management, and Vinita Mahtani-Chugani, Primary Care physician and researcher attached to the Research Unit of the University Hospital Nuestra Señora Candelaria and Management, as well as the working group Hotel Medicalizado Tenerife Sur Covid-19, made up mainly of primary care health workers, SUC, of the two university hospitals of the Island (HUNSC and HUC) and of the General Directorate of Public Health of the SCS.
In the article they indicate that it was necessary to apply “a health and organizational logistics based on disaster medicine but adapted to an urban environment, in unique medical situations “and a scenario” without precedent in Spain “, since” the closest situations are those of the Hotel Metropole, in 2003 during the SARS epidemic, and that of the Hotel Metropark, in 2009 by H1N1, both in Hong Kong, where guests had to be quarantined for seven days. “
“The SCS quarantined the hotel and organized an emergency sanitary device, coordinated by the Tenerife Primary Care Management and the SUC, in which in addition to their own toilets, professionals from the two reference hospitals in Tenerife participated71 professionals participated in this device (13 doctors, 42 nurses, 4 administrative assistants and 10 logistics management technicians), reinforced with volunteers from the Psychological Intervention Group in Emergencies and Disasters and with translators from the Spanish Confederation of Professional Federations and Associations. of Tourist Guides.
To which were added effective of the National, Autonomous and Local Police and the team of hotel professionals. The professionals identified up to 22 organizational, logistical and healthcare challenges, which the emergency device had to face and quickly solve, “with the aim of turn a hotel into a pseudohospital, with healthy clients, clients suspected of Covid-19 by close contact, and uncertainty about the level of contagion to other guests and hotel professionals. “
Six of the challenges identified were logisticalHow to create a sanitary device outside the hotel with all the necessary resources for sanitary support and clinical management (tents, bathrooms, offices, changing rooms, furniture, telephones, computers, printers, restaurants) and nine toilets, such as the identification and containment of possible positive cases starting from case zero, carrying out the necessary tests and forcing strict confinement and ensuring adequate health care for those guests who had other health problems, in some cases of seriousness.
As well as five legal challenges, how to establish fluid communication with the embassies and consulates of the countries of the 24 nationalities of the guests, to proceed with their departure before the end of the quarantine, and various social (media pressure and stigma).
Precedent for the pandemic
The authors note that “the events after the confinement of the hotel are well known, having setting a precedent that has led to the use of hotels as healthcare resources and confinement of mild patients “and that quarantine” was justified as a public health measure, since knowledge about the infectious agent was scarce at the time of issuing the confinement order. “
The keys to success, they conclude, were the creation of a well-coordinated, multidisciplinary team, with clear procedures, under collaborative leadership and with a common goal, where all the professionals had their role and their value; have all the necessary human and material resources and exemplary coordination with all the institutions involved in the monitoring and departure of hotel guests. “Organizational capacity, triage, and public health protection measures have demonstrated their undoubted value in containing situations that affect large masses of population in diverse circumstances.”