The sixth wave slows down surgical activity in Canarian hospitals

The incidence of the sixth wave in Canarian hospitals it is slowing down its usual surgical activity, although not the urgent or oncological one. Although it is not being the most dramatic wave for the critical units of these centers, the exorbitant growth of cases in the Islands causes that a large part of the hospitalization beds are being used to care for these patients. This occupation, in turn, limits the resources of the centers to hospitalize to those who would have to do it after undergoing surgery for a disease that affects their eyesight, their joints or their hearing, and in this circumstance, the managements have chosen to delay these interventions until further notice.

The number of older and multi-pathological patients, as well as unvaccinated adults, who develop bilateral pneumonia due to COVID-19 is lower in percentage terms than in other waves. Specifically, in the third wave - Christmas 2020 - the number of patients hospitalized for active cases amounted to 6%, while in the current tsunami, thanks to vaccines, only 1% of those cases require hospitalization. In fact, most patients show mild symptoms and are discharged much earlier. The problem, however, is that the resources of the health system are finite and if infections continue to grow "there will come a time when the number of patients is the same as at other times of the pandemic in absolute numbers", as highlighted the manager of Gran Canaria Maternal and Child University Hospital Complex (Chuimi), Alejandra Torres, which could again lead to the collapse of the hospitals.

In two weeks, covid income has increased 34% in Tenerife and 20% in Gran Canaria. In La Candelaria Hospital, the most affected in this wave, there are 107 hospitalized patients and up to five floors dedicated exclusively to covid care - the maximum during the pandemic has been nine.

At the Hospital Universitario de Canarias (HUC) there are already 69 patients occupying a hospital bed on the floor, a figure that exceeds the one they had in the fifth wave and which has forced the closure of four floors (the maximum peak of the pandemic forced the establishment of six). The situation is no better in the Chuimi, which already houses 64 hospitalized patients in the plant. The consequences of this slow but constant increase in hospitalized patients worry health workers who do not know how much more the virus will have to spread before it suffers a devastating saturation again.

The three hospitals have been forced to delay or suspend until further notice the surgical activity of the plans to improve the waiting lists. In the case of La Candelaria, given this circumstance, it is being used to "promote major outpatient surgery and the surgical day hospital," as its manager, Natacha Sujanani, explains.

The same has happened at the HUC, where the deputy medical director and covid coordinator, Melchor Rodríguez, admits that covid patients generate what is called "competitive risk." This means that, due to the urgency of their pathology, these patients displace the diagnosis or treatment of other less serious ones. "Our system was not designed for a pandemic," highlights Rodríguez, who points out: "if under normal conditions we have a delay in the waiting lists, imagine now." Despite having had to stop, for the moment, less urgent surgeries, those responsible for hospitals recall that oncological and urgent surgeries are being carried out without problem.

Saturated emergencies

The sixth wave is not allowing the Emergency areas to work normally either. "This sixth wave has saturated the service more than at any other time in the pandemic," highlights Sujanani, who explains that in recent weeks they are seeing an average of 300 patients a day, when the normal thing is to treat about 200. In The HUC have been the workers who have denounced that the situation is taking them, once again, to the limit.

"The situation is complicated because the number of attendees is higher than expected and the bed forecasts are lower than the needs," says one of the workers who has asked to keep his identity hidden. This same health worker affirms that those responsible for the HUC have not anticipated "the increase in positive cases" and insists that, in the coming weeks, new resources should be put in place, such as alternative circuits of rapid evaluation that do not require that the patients are wandering in search of assistance between Primary Care and hospital. The HUC, for its part, has implemented a Contingency Plan and ensures that there are "enough beds" to meet the demand.

One of the causes of this saturation of the Emergencies, which also affects Gran Canaria, is that "many asymptomatic patients or close contacts are going to the emergency room for a test." This is recounted by Juan José Díaz, medical director of the Doctor Negrín University Hospital, who insists on the need for the population to become aware that this service is there to cover people with symptoms. "If you are asymptomatic, do not go to the emergency room because you can collapse health care," says Díaz. Torres subscribes it, who admits that "many patients are attending without having gone through Primary Care."


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