The Valencian Community is approaching 3.000 coronavirus infections, with 143 fatalities and 44 discharges. The rate of infection is, at the moment, higher than that of people who pass COVID-19 and many of these positives are from health workers.
The Consellera de Sanitat, Ana Barceló, confirmed a few days ago that there were 25 workers at the Dénia Hospital who had tested positive. It is normal, they are the most exposed and the ones that require the most protection. But do they have it?
In addition, another of the big problems with such high numbers of infections, and in constant growth, is the space to attend to them. Is the Marina Alta ready? Knowing the large number of doubts that exist among the residents about the characteristics of the coronavirus and how it is fought against in the region, this editorial office has contacted Vicent Salvà, Supervisor of the ICU of the regional hospital, who has answered all our questions in this interview.
QUESTION. What is COVID-19 and what differentiates it from a common flu?
ANSWER. COVID-19 is a coronavirus that, like all of its family, have special predilection for infecting the respiratory tract. Fortunately, in the vast majority of cases the infection causes mild or moderate symptoms.
It is true that the clinical picture, when it is not complicated, resembles that of the flu: fever, malaise, cough ... However, there are significant differences between this virus and the flu virus. High contagiousness and the ability to cause severe pneumonia are some examples.
Q. In which cases do you require admission to the ICU?
R. Unfortunately, in some cases, the least, the infection reaches and spreads in our lungs and causes pneumonia that forces the patient to be admitted to the hospital.
"The ICU still has free beds but the forecasts are that we will collapse in a few days"
Q. What is the current situation like in the intensive care unit of the hospital?
R. Since last Monday, the unit has been closed only for cases of critically positive patients or those suspected of COVID-19 infection. This is a necessary measure to avoid contagion to the rest of critical patients and to improve safety for professionals. The entire Unit is considered an isolation area. The rest of the patients have been transferred to a second unit that has been set up to take care of cases not related to this infection.
Q. How many beds do you have and how many are currently occupied?
R. Our ICU has 14 beds. Right now - Wednesday, March 25 - the Unit still has free beds but the forecasts are that we will collapse in a few days.
Q. Have any plans been transferred to you in case they were fully occupied and you ended up overwhelmed?
R. Yes. There is a contingency plan that contemplates doubling the number of beds for critically ill patients if necessary.
P. The Consellera de Sanitat reported a couple of days ago that there were 25 infected toilets in the Dénia Hospital. Has it affected your team?
R. Clear. It is unavoidable. We live with concern and some anguish this situation that affects us and very closely. Commitment to our profession is unquestionable, but it is human to think about our own health and that of our families.
"Neither industry nor hospital stocks were prepared for this"
Q. What are the preventive measures you take?
R. COVID-19 is a type of coronavirus that it is spread by the contact of drops. This makes it necessary to use waterproof gowns or overalls, masks, gloves, protective glasses, etc. In addition to universal protection measures, especially hand washing.
Q. Do you have the necessary material?
R. This is a subject that has concerned us greatly. Our hospital has not been an exception to the rest of the centers. Access to protective equipment is highly restricted and limited to what is strictly necessary to avoid shortages. It seems that the situation is gradually improving. Neither industry nor hospital stocks were prepared for this.
Q. How often are you tested for COVID-19?
R. The test is performed on personnel who present symptoms compatible with the infectious symptoms or, without symptoms, if the professional considers that they have suffered a risky exposure. From there, the monitoring is carried out by the Preventive Medicine service according to each case.
Q. In case you test positive, what is the protocol? Do infected toilets become patients? Are there enough substitutes to keep the necessary staff?
R. Staff who test positive cannot work. He must remain at home, if possible, isolated during the period we call "quarantine" or until the symptoms subside completely.
The problem of replacing all the colleagues who are not coming to work is simultaneity. That is to say, many positions have had to be filled in a few days. This has put a lot of stress on the organization. They are covering themselves with new contracts but also with the overexertion of the colleagues who are working and are replacing them.
"Probably, during the days prior to the decree of the state of alarm there was a massive contagion in our region"
Q. What are your usual interventions with patients admitted for coronavirus?
R. In the case of critically ill patients, their biggest problem is that they suffer a severe difficulty breathing. They need to be sedated deeply and connected to a respirator. And from there all the treatments and care of a critically ill patient with respiratory sepsis. But in addition, our efforts must also focus on prevent secondary complications from appearing to the clinical picture: renal, cardiac complications, etc.
Q. How do you think the situation will evolve?
I think we still have several days to see the peak of infected patients. Probably, during the days prior to the decree of the state of alarm, there was a massive contagion in our region. Many of those infected have not yet "turned heads". From the confinement order it is certain that the number of infections was substantially reduced.
That is why it is so important that we stay at home. The healthcare system can withstand a peak in healthcare demand for a few days, but not if it is sustained for several weeks. It is absolutely crucial that we all sacrifice ourselves to get out of this situation with as few lives lost as possible.
And one last tip for citizens: wearing a mask is fine but it is as important or more than Let us be very careful in what we touch and maintain strict hygiene of our handsThey are the main vehicle by which the virus is spread and spread.