The last blow of the rise in infections has stoked where it was not expected to do so, but the trend repeats itself. Spain reported 61% more hospital occupancy on Thursday compared to the previous week, as a result of the huge increase in incidence in the last month. The low average age of COVID-19 infections had raised hopes that it would not impact hospitals and ICUs. This Thursday there were 1,550 more patients in the ward than seven days ago, and the pressure on intensive care had gone from 6.6% to 9.18%, although it is expected to continue to rise.
Communities tighten restrictions: consult the new measures territory by territory
“The percentage is lower than in other waves, but there are so many contagions that by probability it would have repercussions in hospitals”, assumes Ricard Ferrer, member of the board of directors of SEMICYUC, the Spanish society of Intensive Medicine. Until now, the greatest impact of the rise had been seen in Primary Care and Public Health services, responsible for diagnosing the disease and tracking outbreaks. Hospitals usually notice this explosion two weeks after the increase in incidence for the plant and three weeks for the ICU. And so it has been. The problem is that there is no prospect that it will subside.
“What worries us the most is that right now there is no immediate horizon,” laments Ferrer. “We only see rises and rises, but no predictive model gives us a clue.” This uncertainty, in the middle of July and combined with the health care holidays, puts the centers in a critical situation. Catalonia, for example, has had to open COVID plants that had been closed for several weeks. “We have to redo the planning of the entire summer because nobody expected this and beds, professionals and equipment are needed”, sums up the intensive care physician. His hospital has gone from having 114 people admitted to 209 in less than two weeks. “It makes the day to day much more difficult,” he acknowledges.
People do not appreciate what it means to lose everything that we had already advanced
– General Council of Nursing
For Guadalupe Fontán, COVID-19 specialist at the General Nursing Council, it is like “reliving last summer.” “It is devastating to see a little light at the end of the tunnel and that something always happens,” he describes. In his case, the rise directly implies giving up holidays, re-selecting patients to enter, opening specific COVID areas and, at the same time, continuing to vaccinate at a good pace. “The feeling is that we are always behind the virus, and the nurses are tired of the effort,” he recalls.
Regarding the profile of the patient, Fontán notices a clear drop in average age. “The vaccine is dampening the severity, but there are also people in their 30s who are diabetic, obese or with kidney problems who end up hospitalized,” he says. Ferrer perceives the same feeling from Catalonia, where most of those admitted to the ICU are around 40 years old, are still unvaccinated or have an incomplete schedule. “They are normally parents or relatives of younger people who are infected,” he observes.
The greatest upward trend is found in Catalonia, which has gone from 3.1% hospital occupancy in one week to 6.8%; Andalusia, from 2.8% to 3.8%; the Valencian Community, from 2.7% to 3.8%; and Cantabria, from 3.4% to 4.3%. Regarding the ICUs, Catalonia (24.6% occupancy), the Balearic Islands (10.5%), Madrid (10%) and Castilla y León (8.9%) top the list.
The occupation in the Castilla y León plant triples that of a month ago. Andalusia on Tuesday recognized its concern about the drop in the age rate of those hospitalized. Of the 102 hospitalizations last weekend, 40% were people under 40 years old and 85% had not been vaccinated. For its part, the Government of the Balearic Islands has also shelled the intensive care admissions of each of its hospitals. In the Balearic case “COVID has hit all ages”, from 23 to 78. It does not indicate what level of immunity each of the patients had, but experts ask not to forget about “vaccine failures”. These gaps cause that there is a small percentage of people who do not generate any type of immunity or who lose it after a while.
Regarding the immunity time of the serum, both Ferrer and Fontán have also noticed several reinfections among health workers who received the complete regimen. “They do not have a serious illness, but they do cause sick leave, which complicates the coordination of the workforce,” explains the head of the ICU at Vall D’Hebron hospital. “Holidays, the shortage of summer, the serious situation of many consultations and reinfections make it very difficult,” shares Fontán, a nurse in Madrid. “We must remember that vaccines do not prevent contagion or that we infect,” he adds.
Delta and Summer Celebrations: The “Explosive” Mix
Ricard Ferrer is clear about the two reasons for the abrupt increase in infections and, subsequently, income in Catalonia: the Delta variant, which occupies 80% of the ecological niche there, and popular festivals such as Sant Joan or the summer solstice . “This mixture has been explosive, but throughout the Mediterranean arc,” says the head of the UCI. According to him, when the Delta mutation predominates in other communities, transmissibility will increase to the same level, especially if precautionary measures are not taken.
“The second half of June and the first of July has been a time with a lot of social interaction, graduation parties and end-of-term trips. It makes it clear that the school and university bubbles have worked very well and that, when they have been broken, it has been had an explosive effect “, reasons Ferrer.
It makes it clear that the school and university bubbles have worked very well and that, when they have been broken, it has had an explosive effect
– Member of the board of directors of SEMICYUC
Fontán, again, turns to last summer. “The end of the mask in the open air and the good vaccination rate has created a false sense of security that is overwhelming us,” says the nurse. “People do not distinguish that they can take it off only if they maintain a safe distance; and it happens with young people and with the not so young,” he claims.
The SEMICYUC spokesman believes that the population is now doing a “partial reading” of the measures. With masks, outdoor and nightlife entertainment. “The safe culture drills, like the ones that were carried out in Catalonia, are not what we are seeing now: it not only consists of testing for antigens, but also in keeping distances and keeping masks”, he recalls. For there to be a sudden drop in cases that allows hospitals to be released, this must be controlled and “vaccinate, vaccinate and vaccinate” the age cohorts that remain exposed. From the age of 40, who are now admitted to the ICU, to the age of 20, “who are the engine of the epidemic.”
“We understand that it is necessary to intersperse with the economic recovery, but without generating the feeling that everything has already happened,” claims the Madrid nurse. “People do not appreciate what it means to lose everything that we had already advanced,” he concludes.