Madrid hospitals begin to shake one more summer. The professionals expected it because the situation is repeated every summer season in public health: they close beds in the reference centers and the staff is kept low for the holidays due to the lack of replacements. The MATS union has already warned in a statement of the “saturation of emergencies” due to the advent of the fifth wave of infections, milder but numerous and reaching the doors of the emergency room due to the collapse of Primary Care. Cases are handled with fewer staff and there are also fewer beds available to admit them. To this must be added, the professionals agree, the consequences, in the form of advanced and serious diseases, of a pandemic that left operations, tests and appointments with specialists for later. Waiting lists for surgeries have grown to 3,500%.
Madrid is the only community that delays the second doses of the vaccine
“In the waiting room we have to discern between a possible heart attack, low back pain or earache. The last two could be attended in Primary, but they only give telephone appointments and you have to wait weeks for a face-to-face so they come to the emergency room and this collapses, “explains a Gregorio Marañón worker. Young people also arrive at the emergency room of this hospital to do a PCR to the disbelief of the health workers, while on Tuesday morning there were 90 patients pending admission. Some, without space in the boxes, have had to be placed in the corridors of the observation area, where they have installed plugs in anticipation that the situation is repeated, describes the utility, which prefers not to give its name.
Given the uproar of the image, workers say, orders have been given to put three beds per room to counteract the closure of plants in summer. At least 50 entry posts are not operational in this center. It’s not the only one. In La Paz, the time to go to the plant is already delayed for more than 24 hours, according to the MATS union, because “there is nowhere to put the patients.” The Ministry of Health does not provide data on how many beds have been closed this summer. UGT estimates that there will be 2,300 until October, 20% of the total.
Hospitalizations due to COVID began to increase in the region on July 8 with a change in the trend extending to all of Spain. That day, 394 people had been admitted because of the virus. The number reached 745 this Monday. The fifth wave, however, is not measured by this parameter at the moment since the cases are less serious due to age.
The number of infections and the rate of incidence take better the pulse of what is happening: those diagnosed on average a week draw an upward curve since the beginning of July. On day 1, 621 were recorded on a weekly average and the figure goes to 3,055 on the 19th of the same month.
The rate of infected per 100,000 inhabitants stands at 467 in the last 14 days, according to the latest data update. Three weeks ago, it did not reach 100. However, Madrid is not the region with the highest proportion and the rate is far from the exorbitant figures of other times when vaccination was not so advanced. All the territories of Spain are in an ascent phase and the most worrisome situations are occurring today in Catalonia, Navarra and Castilla y León.
The unions insist that the problem is not only the rebound in infections, but the weak situation of the Madrid system every summer due to the absence of reinforcements, which makes it much more vulnerable to saturation. The infections are milder due to the effects of vaccination and because they affect younger people, but they are numerous enough to put in check once again Primary Care, the base of the Madrid health system and the Achilles heel of public service in the region governed by Isabel Díaz Ayuso.
Health centers are also not being able to adequately care for non-COVID patients and outpatient emergencies, the so-called SUAPs, have remained closed since the beginning of the pandemic. “The more saturated Primary Care is, the more people go to hospitals, whether or not it involves admission. Tracing is almost impossible,” says Julián Ordóñez, Secretary of Health at UGT Madrid. MATS also denounces that the Ministry of Health has hardly incorporated reinforcement personnel this summer because they are using the 11,000 COVID contracts for this.
The Ministry of Health ensures that the situation is “stable” and under control. “The emergencies can have points or peaks of activity, which are being monitored at all times by the Madrid Health Service. The increase in Covid-19 patients who require income continues to be slight due to the vaccination campaign,” say department sources directed by Enrique Ruiz Escudero. On the reinforcements of personnel, a spokesman responds that “the managements carry out the necessary hiring in case of increase of the care demand”.
“If the base of the system does not work, it has a negative impact on the next level, which is the hospitals. In the health centers we find people who go directly to the emergency room so as not to wait or because they do not even pick up the phone in administration. supply “, sums up María Justicia, head of Primary Care at AMYTS. The health workers of the outpatient clinics will assume, one more summer, the agendas (appointments) of their colleagues who are going on vacation and the waiting times are triggered “like never before in history I had seen,” says Justice.
The situation, controlled for the moment, has not forced to take extreme measures such as suspending the vacations of the health workers. Although in some places, such as the Móstoles hospital, they still do not have all of them with them. The center has reopened a plant for suspected COVID patients and health workers suspect that beds may be reopened. With what personnel would they be served? “The management dropped that in some autonomous communities they are already taking vacations,” they assure from the Workers’ Commissions. For the union, this “would be the final touchstone for health workers, not to let them go on vacation.”
The professionals are exhausted because they do not finish seeing the light at the end of the tunnel after a year and a half at full capacity in conditions in many precarious situations. At Gregorio Marañón, for example, they are denying unpaid leave for the care of minors or elders. “They argue that there are no people to replace us,” says one of the staff to the day of these refusals.
This is also the first summer that new rules are applied to take paid leave to care for lights due to the need for personnel to care for COVID patients. “Now they can only be taken once per child or per adult. If you took it last year, you cannot systematically take it, even if it is only a month,” says Ordóñez. The UGT requested by letter to the General Directorate of Human Resources to reconsider this policy. Unsuccessfully.
Data and graphs Ana Ordaz.