The expansion of the coronavirus is hitting with disproportionate force in the Basque Country. Just two weeks after the announced end of the state of alarm, on May 9, the increase in infections is incessant and the situation in hospitals is critical. The scenario is “very worrying”, recognized this Monday the Basque Minister of Health, Gotzone Sagardui. One of the most alarming indications is the increase in the occupation of health centers, with 568 infected patients treated in the ward and 192 seriously ill patients in ICUs. 83% of intensive care beds are occupied and 53% are used by covid patients, doubling the extreme risk threshold. The number of hospitalized patients has quadrupled since last October. The healthcare tension already affects the entire healthcare network, from primary care to critical care units. The Basque Government has been forced to take drastic measures: from this Monday and for at least two weeks non-urgent surgeries will be postponed in all the operating rooms of the public health system. During this period, only urgent, oncological and non-delayed interventions will be performed.
Several weeks ago the red alert was lit in the Basque Country, and especially in Gipuzkoa, where the virus has spread throughout the province. A week ago, 65 Basque towns had exceeded the rate of 400 cases per 100,000 inhabitants in the last two weeks. As the number of positives has risen, hospitals have been receiving patients incessantly, reaching one hundred for several days, which has resulted in an increase in the pressure on care. Amaia Mayor, representative of the Satse nursing union, describes the situation like this: “There is a lot of pressure in the health centers, the hospital units are being reorganized and new spaces are being opened to care for covid patients. The ICUs are full and patients are being transferred from Gipuzkoa to hospitals in Álava and Bizkaia. To this is added that there is a greater need for nurses with training in critical care ”.
The latest data on the epidemiological situation corroborate the worsening. The cumulative incidence is 544.7 cases in the Basque Country as a whole, the highest rate in Spain. The numbers are especially worrying in Gipuzkoa, which accumulates 726.4 diagnoses per 100,000 inhabitants. When the state of alarm was decreed in October 2020, Euskadi was in 263.21 cases (less than half that at present). Then there were fifty patients in ICUs; now they are four times more. “This had not occurred in the Basque Country since the first wave of the pandemic,” says the director of Health Assistance for Osakidetza (Basque public health), Víctor Bustamante.
The nursing community has already verified that they are “canceling surgical appointments to free up beds,” says Mayor, “and to be able to assign health personnel to the operating room to care for critical patients.” And this translates into a greater care load: “The emergency room nurses, the covid plants and especially the ICUs are full and very tired.” “We need to increase the number of nurses and take note of all this that is happening for the future, because we are taking the pandemic forward by squeezing the nurses and the rest of the staff,” warns the union spokeswoman.
Tiredness has also spread among doctors: “We are very fatigued and hopeless. We have not had rest, neither physical nor psychological, even in low times ”, affirms a spokesman for the Euskadi Medical Union. He adds that one of the main changes that medical personnel have observed with respect to the previous waves is the decrease in the average age of those infected who are admitted, which now stands between 40 and 55 years in the Basque Country. “There is an overload in care” despite the “titanic work”, highlights this doctor. He says that professionals are doing in primary care services by filtering patients in order to “serve as a retaining wall” that reduces hospital admissions and avoids overload in the emergency room.
The maximum capacity of the health network to face an extreme situation generated by the pandemic is 690 ICU beds. If those beds are occupied, scenario 5 of the contingency plan would be reached, which is currently in phase 3, as reported by the Ministry on Monday. On April 20, the maximum number of hospital admissions due to covid was reached, with 117 in a single day, something that had not occurred since last November. Faced with this situation, the Department of Health is considering going from the current scenario 3 to 4 of the health contingency plan. This leads to an increase in the resources allocated to the care of covid patients both in the ward and in the ICUs.
The sector counseling trust the remedy to this stressful socio-sanitary scenario to the good behavior of citizens in compliance with the rules and restrictions (meetings in homes are prohibited and the hotel industry closes at 8:00 p.m.), and also to the effect of vaccinations . In this field, the Basque Country started the inoculation process more slowly than the rest of the autonomous communities, which placed it in last place in the number of vaccines administered during the first months. The Basque health authorities assure that the rhythm has accelerated with the placement of 88.1% of the vaccines received. However, it continues to lag far behind other territories: according to the latest report from the Ministry of Health, Euskadi has only vaccinated 32.2% of people between 70 and 79 years old, when the national average is 59.2%; in the 60 to 69 range, 36.9% have been immunized and the average in Spain is 42.3%
The vaccination plan has been punctuated by episodes of confusion and confusion among the population. Sending messages to the mobiles of elderly people has not had the desired effect. The appointment system through the web collapsed at the first change when it was opened to the population over 70 years of age.
The Basque Government fears that this panorama will worsen and go from black to very black if the repeal of the current state of alarm is confirmed as of May 9. If before that date it is not possible to stop the contagion curve, say sources from the Lehendakaritza (presidency of the Basque Government), the situation could become much more critical as the autonomous communities do not have legal instruments to impose restrictions on schedules and mobility from That date.