Coronavirus: relief after the storm

Cases have decreased for 15 weeks and, with it, hospitalizations for covid fell to 2,103: a considerably lower figure compared to the peak in June, when the occupation had reached 7,969 Intensive Care Units. If during the second wave, the average daily infections reached 33 thousand, currently that figure is below 3 thousand. Since March 2020, the government set itself the goal that the health system does not collapse, that is, that all citizens who require it could be served. And that goal was met. Although it is still missing, its protagonists (nurses, doctors, specialists from different branches, administrative and service personnel) breathe a bit of tranquility for the first time in a year and a half. After so many months in the trench, of interrupted rest, of stress on the surface, of putting the mind and – above all – the body; after all, times of relative calm seem to come.

“It is all very auspicious, I can not do anything but live it with a lot of optimism, especially after the critical situation we experienced just a few months ago. This is a reality that to different degrees is replicated throughout the country, both in the public and private spheres ”, says the intensive care physician. Arnaldo Dubin, which –although he doesn’t notice it– already shows another face. “Covid is less and less frequent in intensive care. In fact, the situation we face today is very similar to the usual one in the pre-pandemic stage. We are going to a completely different situation, next year we will be very close to what we knew as normality”, Anticipates the referent.

Nationwide, intensive care beds are 41 percent occupied; while in the AMBA, that percentage increases to 43. Queen rose, president of the Argentine Society of Intensive Care, agrees with Dubin’s diagnosis but warns that “the thing did not happen.” “We are much better, we have very few hospitalized covid patients. In some places, they have been without new income for several days. This brings relief because we can also begin to respond to other pathologies: interventions and procedures that were interrupted by the pandemic ”. And he adds: “We are still expectant with Delta which, so far, is quite contained. But we learned to prepare for the worst case scenario ”. Reina’s warning is well founded: Delta continues to lurk (its community transmission will probably be declared soon) and, in addition, there are other variants of epidemiological interest that could begin to spread and cause problems. Relief does not equal relaxation.

The miracle of science

There is nothing to give him: the best tool that humanity has at hand today – more or less closely, depending on the case – are vaccines. To date, although they have been seen to lose effectiveness against Delta when preventing infections, the good news is that they continue to provide excellent protection to prevent hospitalizations and deaths. In the country, 63.4 percent have already been immunized with one dose and 40.7 percent with both.

With increasing recurrence, the news about the institutions that, for the first time in months, do not admit patients with covid. The Nueva Esperanza Zonal (in Santiago del Estero) and El Cruce (Florencio Varela, Buenos Aires) were the last to spread the good news. And just to mention a few, but in truth this state of affairs is revealed in various latitudes of the national territory. “The decrease in cases, clearly, had to do with vaccination and with the inclusion of young people, who little by little are completing their schedules. In March-April, the inpatients were adults aged 30 to 50 years who had not been inoculated. In the present, this situation is changing again because many are already protected. We have to get to have, at least, 60 percent of the population with two doses, and the truth is that we are already close”, Emphasizes Reina.

It is often said that vaccines are victims of their own success because, unlike drugs whose beneficial effects are immediate and palpable, with them prevention is built silently inside the body. However, the work they do to strengthen the immune system is undoubted. Although today the deaths are an average of 130 per day; If the delays in cargoes exhibited by a good part of the jurisdictions are taken into account, there are analysts such as Jorge Aliaga, who argue that the current average is close to 100 each day. This data is conclusive, because, during the second wave, the daily average of deaths was above 600.

The emotion in the first person

In health institutions, relief comes after 18 months of uninterrupted darkness. Its workers breathe: they see a free bed and their eyes fill with tears; they buy a blackboard to write down one by one the days without new admissions of covid patients; smiles and hugs are given as they have not been offered for a long time. “Of course, all our lives we celebrate when our patients, after fighting it, left discharge; but with covid everything is stronger”Says Reina.

During the pandemic, feelings are heightened and feelings are extreme: if sadness is experienced with intensity, the same thing happens with joys and euphoria is unleashed. “It was very hard to cope with exhaustion and helplessness from not being able to do more for our patients; but it is also very strong when someone recovers and leaves discharge, or when they do not enter directly, as is happening now. We had never bought a blackboard to record the days that passed without having new hospitalizations. The emotion is so great that it is inexplicable”, Shares the doctor with a voice on the verge of breaking.

“I’m relieved, there is no other way to better characterize it,” says Dubin, who seems to leave behind the heavy backpack that he carried on his shoulders. “Personally, I have not been admitted to intensive care for more than a week. There are many patients with covid, but they are already chronic, that is, they have been for several months and are no longer epidemiologically active. The notable decrease in infections, logically, has an impact on intensive care ”. To cite an example, CABA is in the order of 200 daily infections; if one takes into account that around 5 percent are interned, there are about 10 people in the entire City who will require a bed every day. A situation that the Buenos Aires health system is in a position to address. In fact, any estimate may need to be readjusted, as people who become ill around this time are often younger and therefore exhibit less critical forms of the disease.

However, they remain pending accounts. There is still much to be done in relation to the work related to intensive care in the country. Like all great events, the COVID pandemic will leave consequences for health professionals, and will imply a turning point for people who, from any point of view, left everything behind. “The intensivists were badly hit, with an enormous stress level. Some express the will to leave their job”Describes Dubin. The pending issue, from here, is to improve working conditions and the reference is not only for wages. “Those of us who work in therapies we are an endangered species, our survival depends on sanitary and political measures. We need to prioritize the specialty and that, to begin with, our universities provide tools and knowledge in the area from undergraduate training ”.

The joy of the “undetectable”

In addition to the situation in intensive care, another index that allows a clear glimpse of how the epidemiological panorama changed is marked by the number of samples processed by laboratories. In recent times, there were days when recognized testing centers highlighted the absence of positive cases among the samples they analyzed.

Thursday, the Virology Laboratory of the Posadas National Hospital, for the first time in the entire pandemic, did not record any new covid infections. At the peak of the pandemic, it processed 300 samples daily with a positivity of up to 80 percent. In the last month, the samples dropped to 100, with 10 percent positivity. Another emblematic case is that of the National University of Quilmes that, among other actions, it converted its Biotechnology Services Platform into a center for the processing of Sars CoV-2 samples. “Throughout the pandemic I was characterized as pessimistic, but we were really realistic: we were seriously complicated. For several weeks we have been very confident and everyone is surprised. Better times are coming, we smile again”, Share Alejandra Zinni, Director of the Department of Science and Technology of the UNQ, and scientist in charge.

It is that the specialists in charge of the sample processing always functioned as a thermometer of the situation. That in the present they glimpse another scenario does not stop generating tranquility. “There is a data that is emblematic and for others illustrative. In our diagnostic laboratory, at the beginning of April, we experienced the peak of samples received, around 700. And, last week, there were days that we only counted three or four ”, he details. And he concludes: “Not only that, for several weeks we have noticed a very sustained decrease in positivity: we have more and more days in which there are directly zero positive cases”.

Zero positive cases when, during the worst moments of the pandemic, the average positivity at the national level was 65 percent, according to the references shared by the researcher from the UTN Regional Concepción del Uruguay, Soledad Retamar.

the fear of death

“What feeling would you not like to experience again?” The question is for Zinni.

-The fear, that which is felt in the belly, of not knowing what we are facing, what can happen. That was overcome because there was a communion of people who began to work and when one declined, the other supported. What I am telling you was experienced in many institutions in the country. The first test that gave us positive in early 2020 we felt a horrible fear of death. The most visceral and primitive fear. I don’t want him to come back again, I hadn’t felt it in my life. Today the reality is different and we breathe.

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