Thursday, October 29

Second wave of the coronavirus: there is no lack of resources, there is plenty of bureaucracy

On May 19, I wrote an article in this newspaper entitled The end of the epidemic which highlighted, for some days now, the lack of income due to Covid in the different HM hospitals. I encouraged then to restart, with prudence, normal health activity After the blockade suffered in that first wave, and although he gave it up, he warned of the possibility of a second in the autumn.

It is obvious that the confinement and the drastic decrease in mobility, the result of the state of alarm decreed by the Government, allowed the virus to stop spreading until it almost disappeared. I attest that during the weeks of June prior to the lifting of the state of alarm, there was not a single patient who was admitted for Covid in the hospitals that HM has in Madrid, León, Galicia and Barcelona. Something similar must have happened in the rest of the territories because, at that time, the global incidence did not exceed 5 cases per 100,000 inhabitants, and there were areas with zero cases.

In Spain, thanks to confinement, there were practically no viruses then. Therefore, what has happened this summer to have had such a bad evolution and in such a short time? Doing analysis of what happened Between the first wave and this second, which looks like it will stay for many months, I think the reasons that have caused one and the other are very different.

In spring there was a unexplained delay in raising the alarm by the authorities. That was the reason that, first in Madrid and then in other areas, hundreds of thousands of people were suddenly infected. That is the only cause.

The Ministry was not prepared, neither by resources nor by experience, to be able to face what came upon it

From that moment on it was essential for the Government to assume the sole command to try to coordinate the actions. But it was seen that the Ministry of Health was not prepared, neither by resources nor by experience, to be able to face what came to him. Possibly no one could have properly dealt with something like that.

With the perspective that time gives, I think that all the administrations -state, regional and local- did the best they could, but simply the plethora of patients was unaffordable for resources that we did not have and that in no case could we maintain in conditions normal. That is, there was a resource crisis. To deal with these types of cases, it is essential that surveillance institutions work, which is what they are for.

Now, the launch of the operation to contain this second wave of the pandemic is what has really brought to light the seams of an outdated healthcare system, uncoordinated, excessively bureaucratic and not very agile in its response capacity. If well organized, now there would be enough resources to control the situation. In this second wave we have suffered a bureaucratic crisis.

With the number of infected, hospitalized and dead that there have been, it continues to surprise me that there are still those who speak out in favor of maintaining the current public management regime. It is clear that it has been unable to reinforce the system -starting with primary care- with enough speed to be able to contain an expansion of the virus that you could see it coming since July. That is not the public health that we all want.

At the beginning of July, precisely, I warned that it was necessary to incorporate the tracker groups into the Army. That was much better than seeing them pick up corpses for lack of sufficient funeral resources, as has already happened.

If no changes are introduced, there are only two options: either assume the collapse of the system or decrease mobility

Today we are faced with an endemic situation, with a contagious and fatal disease, which occupies a large part of health resources to the detriment of other pathologies that are more lethal but less urgent. In addition, in the absence of a vaccine and truly effective treatment, if no changes are made, there are only two options: either assume hundreds of deaths a week and the collapse of the system, or apply measures that reduce mobility, thereby suppose for economic activity.

Therefore, either we are really capable of coordinating all of us and working in unison to adapt to the situation and be able to fight the virus effectively, or what awaits us until the arrival of mass vaccination -which will not be before the autumn of 2021- It will be a authentic ordeal, sanitary and economical.

In the same way, or we are capable of introducing the necessary changes in our health system at the level of financing, integration, coordination, digitization and reinforcement of basic services, putting the interest of patients first, or the virus will take away what has been our greatest pillar of the welfare state so far, which would be reduced to the condition of a very poor public service.

There is a saying that says “faced with a problem, the rational is to solve it, the political is to deny its existence.” I am afraid that Covid-19 does not leave us that second option.

*** Juan Abarca Cidón is president of HM Hospitales.

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