“Come out patient, come out patient!” is the scream that is heard in the corridors of the Zona General Hospital (HGZ) 32 of the Mexican Institute of Social Security (IMSS) to announce the transfer of a patient suspected of suffering from Covid-19, and to whom, instead of mobilizing it in an isolation capsule like those seen in hospitals in other parts of the world, it is only covered by a normal sheet with which the medical staff “makes him a house” so that he does not fall on him, since he is intubated.
In this outrageous and worrisome way it is as IMSS doctors, nurses, stretcher-bearers, radiologists, staff, and patients; They face the emergency due to the pandemic in Mexico, where, according to official figures from the federal Ministry of Health, there are already 1,215 positive patients, 29 deceased and 3,511 suspected cases, just one month after the first infected patient was detected. from respiratory disease. And this is just beginning.
HGZ 32 emergency doctors spoke with Infobae Mexico of the fear they feel of facing the Covid-19 pandemic without adequate protection measures, since, although the authorities assure that they have been given the necessary equipment, the reality is that they are of poor quality, and have even been broken, which leaves them exposed to contagion.
In addition to this, the medical staff of this hospital must face a more difficult: for two years, the HGZ was damaged by the earthquake of September 19, 2017 and to date, they continue to be crowded in a very small place within the Regional Hospital No. 2 of Traumatology and Orthopedics, located in the Bombas road, in the Coyoacán City Hall.
Even so, the authorities designated the General Hospital of the Zone (HGZ) 32 to attend to the patients of Covid-19.
A doctor, who agreed to speak to Infobae Mexico under conditions of anonymity, noted that two weeks ago they were told that emergency and internal medicine doctors (not specialists in respiratory diseases as it should be) will be in charge of caring for patients affected by the coronavirus, reason why they “conditioned” an office called Triage where all patients with respiratory symptoms are initially received
“But that Respiratory triage It is not the right place. There we should have a separate area to put on the necessary equipment and check those patients so that we do not catch it, (but) we have to dress, outside, almost in the hall. There we receive them, there we assess whether they can go home to have treatment or if they are seriously ill, they already have to be admitted, ”he explained.
He explained that in emergency rooms three isolated patient cubicles were conditioned and just this week (the previous one) it is being conditioned so that the patients can go upstairs.
What will happen if many patients arrive and those cubicles become insufficient? He was asked.
“It is the same thing that we have asked our bosses. Right now this is just beginning and we have been having patients daily in those cubicles. There have been three patients daily and they leave. But in this week (the previous one) we have seen that the number of patients is increasing and right now they are supposed to be opening beds in the apartment. They already seem to have conditioned the third floor exclusively for those patients. But still, as we see the circumstances, they are not going to reach those beds“, said.
“We don’t know the number of beds. Just this week we were informed that the hospital is going to be a reference for Covid patients, but everything has been from one day to the next, “he said.
The doctor explained that so far they have treated three seriously ill patients who have needed the use of a mechanical ventilator (respirator)But there are many others who have been sent home, with epidemiological surveillance.
“Patients who enter with mild symptoms, which are not complicated, are sent home to be in isolation, under surveillance and depending on the results of their tests, the epidemiology service of the hospital is following them up. Serious patients who have been admitted to the emergency room, for example, have been sent to the La Raza Hospital for Infectious Diseases, others have died and right now those who are going to start going upstairs“He detailed.
One of these deceased patients, identified as Felix, was fatality number four., whom federal health authorities only identified as a 71-year-old man from Mexico City who suffered from diabetes and kidney failure.
Felix died on Sunday March 22 at the General Hospital of Zone 32, but his death was made known the following day.
“That patient (Félix) died in the hospital and the daughter of that patient (identified as María Teresa and who also arrived at HGZ 32) was the one who was sent to the Infectology Hospital of La Raza and yesterday (Thursday) we learned that He’s already dead”said the Doctor with a specialty in emergencies.
Félix was the grandfather of a young man (who could not be identified) who went to the concert by the Ghost band on March 3 at the Palacio de los Deportes and who remains asymptomatic. The young man is the son of Mrs. María Teresa.
When asked expressly if the medical authorities do not follow-up on the relatives of patients with Covid-19, the emergency physician said: “Epidemiology is supposed to monitor these relatives, but we no longer have contact in the emergency department. with the follow-up that epidemiology carries ”, he explained.
But the case of Félix is not the only death in the General Hospital of Zone 32. On the same Sunday, the 22nd of the night, another serious patient arrived with all the clinical symptoms of Covid-19, but the sample could not be taken because he died.
The test is not being applied to all suspected cases
Contrary to the call of the World Health Organization (WHO) that has asked the governments of the world to carry out all the necessary tests on people suspected of being infected with Covid-19, federal health authorities assure that they will not be applied. en masse.
But the worst is in Mexico, they are not being carried out on people who present symptoms, which is causing under-registration in confirmed cases.
“We have been told that out of every 10 patients who come in with mild symptoms, only one is sampled. So what about the others? And those are the indications we have, but we, depending on how we value the patient, we decide whether to take it or not. But they are limiting us in taking samples ”he assured.
He recalled that the same situation was experienced in 2009, during the AH1N1 influenza pandemic.
“The same thing happened when AH1N1 influenza occurred, so it did. When there were deaths, there came a time when we were prohibited from putting on death certificates that Influenza was the cause of death. The authorities reach that level. They were given unspecified pneumoniarevealed.
Medical staff exposed
Two doctors who had contact with Mr. Félix were infected by Covid-19, reason why they are isolated in their houses with slight symptoms. “Luckily they have not worsened,” he said.
The contagion of both medical specialists occurred due to the deficiency of the equipment with which they have to care for patients, which has been broken because they are of poor quality.
“They are giving us the equipment, but to begin with it is not the one indicated, the quality is not what it should be and the personal protective equipment, because unlike other countries, it is a very poor quality and they give it to us, but very restricted ”.
He gave as an example the case of the mouthguards, which, some have been broken.
“The masks that all people bring if they last 15 minutes, but the appropriate masks that are called N95 those if they last us an 8 hour shift. And those also restrict us, we have to be almost begging them to give us every shift and it is daily ” (sic).
“We have tried to look for it outside, buy them ourselves because they limit us a lot. They say N95 but they are sloppy, they are pirates“He assured.
He explained that every time they care for a patient with severe pneumonia and a ventilator, they need a face mask and all new protective equipment.
“(…) After seeing that patient, that mouthpiece is discarded because it is already contaminated, it already has the virus impregnated and we cannot use it with another patient. But it is not only the mask, but all the complete protection equipment: N95 mask, hat, goggles, gown, nitrile gloves that we do not have (we have latex that does not protect the same) and boots, “he explained.
“Those of us who have bought the nitrile gloves get hold of what we buy. Those of us who have bought mouth guards of the right brand, from our pocket, ”he said.
He assured that They could not buy the complete equipment because they are already out of stock.
“So that is also another problem and where there is, where it has been found, prices are going up to five times. We have searched the internet Amazon and in Free market Y there are places where up to a thousand pesos each mouth mask has been raised“He asserted.
Although they have exposed their situation to their bosses, they say that is what their bosses send them.
“Each manager throws the beanbag to the top one and they wash their hands with that and that’s it. They say: it is what there is, it is what we have and now“
Given the lack of quality supplies, the medical personnel of the General Hospital of Zone 32 live with the anguish not only of catching, but of transmitting the disease to their families. That is why some of them are organizing to live in one place and not go home, in order not to expose their loved ones.
“Some colleagues are renting or leaving with someone who lives alone so as not to go home and put their relatives at risk. We know that it is our job and we do not refuse to do it, but we are afraid, we are nervous, anguished, of infecting ourselves and infecting our relatives ”he related.
He acknowledged “we are with that concern of uncertainty because, well, how long will I have to be like this. Also, we don’t know how long this pandemic will last because it is only just beginning. So this goes on for months because this is how the curve is being seen ”.
The doctor pointed out that not only they are exposed.
“The truth is that all of our colleagues at the hospital are exposed: from quartermaster, stretcher-bearers, nurses, radiologists. In other words, all of us who are in contact with these patients also have the risk. So what we are asking the authorities is the necessary equipment and that it be of quality because they say: well, there you have it, but in reality they are not of adequate quality.“He stressed.
Due to the risk in which they live day by day, the emergency doctors of the General Hospital of Zone 32 have asked to be granted a bonus called “Risk of infectious contagiosity”.
“It is an extra payment that is given by irrigation and emergency doctors do not have it. And we have already had many years commenting on the authorities that we are in the emergency room, of course we have that risk of infectious contagion and they say no. Last week we commented that to our head of service and he says ‘yes, you do have it, you do pay that item of infectious contagiousness,’ but the truth is that no, ”he concluded.
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