Minggu, 29 Maret 2020

Coronavirus Hits Spain’s Health Services Hard - The Wall Street Journal

Funeral rites at a Madrid cemetery on Friday.

Photo: Bernat Armangue/Associated Press

BARCELONA—In Spain, the country with the world’s second-highest death toll from the new coronavirus, the pandemic is leaving health services on the brink. Infected patients are left for days in wheelchairs because there are no beds, and protective equipment for medical personnel is so scarce that some are fashioning gowns out of garbage bags.

Over the past two weeks, Spain has suffered one of the fastest-growing outbreaks of the coronavirus. That has caught its health sector largely unprepared, say medical personnel, echoing similar problems in Italy and offering a cautionary tale of what other countries could face as the pandemic accelerates.

“We didn’t learn the lessons from Italy. We didn’t prepare for the epidemic and the system is now overloaded,” said Ángela Hernández, deputy general secretary of Madrid’s Amyts, a doctors’ union.

Health-care workers at University Hospital in Coruna, in northwestern Spain.

Photo: miguel riopa/Agence France-Presse/Getty Images

In the past week alone, total infections in Spain almost tripled, reaching 79,000 on Sunday, while deaths have almost quadrupled to 6,528, the world’s second-highest death toll from the disease after Italy.

Two weeks ago, Spain’s government placed the country under lockdown in an attempt to stop the virus’s spread. Spaniards were barred from leaving their homes except to buy food, medicine and other essentials—with exceptions for those who had to go to work and for other emergencies.

On Saturday, Prime Minister Pedro Sánchez announced his government would tighten lockdown measures, by forcing all workers in nonessential sectors to stay at home for two weeks starting on Monday.

The outbreaks are largely clustered around Madrid and Catalonia, which together account for half the total infections and more than two-thirds of deaths. In those areas, the pressure on hospitals is intense. By Sunday, nearly 4,900 people were in intensive care, a sixfold increase from 10 days earlier.

The regions of Madrid and Catalonia each had roughly 600 beds available in intensive-care units before the outbreak, but are now treating double that in these units, according to Spain’s health ministry and the Catalan Society of Intensive and Critical Care Medicine.

At some hospitals, patients are kept waiting for up to 24 hours on gurneys in corridors and on the floor, according to medical personnel working in the most stretched hospital. María José García, a spokeswoman at nurses’ union Satse, confirmed that nurses have reported such incidents to the union.

One Madrid hospital was so overwhelmed that personnel had to leave coronavirus patients for as many as three days in wheelchairs because they lacked beds, said a nurse working in the hospital. Ms. Garcia confirmed that nurses have reported such incidents to the union.

“The ministry is working to cooperate in providing materials to all regions,” said Spain’s health ministry.

The ministry didn’t comment specifically on the severe lack of space in some hospitals.

The health department for Madrid’s region didn’t reply to a request for comment. The health department of Catalonia, the region that is home to Barcelona, reiterated it is working to equip health-care professionals properly and ordered protective equipment as soon as the first coronavirus case was detected in the region in February.

The Catalan health department also said sports centers near four main hospitals in Barcelona would be adapted to accommodate up to 600 patients.

La Paz Hospital in Madrid has doubled its emergency room by taking over the hospital gym and the waiting room, where doctors now attend to patients. New patients now wait outside in a temporary tent set up in the ambulance parking lot.

“Patients keep coming every day more and more. I just can’t imagine how we are going to deal with them in a few days,” said Guillén del Barrio, a 30-year-old emergency room nurse at La Paz Hospital. “There are many of us going home crying every day.”

Authorities in Spain have taken over private hospitals and turned some hotels into makeshift health-care facilities. In Madrid, authorities are setting up a 5,500-bed military facility in a conference center.

Meanwhile, doctors and nurses say there has been a serious shortage of medical equipment and personal protective equipment such as masks, visors and special gowns designed to protect against infection.

The shortage of masks and of protective visors is such that nurses have to keep them on for their entire shifts, sometimes lasting 14 hours, meaning they cannot eat or drink for the whole time, according to Satse, nurses and doctors.

They sometimes end their shift with bruises on their face from having kept the equipment on for such a long time.

In some of Madrid’s hospitals, personnel have used red, blue and yellow plastic ponchos donated by local amusement parks because they didn’t have proper gowns, according to Satse and a nurse working at one of the affected hospitals.

In other hospitals nurses made their own gowns with plastic garbage bags and used shower caps to cover their hair.

Two Clusters

Hospitals in Madrid and Catalonia are under severe pressure due to the sheer number of cases they have to treat

Covid-19 cases

CATALONIA

Barcelona

Madrid

Cases

Hospitalized

ANDALUCIA

20,000

Sevilla

10,000

Canary Islands

1,000

Cases

CATALONIA

Barcelona

Madrid

Cases

Hospitalized

ANDALUCIA

20,000

Sevilla

10,000

Canary Islands

1,000

Cases

Canary Islands

CATALONIA

Barcelona

Madrid

ANDALUCIA

20,000

Sevilla

10,000

1,000

Cases

Cases

Hospitalized

Canary Islands

CATALONIA

Barcelona

Madrid

ANDALUCIA

20,000

Seville

10,000

1,000

Cases

Hospitalized

Cases

Source: Spanish government

“This is absolute chaos. The situation is devastating. There was no preparation whatsoever, so when the outbreak began, we ourselves found that the protective equipment we had was insufficient or not of adequate quality,” said Ms. García.

The Spanish Health Ministry declined to comment on specific shortages of protective gear but said it continues to work to ensure the supply of such materials to all regions. The government has recently bought almost 700 million masks and 11 million gloves, as well as 950 ventilators, machines that are critical to treating the most serious cases of coronavirus infections.

Health workers worry that the shortage of adequate protection may help explain why the virus has infected so many health workers in Spain, which in turn has reduced the number of available medical personnel.

According to authorities, around 15% of known cases in Spain—or about 9,400—are health workers, compared with roughly 8% in Italy.

Last week, the Spanish government said it was adding 50,000 additional medical workers, including retired doctors, recently graduates and students.

Health-care workers hug each other as they are cheered on by people outside La Fe hospital in Valencia.

Photo: jose jordan/Agence France-Presse/Getty Images

“No one smiles anymore. Everyone works tons of hours,” said Anna Serrabou, a doctor at the emergency unit in Moisès Broggi Hospital near Barcelona. “People call us heroes, but in fact we feel powerless.”

A 42-year-old person infected with the virus recently was brought to the emergency room at a hospital in Barcelona, only to find there was no space in its intensive-care unit.

Susan Judas, a doctor at the hospital, and her team called hospitals in the surrounding area. One had a free bed, but was too far to bring the patient in time.

Finally, a bed in a nearby hospital became available when another coronavirus patient died.

“I have the feeling of living in a nightmare, that this is not happening in reality,” said Dr. Judas. “But then, after finishing your shift and resting, you realize that yes, this is really happening.”

Write to Giovanni Legorano at giovanni.legorano@wsj.com

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2020-03-29 11:04:02Z
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