Saturday September 26th, 2020 11:35PM

Doctors in hard-hit Madrid: 'It's like March in slow motion'

By The Associated Press
Related Articles
  Contact Editor

MADRID (AP) — It feels like a flashback. Pneumonia, a common acute manifestation of the COVID-19 disease, is keeping Spanish intensive care wards busy again. And it's also leaving medical workers who are still recovering from the pandemic's peak with an anxious sense of déja vu.

Foreseeable as it was, the second wave has arrived in Europe earlier than expected, hitting countries with different intensity. In Madrid, for the second time the capital worst hit by coronavirus outbreaks on the continent, doctors and nurses say that authorities are responding, again, too erratically and too late.

“In a way, it’s like the situation in March but in slow motion," said Dr. Carlos Velayos, who works as an intensive care unit physician at the public hospital in suburban Fuenlabrada. The hospital is expanding its ICU capacity from 12 to 24 beds by the end of September, as all of them are currently filling up with coronavirus patients.

With 1,281 patients in ICUs as of Wednesday, Spain has roughly as many beds devoted to treat grave patients of COVID-19 as France, the United Kingdom, Germany and Italy together. And 359 of them are in the Madrid region, which for the past week has accounted for roughly one-third of a national average of 8,200 new infections per day.

Spain's virus caseload, above 600,000, is one of the world's highest and more than 30,000 have died in the country for the new virus.

Velayos said that prediction models were telling hospital administrators in Madrid that some ICU wards could reach peak capacity in the second half of September. But little or nothing has been done to avoid returning to extended shifts among many health professionals that are still recovering from the stress of the pandemic's first wave.

“In March, it was like a nuclear bomb that brought the health system as a whole to a collapse in a matter of weeks," Velayos said. “We might not be there yet, but that’s not a reason not to be worried. We have allowed the outbreaks to reach a level of being uncontrollable.”

Medical workers are this time better prepared, with lessons learned on how to treat incoming patients more effectively and they have means to better protect themselves against contagion. But operating rooms in the Madrid region, which has a population of 6.6 million, are already being turned into ICUs and surgeries have been postponed, while hospitals compete to hire professionals for the expanded capacity.

Regional authorities say that the health system still has room to manage the incoming flow of patients, but following warnings by medical personnel like Velayos, officials are now reacting with stricter measures that could include selective lockdowns in parts of the city as early as next week.

The restrictions, if finally adopted, will center on urban areas where the coronavirus is spreading faster, officials announced Wednesday. That's suburban towns like Fuenlabrada, but also working-class neighborhoods in southern Madrid where contagion rates have been steadily soaring since August.

They also happen to be areas where less affluent residents and mostly migrant families cram into small apartments and commute on public transportation to manual work in other quarters of the Spanish capital.

Ángela Cantos lives in the Vallecas neighborhood, one of the hot spots in the recent wave of outbreaks. She said that if her neighborhood is locked down, “then Madrid will be paralyzed.”

“Who is going to cook and clean in other districts if they close down here?" she said.

The regional deputy health chief, Dr. Antonio Zapatero, said Wednesday that “Madrid wants to flatten the curve before the arrival of autumn and the complications that cold weather could bring,” adding that the “drastic measures” to be taken will be decided by the weekend.

Zapatero also said that people have relaxed protection measures by holding large gatherings, often forgetting about social distancing or masks. He also announced that police will monitor compliance of mandatory self-isolation since at least 90 people have been found to be skipping quarantines after testing positive for the new virus.

The country brought contagion under control earlier this year with a three-month lockdown, one of the strictest anywhere, but since it relaxed restrictions in mid-June, outbreaks have spread throughout the country.

The Spanish government says the country is now doing more tests and that more than half of the newly infected show no symptoms. But health centers are starting to struggle to cope with the number of virus tests required and responding to patients. In hospitals, 8.5% of the country’s beds are now treating COVID-19 patients, but in Madrid that share jumps to one in five beds.

In terms of ICUs, official data shows that 38% of the region's beds have coronavirus patients, although some hospitals are already at 90% of their capacity before rolling out emergency plans for new beds, like they did in spring.

“Madrid is maintaining a steady level of infections, but we have to take into account the impact of the pandemic in primary care, in hospitals, which is totally sustainable at the moment. But we have to make that line of infections decrease,” said Zapatero, who back in March was tasked with Madrid's makeshift hospital of 1,500 temporary beds in an exhibition center.

This time, officials are hoping they don't have to reach that point. The regional government is spending 50 million euro ($59 mimllion) to build by the end of October a massive permanent new “epidemics hospital” with more than 1,000 beds. It's also promising more resources for primary care, since health centers have now become the new bottleneck of citizens concerned that they may have contracted the virus.

In addition to performing most of the testing, first-row doctors in Spanish health centers have now taken the burden of contact tracing.

“The problems in primary care are not from the past six months," said Dr. Olaya Muñoz, who works in a health center in the heart of Madrid. "COVID has just been more stress for a system that was malfunctioning for at least a decade.”

Muñoz finds time to talk, while catching her breath, as she walks uphill to visit two elderly patients at home. After that, more than 40 appointments await her back at her community health center. Although these days they do most of them by phone, she can't devote more than an average of six minutes per patient.

"The workload is just unbearable,” she said.

Dr. María Cruz Martín Delgado, spokeswoman for Spain's intensive care specialists' association known as Semicyuc, says that a collapse in primary care couldn't only lead to more asymptomatic cases to go undetected but also poorer or no treatment of other illnesses that eventually could lead to more patients downstream, in hospitals and ICUs.

What Martín wants is a clear protocol from authorities at the national and regional levels on how to proceed.

“We need to know what is the point when we need to turn down other patients, because we doctors can't take all responsibility again having to respond to an emergency when we are not given the resources to do so," she said.

Velayos, the intensive care specialist from Fuenlabrada, said that the work overload in March and April was widely acknowledged among his colleagues “as part of an exceptional situation that needed to be met with all the world’s generosity.”

“But right now we are talking about a situation becoming chronic, where stress is going to be the norm and routine," he said.


Associated Press writer Alicia León contributed to this report.

  • Associated Categories: Associated Press (AP), AP Health, AP World News, AP Business, AP Business - Industries, AP Business - Health Care
© Copyright 2020 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Doctors in hard-hit Madrid: 'It's like March in slow motion'
Authorities in Madrid say selective lockdowns will be introduced in urban areas where the coronavirus is spreading faster to avoid bottlenecks in health services
3:21PM ( 4 minutes ago )
Belarus leader Lukashenko disparages protests as US plan
Belarus’ authoritarian leader is seeking to disparage protesters demanding his resignation for a sixth straight week after a disputed election by accusing the United States of fomenting the unrest
3:15PM ( 10 minutes ago )
UK to ration COVID-19 testing amid testing failures
U.K. lawmakers have criticized the government’s handling of the COVID-19 testing crisis for a second day as opposition leaders say Prime Minister Boris Johnson lacked a cohesive plan to tackle the virus as the country faces a second wave in the pandemic
3:13PM ( 13 minutes ago )
Associated Press (AP)
Leave of absence for health official in furor over meddling
The Trump administration health official accused of political meddling in the government’s coronanvirus response is taking a 60-day leave of absence
2:08PM ( 1 hour ago )
US outlines sweeping plan to provide free COVID-19 vaccines
The federal government is outlining a sweeping plan to make COVID-19 vaccines available for free to all Americans
2:00PM ( 1 hour ago )
The Latest: CDC director: Scientific integrity not altered
The director of the CDC told Senate lawmakers that his agency has not altered its scientific publications on the coronavirus
12:26PM ( 2 hours ago )
AP Health
South Africa says 12 million 'probably' had coronavirus
South Africa's health minister says about 12 million people in the country have “probably” been infected with the coronavirus
2:15PM ( 1 hour ago )
Pentagon Papers leaker comes to the defense of Assange
Daniel Ellsberg, one of the most famous whistleblowers in living memory, came to the defense of WikiLeaks founder Julian Assange in his legal fight to avoid extradition to the United States from Britain
2:15PM ( 1 hour ago )
Ukraine, Belarus trade accusations over Jewish pilgrims
Ukraine and Belarus are trading angry accusations over thousands of Hasidic Jewish pilgrims who have remained stuck on their border after Ukraine denied them entry because of coronavirus restrictions
1:57PM ( 1 hour ago )
AP World News
US charges 5 Chinese citizens in global hacking campaign
The Justice Department has charged five Chinese citizens with hacks targeting more than 100 companies and institutions in the United States and abroad, including social media and video game companies as well as universities and telecommunications providers
2:44PM ( 42 minutes ago )
Federal Reserve adjusts inflation target, rate unchanged
The Federal Reserve adjusted its inflation target to seek price increases above 2% annually, a move that will likely keep interest rates low for years to come
2:04PM ( 1 hour ago )
'Nothing left in the bucket': Wildfire resources run thin
Firefighters battling the West Coast wildfires say this year's blazes are some of the worst they have ever seen
1:38PM ( 1 hour ago )
AP Business
Wall Street opens higher ahead of Fed statement
Stocks on Wall Street are opening higher Wednesday ahead of a Federal Reserve policy announcement
9:43AM ( 5 hours ago )
Top EU official proposes new 2030 target to reduce emissions
The European Union’s top official has proposed a more ambitious target for cutting greenhouse gas emissions in Europe
8:35AM ( 6 hours ago )
World stock markets subdued ahead of Fed statement
World markets are trading in narrow ranges ahead of the Federal Reserve's policy announcement
7:37AM ( 7 hours ago )
AP Business - Industries
The Latest: Oklahoma inmate deaths likely linked to COVID-19
The Oklahoma State Department of Corrections says two more state prison inmates have died, and the deaths could be linked to COVID-19
5:14PM ( 22 hours ago )
The Latest: Missouri students expelled over virus violations
With more than 1,300 of its students infected with the coronavirus, the University of Missouri in Columbia has expelled two students and suspended three others for violating rules meant to slow the virus’ spread
4:19PM ( 23 hours ago )
The Latest: Fauci: Vermont's virus efforts model for nation
Dr. Anthony Fauci calls Vermont’s ongoing efforts to control the coronavirus a model for the nation
3:25PM ( 1 day ago )
AP Business - Health Care
Belarus leader Lukashenko disparages protests as US plan
Belarus’ authoritarian leader is seeking to disparage protesters demanding his resignation for a sixth straight week after a disputed election by accusing the United States of fomenting the unrest
3:15PM ( 11 minutes ago )
UK to ration COVID-19 testing amid testing failures
U.K. lawmakers have criticized the government’s handling of the COVID-19 testing crisis for a second day as opposition leaders say Prime Minister Boris Johnson lacked a cohesive plan to tackle the virus as the country faces a second wave in the pandemic
3:13PM ( 13 minutes ago )
What's in a name? At the Vatican, a debate on inclusiveness
The Vatican responded Wednesday to criticism that the title of Pope Francis’ upcoming encyclical on the post-COVID world is sexist, saying the document, “Fratelli Tutti,” ("Brothers All") in no way excludes women
3:07PM ( 19 minutes ago )
Study hints antibody drug may cut COVID-19 hospitalizations
A drug company says that partial results from a study testing an antibody drug give hints that it may help keep mild to moderately ill COVID-19 patients from needing to be hospitalized, a goal no current coronavirus medicine has been able to meet
3:05PM ( 21 minutes ago )
Federal Reserve sees rates near zero at least through 2023
The Federal Reserve expects to keep its benchmark interest rate pegged near zero at least through 2023 as it strives to accelerate economic growth and drive down the unemployment rate
2:59PM ( 27 minutes ago )