QCOSTARICA – Between the different hospitals of the Caja, an average of 20 land transfers and at least one air transfer of patients with covid-19 are made daily.
Carrying out these transports, either by road or air, to ensure a bed for critically or severely ill patients in San José, implies an almost perfect synchrony in the coordination that is needed, not only between health services, but among others that participate to guarantee opportunity and quality in the care of these patients.
This coordination is one of the factors to which the medical manager of the Caja Costarricense de Seguro Social (CCSS), Mario Ruiz Cubillo, attributes that, until now, hospital services have not collapsed as expected in early January.
The disorders that were seen at the end of the year in different parts of the country had technicians launch forecasts and estimate a demand much higher than the capacity between the second and third week of January.
It hasn’t happened, at least not until now.
The CCSS bed report, on Friday, January 22, recorded for that day 21 free beds of the Intensive Care Units (ICU) for the care of critically ill patients, of the 109 available: 79% occupancy.
Of the 240 ICU beds for patients in severe condition, 117 were free on January 22.
The CCSS has insistently clarified that the occupancy varies from one moment to another for reasons that include the death of patients, discharges and transfers out of the ICU.
According to Ruiz, who at the beginning of January said that “only a miracle” would prevent the collapse of hospitals these days, a “high pressure” on hospitals remains.
“The occupation of critical beds is 79% and of severe beds 51%. (…) The work teams of all hospitals and health areas have ensured that patients have the best care in the shortest possible time.
“The places where at the moment there are more patients in need of hospitalization are the Brunca region and the Huetar Atlántica region, because the virus moves through regions.
“We have ensured, as far as possible, that these regions are not saturated, and transfer patients to the metropolitan area,” explained Ruiz.
Not only personnel from the CCSS participate in all these operations, but also personnel from the Fuerza Publica (Naitonal Police), Traffic Police, Air Surveillance and the National Emergency Commission, to name a few.
Ruiz recognized that among the hypotheses in the decrease in positive cases, is the fact that people are not consulting the emergency services to get tested, that is they are not seeking out medical services until they are severely sick for fear of being ordered to quarantine.
“We have the capacity to carry out more tests, but people are not arriving. There are people who get sick but not so severely, and do not go to the services because having positive covid implies a health order. This is one of the possibilities.
“What we have also analyzed is that in December people with more risk factors possibly took better care of themselves and avoided being exposed to crowds, and the crowds that we saw were of people who did not have these risk factors. They are hypotheses,” Ruiz clarified.
Another possible cause of the containment of hospital demand could also be related to measures to restrict the mobility of people, the vehicular restrictions, which could have contributed to preventing the spread of the virus.
Until Friday, the latest day the Ministry of Health reported numbers, there was a reduction in hospitalizations and a daily average of 17 deaths from causes related to covid-19.
Despite the above, Ruiz reiterated, the system remains under strong pressure and there are days when occupancy reaches 85% or 90% of the total installed capacity.
“We have to be clear that the (medical services) system is under great pressure. We have to keep working to get ahead of this emergency. The vaccine prevents you from getting severely ill, but it is not a cure as such. While we are in a pandemic, we have to promote the values of faith, hope and solidarity,” said Ruiz.