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At around 7:00 am on Good Friday, paramedic Víctor Rivera arrived at the residence of an 83-year-old woman in the metropolitan area.
After an initial evaluation, Rivera indicated to the patient that she needed to go to a hospital immediately because she had high blood pressure. He even showed her the cardiac reading on the monitor.
“But she told us that she did not want to go to the hospital because of COVID (19), that she did not want to be exposed. We oriented her several times, but she remained in denial,” Rivera said.
“That same afternoon, at around 3:00 pm, they activated us for the same house and when we arrived, the patient was already on the floor, with no vital signs,” he added. “A relative told me that (the patient) screamed and collapsed. But she could not help him, because they are two old ladies.”
For cases like this, Rivera and other representatives of the emergency medical industry raised the alarm about what they consider an alarming reduction in transfers to hospitals during the emergency caused by the COVID-19 coronavirus.
They point out that this decline has not only already caused the loss of jobs for hundreds of paramedics, which poses risks in the future, but is costing lives.
“There are people dying in the houses,” said Rivera.
He added that “in these two weeks” he has attended three other cases himself, where the patients have refused to go to the hospital for the same reason and then they have called them a second time, when the patient “no longer has vital signs.”
“They are waiting until the last to call an ambulance … when they are practically already unconscious,” he added.
Rivera works for the United Ambulance company, whose owner, José Quintero, said that in the past two weeks he has handled at least five cases of patients who died after refusing to transfer to a hospital for fear of becoming infected.
“It is a very worrying thing … It is very difficult to tell an elderly person that he has to go. We cannot always solve him at home. I do not have insulins in the ambulance or I cannot always tell them that what they have is something lethal because, for example, I can’t do an electrocardiogram, “said Quintero.
“People are staying at home afraid to go to an emergency room because they don’t get it. When a paramedic tells them they have to go to a hospital, it’s not a whim, it’s because they need it,” he added.
After conversing with owners of other ambulance companies, Quintero said “a reduction of 50 to 60 percent in emergency transfers is seen” to hospitals.
This trend is compatible with the reduction in hospitalizations, as reported by representatives of that industry.
Earlier this month, the president of the Hospital Association, Jaime Pla, told El Nuevo Día that the country’s hospital occupancy that week was around 38%.
They recommend going to the hospital
For the president of the College of Surgeons, Víctor Ramos, it is not only a problem that patients do not want to go to a hospital when they need to, but they are also not communicating with their doctors.
“It is something we are seeing around the world,” said Ramos. “People’s fear of going to emergency rooms and their doctors’ offices not only fuels COVID cases, but conditions that require follow-up.”
“Staying to wait to see what happens and not contacting your doctor is not the alternative,” he added.
Ramos, Quintero and Rivera affirmed that citizens should not fear going to the emergency rooms if health conditions require it.
“The emergency rooms are empty. Now they are safer going to the hospital,” Rivera said.
In turn, Ramos highlighted that “hospitals take all the necessary alternatives. You go when necessary, but you cannot be without communicating.
“If it is not treated in time, it will deteriorate. It is something that is happening,” he said.
Risk for exodus of paramedics
For his part, Bryan Vélez, owner of the BVR Ambulance Best Care company, said that in his specific case the decrease in transfers to hospitals has been almost 20% so far this April.
He noted that the reduction began to be seen gradually after January, when he had 1,114 emergency transfers to hospitals. In March it dropped to 836 and has barely 327 people so far in April.
“This month is on the floor,” said Velez.
He explained that, at the same time, the percentage of calls that result in people not transferred has increased.
In addition to posing a health hazard to patients, this reduction has resulted in financial losses for ambulance companies and paramedics who have been laid off.
According to Vélez, the situation has been aggravated because they have had to incur additional expenses such as protective equipment for the paramedics who are used in each case they attend and other measures to prevent infections.
Vélez pointed out that 18 category III companies, which are emergency companies, have reduced working hours to 544 employees to 30-hour hours. Meanwhile, those same companies have dismissed 244 paramedics.
In his case, Quintero said that of the 180 United Ambulance employees, “he has had to send 40 to 45 employees home. Some leave for vacations and others for unemployment.”
“There are no patients to transport and we fear that they (the paramedics) will leave us,” Quintero said.
According to Vélez, of those who worked in his company, “they have already gone from four to five to Florida.”
As with the exodus of doctors and nurses, paramedics are emigrating because the state of Florida has established a “reciprocity” agreement. This means that the Puerto Rico medical emergency technician receives a license to work there and that in turn is valid to work in states that have agreements with Florida, where they charge between $ 30 to $ 40 per hour, while on the Island the Salary is up to $ 10, Quintero said.
Pedro Martínez, president of the Association of Emergency Medical Technicians, Paramedics and Operational Personnel (Atempo), warned that if measures are not taken, there will be consequences when the emergency passes.
“We need paramedics to be included in the incentives offered by the government to nurses and doctors. If they leave, it is raining wet, because there is already a shortage of paramedics in normal times. State Medical Emergencies refers 70% of the cases, “he said.
For Vélez, the incentive for private paramedics to remain urgent, considering that the peak of COVID-19 infections may require the availability of personnel who are leaving the Island.
“The government says that we are at the peak, but they are not doing tests. Now they say that the peak will be until May, but when we get there, we will not have a payroll,” he said. “Then when the emergencies are back to normal, there won’t be enough paramedics and waiting times will increase in emergencies.”
Representatives of that industry held a demonstration yesterday in front of the Capitol and Fortaleza, while they sent letters to the legislative presidents and to Governor Wanda Vázquez, but Martínez said they have received no response.
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