On May 7, Madrid tried for the first time to go to phase 1. The Government denied it. It happened a week later. For 15 days, the Executive of Isabel Díaz Ayuso repeated that there were no “technical criteria” for this refusal. There were several. Two of them are essential: reinforce the templates and increase the ability to do PCR. And one, key: trackers. Those in charge of finding out where and with whom the new cases of coronavirus have been, contacting these people and being able to close a new transmission, prevent the virus from spreading again.
Until now, the Community kept the equipment, the operation and their location in absolute silence. This Tuesday, a visit was allowed to one of them, in Coslada; although they do not provide more information than that group. The first time that the region requested a phase change, those specific teams due to the covid-19 crisis were not working and the protocol that had to accompany primary care (AP) and Public Health (SP), the two pillars, did not yet exist. to control the pandemic from now on. With the second attempt, they had barely 48 hours ripped off. They started on May 11.
A week ago, the Community assured in the documentation that it sent to the Ministry for the de-escalation that the system of early detection and follow-up and traceability of cases had 36 epidemiologists, 16 resident doctors of the fourth year and 14 of the third and second year, inspectors of the General Directorate of Sanitary Inspection and Planning and of the public health centers of the City Council and new hires of 66 community nurses and 40 operators for the Personalized Care Center (CAP). 172 professionals.
“For now, the residents’ thing is not true. Except for those who were in the areas of Public Health doing the rotation when the pandemic arrived, the rest of us are not incorporated nor is it clear how many or how we will do it, ”explains one of them. Still this May 27, neither the health centers nor the areas of SP have the promised reinforcement of 600 people for primary and up to 172 in SP. The Ministry of Health, after repeated questions, does not answer how many people are currently doing the tracing or how they are distributed or when that growth of the templates is expected to be completed. And in the last report from the Ministry, which allowed Madrid to go to phase 1 on Friday the 22nd, the Government included this reinforcement as a “forecast” and urged that it be formalized.
Improvements in detection, more PCR and the forecast of more staff, keys to the transition from Madrid to phase 1
–Meanwhile, around 36 professionals – the number that seems closest to the reality of those offered by the Ministry, according to several professionals in this field – are divided into the 11 technical units of Public Health that the Community has, where among its functions is routinely doing the same screening for other diseases. It is also there where they do it now for the covid-19. They began to conduct this research systematically at first, when there were only a handful of cases. But the virus exploded, the accumulation of positives came over them and it was impossible to keep up with the evolution of the pandemic. They resumed on May 11.
They receive daily, through their surveillance system, the information of confirmed cases from the laboratories. Then tracking is activated. There are 26 people in the Coslada unit, six of them joined at the beginning of the crisis. Nine are trackers. This Tuesday they were on the phone. Several simultaneous conversations crossed in the office of that area that covers a population of approximately half a million people. It serves the districts of Chamartín, Salamanca and the municipalities of Coslada, San Fernando de Henares, Velilla de San Antonio and Mejorada del Campo; in coordination with 22 health centers, four public and six private hospitals.
The first call is “crucial”
One of those voices belongs to a nurse. He asks a retiree if his wife had had the test and which one, while recording the information on a sheet where dates and data are crossed. “You have to act in individual cases to know who have been close contacts [alguien que ha estado a menos de dos metros sin utilizar las medidas de protección por un periodo de más de 15 minutos] so that they are also in isolation or have a PCR if they start with symptoms, ”explains Andrea Núñez, another of the team’s nurses.
Detective work of trackers
–The follow-up of all these contacts will be taken care of later by the CAP personnel, who maintain vigilance, indicate precautions such as taking the temperature twice a day and refer to a health center if symptoms begin. But the “crucial” call is the first to the infected. The adjective is provided by Nelva Mata, a Preventive and Public Health doctor and coordinator of that team of trackers that quantifies that first conversation in a minimum of 30 minutes. “You have to earn their trust, be very empathetic and you are already conducting the survey.” They have to identify what the infected person has been doing since the two days before the onset of symptoms. “In the asymptomatic, since they have the positive result of the test we go backwards,” says Mata.
After more than two months of confinement, the contacts have been especially with the cohabitants, “but also if they have had work contact, they ask him for the name of the company, a phone number of a person in charge, the type of work he performs and Contact the occupational risk prevention service to notify them. Or if it is a person who receives home care, they must contact the person who provides this help, “adds the doctor. Now, with the transition to phase 1, tracking is complicated by social gatherings. “Everything is very important, that nothing escapes,” concludes Mata.
Madrid asks again for the phase change without establishing or developing the Health requirements
–For that not to happen, you need hands. In the Community, with 6.6 million inhabitants, the forecast of reinforcements is far from the figures that experts consider optimal. One of those figures, the one managed by Germany, is five trackers for every 25,000 inhabitants; With that fork, the Community should have around 1,320.
Closer, the numbers do not get there either but they also exceed the region. Catalonia, with 7.5 million inhabitants, estimates 328 people; in Castilla y León, 500 for 2.4 million inhabitants; and in Castilla-La Mancha, with two million citizens, 330 nurses have already been hired, who have joined 90 Public Health people. Madrid, the territory hardest hit by the pandemic, offers to close the 172 virus. It is May 27 and not all have arrived yet.
Madrid, the territory most hit by the pandemic
Confirmed cases. Madrid have a cumulative of 68,505 infected by covid-19, 81 of them diagnosed in the last 24 hours.
Patients. 1,052 patients remain on the floors of Madrid hospitals, 212 of them in the ICU. Since the pandemic began, 42,862 have required admission and 3,646 in intensive care units.
Deceased. Until this May 27, in hospitals, 9,035 people have died. 14,671 according to the figures of the Community that include hospital centers, other social health centers, homes and “other places”, which have never specified what they are.
Cured. Since the beginning of the crisis, 41,716 people have been discharged, 114 cured in the last 24 hours.
Cumulative incidence [casos diagnosticados en los últimos 14 días por cada 100.000 habitantes]. The number of cases diagnosed in the last 14 days is 1,773, which shows an AI of 26.61, the second highest behind Catalonia (34.12).
Home care.From primary care, professionals in Medicine, Nursing and other categories have carried out a total of 305,344 home follow-ups. In the last 24 hours, 4,571 were made.
Information about the coronavirus
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