Covid-19 do Brasil: city in the state of São Paulo says it may be forced to take patients off ventilators as cases increase across the country

Covid-19 do Brasil: city in the state of São Paulo says it may be forced to take patients off ventilators as cases increase across the country

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Coronavirus cases are increasing in Brazil and the country’s health systems are increasingly overburdened. In almost all states in Brazil, occupancy rates in intensive care units (ICUs) are equal to or higher than 80%. Some of them are 90% or more, and some have exceeded 100% occupancy, forcing them to refuse some patients.

State governors, mayors and local medical teams now say they are running out of supplies to treat even Covid-19 patients who have been given precious ICU beds. Stocks of medications that facilitate intubation could disappear in the next two weeks, according to a report by the National Council of Municipal Health Secretaries. And the National Association of Private Hospitals (ANAHP) predicted that private hospitals will run out of medicines needed to intubate patients with Covid. -19 until Monday.

In the coastal city of São Sebastião, in the interior of São Paulo, the mayor Felipe Augusto resorted this weekend to public appeals for more supplies from the state government.

“Our stock lasts until Monday, and will only be used for patients already intubated. The problem is that the lack of these drugs requires extubation – that is, you will have to remove this patient who is seriously intubated and change to breathing masks. A huge risk, “the mayor told CNN Brasil on Saturday.
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Doctor Juan Lambert, head of the largest hospital in San Sebastian, told CNN on Sunday that 10 Covid-19 patients are intubated in his hospital and that the state government gave them time by sending supplies for a week after Augusto’s appeal circulated. in the media.

“Thank goodness the secretariat got in touch and made us a priority in distributing supplies.” Said Lambert.

But with the entire country stretching to accommodate new cases in a rush, even the wealthiest state in Brazil may not have much more to offer. On Saturday, the health department of the state of São Paulo predicted that stocks of medicines used for intubation in public hospitals would last just another week.

In an official note to CNN, the secretariat said it had been demanding “express and urgent measures” from the Ministry of Health of Brazil. The ministry did not respond to repeated requests for comment.

A national crisis

According to a CNN analysis, almost a quarter of Covid-19’s global deaths in the past two weeks have occurred in Brazil. At least 294,042 people have died in the country since the pandemic began.

Last week, the National Front of Mayors of Brazil (FNP) sent a letter to President Jair Bolsonaro and the Ministry of Health asking for “immediate measures” from the federal government to provide sedative and oxygen drugs to patients intubated with Covid-19 and other diseases .

“It is unreasonable for people, Brazilian citizens, to be driven to deaths so desperate for ‘drowning in the dry’ or to have to be tied up and to remain conscious during the delicate and painful process of intubation and throughout the period people are kept intubated “, says the letter.

The Federal Pharmacy Council (CFF) also warned that there is evidence of a shortage of neuromuscular blockers, sedatives and other drugs used in intensive care, such as midazolam, essential for safe and human intubation.

These were not the first such warnings. In August 2020, a report by the National Health Council – an agency linked to the Ministry of Health of Brazil – described the risk of a shortage of medicines in the midst of the pandemic.

“The scarcity of these medications puts at risk the entire planned health care structure during the pandemic … because even with available beds, without these medications, it is not possible to perform the procedure, which can cause the entire health system collapse, “wrote board chairman Fernando Pigatto, chairman of the board.

A call to change tactics

Bolsonaro, who celebrated his 66th birthday on Sunday, has seen an increase in public disapproval rates, as Covid-19 persists in the country. A survey by the Datafolha research institute last week showed 54% disapproval of the way it handled the pandemic.

The president refused to endorse blockade measures, arguing that he is protecting the freedom of citizens and the economic health of the country. His government also said that state officials have the authority to take precautionary measures.

However, Bolsonaro announced last week that his government had taken action to prevent governors and mayors from imposing certain restrictions, after several adopted curfews and other strict measures. “This is a state of siege, which only one person can decree – me,” he said.

More than 500 prominent Brazilian bankers, economists and politicians on Sunday published an open letter in the country’s largest newspapers asking the federal government to rethink its approach to the pandemic.

“This recession … will not be overcome until the pandemic is controlled by competent federal government action. This underutilizes and misuses the resources at its disposal, including ignoring or neglecting scientific evidence in designing actions to deal with the pandemic,” bankers and economists wrote.

“We are on the threshold of an explosive phase of the pandemic and it is essential that, from now on, public policies are based on data, reliable information and scientific evidence,” says the letter.

CNN’s Hira Humayun and Caitlin Hu contributed to this report.

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