Brazil Covid-19: a city in the state of Sao Paulo says it could be forced to remove patients from ventilators as cases increase nationwide

by

Coronavirus cases are on the rise in Brazil and the country’s health systems are increasingly overflowing. In almost all states of Brazil, employment rates in intensive care units (ICUs) are equal to or greater than 80%. Some of them exceed or exceed 90% and a few have exceeded 100% occupancy, which has forced them to set aside some patients.

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

In the coastal city of Sao Sebastiao, in the state of Sao Paulo, Mayor Felipe Augusto turned to public calls this weekend for more supplies from the state government.

“Our stock lasts until Monday and will only be used for already intubated patients. The problem is that the lack of these drugs requires an extubation, that is, you will have to remove this patient who is in a serious and intubated state. and change it to respirators. A big risk, “the mayor told CNN’s subsidiary CNN Brazil on Saturday.
No vaccines, no leadership, no end in sight. How Brazil became a global threat

Dr. Juan Lambert, head of Sao Sebastiao’s largest hospital, told CNN on Sunday that 10 Covid-19 patients are intubated in his hospital and that the state government had saved them time by sending supplies worth a week after Augusto’s petition circulated in the media.

“Thank God the secretariat came and made us a priority in the distribution of supplies.” Lambert said.

But with the whole country stretching out to accommodate new cases, even the richest state in Brazil may not have much more to offer. On Saturday, the Sao Paulo state health department predicted that stocks of drugs used for intubation in public hospitals would only last another week.

In an official statement to CNN, the department said it had been demanding “urgent and express action” from Brazil’s health ministry. The ministry did not respond to repeated requests for comment.

A national crisis

According to a CNN analysis, nearly a quarter of Covid-19’s global deaths over 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 health ministry calling for “immediate action” by the federal government to provide sedation and oxygen medications to intubated patients who have Covid-19 and other diseases.

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

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

These were not the first warnings of this kind. In August 2020, a report by the National Health Council (an agency linked to the Brazilian Ministry of Health) described the risk of a drug shortage amid the pandemic.

“The scarcity of these drugs puts at risk the entire structure provided for health care during the pandemic … because even with the beds available, without these drugs, it is not possible to perform the procedure, which can causing the whole health system to collapse, “wrote Council President Fernando Pigatto, President of the Council.

A call for change of tactics

Bolsonaro, who celebrated his 66th birthday on Sunday, has seen scores of public disapproval rise as Covid-19 persists in the country. Last week, a poll by the Datafolha polling institute showed a 54% disapproval for its treatment of the pandemic.

The president has refused to approve the closure measures, arguing that it protects the freedom of citizens and the economic health of the country. His administration has also said state officials have the power to take precautionary measures.

However, Bolsonaro announced last week that his government had filed a lawsuit to prevent governors and mayors from imposing certain restrictions, following several adoptions of 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 published an open letter to the country’s largest newspapers on Sunday calling on the federal government to rethink its approach to the pandemic.

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

“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,” the letter said.

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

.Source