RIO DE JANEIRO (AP) – Reports are emerging of Brazilian health workers forced to intubate patients without the help of sedatives, after weeks of warnings that hospitals and state governments risk running out of critical drugs.
A doctor at the Albert Schweitzer Municipal Hospital in Rio de Janeiro told the Associated Press that for days health workers diluted the sedatives to make their stocks last longer. Once exhausted, nurses and doctors had to start using neuromuscular blockers and tying patients to beds, the doctor said.
“You relax the muscles and do the procedure easily, but we don’t have sedation,” said the doctor, who agreed to discuss the sensitive situation only if not named by name. “Some try to talk, they resist. They are aware. “
The lack of necessary medicines is the latest pandemic problem to occur in Brazil, which is experiencing a brutal outbreak of COVID-19 that has flooded the country’s intensive care units. The daily death toll is 3,000 on average, which accounts for a quarter of deaths worldwide and makes Brazil the epicenter of the pandemic.
“Intubation kits” include anesthetics, sedatives, and other medications that are used to put seriously ill patients on ventilators. The press office of the health secretariat of the city of Rio said in an email that the occasional shortage in the facilities of Albert Schweitzer is due to difficulties in obtaining supplies to the world market and that “replacements are made so that the assistance provided is not harmed ”. He did not comment on the need to tie patients to beds.
The newspaper O Globo reported similar ordeals on Thursday at several other hospitals in the Rio metropolitan region, with people desperately calling other facilities looking for sedatives for their loved ones.
It is unclear whether the problem seen in Rio remains an isolated case, but others sound the alarm about the impending shortage.
Sao Paulo State Health Secretary Jean Carlo Gorinchteyn told a news conference Wednesday that the situation was dire in hospitals in Brazil’s most populous state. On Thursday, more than 640 hospitals were on the verge of collapse, with the possibility of a shortage in a few days, officials said.
“We need the support of the federal government,” Gorinchteyn said. “This is not a necessity for Sao Paulo; it is a necessity for the whole country. “
State health officials sent nine requests for intubation medication to the Ministry of Health in the past 40 days, according to a statement Wednesday. His latest delivery was enough to cover just 6% of the state’s monthly public health network needs, officials told AP.
Federal Health Minister Marcelo Queiroga, who took office last month, said Wednesday that a shipment of sedatives was expected to arrive in Brazil “in the next ten days.” It is the result of a contract signed with the Pan American Health Organization.
He said two separate efforts are being made to acquire medicines in the international market “to end this day-to-day struggle”.
For many weeks, the ministry has also faced logistical restrictions when it comes to supplying oxygen to hospitals across the country. Queiroga said it remains “a daily concern.”
A more contagious variant of the coronavirus, known as P.1, has spread across Brazil this year. It can also be more aggressive than the original strain and health professionals have reported that patients need much more oxygen than last year.
The private sector has stepped up to help address some of the supply deficits. A group of seven large companies donated 3.4 million doses of drugs for intubation, enough to manage 500 beds for six weeks, to the Ministry of Health.
A first batch of 2.3 million was scheduled to arrive from China on Thursday afternoon at Sao Paulo International Airport and to be distributed to states with critical shortages, the ministry said in an email response to questions of the AP on the supply bottle necks.
Last month, the Ministry of Health confiscated drugs for laboratory intubation, according to reports, as a means to distribute them to the most needy hospitals. This has caused stocks of other facilities to dwindle, said Edson Rogatti, director of an association of more than 2,000 hospitals across the country.
“If we run out, the healthcare sector will be in chaos,” Rogatti told Globo News TV.
Scarcity is not limited to the public sector. The Brazilian private hospital association published a survey on Thursday in which nine of the 71 institutions reported having supplies for five days or less. About half said they had had enough for a week.
Private facilities are looking to import medicines from India, but still need regulatory approval, the association told AP.
The city of Itaiopolis, in the southern state of Santa Catarina, reported this week on a shortage of sedatives and oxygen. The neighboring state of Rio Grande do Sul also reported that supplies were running out.
“The situation is desperate,” Rio Grande do Sul health secretary Arita Bergmann said on Thursday. “We urgently need the Ministry of Health to replenish hospital stocks, or intubated patients may wake up without medication, and that would be terrible.”