Flu epidemic hits medical centers: “Emergencies are fully saturated” | Society

Sanatoriums cannot cope with the seasonal epidemic of respiratory viruses. At the end of 2023, the flu returned with a vengeance after several seasons of abnormal behavior caused by the coronavirus. And he joined covid, which, although with less impact and virulence, is also present in consultations interrupted by high patient demand and staff depletion due to the Christmas holidays. “Non-hospital emergency services (in outpatient clinics) are completely saturated,” sums up Lorenzo Armenteros, spokesman for the Spanish Society of General Practitioners and Family Physicians (SEMG).

The latest epidemiological data published by the Carlos III Institute of Health refers to the week before Christmas Eve. By that time, there had already been an increase of more than 100 points compared to the previous one in the incidence of acute respiratory infections in primary care: from 806 cases per 100,000 inhabitants to 916. And everything indicates that at a later date, with celebrations and family gatherings between them continues to grow strongly. New data will be published this Thursday, but experts expect the number of infections to continue to rise in the coming weeks, peaking in the second half of January.

Doctor shortage

Despite the predictability of these winter waves, history repeats itself with greater or less force every year in medical centers, amid chronic shortages of specialists that the pandemic has exposed and which shows no signs of being resolved. The Ministry of Health itself, in a report a year ago, admitted that there were a thousand fewer family doctors than in 2018. retirement, which seems very difficult, since the conditions and salaries offered by autonomous communities in medical centers force many specialists to work in hospitals or abroad.

Entrance to the Abrantes Medical Center in the Carabanchel neighborhood of Madrid, this Wednesday.
Entrance to the Abrantes Medical Center in the Carabanchel neighborhood of Madrid, this Wednesday. Marshal (EFE)

In Malaga, where Leovigildo Ginel, a member of the Spanish Society of Primary Care Physicians (Semergen), serves, this Christmas they broke the record for patients arriving without an appointment: 178 in one day. The four doctors who were working joined those who were already on their agenda. “More than 60 to 70 percent present for the same thing: respiratory symptoms,” Guinel says. Most of them are influenza, the incidence of which is twice that of Covid. Both join other pathogens with similar symptoms that are usually undetected.

Most health centers do not carry out tests to determine what kind of virus it is, and this is reserved for so-called “sentinels” that serve to measure the impact of the epidemic in the country. Treatment, regardless of the virus, is also the same for people without underlying conditions. Good hydration and paracetamol to relieve discomfort. This is what doctors generally recommend, in addition to taking precautions to avoid infecting vulnerable people.

For this reason, Armenteros urges people who are not at risk not to go to a health center at the first symptoms: people over 80 years of age, people with underlying health conditions or those with weakened immune systems. “Don’t be scared, you need to give a reserve of 48 hours to see how the symptoms develop, take an antipyretic or anti-inflammatory in small doses and see what the situation is. If the condition has not improved during this time, medical attention is also not required; “It should be reserved for more severe symptoms such as shortness of breath (feeling of suffocation), fever lasting more than four days, worsening respiratory illness, change in mucus color…” Armenteros lists.

One of the problems for many patients is that they need a medical certificate confirming their sick leave. “Here we have a very strong service sector in which remote work is not possible. Ideally, there would be something like what other countries are doing and what we have been demanding for some time: a responsible application by the patients themselves for sick leave, which lasts no more than three or four days. This will partially prevent oversaturation of medical centers,” says Guinel.

This Wednesday, two people leave the Abrantes Madrid Primary Health Centre.
This Wednesday, two people leave the Abrantes Madrid Primary Health Centre.Marshal (EFE)

Armenteros said this wave of flu could be mitigated by higher vaccination rates and greater enforcement of the safety measures society has taken during the pandemic, such as the use of masks and air filtration systems. Data on the vaccination campaign throughout Spain is not yet known, the Ministry of Health will publish them when the season ends. But Armenteros believes coverage has been “low”, including among children who report the majority of cases, despite the first launch of a mass immunization campaign for children under five in 2023.

This is supported by data such as that provided on Tuesday by Catalonia, where only 46% of the population over 60 have received a jab, although the target was to reach 75%. In the Valencian Community, Health Minister Marciano Gómez urged the population to get a dose and also announced they were considering a return to mandatory mask wearing in health centers amid rising infections.

Are we facing a more dangerous epidemic than in previous years?

Most of the viruses circulating this season are influenza A, which usually leaves more severe symptoms than other variants. But it is still a well-known pathogen. Judging by the data that has been published so far, Spain is not facing an extraordinary situation.

José Maria Eiros Buza, director of the National Influenza Center of Valladolid, explained last week that “we are seeing a general situation” in the northern hemisphere at this time of year. “Influenza is an infectious disease that occurs during the autumn and winter months, associated with weather conditions and overcrowding. “As a message to people who may be infected, it is not the same whether they are a healthy person without any underlying pathologies who can survive without going into the health care system than people with fragile health or the elderly.”

It is the latter who usually require hospital care due to respiratory viruses. Incomes are growing, but the situation in hospitals is far from the situation in medical centers. Antoni Torres, member of the respiratory infections department of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), emphasizes that the collapse occurs in primary health care, since the vast majority of patients are not serious. “We already have some income, but it’s still small. We will see the data after the epidemic ends. There are still dates of great overcrowding and infections,” he concludes.

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