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In just one month, the profile of patients admitted to
ICUs
has changed: they are younger because the older ones are vaccinated, to which is added that the new
Covid
strains
have a faster course;
many attend the consultation in the morning and are admitted within a few hours.
This is how the president of the
Spanish Society of Intensive, Critical Medicine and Coronary Units
(SeMicyuc) recounts it,
Ricard Ferrer
, who assures that the new variants are influencing the severity of patients,
especially in the youngest
(those of 40 and 50 years) who arrive with a "very acute" clinical picture of the disease.
Ferrer recalls that before "patients went to the ward first, some improved and others went to the ICU" but that has changed dramatically due to the
predominance of the
highly contagious and fast-moving
variants
, especially the British one.
This intensive care physician and head of the ICU of
the Vall d'Hebron hospital
(Barcelona) is not given to making predictions but "logic indicates that with more
vaccines
and fewer restrictions", in the coming weeks the population in the
Intensive Care Units
will be the youngest, because it will be the unimmunized one.
At the moment, the average age is 62 years but in a few weeks this average will drop and the dominant group
will be in the 40s and 50s
.
Intensivists are also concerned about those under 35 who, although not many are admitted to the ICU at this time, coincide in a pattern of obesity.
There are also pregnant women who are infected with
Covid
in an advanced stage of pregnancy and who have to enter to receive close surveillance since breathing is very difficult and require monitoring care of the fetus.
However, despite this evolution to a younger profile, mortality in
ICUs
remains stable and remains at around 20%.
Ferrer
emphasizes that "it is very difficult for mortality to drop much more" given that it is a unit in which those who enter are at risk of death:
"There is no zero mortality
.
"
Although young patients have a better prognosis and more functional reserve, this has not been reflected in the death rate because, according to
Ferrer
, "we still have a mix of ages in ICUs."
In addition to the variants of the
Covid
, the intensivists confirm a lot of "social" transmission, which occurs "when the informality in the environment is jumped and
there are no super restrictive protocols
, nor good ventilation, nor people with masks spaced out."
And the saturation in ICUs due to this "progressive and contained" increase in infections reverts to a "generalized situation of surgical stoppage", he explains.
Despite this,
Ferrer
specifies that "we are not in a fourth wave. To say that would be exaggerated" and points out that the postponement of interventions follows
a "heterogeneous and irregular" pattern
, according to hospitals and autonomous communities.
To delay or not an operation is ultimately a hospital-to-hospital decision, he adds.
To contain the transmission,
Ferrer
appeals to maintain the restrictions and considers that if the
state of alarm
finally ends on May 9
, there will have to be alternatives that, in the case of hospitals, allow additional hiring such as retired personnel or contracts specific, only possible in an exceptional situation.
Therefore,
Ferrer
trusts that if the state of alarm declines, a royal decree will be approved that maintains the current facilities in hiring.
And in this situation he says that in hospitals the summer is already being organized so that "service can be given to everyone who needs it", but also so that health professionals can, this time, enjoy their rest period, for the first time since the start of the
pandemic
.
According to the criteria of The Trust Project
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