• Direct: last minute of the coronavirus

The Ministry of Health of the Community of Madrid coordinates the health device in the region with the highest number of positive for coronavirus, 12,352 according to the latest balance, and where more than half of the 2,696 deaths in Spain since the start of this crisis are concentrated. . Enrique Ruiz Escudero gives an interview to EL MUNDO in the week in which it will be known if the restrictive measures adopted since the beginning of March are working.

Until when is the critical phase in the evolution of the coronavirus in Madrid to be prolonged? The forecast of the experts is that at the end of this week the famous peak will occur, that is to say that the number of new infections a day is less than that of the yesterday. It would be very good news epidemiologically, but from the healthcare point of view the scenario would continue to be just as committed. The challenge is absolutely healthcare: there are many cases that occur very quickly and strain the healthcare system. If the limitations on mobility in force had not been effective, would you support Madrid's closure? restrictions would not work, they would have to be tightened over time or with a more harsh measure. But you have to assess each day. Is the expected date for the number of hospital discharges to be higher than that of new cases is still April 15. Always from the point of view of caution, but if the peak occurred this week we could already pose that scenario, because three weeks will have passed more with containment measures that will be maintained until at least after Easter. In recent days we have seen images of hospitals with patients on the floor, in chairs in the hallway ... Will we have to get used to it? All the emergency services have a care burden that they have not had in their history and we apologize, but they have been specific images. As soon as we have the hospital fully operational in record time in Ifema, the situation will change. Will there be ICU beds for all patients who need them, who since the arrival of the coronavirus have already exceeded a thousand? Before this health crisis Publicly we had 540 ICU beds and now 1,400, the capacity of the system has almost tripled. But even so, we are prepared to activate all the necessary resources at Ifema because it allows flexibility when it comes to growth. Also in hospitalization, we have gone from 14,000 operating beds to 20,000. The response as a healthcare system has been absolutely impressive: from hospitals to retrain services, from professionals who were in other specialties to retrain ... Are patients with older coronaviruses or serious illnesses being evicted? Health has not given any instructions in this regard. I refer to what the intensivists themselves, with whom we have a daily communication, tell us: they raise the patient's situation, the underlying pathology he has and what the clinical scenario will be, and from there it is how they make decisions , but as they do with peritonitis or an invasive stroke. There are also cases of extubated patients, a message of hope must be sent. This Tuesday the Ministry of Health empowered the health authorities of the autonomous communities to "intervene" in the nursing homes. Is this measure late after they have been one of the sources of contagion? Initially, we planned to complement the residences with geriatric services and from there establish a response in the event that a residence had positive cases (...). We need information on how the situation is, if it is not very difficult to act. Are you in favor of the UME sending toilets to the residences, as claimed by the Ministry of Social Policies? It does not seem like a bad solution, but in Madrid there are 502 residences and The EMU's health response capacity is not the volume that is needed at the moment. We will have to look for different routes. How long will the medical equipment that will be imported in two planes from China last? It will allow us for three or four weeks to have enough clearance so that all the professionals are protected and without anxiety of if the gowns or masks (...). If another order has to be made again, we will. The communities have started to acquire materials after the central government centralized purchasing system has not worked. What do you attribute it to? I believe with absolute frankness that it was a lack of capacity. Because when you have the responsibility for healthcare management you are used to moving, the day-to-day care makes you open all possible ways to contact providers. If you have neither ways nor sources to bring material, what has happened happens. It has been a drama especially in the Community of Madrid, but it has happened in all the autonomous communities. In Madrid there are more than 600 infected toilets and 1,400 isolated in prevention. Is it because of the lack of personal protective equipment? There is also the contagiousness of the virus, not only in the work and social environment, but also in the family. Being in this phase of sustained transmission, determining where the contagion comes from is difficult, although when you are treating patients with coronavirus your exposure goes up, that is clear. But have they been unprotected? We have tried by all means to be with the necessary degree of protection. Surely there has been a situation in which they have been without the proper protection, it has also been a complaint from professionals from the first moment. They warned him and we have done a job of claiming the Ministry of Health and then we had no choice but to open our way to acquire, but we must continue bringing more. Are health workers with coronavirus symptoms being forced to work? There will never be such an instruction and I am not aware that in any hospital in Madrid today professionals with symptoms are forced to work.

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