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- Congress: Entrepreneurs of nursing homes denounce that they asked the ministers for help and only received reproaches
Nursing homes without doctors and nurses, without protective material, without tests, without respirators, without the possibility of referring patients to hospitals. Nursing homes that received "changing instructions" from administrations.
Nursing homes with "three times as many sick leave" as health personnel.
Nursing homes that in early June remain "undiagnosed by all residents and workers."
Nursing homes to which the autonomous communities sent Personal Protective Equipment (PPE) in a "sporadic, insufficient and disorderly" manner.
Nursing homes that had corpses because the funeral homes were not going to pick them up.
Nursing homes that did not get a response from some ministries or a simple acknowledgment from others.
All the quotes and some more are in a report from the Business Circle of Attention to People (CEAP) dated June 5 and in the words of its president, Cinta Pascual , in an interview that she gave EL MUNDO this Saturday.
The president of the employers' association for private residences on Friday amazed the deputies of the Commission for the Reconstruction of Congress with an account from the report that denounces the situation experienced in the harshest weeks of the coronavirus pandemic. But the time he had as an appearance did not allow him to retract the entire 45 pages of the document, which illustrate, data by data, something that he did express at the parliamentary headquarters. "It was a horror."
- The report is devastating. It draws a feeling of helplessness in the face of a tsunami of deaths, lack of material, conflicting instructions, and administrative silences. A kind of clamor in the desert.
- In many residences, there was a lack of personnel because they were taken away by the health system, which paid more, or because they were even discharged by telephone without taking the test. There was no oxygen, no test, no protective material. Foreign doctors with degrees but no legal residence were not hired. We are faced with ethical dilemmas in administering morphine to some elderly people wondering if otherwise it might have been done differently. We requested meetings and material and they did not answer us or told us that they understood us but nothing more. We ask for meetings with Pedro Sánchez, Pablo Iglesias and Salvador Illa. We call Moncloa, Vice Presidency, Health, Defense and Migrations. What we did was ask for help. The pandemic is happening, but it is not over. But what I can say is that there were 25 or 26 days of hell.
- Tell me one.
- We began to meet residents who had passed away and were still in the residences. One day I called the director of one of the best funeral homes we work with and asked why they didn't come to pick up the deceased. And he replied: 'Because I do not have protective equipment to send my people to collect corpses. I cannot send them without any measure of protection. ' Neither the doctors came to certify the death, nor the funeral homes to collect the deceased. Everything was overflowing.
CEAPS brings together more than 1,800 residences, a network of 90,000 workers and around 200,000 of the 380,000 places that exist throughout Spain. In other words, more than half of the elderly who live outside their homes are in the residences represented by Cinta Pascual, 67% of which are managed by small and medium-sized companies.
Seven out of 10 deaths from coronavirus have been elderly, much of whom lived in residences. The analytical report of management in residential centers in Spain during the Covid-19 denounces the "abandonment of the administrations" to this residential and collective world on which the pandemic was fathered.
For example, when referring sick residents to the hospital. "Although it cannot be demonstrated that there has been a systematic exclusion from emergency room care , it is seen as a consistent and reiterated behavior during the months of March and April."
CEAP President, Cinta Pascual, on Friday in Congress.EFE
Thus, the document cites orders from Castilla y León to attend residents "without the need to refer them", providing the residences with "personnel, oxygen therapy, venous antibiotic treatment." It also refers to the "exclusion criteria" for hospital referral that the Community of Madrid initially established: "Subsidiary patients for palliative care, patients with criteria for cancer terminology, patients with neurodegenerative terminology and patients with severe functional impairment plus moderate cognitive impairment."
And he suggests that the referral protocols of the Valencian Community "could exclude many of the residents due to their profiles, such as level of dementia, previous illnesses or life expectancy of less than one year.
"There are no data that demonstrate that the hospital referral of all residents who needed it and to which they were entitled would have reduced the number of deaths. There are, however, that in the circumstances in which they occurred and with the symptoms they presented, under normal circumstances, a high proportion of residents who have died in nursing homes would have been transferred to hospital emergency services. "
- To what extent did the collapse of the health system influence?
- It was decisive. The big question we ask ourselves is: Could the lives of those who did not move to hospitals have been saved? In cities where the system was collapsed they were not moved. And we couldn't do that. It was a political decision. I am sure that no one wanted not to help, no politician wanted no one to die. But you cannot leave the sick in the residences if you are not going to bring personnel, protective equipment, droppers, masks, tests ... Ethically you come to a conclusion.
- And what is that conclusion?
- That there was a screening of the population. The system was collapsed, there were no beds for everyone and it was decided for whom and for whom not.
- It is a very strong statement ...
- It did not happen every day, nor in all of Spain, because not all of Spain was collapsed. But it happened. It was a horror.
The CEAP report says that the State "prioritized" the delivery of protection material (PPE, masks, gloves, gowns, disinfectant gels, screens) to hospitals, but that "it did not comply with the protocol of supplying these equipments to the residences" because the hospitals themselves "did not have enough for themselves."
"Desigual" test cast
Remember that the High Court of Justice of Madrid forced the community to deliver PPE to staff of the residences in a judgment of April 13. And that the Valencian Community or Andalusia knew the lack of material and shortages from the first and second weeks of March.
It also ensures that the delivery of tests for the detection of infected persons was "uneven", that urgent requests for remittances of diagnostic tests were neglected and that today there are communities such as Castilla-La Mancha, Aragón, Castilla y León or Madrid where they do not General tests have been carried out on residents and workers. And that in no Spanish residence have "periodic tests" been carried out on all employees and users.
- What did you do without protection material and without test?
- On March 19 we urgently requested the supply of equipment, warning that the system would collapse that same week. We had no response. The next day we made a massive request for masks confiscated by the Ministry of Health. On April 3 we urgently asked for a test. And on May 6 we made an urgent request for supplies. We spoke with the autonomous communities and they told us that this depended on the ministry. And we talked to the ministries and they didn't tell us anything or that they understood us. In the absence of answers, we tried to buy in the market.
- What happened?
- At the beginning of April I had a very hard meeting with our managers from different communities. I told them that the situation was like a war in which we had no weapons, we were not protected, and that we had to find suppliers and make a massive purchase of material. We located a Spanish supplier who worked with China and filled a plane with masks, gloves, gowns, tests ... On April 1, the provider called us saying that the plane was at El Prat airport and that it had the OK of the Government. But the days passed with that paralyzed and on April 9 the single command decided to send all that material to other parts.
The report of the CEAPS Health and Public Health Working Group affects the lack of personnel suffered by the residences for two reasons: they were taken away by the health system or suffered many sick leave.
- You did not do anything to replace it?
- We do not stop warning and suggesting solutions. The health system of the autonomous communities paid more. Also, sometimes, our staff would be discharged over the phone. The worker called the health center saying that he was in contact with people who could have Covid and told him not to leave home in 15 days. Without even testing him. There were three times more casualties than among health personnel. On April 15, I managed to speak on the phone with the Secretary of State for Migration to ask her, as it had been done with the shearers, to allow Latin American toilets who had a degree but no residence permit. It seemed reasonable to him and he told me to speak to a person in the specific area. I spoke to him, he also thought it appropriate and asked me to send it to him in writing in an email. I wrote an email and still have no answer.
- If you had to choose a moment of relief and a moment of pain, what would they be?
- The best was getting a referral from a resident after seven hours of negotiating with a hospital. In the end, at 1.30 a.m. they admitted him. A month later he returned to the residence fully healed. There are no words for that joy. The worst ... See a doctor, on a very quick visit, not like the usual ones, enter room after room and say: 'Morphine, morphine, morphine'.
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