In Spain, third wave of Covid-19 forces some hospitals to cancel surgeries

The surge in coronavirus cases in Spain is starting to have an impact on hospitals’ ordinary activity. The clearest case is the Valencia region, where non-essential procedures including diagnostic tests and surgeries are being cancelled in order to focus resources on Covid-19 patients. In Catalonia and Galicia, hospitals are also feeling the strain and have begun to cancel procedures that are not considered vital.

“The forecasts are very bad, and the direction of the epidemiological curve is nearly vertical. If things keep going this way, in 15 days the hospitals will no longer be able to cope,” warned Javier García Fernández, president of the Spanish Anesthesiology Society.

We are concerned and low in spirits: this is looking a lot like the first wave

Miriam Rubio, nurse from Segovia

Healthcare workers consulted by this newspaper agreed that the outlook is gloomy. “We are concerned and low in spirits: this is looking a lot like the first wave,” said Miriam Rubio, a nurse in Segovia.

Covid-19 hospitalizations have grown 69% since Christmas and coronavirus patient occupancy of intensive care units (ICUs) has risen 44% during the same period.

Extremadura, which has the highest incidence rate in Spain (1,131 cases per 100,000 inhabitants over the last 14 days), has not suspended any hospital activity yet, but “the possibility is being considered” in some health areas, according to a spokesperson for the regional government.

In Madrid, despite an incidence rate of 627 cases per 100,000, hospitals have so far not had to reorganize their planned procedures. Recent delays in operations have been mostly caused by the snow storm.

Valencia

In the Valencia region, by contrast, the executive has issued orders to cancel non-essential procedures, to prepare more beds for an expected rise in patients, and to have around 280 beds ready at field hospitals for milder cases who will be sent there if hospitals become overwhelmed.

Meanwhile, around 35 non-coronavirus patients have been transferred to private facilities, and the public hospital in Elche (Alicante) has emptied its chapel in case it needs the space for additional beds.

The Mediterranean region has a 14-day cumulative incidence rate of 609 cases per 100,000 people, far above the Spanish government’s extreme risk threshold of 500. And 45% of its intensive care beds are now occupied by Covid-19 patients.

Catalonia

In Catalonia, the situation differs from hospital to hospital, but all those consulted shared the same concern about imminent saturation. “We are pretty stretched, but for now we have not deprogrammed anything and we will try to hold out as long as possible. If this pace keeps up, we’ll have have to deprogram [procedures] in a few days or next week,” said a spokesperson for Clínic Hospital in Barcelona.

At Vall d’Hebron hospital, all activity is still underway, but at Sant Pau, which has around 30 Covid-19 patients in intensive care and 88 more in regular care, non-essential procedures were cancelled on Wednesday.

Hospital del Mar’s ICUs are full of Covid-19 patients and three operating rooms have been closed because workers need the post-surgery equipment for critically ill patients with other ailments. At Girona’s Trueta hospital, four operating rooms are closing in the afternoons.

Other parts of Spain

Galicia’s regional premier, Alberto Núñez Feijóo, said that hospitals have not been significantly affected by cancellations of elective procedures.

The Basque Country is in Scenario 3 of the region’s contingency plan for ICUs, which means that “human and material resources are being prioritized,” said a source at Osakidetza, the Basque healthcare system. “Elective surgeries are being done, but fewer of them.”

In Andalusia, the Clínico Hospital in Málaga is getting more ICU beds and a specific area for Covid-19 inside the emergency room. Hospitals in Cádiz are focusing on surgeries requiring fewer than three days’ stay, and on outpatient procedures.

With reporting by C. Vázquez, M. Ormazabal, I. Valdés, E. Saiz and L. Tolosa.

English version by Susana Urra.