The rapid increase in new daily cases has practically brought the capacity of ICU beds, especially critical ones, of the hospital network of the Costa Rican Social Security Fund (CCSS) to the limit.
Dr. Mario Ruiz Cubillo Ruiz, medical manager of the Fund, reported that this unprecedented increase in recent weeks is leading to the occupancy of ICU beds at occupancy levels never recorded during the entire pandemic.
Since the first person hospitalized for covid-19 in the country, critical moments have been experienced, said Ruiz Cubillo: the first was in September 2020 (627 patients), the second in December 2020 (644 patients) and this week 662 hospitalizations were registered , projecting to be the most critical of all the moments lived to this day.
It should be noted that there were 258 people in ICU hospitalization in September, in December 252 patients, this Friday, April 23, 285 people, and today, Saturday, April 24, we reached the worrying figure of 303 people hospitalized in the ICU for covid-19, said the manager.
Two of every 5 people hospitalized for covid have required intensive care. Dr. Ruiz explained that as of January of this year, patients remained hospitalized in the ICU for an average of 10 days. The more days the hospitalized people remain, the less availability of beds. Currently this stay has increased to 13 days. In the same way, he drew attention to the fact that people under 65 years of age present greater severity. 60 percent of people currently hospitalized in the ICU are between 30 and 59 years old. “This shows that the disease also presents complications in young people,” he pointed out.
ICU bed occupancy
The CCSS has 348 ICU beds and 607 in a room for covid care.
ICU beds are distinguished by level of complexity: critical ICUs that are divided into adult and pediatric. At the cutoff of this Saturday, April 24 at seven in the morning, of the 125 critical ICU beds for adults, 94% were occupied: 117 occupied, 7 free.
Regarding the pediatric critical ICUs, of the 5 enabled beds, two beds are occupied. Regarding severe ICUs, of the 207 enabled beds, 84% were occupied: 172 occupied and 32 free.
The manager said that last night the Fund analyzed in the hospital network the location of patients who required a critical ICU bed. The non-covid ICU beds also have a high occupancy, 85%, which significantly reduces the margin to expand a greater number of critical ICU beds for covid, explained the medical manager.
Ruiz Cubillo said without hesitation that “there is an imminent risk that in a very short term ICU beds will be exhausted, at this UNPRECEDENTED moment that we are experiencing growth in new cases.
And he affirmed that “the Fund has the ability to care for all people for covid and other diseases, but it does not have the ability to care for ALL AT THE SAME TIME.”
The manager was blunt in that to bring the system to its maximum capacity or even exceed it, “we would be writing one of the most painful chapters of the pandemic with the largest number of deaths, not only due to the severity of the virus but also due to the impossibility of resources hospitals required for care ”.
19-year-old patient transferred in critical condition.
A specialized first medical intervention team (Prime) of the Costa Rican Social Security Fund (CCSS) is currently carrying out the transfer of a 19-year-old patient with covid-19 from the Atlantic region.
This is the youngest patient Prime has transferred during the entire pandemic and it is performed due to his critical condition. The Prime team is made up of an emergency doctor, a nurse and a respiratory therapist who make the journey in an ambulance equipped for those cases of the Specialized Center for the care of patients with Covid-19 (Ceaco). According to the COV-19 Transfer Center, this afternoon the coordination with the centers involved was carried out, where the young person remains hospitalized and the one who will receive him to continue with the medical approach.
Pandemic is moving faster than in 2020 despite vaccination.
In 2020, the country took approximately 10 weeks to go from 400 new cases a day to more than 1,200, and this time it took three weeks to reach and even exceed that number, registering up to more than 1800 cases in a single day. This week “we reached the highest numbers both in positive cases diagnosed daily 9 133 in total and in the care of patients in intensive care beds, in total 303 beds occupied, approaching the maximum level of the capacity of the hospital network”, reported manager.
He added that the Fund has made all possible efforts to face the pandemic, “but the resources available are finite and there is no system in the world that can adequately respond to an accelerated increase like the one we are in today.”
Dr. Mario Ruiz was emphatic that “there is a limit and when we talk about hospital capacity for the pandemic it is more limited in terms of specialized human resources and ICU beds, and we are also dealing with the same resources to the increase in patients with severe diseases not associated with covid, patients with decompensation of their chronic diseases, traffic accidents, patients victims of violence, among others, who also require a hospital bed.
The hierarch was forceful in that the accelerated growth as we have experienced in recent weeks projects the demands on the health system close to its limit capacity, even with a significant probability of exceeding it.
“These projections estimate that the maximum capacity of hospital resources will be reached within the next two weeks,” he emphasized.