Dear friends from Sarasota, Florida fans of this humble blog because I know how interested you are about the public health situation in Cuba. Currently the situation on the island, according to what they communicate to us by messenger from Santiago de Cuba and Guantanamo, my wife's relatives, is very difficult, every time a pregnant woman dies of coronavirus and in my opinion this is due to the impossibility of obtain credit and make purchases of hospital and pharmacy supplies, the Ministry of Public Health is depending on donations from countries like China that every time send a plane with medicines. It is a very difficult situation because they are only guaranteeing medicines for thousands of infected children.
Pregnant women, be wary (+Video)
CAMAGÜEY.- The increase in cases of pregnant women suspected or positive for COVID-19 impels the health system in the province. The diagnosis of 154 pregnant women in the month of August increased tensions in the Red Zone, and points out as an urgency to transform the complex situation with the best therapeutic weapon that continues to be prevention.
Photos: Alejandro Rodríguez Leiva/ Adelante
From the window of his room on the second floor, he scolds him for lowering his nasobuco when speaking. He is upset because they don't want to receive the jaba before 11:00 a.m. At his side, a gentleman stokes wood to the fire: "How is the food?" She responds with her hands in the form of a narrow circle.
That man put the car from the municipality. It is known by the key with which it "cleans" its teeth. He has just had a snack and suggested cookies for the young woman from the timbiriche opposite.
The scene happens on 1st Street, a few steps from the metal door. There you can access the Centennial Hospital. Since June 17, it has been operating as an isolation center for pregnant women suspected and positive for COVID-19. Patients spend a few days. Health personnel endure the three months.
IN RED ZONE
If the man with the key in his mouth and the future father tried to imagine the stories of those who care for his sick girl, maybe we would come across a different scene. They would appreciate the joy of having Dr. Eduardo Arsenio Rojas Pérez.
Every day, in the "Centenary" the visit pass is made by Obstetrics and Internal Medicine. The individualized treatment of the 49 patients located in four rooms depends on the comprehensive evaluation. The clinician Saadi Al-Azzawi Abreu participates in this team. In the photo we see Dr. Eduardo Arsenio Rojas Pérez; next door, Thais Aimee Dip Triana, resident in Obstetrics; and in front, Zeida Alfonso Maza, graduated in Nursing.
"They say that he is expert, therefore, he must take care of himself. How healthy is the work in the Red Zone for you?
"It's true, I've been on the fence since 2018. Working so many hours standing caused me a deep vein thrombosis, which led to surgical treatment. It limited me to only eight hours of work. Even so, I have always given my disposition. At first it was with patients suspected of COVID-19, before these three months in the same Centennial Hospital.
Dr. Eduardo graduated as a doctor 27 years ago. Four years later he became a specialist in Gynecology. Then he added the Master's Degree in Comprehensive Care for Women, the category of Assistant Professor and is an aspiring Researcher.
"Residents, nurses and service personnel work 24 for 72 hours. I am as a specialist from Monday to Saturday for eight hours, and on Sundays I go from home to organize the work on Monday," he adds before ensuring rigor in protecting himself. Every 14
days they are PCR.
—Since COVID-19, what changes and what remains in the care of pregnant women?
—Protocols for obstetric follow-up are maintained, with changes in the management of patients, both pregnant and puerperal positive for COVID-19. With the positive antigen kit, the "Centennial" is entered for medical treatment and confirm the diagnosis by PCR.
"From what you have dealt with, what do you attribute the increase in cases to?
—To the non-protection of them or of the members of the family. And I think it may be related to asymptomatic cases, especially those with more than 21 days after the third dose of the vaccine. That is why I advise leaving home only for a scheduled medical consultation, with all the means of protection. Inside the home, the nasobuco should be used and distancing from pregnant women, puerperal women and newborns should be maintained.
HOSPITAL MANAGEMENT
From my head does not come the gesture of the hands to suggest little food. "They receive the diet they need, but they say they are not filled," says Tatiana Hernández Hernández, deputy director of Medical Assurance at the Ana Betancourt maternal hospital. She is also the mother of an eight-year-old boy.
"We had to limit the number of beds of the 'Materno' to create an isolation center in the 'Centenario'. At first they
were transferred to the Amalia Simoni hospital. Then the Cardiocentro of the Manuel Ascunce provincial hospital was established, as a therapy for clinical evolution or obstetric situation, "he says.
The increase in cases during August, mainly from Florida and Vertientes, motivated the fear of being left without enough beds. Hence the agility in foresight and the search for solutions.
"The 'Centenary' functions as a center dependent on the 'Materno'. We started with 41 beds, expanded to 49, but it has been necessary to create other places. In the School of Nurses we started with 34 capacities, and we must reach 60. For the most complex we have 28 beds in the Cardiocentro, where we guarantee gynecobstetras, neonatologists, intensivists and residents, together with the specialists of the 'Provincial' who work on ventilated and critical cases, "explains Dr. Tatiana.
In the most complex enter the emergencies, the criticisms, the pneumonias by COVID-19 and the births of positive patients or still affected by its sequelae.
"Re-entry has not been characteristic. Yes, many of the patients with torpid evolution of the disease, who have been in the Cardiocenter or in the therapy of the Provincial Hospital, present a pneumonic picture due to sequelae. When they are better
they move here, but it has not been typical," he says.
Dr. Tatiana is a 32-year-old tunera. He became a specialist in Pharmacology in Camagüey, and here he stayed. Since December she has served as deputy director, and dreams, when possible, to devote herself to teaching. Meanwhile he suffers from the evils of indolence, also pandemic.
"We have had positive ladies with a two-year-old baby, and they are pregnant, mothers with newborns in their arms. The deceased with COVID-19 and post-COVID-19 hurt us. I'm talking about puerperated people who leave their children, or who don't get to know them. It's hard for people who are giving it our all every day. The losses for the family nucleus are often never overcome," he concludes.
LIFE IN NUMBERS
According to their accounts, during the last trimester, 35 babies were released in the Cardiocentro, of them, 32 by cesarean section. At that time, 366 pregnant women entered the "Centenary", and 328 graduated.
At the point of a pencil they carry a lot of data in the
Department of Medical Records of the "Materno", where Dr. Ta- tiana can be found when she does not meet or supervise the "Centennial".
In that office works Odalys Plaza Luaces, voice very expected by his parts of births through Radio Cadena Agramonte.
"Yes, we have felt fear but we have to give the
information," explains the second of the department where outpatient consultation is controlled, births, hospital infections, blood bank, transfusions, coding (how the clinical history is treated), hospital movement (admission and discharge) and vaccination, among other matters.
"There has been an increase in COVID-19 in births and pregnant women in these three months. Let's think that later, because of vaccines, there are fewer patients with diseases. This is the time of rise of births, of a lifetime, "says the graduate in Statistics, with papers in hand, from where she gets the record of about 970 newborns, born from June to the end of August.
The average per year is around 5,000 babies.
COMMUNITY IMMERSION
We lacked an edge to address the issue in question, which is neither in the hands of the "Materno" nor the "Centenario", nor the Cardiocentro. It's about the beginning of the problem, there in the community. Where are the prevention actions going? In this regard, says
obstetrician Jesús Sayú Romero, from the Maternal and Child Department of the Provincial Health Directorate in Camagüey.
"Pregnancy is a thrombotic state per se, and in addition, to accept it, women of childbearing age are immunosuppressed. COVID-19 takes advantage of that, according to recent studies in placental cells. On the other hand, it hits hard the
social indiscipline, the non-perception of the risk of the families of the pregnant women".
—In meetings it was said that they would give Nasalferon to all and enter homes that could not keep their distance at home, was it applied?
—There was a survey of the total number of pregnant women to offer Nasalferon to all in the third trimester, and to contacts of positive, suspicious cases. They will not be entered into the home under any circumstances. Institutional admission under the supervision of health personnel is protocolized.
—What is the protocol with pregnant women in the community?
—It is aimed at prevention through emerging measures. It implies the admission of pregnant contacts of positive cases, that of all from 26 weeks with comorbidities such as hypertension, diabetes mellitus, bronchial asthma, obese, extreme ages. In addition, the vaccination schedule with Abdala was fulfilled. Treatment is performed with antiplatelet agents such as Aspirin 81 mg, Clopridrogrel 75 mg, Fraxiheparin and bandages and elastic stockings.
"During 2020 there were not even serious or critical maternals for COVID-19. This year we have had an increase in severe forms of the disease since mid-June. Teams were created for the care of critical maternal care for COVID-19. Many times the result was not satisfactory, so families have lost a loved one in this long-awaited state of life. We call for alert to the population of childbearing age, pregnant women and mothers with infants. They must take extreme protective measures."
The recommendation of Dr. Jesus brings back to mind the scene of the girl leaning out the window, and the recklessness of the two men annoyed from the street. They, at no time, applied hypochlorite or alcohol solution to the hands with which they lowered and raised the nasobuco to rezongar or take to the mouth the key of the car.
Moral: to incredulous relatives, pregnant women more suspicious of all. Be suspicious.
No comments:
Post a Comment