RIO DE JANEIRO, BRAZIL – The director of the largest reference center in the treatment of coronavirus in the State of Bahia, infectologist Roberto Badaró, said yesterday that 40 percent of deaths recorded at the Espanhol Hospital as Covid-19 are caused by other diseases.
After six years of closure, the Espanhol was reopened by the government of Bahia in April as an exclusive treatment facility for the novel coronavirus, with 220 beds, 140 of which in ICU, in a R$8 million investment.
“I will offer a simple example: at Espanhol Hospital, 40 percent of the patients I get do not have Covid. And they die. And on the death certificate is written: Covid. Because there are three fields on the death certificate. A patient comes in with suspected Covid, so he or she is included in the statistics. This needs to be looked at very carefully.”
The statement was made during a live interview on Radio Metrópole FM on Thursday. Badaró answered a question asked by host Mário Kertész about the reasons why the records of coronavirus cases in Brazil are five times higher than in India, a country with a population almost seven times greater than Brazil. “And what do these people die of?” Kertész asked. “What have they always died of. Of strokes, cardiovascular diseases, diabetes,” he replied.
The Health Secretariat of Bahia (SESAB) published an official note on its website, in which Badaró changed his version and said that the statement made on Radio Metrópole does not reflect reality. “I have come to publicly say that the way I expressed myself does not correctly reflect what happens at Espanhol Hospital,” he said.
“It’s not correct to say that deaths are wrongly recorded as Covid-19. In fact, all deaths at the Espanhol Hospital are endorsed by the medical coordination. If a death occurs, it is the hospital’s obligation to issue the Death Certificate (DO), to include the corrected cause of death rather than maintaining the suspected diagnosis on arrival,” the director said.
According to him, the procedure followed by the hospital can be corrected later by the authorities and the suspected deaths are not included in the SESAB’s figures. “In the event of a death occurring before a laboratory result, the DO will be issued as “suspected Covid-19″ and can be corrected postmortem by the state health authority. In this scenario, it should be noted that Epidemiological Surveillance, in an assertive manner, only counts death certificates classified as suspected cases of coronavirus after investigation and/or laboratory results have been confirmed”, he justified.
Family requests
Also during the interview to Radio Metrópole, the chief researcher of the Senai Cimatec Institute of Health Technology and member of the Committee of Governors and Experts of the Northeast against Coronavirus stated that the diagnosis for Covid-19 has been used as an alternative by relatives of patients of other diseases to find ICU vacancies.
The infectologist even mentioned the example of a diabetic woman whose glycemic index was over 1,000, but the family appealed to him for a position in the ICU because her sister would have contracted coronavirus. “She was suffering from diabetic ketoacidosis, she then went into respiratory failure and was intubated. Is that Covid? It’s not. But in order to get access to an ICU, she puts down Covid and goes to the hospital.”
“So I have a really hard time, I’m being very honest, to understand this mortality data, if they’re purely Covid. When patients aren’t infected by Covid, they come to an ICU and are left behind. They will be attended to later, if they are not directly suspected of having respiratory distress,” he added.
Later, in the same note released by the SESAB, Badaró praised the work of health professionals and the action of the state government. “I want to reiterate my respect for the exquisite work that has been conducted by the State Government to open ICU vacancies throughout the State. I also commend the effort of the Central Regulation professionals, who have been working with the UPA and regulating patients to hospitals in record time, preventing deaths due to lack of adequate assistance”, he said.
Badaró said patients need to be seen, even if they are not confirmed for Covid-19. “Not all patients admitted to hospitals will have the PSTN result confirmed before admission. Therefore, a portion of hospitalized patients will not have a confirmed diagnosis until the Central Public Health Laboratory (Lacen-BA) results are received. It is up to the reference hospital, which takes in the suspected patients, to investigate, treat and refer the case appropriately”.
Repercussion
For urologist Modesto Jacobino, Badaró’s statements are serious and need to be ascertained. He notes that doctors who make false statements to cover up the true cause of death are committing the crime of wilfull falsehood, which in addition to the penalties provided in Article 229 of the Criminal Code, can lead to the cancellation of their professional license.
“Badaró did not speak of one or two percent, he spoke of 40 percent. This represents a large contingent of families stigmatized by an illness that does not entitle them to visit their loved ones in hospital, to mourn their bodies at a common funeral and not even to be paid life insurance since insurance companies refuse to pay because it is a pandemic. It’s a situation that has very dramatic consequences for the victims’ families, a police case,” he said.
Jacobino lodged a complaint with the CREMEB (Regional Medical Council of the State of Bahia). He believes the case warrants a thorough investigation, beyond the scope of the Espanhol Hospital, which investigates whether or not there is any guidance for intensive care physicians in Bahia to fraudulently attest to coronavirus deaths, as was reported by the Ceará physicians’ union to the Prosecutor’s Office.
This allegedly occurred with retiree Antônia dos Santos, 98, who died on May 19th. “My grandmother had no fever, she was not coughing, she had a 7.5 cm diameter mass in her intestine that produced blood in the stools which was detected by ultrasound, and nevertheless the doctor wanted to declare that she had died from coronavirus,” says receptionist Gabriela Silva, 35. “It was almost half an hour of arguing with our family before she decided to reverse the decision and declare that the cause of death was acute respiratory failure.”
The doctor and city councilor Cezar Leite announced through social media that he had lodged an inquiry petition with the Federal Prosecutor’s Office and the CREMEB to investigate the Espanhol Hospital and other hospitals in Salvador. “As a city councilor, a doctor and a citizen, I have the duty to inspect and ask for transparency in this process. We must not forget that we are dealing with lives and public money,” he said.