Armed Forces hospitals in Brazil leave up to 85% of beds unused without serving civilians – report

RIO DE JANEIRO, BRAZIL – After a TCU (Federal Audit Court) decision on March 17, the Brazilian Armed Forces opened, for the first time in the pandemic, the data on bed occupancy for patients with Covid-19 in military hospitals. The spreadsheets show that the Armed Forces blocked beds waiting for military personnel inwards and ICUs and that there are units with up to 85% vacant beds.

The TCU is investigating potential irregularities by the Ministry of Defense, the Army, the Air Force, and the Navy in not providing civilians with beds for Covid-19 in military health units.

These units used at least R$2 billion of the federal Budget in 2020, according to a TCU audit.

Auditors sustain that military hospitals should make agreements with SUS to expand services to the general population during this most critical phase of the pandemic when there is a general collapse of public health networks in the states.

According to the TCU, the reservation of vacancies for military personnel goes against the principles of human dignity and violates the constitutional duty of the State to offer universal access to health care.

The Ministry of Defense requested 10 more days to systematize the data, which was authorized by the plenary of the TCU on the 24th. After the deadline, the first spreadsheets with the information started to be published in the Armed Forces sites. The spreadsheets themselves register which beds are reserved exclusively for military personnel and their families.

Until then, the Ministry of Defense, the commands of the Armed Forces, and the direction of the HFA (Armed Forces Hospital), in Brasilia, avoided saying whether or not the units were opening spaces to civilians, given the collapse of the public health networks.

The newspaper Folha de S.Paulo requested information from HFA, Navy, Army, and Air Force, through the Access to Information Law, about the allocation of vacancies to civilians. The answers given by the first two institutions confirm that the beds are reserved for military personnel and their dependents and that no vacancies were opened to civilians in general.

At the HFA (Armed Forces Hospital in Brasília), only civilian employees of the Ministry of Defense are attended to. The hospital also serves President Jair Bolsonaro, Vice President Hamilton Mourão, and ministers of state.

The Army stated that its system is military-oriented, without saying whether it has made any exception for civilians. The Air Force asked for more time to respond.

Folha de S.Paulo found the spreadsheets with data about the occupation of beds published by the Aeronautics, Army, and HFA, published after the TCU’s determination, but not those of the Navy.

The Air Force lists 27 health units, of which 14 have beds reserved for Covid-19 patients. In almost all of them, there are no vacancies in ICUs, which are full, according to data updated on Monday (5). There is an exception: the ICU at the Aeronautics Hospital in Recife, where the occupancy is 71.43%.

As for infirmary beds, only three are 100% occupied. In other six, the rate is 50% or less. These are the cases of the health squadrons in Guaratinguetá (SP), Curitiba (PR), Natal (RN) and Lagoa Santa (ES), with occupation rates below 25%.

The clinical bed occupancy for Covid-19 at the Canoas Aeronautics Hospital (RS) was 41.67%. At the Aeronautics Hospital of Manaus, it was 50%.

The Army disclosed the general availability of beds, not only for Covid. According to the force, 23 health units have 366 beds, a third of the total. In 14 of them, the general occupation is 50% or less.

The biggest idleness, according to the Army’s spreadsheet, are in the Hospital de Guarnição de Florianópolis (13% occupation), in the Hospital Geral de Curitiba (19%), in the Hospital de Guarnição de Marabá (PA) (22%) and in the Hospital Geral de Juiz de Fora (MG) (26%).

In the case of ICUs, there is a scenario of overcrowding. Nineteen Army military hospitals offer 217 beds, and only three do not have 100% or more overall occupancy.

At the Hospital de Guarnição de Marabá, there are two vacancies and both are free, according to the Army. At the Manaus Area Military Hospital, overall occupancy is 33%; there are six active beds for Covid-19 patients. And at the Hospital de Guarnição de Porto Velho, there are four vacancies, all free.

The administration of Covid-19 beds in the Army’s military hospitals is part of the so-called Operation Apollo, whose actions are managed by the General Staff Department.

The head of the department is General Paulo Sérgio de Oliveira, who was appointed last week to the post of Army Commander, after the resignation of the current commander, Edson Leal Pujol.

At the HFA, almost all the 40 ICU beds are occupied with Covid-19 patients. The published rate is 97.5%. The beds in the infirmary are 57.1% occupied, according to an update made by the hospital on Tuesday.

Of the patients who are in infirmary (there are 70 beds), 10% are on a waiting list and are waiting for an ICU spot, according to the HFA. Part of the beds in the infirmary are for patients who have been discharged from the ICU.

According to the Ministry of Defense, regarding the HFA, the number of ICU or clinical beds is not constant and adapts to demand. There is no idleness and there is high turnover, the ministry stated. “This happens not only in military hospitals but also in public and private hospitals,” it said in a statement.

“The information about the occupancy rate refers only to the data of the current day, because any number or percentage related to the availability of beds that is wrongly disclosed may build an uncertain scenario, which does not match this reality that changes all the time,” it said.

The ministry said it has provided all the data to the TCU, based on the determination made. “The military hospitals have a limited number of beds, just like the public hospitals. These data are available on the Internet and can be accessed, in an unrestricted way, on the HFA and Armed Forces websites.”

The percentage of active duty military personnel infected with the coronavirus because they are on the front lines exceeds 13%, a figure higher than the national average, according to the note.

“This high number, added to the large number of dependents, military reserve, retired and pensioners, usually of quite advanced age, who are cared for by law, has kept the health system of the Armed Forces and military hospitals at the limit of their capacity, as in the rest of the country,” said the Defense Ministry.

Source: Folhapress