Belo Horizonte Physicians Issue Letter Alerting to ‘Surge’ of Covid Hospitalizations

RIO DE JANEIRO, BRAZIL – The first wave of Covid-19 in Belo Horizonte has not yet been overcome, but a second peak of the disease may be approaching. Over the past three days, the number of hospitalizations of critically ill patients with the novel coronavirus has increased by 20 percent.

Specialists fear that the capital will once again face a critical scenario of the disease, with a surge in deaths. As a result, intensive care doctors have released a letter, which is going viral on social networks, alerting the population to the situation in healthcare facilities.

Head of the Intensive Care Center (CTI) of the Vera Cruz Hospital and the Minas Gerais State Servants Pension Institute (IPSEMG), Rogério Sad reports that after a period of stabilization of the disease, the number of infections has increased again in the past ten days.

“And this week there was a significant increase in ICU hospitalizations. Recalling that the patients who go to the ICU are more critical and, therefore, have a higher mortality. As infections increase, there are more patients and more deaths,” he emphasized.

The growth of hospitalizations, according to the specialist, is due to irresponsible relaxation, on the part of the residents, of the sanitary safety measures capable to contain the spread of the virus. Crowds, abandoning the wearing of masks and inadequate hand hygiene are among the risk factors.

“People think that the pandemic is over, but it is here. Although the situation was under control in recent weeks, from the standpoint of stabilization, the first wave has not yet passed. So we may have a second peak within the first wave,” explained the doctor.

In the letter, signed by several intense care physicians in the capital, they report that the pressure experienced in the healthcare system can translate into deaths.

“It is important to note that at the peak we had 20 deaths per day by Covid-19 in the city and that in recent weeks we had succeeded in lowering this number to about five deaths per day. If we fail and go back to the numbers we observed at the peak in July, we will be condemning 15 more people to death per day,” they observe.

Confirmation of the disease

According to Hermes Pardini, which controls over 5,500 laboratories in the country, the number of positive coronavirus infection tests in private laboratories in Brazil increased by 25 percent in the first half of November compared to the first two weeks in October. In the same period, the demand for tests increased by 30 percent.

The São Paulo Laboratory, in São Paulo state, recorded an even higher testing increase, of 100 percent. In the first 15 days of November, the PCR test Positivity Index for Covid-19 doubled compared to the same period in October.

The laboratory director and physician, Daniel Dias Ribeiro, alerts that this is not the time to abandon preventive care. “The wearing of masks, constant hand sanitizing, and social isolation are key to keeping the rates low. We do not yet have the vaccine against Covid-19, which is the only solution to restart social activities as they were before,” he adds.

The full letter divulged by intensive care physicians below:

“After 13 consecutive weeks of a steady decline in the number of ICU beds occupied by Covid patients with a drop from 555 to less than 200. After that, we observed another three consecutive weeks of relative stability. However, last week we noticed a rapid and worrying 20 percent increase in the number of intensive care Covid patients and 23 percent increase in the number of mechanical ventilation of Covid patients.

This observed increase was of 197 to 236 patients in isolation beds for Covid-19 in Belo Horizonte ICUs and an increase from 115 to 142 in the number of more critical patients and on mechanical ventilation because of the disease.

These numbers confirm the subjective perception of all and the objective warning signs that we have seen in recent days with an increase in the number of emergency rooms with acute febrile respiratory symptoms, a rapid increase in the number of new cases confirmed by laboratory tests, a worsening of the transmission rate of the disease, to RT levels above 1.1 that had not been observed since July.

This is a strong indication that we are facing a resurgence of the first wave of the disease. Technically it is not the second wave as in some countries, because we had not yet left the first wave, given that we have not managed to reach a low number of new cases that would allow us to consider children’s return to school, for instance.

Therefore, it is imperative that we resume the collective effort to increase the adoption of preventive measures capable of reducing the transmission of the disease, returning everyone to the level of commitment and care we had before when we managed to lower the critical numbers of the disease (new cases, occupied beds, deaths per day) to a third of what they were at the peak.

It is important to note that at the peak we had 20 deaths per day from Covid-19 in the city and that over the past few weeks we had managed to bring that number down to about five deaths per day. If we fail and we return to the numbers we observed at the peak in July, we will be condemning 15 more people to die per day, for lack of compliance with measures that we already know are effective and possible to be implemented. We all know that one of these people could be someone dear and close to us.

Therefore, the importance of preventive measures is worth noting:
Measures of individual responsibility:
1. keeping at least one and a half meters distance from other people
2. correctly wearing masks, particularly when away from home
3. Sanitizing hands with soap and water or with sanitizer gel whenever necessary
4. Avoid touching the face
5. Avoid or limit the time spent in closed spaces with many people
Measures of collective responsibility:
1. Campaign on the significance of these measures
2. Provide tests for all cases, even for mild cases and test the contacts of confirmed cases
3. Ensure quarantine of suspected cases and isolation of confirmed cases
4. Ensure that all environments for public use are well ventilated or with air filtering
5. Ensure that when an effective and safe vaccine is available, it is quickly made available to all with clear and correct priority criteria
6. Ensure adequate medical care for all, both in the primary care network, in emergencies, in hospitals, and in intensive care units.

Meanwhile, we doctors and other intensive care professionals will pursue our mission to save as many lives as possible of patients who may need intensive care. We are proud that so far no deaths have occurred due to the lack of intensive care in our city.

We would like to make sure everyone does their part while we continue to do ours.”