Covid-19: São Paulo confirms 1st death in ICU line, anticipates holidays, but discards lockdown

RIO DE JANEIRO, BRAZIL – The healthcare system in Brazil’s largest city is “collapsing”, said São Paulo mayor Bruno Covas, who on Thursday, March 18th, confirmed the first death in the São Paulo capital due to the unavailability of Intensive Care Unit (ICU) beds to treat Covid-19 patients.

“The lethality rate is lower than last year’s peak, because our professionals are better prepared to care for patients. But now, if this curve [of infections] continues to grow, we will see an increase in cases of people who can’t get ICU beds,” Covas said. There were at least 475 people in the city of São Paulo waiting for an ICU bed by Thursday.

Given the severity of the situation, the São Paulo city government announced the anticipation of five public holidays in an attempt to contain the spread of the novel coronavirus, repeating the strategy adopted at the start of the pandemic in 2020.

Two of the holidays are in 2021, but three others have had their dates in 2022 brought forward – the new holiday period runs from March 26th, a Friday, to Thursday, April 1st, and will be combined with Good Friday, a national holiday that falls on April 2nd.

“If we can get 15 days [in which] people return to the isolation rates at the start of the pandemic, we will achieve an improvement in the number of cases and hospitalizations,” said the mayor in an interview earlier in the day.

On Thursday, the São Paulo government sent a mass cell phone messages to alert about the “high risk of beds becoming full in the state.” “Stay at home. Protect your family. If you must go out, wear a mask!” the message reads.

Despite the critical situation in São Paulo’s healthcare system, Mayor Bruno Covas has ruled out the option of imposing a lockdown in the city. “It is not feasible to decree a lockdown in the municipality. We have 1,000 Metropolitan Civil Guards. It is impossible to monitor if people are leaving home with 1,000 guards,” he justified.

The first victim of the lack of ICU beds in São Paulo is Renan Cardoso. He was only 22 years old and died last March 13th. According to the medical report released by the Municipal Health Secretariat, the patient was admitted to the São Mateus II Emergency Room (in the East Zone of São Paulo) on March 11th – he was confirmed for coronavirus two days earlier and had been suffering from dyspnea (shortness of breath) for seven days.

“Due to obesity and mild respiratory discomfort presented, the medical team chose to keep the patient under observation and subsequently keep him hospitalized in the unit with O2 support,″ describes the medical report.

The search for an ICU bed began the day after Renan reached the hospital. However, at around 4 PM on March 13th, the patient’s respiratory condition worsened. The health unit was able to provide a mechanical ventilator in only 15 minutes (according to the medical report), but, despite being intubated, the young man suffered a cardiorespiratory arrest in the emergency room. All this occurred outside the ICU environment, which was essential for the severity of the young man’s condition, who died that day.

The state of saturation of São Paulo’s healthcare system has led private hospitals to request public beds for the first time in history. According to the Municipal Health Secretary, Edson Aparecido, at least 15 private facilities have requested 30 beds from the State to cope with the demand. However, the Secretary pointed out that the demand “may be linked to the fact that patients are unable to complete the full treatment in the private network,” for financial reasons.

Source: El Pais