Fourteen communities, in addition to the autonomous city of Ceuta, reached their highest level of hospital bed occupancy this week since August, a sign that the second wave of infections has reached the hospitals in full. In ten of them this occupation exceeds 15% and puts them at very high risk, according to the threshold established by the Ministry of Health. The level of risk is also very high in the intensive care units of these communities, with over 25% of the beds occupied by covid patients.
Data from the last few days suggests that this could change in the coming weeks: a stabilization in the income rate has begun to appreciate for the first time since October. Even so, they continue to increase and threaten the hospital situation. In the last month, the growth of acute care wards was 80%: if in September 9 out of 100 beds were occupied by patients with covid, now they are 16. In intensive care, the occupation has gone from 18% to 30% .
This hospital rebound was expected after the increase in infections in recent weeks. We know that a spike in cases is usually followed by a spike in hospitalizations of seven to ten days, after which first the occupancy of the hospitals increases and then the pressure on the intensive care units. This has happened again in the last few weeks because the typical patient profile has changed: he is over 60, has more previous illnesses and more likely to end up being a severe case.
Income skyrockets in Asturias, Ceuta and Catalonia
In the past two weeks, hospitalized patients have increased in Asturias, Catalonia and Ceuta at a faster rate than in the rest of Spain. If the new income is kept at the current rate, it could double in less than 20 days. This was the case in the Principality, where the increase in cases in mid-October brought the occupancy of beds to 23%. This will likely put even more pressure on your intensive care units, already at 40%.
In Catalonia, employment was already above average due to the wave of infections in August, but in recent weeks it has exceeded 40%. In the summer, most of the hospitals did not overflow, which was the case in primary care, which operated beyond its means. It’s different now, he explains Clara Prats, researcher at the Polytechnic University of Catalonia: “In the summer, the majority of cases occurred among young people, especially in the age group between 20 and 29 years, and to a lesser extent between 30 and 49 years. the symptoms, when they exist, are milder ”. Then the incidence did not exceed 200 cases per 100,000 inhabitants, now it is 800 and with this “it has increased in the higher age groups, which are those at greatest risk of complications”.
They are not isolated cases
The hospital situation in Catalonia is no exception, but is repeated in other communities. This is confirmed by several doctors, including Gonzalo Tamayo, of the Cruces Hospital in Bilbao: “the severity of patients is what has changed the most compared to the peak at the end of August and September. They are older again, with more associated pathologies, such as the March or April profile ”.
The income pace of the past few weeks reflects a similar landscape across 13 communities, where income could double in less than a month if the trend continues. Employment is over 20% in Andalusia, Aragon or Castile-La Mancha. In Navarre, the incidence of the virus has been among the highest in the country for weeks, but new infections appear to be more controlled. This would explain the stabilization of the occupancy of their beds at around 20% – and 40% in intensive care -. But the improvement in the growth rate hasn’t stopped them from having to cancel already scheduled operations.
The occupancy of intensive care beds in Aragon and La Rioja is also growing, where 50% are covid patients. In Castilla y León, 40%. The figures reflect the reality of one of the largest hospitals in the community, the Río Hortega de Valladolid. Cesar Aldecoa is responsible for anesthesia and resuscitation: “We are in a key moment. We’ve had days with much above average income. We now see that the peak of income appears to stabilize, although it has not stopped growing. And it has yet to reach the intensive care units. Since the stay in the ICU is often long, more than 10 or 15 days, this is where the greatest pressure comes ”. In this, as in most communities, protocols are already in place to transfer the most seriously ill patients to hospitals with fewer capacity problems.
Calm tense in Madrid and the islands
The data is better in the communities that have so far turned the last corner. In Madrid, where the peak of infections occurred at the end of September, employment continues to decline, albeit very slowly. In the ICU it remains constant around 40%. Even in the Balearic and Canary Islands, the number of beds occupied by covid patients remains stable.
The curve these communities draw could indicate the path that those who are now at their peak will take. The next week will be 14 days after the state of alarm and other restrictions go into effect. If these measures have worked, the improvement in infection control should begin to be evident in the coming days and, predictably later, in hospitals.
In recent days, income has already been growing at a slower rate in many communities. Even so, “being optimistic, there still appears to be at least a month of high blood pressure in hospitals,” says Saúl Ares, a CSIC researcher. “Hospital employment is always lagging behind and reacting more slowly. But the last week of October, employment growth has remained steady and this week appears to be falling.” Clara Prats, from the Polytechnic, points out this: “The measures take between 10 and 14 days to be seen in new cases, but can take up to 1 month to be seen in the hospital occupancy rates.”
The employment and income data used in this analysis come from the hospital admissions database published by the Ministry of Health in its daily report. To sort autonomous communities by the rate of income growth in their hospitals, we estimated their doubling time. We first calculated the daily income as a daily average of a 7-day rolling window. To calculate the doubling time we used a window with the previous 14 days for each date and we adapted an exponential curve, from which we take the corresponding doubling time value. Our calculation is similar to that of this work.