Risk of contagion of covid19 in ambulances

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For some companies it is “too much investment”; for others, it is responsibility of public health and not of them. The majority of a crucial link in the health system they work without having PCR: Nobody knows for sure how many ambulance technicians carry the virus with them.

The absence of diagnostic tests it is the main danger that the health emergency technicians (TES) consulted in Catalonia, Madrid, Aragon, Extremadura, Galicia and La Rioja warn about. Today, PCR is done on doctors and nurses, and even on public ambulance TES, but not on private contractors, the vast majority.

“They forget that a medical act begins before arriving at the hospital, when a wounded or chronic person is picked up to transport him,” argues JF, a technician with 12 years of experience in the ambulances of Aragon. Comes from transferring a grandmother with a broken hip. The woman lives with her husband, also elderly, and after falling, he was unable to lift her.

JF wonders how many people may have gotten sick in his vehicle, and when will he catch it, if he hasn’t already: “Without preventive control I do not know. The same I have been asymptomatic and I have infected to people. There are few closer contacts than picking up an elderly man from the ground and putting him in the ambulance, even if you wear a mask and gloves, “he explains.

Antigens

Know well that risk Jose de la Rubia, health technician and delegate of the USO union in the ambulance contract that Ferrovial has with the Madrid Medical Emergency Service (SUMMA). José has suffered from covid for three months. The virus caused an outbreak of arthritis that left him crippled. His case is lost in the tide of infections registered in Spain, as one more, not differentiated as contagion from health personnel.

In the Spanish Society of Emergency and Emergency Medicine (SEMES), its member Javier Abella certify that there is no national count of infected ambulance technicians, “basically because in most of the communities all TES belong to private companies as subcontractors”.

In Catalonia, warns the life support unit technician Walter Alvarez, USOC Health Transportation Delegate: “It is not just that we take the bug home and infect our families, it is that we can infect the patients themselves. “

His colleague De la Rubia denounces that in Madrid no PCR has been carried out on Ferrovial ambulance workers “since the start of the pandemic.” The company assures that in March “96 tests were carried out in Madrid”, among the more than 400 TES used by the firm. And there was no more.

Regarding the situation in Aragon, Acciona sources assure that in April the construction company bought rapid tests of

“We can infect patients”, warns from Barcelona the sanitary technician Walter Álvarez

antibodies “and began a massive screening campaign, making these tests available to workers, more than 1,000 from April to the present. “Sources of the contract staff corroborate this: the firm does a rapid antigen test on personnel known to have been in close contact with a positive, but no screening is done preventive.

HTG (Health Transportation Group), which manages numerous ambulance trips in Barcelona, ​​does not comment on the case. Neither does Tenorio Ambulances, which has the Extremadura contract and several in Andalusia. All the companies that have responded to this newspaper about the absence of PCR to their technicians They understand that these tests have to be done by public health and not by them.

In Madrid, Ferrovial assures that “as soon as an employee presents symptoms you are referred to the emergency department to receive an early diagnosis. “The same company, regarding the technicians of its contract in La Rioja, reports:” served by the public system“The tests that the company claims have been carried out have been done,” of course, with the resources of the National Health System. “

In La Rioja, Ferrovial ambulance technicians have undergone two PCR throughout the pandemic, one in June and the other in September. They were not made by the company, but by the Ministry of Health.

A Jose Juan Aguilar, Professor of Virology at the Faculty of Medicine of the University of Córdoba, that ambulance technicians do not have PCR done seems to him “fatal, from a virological point of view. And even more so for a virus that spreads so easily. These personnel are very likely to be infected, and must be thoroughly monitored. You can’t have the Sanitation people fighting dinosaurs with slingshots. “

Tell me about your PCR

In an occupational health meeting of the Tenorio Ambulances contract in Extremadura, last July, the technicians asked that, at least, a PCR be included in the annual health examination of the workforce. The firm answered “strictly no”, remember Victor Arnelas, responsible for health transport in USO-Extremadura, which has been fired by Tenorio after denouncing irregularities in the sector. The firm, he relates, told them that it has a thousand employees in Extremadura, “and it is a lot of investment.” That response was only oral.

The refusal to carry out tests on their ambulance toilets is not an obstacle for the company asks for the PCR if they are done in health centers. On May 7, at seven in the afternoon, Tenorio gave his staff an order through his internal app Gam, to which EL PERIÓDICO has had access: “The workers that the SES (Extremadura Health Service ) has performed covi (sic) tests they must communicate it by mail of incidents indicating type of test and result “.

For Javier Abella “tests are needed at least every 15 days, the incubation period and manifestation of the covid. The health ministries test and screen their health workers in hospitals and primary care, which they consider ‘their’ professionals. Not those of the medical transport, despite the fact that we are the link between one and another. Each year 4.3 million urgent trips are made by ambulance, and more than double by non-urgent medical transport. We do not stop being a transmission vector from one side to the other. “

The absence of specific tracking makes it difficult to know how many people have been infected in ambulances in the hardest phase of the pandemic, or how many elderly people who suffered its most atrocious blow in nursing homes. Nor how many are infected today, because under the sirens of the vans toilets often circulate without knowing if they have had a covid case.

No covid alert

If a private ambulance takes a sick person to a public hospital for a fracture, abdominal pain or any other common ailment, and If the patient is diagnosed with “positive covid” in the hospital, the ambulance technicians will take four hours to four days to know. And in the meantime they will continue to take people without having their vehicle subjected to anti-covid disinfection.

It occurs in a country close to 300 days of war against the coronavirus, and despite the painfully learned lessons. In Madrid, “you take a patient who you do not know if he has covid. When the hospital finds out, it tells SUMMA: ‘It’s positive’. And one or the other may take days to inform your company, “denounces José de la Rubia. There is no formal alert network, or monitoring.” The trail of those who have later entered that ambulance is lost, “he adds.

“If you want to know soon if you have taken a covid case, better to have a friend in the hospital “, laments Adrián Zaldívar

In Barcelona “You don’t find out in time, unless you have someone nice at the hospital to tell you”, corroborates Walter Álvarez. His colleague Vicente Mancebo, with 13 years of experience in Alt Penedès ambulances, partially corroborates this: in the area where he works “the information may take a day or two. The Emergency Service receives notice from the hospital, in turn, notify your company, and it is to you “.

“You find out too late and always through unofficial means. Official communication arrives late. If you want to know soon what you have brought in the ambulance, better have a friend in the hospital”, laments Adrián Zaldívar in Logroño, At the age of 18 aboard ambulances, president by UGT of the works council in the contract that Ferrovial has with the Riojan health.

From Ferrol (A Coruña) comments Javier Abella, who in addition to being a member of the SEMES is a technician of a life support unit with 21 years of experience: “There is a gap, there is not a very direct communication between the hospital service and the mobile device, perhaps because most of the medical transport is outsourced “.

“Something is wrong in the system”, says the Public Health expert Rafael Bengoa, former Basque Minister of Health and former adviser to the government of Barak Obama. “The solution path passes through that there is a fast connection between the regional tracking network and the ambulances, to ensure that the transport system does not become an infectious agent “.

“They are ambulances that may be transferring Covid patients and then Covid-free patients, and without disinfection in between. And this happens hundreds of times daily,” Víctor Arnelas laments in Badajoz.

In Aragon, JF, who has no union membership, relates requesting anonymity: “The time that may pass until we find out that we have had a positive for covid varies: from not knowing within minutes, hours, days. time they could have been transported from one more patient to hundreds, thousands & mldr; “

This is yet another of the hidden contagion vectors. Some ambulance users, especially the elderly, find that of ambulances more visible. trips to the hospital crammed into the van.

Crowded

Ahead, a woman on crutches; to his left two old men; behind, two others; and in another back row an even older one, whose cell phone is shaking in his hands, and a woman lying on a stretcher from the Extremadura Health Service. Seven immunosuppressed people, wearing a mask but together in four square meters, star in a video recorded this September on a collective ambulance route in Badajoz.

After a two-hour journey, when they arrive at the hospital, these people will be rigorously separated to avoid contagion … and when they get back into the ambulance they will travel side by side again.

On March 25, Health issued some ‘Recommendations for the Management, Prevention and Control of Covid-19 in Dialysis Units’, indicating to ambulances: “The number of patients who access at the same time should be limited to a maximum of four.”

“Bring up to nine patients together Today in an ambulance it is reckless “, denounces from La Rioja Adrián Zaldívar

Today patients are crammed into vans in various parts of the country. In Extremadura, Víctor Arnelas assures that it is “the lack of inspection that favors it.” In the Balearic Islands, the FES-TES union denounced on August 21 that they transfer up to six patients together. From Logroño, Adrián Zaldívar refers that they have seen each other in La Rioja “Up to nine in an ambulance. That in these times is untenable, a recklessness. No matter how much they wear a mask, they are very close, “he says.

“Bringing patients together for hours today it is not ethical or normal – Javier Abella thinks from SEMES-. The Health instruction limits it to four people, but there is no supervision by public entities that companies comply with it. “

On October 4, The Salamanca Gazette recounted the contagion of a dialysis patient who was in a “crowded” ambulance with another man who was hospitalized. The first had already made five claims for overcrowding.

But perhaps the first warning of the danger of these trips was given in Cáceres. Raul Garcia, director of the La Hacienda nursing home, denounced how a healthy resident and another with diagnosed covid had arrived in the same ambulance. It was last May 8; by then the great mortality of the elderly was only beginning to subside.

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