Flu epidemic continues to increase. In the last week of the year, cases reported by primary care centers increased by 75%, reaching 438.3 cases per 100,000 residents, even on hospital floors, where admissions have declined. There has been a 60% increase in just seven days (up to 9.5 cases per 100,000 inhabitants, according to data published this Thursday by the Carlos III Health Institute.
These are the highest flu rates since the pandemic, which has had anomalous behavior due to the prevalence of Covid in recent years. If you look back, in the worst week of most years it does not exceed 300 cases per 100,000 inhabitants, although it reaches higher levels in the most intense seasons. A succession of parties indicate that the wave will continue to rise for a few weeks, which has led to saturation in many health centers and strained hospitals.
Evolution of acute respiratory infections
Per 100,000 inhabitants as measured by the Sentinel System in the last week of 2023
There are regions that are particularly vulnerable to the scourge of winter viruses. The rate of respiratory infections in Spain as a whole is 952.9 per 100,000 inhabitants (a slight increase compared to the previous week, because while the flu has increased a lot, Covid and other pathogens have decreased), but there are communities that exceed this figure. : Castilla-La Mancha exceeds 1,709, followed by the Valencian Community (1,501), Asturias (1,318) and Castilla y León (1,209). These are data extracted from health centers known as sentinels, which are distributed proportionally across the region and allow extrapolation of the situation across the country as a survey.
It is these communities, in general, that also have hospitals in more complex situations. According to a survey by the CSIF Union, some of them, such as Castilla-La Mancha, are reaching saturation in plants, while others, such as the Valencian community, do not reach that extreme, but some are having to double beds. areas already. Having “difficulties” finding reinforcements.
According to this union and the Spanish Society of Emergency Medicine (SEMES), the emergency room situation is more widespread in most areas of the country. Jose Manuel Fandino of the board of directors explains that in many hospitals “they are breaking attendance records.” He estimates that the demand for these services has increased between 20% and 50%. However, the percentage of patients who go to the emergency room and are admitted to the hospital is almost halved. At his hospital, the University of A Coruña, he is now treating 8.8% of cases, while it is usually between 15% and 18%. “This means people come straight in with pathologies that could be managed at another level of care,” he says.
Although the most severe cases occur in the elderly population, most of whom require hospitalization, infection rates are highest among children. This is the case of the son of Lugo’s nurse, Veronica Arias, who goes to the Gutierrez Health Center to check for itching because he has eczema on his mouth and feet, the result, according to the minor’s pediatrician, of the flu, an illness with which he started on December 27. And it lasted for a week. “They were very bad for four days with medication, corticosteroids and anti-inflammatories.” The symptoms the child presented with were bronchospasm, congestion, cough with copious sputum, and wheezing: “It was very difficult for him to breathe,” he says.
“They had to wait two days to attend to your appointment request,” he says, even as he makes it clear that there is no problem with medical care at the moment in case of an emergency. She and her son have been vaccinated against flu and Covid-19, the child because of his age and she is a nurse. “On these dates we should use masks as a precaution, knowing that viral infections have increased. “You don’t just have to wear it to family gatherings and to hospitals or outpatient clinics, but also to pharmacies and bars and supermarkets,” he claims. Everyone in his house has the flu, there are four roommates.
This spread of flu is also affecting pharmacies. Macarena Perez, vice president of the Seville College of Pharmacists, says the peak in demand has been going on for about 10 days and the virus is also causing casualties among pharmacy workers. “For many patients, they are the first go-to and on many occasions, when there is no underlying pathology or referral criteria to a doctor, symptomatic treatment is recommended for classic viral processes of the winter season. I see the difference with other years is that this time the peak is higher in less time,” he says.
Several unions and medical societies are urging measures to avoid saturation of the health system, a situation that is unforeseeable with respiratory virus epidemics every year due to its seasonality. First of all, they ask the population not to go to health centers if flu symptoms are normal and the patient is not at particular risk (suffered by the elderly and people with associated comorbidities).
José María Molero, spokesperson of the Infectious Diseases Working Group of the Spanish Society of Family and Community Medicine (semFYC), clarifies that “in no case is it suggested that when the population has a respiratory infection they do not go to health centers”, but the aim is to That you would come in when “there is a real clinical need to be evaluated by a professional.” “Saturation interferes with the care of patients who may need it most, and in addition, it creates a greater risk of infection for the rest of the medical facility,” Molero concludes.
Jose David Montero, a 35-year-old chef and also a resident of Gutierrez, is one of those who decided to stay at home. He started with influenza A on Thursday the 28th and felt unwell until the 1st. This Thursday he still has mild symptoms like a hoarse voice. He had a high fever between 39.5 to 40 degrees, a lot of muscle aches and a headache. It meets more city dwellers with influenza A. “At the social level we are not taking any necessary precautions to prevent this because we are leading a normal life,” he admits.
For many patients, however, going to the office is essential if they need time off from work. SamFYC estimates that a quarter of those who go to the doctor with respiratory symptoms do so for this reason. For this reason, it proposes to recover the possibility of issuing discharges and discharges at the same time for seven days, which is the period that is necessary to fully recover many of these processes, as was the case during the epidemic.
These and other primary medical societies have long been calling for changes in the rules governing temporary disability to establish self-justification of absence from work due to illness, rather than sick leave. Short-term health reasons (up to 7 days).
As extraordinary measures for this week of the flu epidemic, they are also recommending the reinstatement of mandatory mask use in health centers, the distribution of hydroalcoholic gel, the determination of isolation areas or specific ventilation measures for waiting rooms.
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