In this pandemic, Portugal has stepped on heaven and hell. The one baptized as the “Portuguese miracle” kept the coronavirus at bay during the first wave, but almost a year later this country of more than 10 million inhabitants is at the head of the planet in infections and in the daily average of deaths. He has had to ask for international help. “The word ‘miracle’ was the worst we could use because that was achieved with work,” laments Aurora Viães, from the local government of the northern municipality of Vila Nova de Cerveira, where a nursing home has gone from not knowing the covid to all of his residents and workers fell ill.
The data is terrifying. Half of the deaths from covid in Portugal occurred in January and the incidence per 100,000 inhabitants in 14 days reaches figures never seen before: 1,438, followed by Israel with 1,060 and the Czech Republic with 902, according to data collected by Johns University Hopkins. The maximum is the City Council of Penedono, in the north of the country, with more than 7,400 cases. The number of deaths from covid per 100,000 inhabitants also leaves the country at the top of the world in the last week, followed by Lebanon and the United Kingdom, according to the same university.
Epidemiologists agree with citizens when it comes to pointing out the trigger for this viral explosion. Portugal was, along with Spain, the European country that established more lax restrictions at Christmas. On Christmas Eve, mobility was total, the curfew was reduced to a minimum and there was not even a limit of people in the houses. “Saving Christmas was a big mistake; We knew it but we did not expect it to be of this magnitude ”, confesses Ricardo Mexia, president of the National Association of Public Health Physicians of Portugal. Mexia criticizes that the restrictions were relaxed without the country having managed to get out of the second wave completely. The festive season started in Portugal with 3,000 infections a day, “a high number despite the fact that the trajectory was downward”, explains the epidemiologist.
Hospitals were unprepared for what was coming and have collapsed, especially in the Lisbon area, from where patients have been referred to Porto and even the island of Madeira. A queue of 30 ambulances loaded with patients was waiting for their turn just a few days ago in the emergency room of the Santa María hospital in the Portuguese capital. Now the most critical point is in the ICU. “We are exhausted and it is expected that we will still go through more than two or three weeks of great pressure,” warns María Manuel Varela, intensive care nurse at the Évora hospital.
There are 1,200 beds available, a good part of them improvised in recent months. More than half was reserved for infected, but the emergence of cases has exceeded such forecast and this Friday there were 904 infected in these units. The main problem is the lack of staff. “There are hospitals that doubled and tripled beds with the same equipment. Nurses and doctors are lacking and we are recruiting from other areas. We train them with the documentation provided by the Portuguese Society of Intensive Care so that they are prepared, ”says nurse Manuel Varela, vice president of this scientific society.
When the pandemic broke out, the Portuguese country had the lowest number of intensive care beds per population in Europe, according to the government itself. It is precisely to these units that the first reinforcement from abroad has been assigned. A medical team from Germany landed in Portugal last Wednesday. There are 26 professionals, including six doctors, who have arrived loaded with 40 mobile and 10 fixed ventilators, 150 infusion pumps and as many hospital beds.
German toilets have been installed in a private center in Lisbon to operate eight ICU beds in an area that has been unused until now due to lack of staff. They will remain there for three weeks, but will be relieved successively every 21 days until March if necessary. His arrival is the result of the call for help that the Portuguese Minister of Health, Marta Temido, launched on January 25. The Galician Government has also offered to host Portuguese patients in the ICU beds of the Vigo hospital and Austria announced this Friday that it will receive Portuguese patients.
At the Santa Luzia de Viana do Castelo hospital, in the northern health district, which is at the fore in number of cases, workers say that this week has been “calmer.” They say it in a day, Wednesday, in which the occupancy of their ICU reaches 96%, according to those responsible for the center. Vitor Jeremias, an emergency transport driver, has just left a covid patient from Ponte de Lima in an emergency room that was recently crowded with infected people, most of them in their 80s.
“They shouldn’t have left so much mobility during the Christmas holidays. As the first wave went well, people were confident, “says Isabel Durais, a neighbor of Fiz, 15 kilometers from Viana, while waiting in the emergency room for her son, who has broken his leg. She toasted on Christmas Eve and New Year’s Eve only with those she lives with so as not to put her 80-year-old mother at risk. But the majority of his compatriots, censure, did not do the same.
The fear that vanished
The Portuguese mood towards the virus has been changing. The first case of coronavirus was detected in Portugal on March 2, a month later than in Spain. This late arrival and a confinement in spring respected with discipline by its population helped to contain the infections and set the Portuguese example as an international model. “People were very scared. In a population so catholic and so united to the religious tradition of farewell to the dead, the dramatic images of Spain and Italy with collapsed hospitals and rows of coffins caused panic ”, explains the councilor of Vila Nova de Cerveira Aurora Viães.
With the return to the streets and the reopening of economic activity, the terror faded, pandemic fatigue took its toll, and public messages softened. Councilor Viães assures that in her municipality she saw how the number of citizens who were looking for legal loopholes to leave home increased and disdained the risks for not having suffered cases nearby. Today he receives calls from desperate neighbors who cannot accompany their hospitalized relatives who are about to die. “Communication failed,” he concludes.
In the Christmas holidays “the message [de las autoridades] It had to have been clearer so that people avoided meeting, ”agrees epidemiologist Ricardo Mexia. The Galician traumatologist Pepe Muras, who has been practicing in Portugal for years, perceived a lack of courage in the politicians to maintain the restrictions when the data began to improve in December. “Are the hoteliers happy now that they have been able to open at Christmas and New Year’s Eve?” He wonders about a sector that, like schools, has been closed and is only allowed to serve take away food.
The pandemic has surprised Portugal with badly wounded health, a decade after the passage of the troika’s scissors on public spending. Only a few months earlier, two hospitals had closed their emergencies due to a lack of doctors and the resignations of health chiefs fed up with working with obsolete equipment followed. The press even reported cases of patients forced to wait four hours inside ambulances because there were no stretchers.
For Jorge Roque da Cunha, general secretary of the Independent Medical Union, the covid has put a “fragile” health system to the test that “was not reinforced” when the economy improved. The deficit in investment in equipment, he stresses, is “decades old” and the doctors, who accumulate fatigue and overtime, “do not have good working conditions.”
The lack of health personnel is dire even outside hospitals. To the rescue of the Lar de Maria Luisa nursing home in Vila Nova de Cerveira where all the residents and workers were infected, students and volunteer nurses had to go. Just 25 kilometers away, in Paredes de Coura, in another center for the elderly called Casa da Misericórdia where dozens of people have been infected, Father Manuel Alberto Domingues has launched a desperate appeal on social networks: “We urgently need nursing professionals by title voluntary, service provision or in another situation ”.
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