His voice is still weak and, therefore, the septuagenarian needs help to make himself understood by his son, who, on the other side of the ‘tablet’, smiles at hearing his father’s voice.
“I haven’t heard his voice for almost a month, it has been a very big marathon. But everything will be fine,” said his son, Rui Ramos.
Manuel Ramos said he misses home, that he is being treated well in the hospital and, in between, the conversation still went through football.
The clinical picture was complicated, with covid-19, diabetes, hypertension, obesity and a recent operation. “But, thank God, things are going well and we will hope that they continue to go well,” said the son.
Manuel Ramos had to undergo invasive ventilation, through a tracheostomy, and, after the tube was removed, he entered a new phase of recovery, but with a long way to go.
In addition to the video call, during a visit to the intensive care unit (ICU) in Vila Real, Centro Hospitalar de Trás-os-Montes and Alto Douro (CHTMAD), it was possible to observe the intensive care physician Igor Milet doing a tracheostomy, the nurse Marta Pinto in a rehabilitation session with a patient and still talking to a patient hospitalized there for 15 days.
Olinda Gomes, 59 years old and resident in Resende (Viseu), said she does not know how she contracted the SARS-CoV-2 coronavirus, because she had been taking care for a long time and never left home without a mask.
The “little strength” I felt was the signal to go to the doctor and turned out to be the most serious case in the family. She did not need invasive ventilation, but pneumonia and the fear of worsening her situation brought her to the ICU.
Chief nurse Jandira Carneiro explained that many of these patients have “major sequelae”, from motor, respiratory or cognitive. “We have patients who arrived here 65 days ago. It is dramatic,” he said.
Marta Pinto, a specialist nurse in the area of rehabilitation, referred that these have been months of “a lot of work”, “some sadness” and “great joys”.
It is that even after the cure of covid-19, there is a “long way” because there are patients who stay in comas induced for several days and their body requires a whole relearning.
“I have had many patients leave here walking on their own feet”, he stressed, explaining that some “have to relearn to breathe, to eat, to cough, to walk”.
Igor Milet stressed that covid-19 is a disease with “a complex, very long course that creates other problems” in patients. “The process of rehabilitation, of recovering quality of life, is often achieved as a result of hard work, but it is also true that there are patients who are left with sequelae for life,” he said.
This disease, he stressed, raised a new “care paradigm” because it removes the “right for the patient and the family to accompany the care process”, for which reason, he added, attempts are made to approach them through audiovisual media.
The CHTMAD ICU reached the maximum capacity of 24 beds occupied with covid-19 patients. This week the number of patients in the ICU was 11.
The months following October were of great pressure and a new area was even activated next to the recovery of the operating room for non-covid-19 patients, as established in the contingency plan. However, this area has already been deactivated.
Francisco Esteves, director of the intensive care service, said that there was no need to transfer critically ill patients to other hospitals and that this hospital center received patients from other institutions.
The doctor explained that at CHTMAD, after the first wave, there was a commitment to anticipating scenarios, planning, strengthening teams and reorganizing the UCI, creating independent circuits and isolation areas with negative pressures.
About 1.5 million euros were invested, more fans were purchased and the number of beds increased from 14 to 24.
“What we did was try to anticipate and plan difficult scenarios so that we can give an adequate response to the community,” said Francisco Esteves.
Around 150 health professionals work in this service and, since March 2020, about 170 critical covid-19 patients have been admitted, with preliminary results pointing to a mortality rate of around 20%.
Doctors, nurses, operational assistants are together in the struggle for the lives of these patients who, at the ICU, are permanently monitored.
Francisco Esteves said that CHTMAD will maintain its “maximum activation profile for as long as necessary” to respond to covid patients and, especially now, increasingly to non-covid-19 patients.
“Right now there seems to be a little bit of relief in terms of workload, now from a psychological point of view I think none of us have yet managed to break free because we are not sure what is next,” said Jandira Carneiro.
The following wave may again be covid or patients with other pathologies and, therefore, “lower the wait” are words that are not used in this service.
Professionals also insist on calling on the population to adopt all necessary precautions to stop the pandemic.
In Portugal, 16,243 people died from 802,773 confirmed cases of infection, according to the most recent bulletin from the Directorate-General for Health.
The disease is transmitted by a new coronavirus detected in late December 2019 in Wuhan, a city in central China.
Source: Correio da Manhã by www.cmjornal.pt.
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