MADRID (AP) – As soon as the dead body is silently pushed on a stretcher, a cleaning battalion moves into the intensive care unit. In a few minutes, the bed in which the 72-year-old woman fought for another week for another breath is cleaned, the glass walls insulating it disinfected with a squeegee.
There is little time to reflect on what just happened, because death leaves room for the possibility of saving another life.
“Our biggest source of joy is obviously emptying a bed, but because someone is discharged and not because he died,” said Ignacio Pujol, head of this intensive care unit in Madrid. “There’s little room there for someone else to have another chance.”
As a wave of infections puts Spain’s public health system back on track, the Isabel Zendal assistant hospital that hires Pujol, a project seen by many as an extravagant vanity venture, is given a new opportunity to prove its worth.
Named after a 19th-century Spanish nurse who vaccinated smallpox over the Atlantic Ocean, the facility was built in 100 days at a cost of 130 million euros ($ 157 million), more than double the initial budget. It boasts three pavilions and support buildings on an area the size of 10 football fields, which look somewhere between a small airport terminal and an industrial warehouse, with ventilation air ducts, medical beds and state-of-the-art equipment. The initial project was for 1,000 beds, about half of which have been installed so far.
Zendal opened to a decline in fanfare and competing criticism on December 1st, just as Spain seemed to alleviate a wave of coronavirus infections after the summer. By mid-December, he had received only a handful of patients.
But Spain saw more than 84,000 new COVID-19 infections on Monday, the largest increase in a single weekend since the pandemic began. The country’s overall number stands at 2.5 million cases, with 53,000 confirmed deaths from the virus, although statistics on excess mortality add more than 30,000 deaths to it.
As the contagion curve multiplied after Christmas and New Year, Zendal became busy. On Monday, 392 patients were treated, more than in any other hospital in the region of 6.6 million.
Spain’s growth follows similar increases in infections in other European countries, especially in the UK, after the discovery of a new variant of the virus that experts say is more infectious. London Nightingale, one of Britain’s temporary hospitals, designed to ease the pressure on the country’s overwhelmed healthcare system, has also reopened for patients and as a vaccination center.
Senior Spanish health officials insist they have found no evidence that new variants wreaking havoc elsewhere are contributing in any way to its own missile infections.. Some experts dispute that, claiming that the country’s limited ability to sequence coronavirus cases distorts reality and that a new home stay order is needed.
On the ground, growing hospitalizations for the virus are already over the top of the second recurrence. Nearly one in five hospital beds has a patient with COVID-19. The new disease also occupies a third of the country’s intensive care capacity, and non-emergency surgery is already canceled.
Along with some medical experts, left-wing politicians and labor unions accuse the Conservative government in Madrid of spending hardware to attract votes instead of consolidating a public health system they have underfunded for years. Investing in contact tracking and primary care previously, they say, could have completely avoided the need for a Zendal.
“Rather than boast of success, filling this makeshift hospital is a huge failure for those leading the pandemic response and also a failure for everyone, as a society, who could have done better,” he said. Ángela Hernández, a spokesperson for the main trade union of medical workers in Madrid, AMYTS.
The last break for the unions, she said, was the regional government that fired medical staff who refused to give up their positions in regular hospitals when they were reassigned to Zendal.
“The project was stupid from start to finish,” Hernandez said. “A few beds without proper staff don’t make a hospital.”
Fernando Prados, Zendal’s manager, says he doesn’t mind the debate, but the 750 patients treated in the last month and a half have already put significant pressure on other hospitals.
“We have already contributed in one way or another,” Prados said. “We know we will continue to have patients with COVID, and once the pandemic is over, this infrastructure will be here for any other emergency.”
In the past, automatic glass doors, patients recover in 8-bed modules, leaving little room for privacy, but providing better monitoring of possible complications in their recovery, said Verónica Real, whose challenge as a primary care nurse was to organize staff teams drawn from other hospitals.
“Some of the health workers arrive with a certain degree of anger at all the noise in our hospital,” Real said. “But once you get here, the attitude changes completely.”
Zendal managers say that a modern ventilation system renews the air of the entire installation every 5 minutes, which contributes to a safer working environment. But they are most proud of the expansion of the intermediate respiratory care unit, where patients receive different types of assisted breathing to overcome lung inflammation.
The head of the unit, Pedro Landete, says that by admitting patients who can get worse in one of the 50 well-equipped beds, they reduce the number of people who subsequently need more demanding intensive care.
José Andrés Armada arrived at the unit with mild symptoms after his entire family became infected, despite what he said was a very careful approach to the pandemic. But the 63-year-old’s health deteriorated rapidly and last week he was on the verge of being intubated in one of Zendal’s twenty intensive care units.
“I know that the economy is something to be protected, but health is more important. We should be locked up by now. You can’t have bars and other places open, “said the former entrepreneur.
“I never imagined he could attack you like that.”
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AP reporter Jill Lawless from London contributed to the report.
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