New ICU admissions due to Covid fall in SP

Hospitalizations in ICUs (intensive care units) for Covid in the state of São Paulo have slowed this week, with new daily records falling in the last seven days.

As of February 1, there were 4,069 patients in ICU beds in the state, with 1,169 new records that day. Last Tuesday (8), 947 new admissions were registered, a reduction of almost 19% in the comparison between the two days. The number of patients admitted to ICU beds is now 3,804.

In the Greater São Paulo region, which includes the capital, 600 new ICU admissions were recorded on February 1st and, last Tuesday (8th), there were 428. In the capital alone, the total number of patients admitted to intensive beds went from 2,213 to 1,971 in the last seven days.

Hospitalizations in infirmary beds also fell, from 7,330 on the 1st to 6,262 on Tuesday (8th), a reduction of 14.6%. The data are from the State Department of Health and are available on the Seade platform.

Even with the downward trend, the ICU bed occupancy rate remains above 70% across the state and in the capital. The percentage went from 72.33%, in the state, on February 1st, to 70.7% last Tuesday, and from 74.8%, in the Greater São Paulo region, to 71.1%.

Therefore, and with the recent explosion of cases due to the ômicron variant, the scenario still calls for care and greater concern, according to experts heard by the report.

The time of hospitalization for Covid fell with the onomicron, according to data collected from the secretary. Now the average is six days. In March of last year, by comparison, it was 11 days.

The shorter hospital stay may be, in part, due to the association of the micron with a milder infection, as it does not reach the lungs as much, as recent scientific studies show, and also due to the large number of people with a complete vaccination schedule (two doses and booster). vaccine) or incomplete (two doses or a single dose).

Despite the slowdown, it is still not possible to say that the peak of hospitalizations caused by new infections in late 2021 and early 2022 has passed, explains Paulo Lotufo, an epidemiologist and professor at the USP School of Medicine.

“It’s the ‘of fifteen’ rule: 15 days for detection [do caso], 15 days for hospitalizations and 15 days for deaths. We haven’t passed that period yet”, he says, citing the delay in records and data outcomes.

For Lotufo, however, the large private and public laboratories, as well as doctors who work at the Hospital das Clínicas at USP, are already seeing a drop in the number of positive cases. “I believe that now we are seeing this tune of hospitalizations and deaths and then we are going to have a slow decline.”

Like him, other experts heard by the report today observe a greater proportion of patients hospitalized in the most extreme age groups: children and the elderly.

“It is necessary to emphasize that those who received the booster dose have a shorter hospital stay. The more up-to-date the patient’s vaccination history, the lower the chance of hospitalization, of progressing to a serious condition and death”, he warns.

According to data from the Vacina Já state platform, the state of São Paulo has 97.08% of the population over 18 years of age with a complete primary vaccination schedule, a rate that reaches 80.98% in the general population.

In children aged 5 to 11 years, more than 2.1 million received the first dose of the vaccine, which is equivalent to 52.95%. Almost 18 million booster doses were applied, which is equivalent to 37.74% of the population.

Private hospitals in São Paulo are also seeing a slowdown in the number of visits for Covid symptoms in emergency rooms and inpatient units.

At Hcor Hospital, the number of people treated with flu syndromes dropped from 150 a day in mid-January to 30, on average, this week.

In relation to hospitalized, there was a more modest drop: from 96 (18 in the ICU) last week to 81, of which 15 in the ICU, this week.

At Hospital Sírio-Libanês, 57 patients were admitted to the ICU this Wednesday (9), of which 21 were in the ICU. On January 28, there were 129, of which 25 were in the ICU.

At Hospital Albert Einstein, 124 patients were hospitalized this Wednesday, of which 46 in the ICU and semi-intensive. On February 4, there were 175, of which 66 were in intensive and semi-intensive care units.

“We are in the descending phase of this wave of the omicron”, says Miguel Cendoroglo Neto, director-superintendent of medical and hospital services at Einstein.

He explains that all indicators that signal a drop in hospitalizations, such as the number of diagnostic tests and the positivity rate, began to fall in the last two weeks.

For example: in epidemiological week 4, between January 23 and 29, there were 10,447 tests, with a positivity rate of 36.3%. The following week, which ended on February 5, there were 8,911 exams with a positivity of 28%.

“We have been observing since week 3 a consistent drop in this positivity. This week’s partial data already points to 18% positivity”, says Vanessa Teich, superintendent of health economics at Einstein.

In Sírio-Libanês, the scenario is similar. “From the last week, we saw the number of cases decreasing. As we have seen in other places and in modeling, it seems that São Paulo is leaving the peak of the curve”, says infectologist Mirian Dal Ben, from Sírio-Libanês.

Despite the enthusiasm for the fall, managers remain cautious. “A lot of doubts remain. Can everyone who has had an omicron be reinfected again by the omicron and need hospitalization? Could a new variant of Covid infection arise from those who have had omicron, delta and already have three doses of vaccine?” , asks Fernando Torelly, president of Hcor.

For Julio Croda, infectologist and researcher at Fiocruz, the signs of Covid deceleration in SP are clear. “The drop in new admissions is the most appropriate data to assess, and we clearly see a drop in daily ICU records. In terms of total admissions, we see a slowdown in the last seven days,” he explains.

Brigina Kemp, former coordinator of the health surveillance department in Campinas and a member of the Covid-19 BR Observatory, thinks that it is still too early to talk about deceleration.

“There are reports of some municipalities with signs of decline, something very small even in the universe of 645 municipalities. We also heard municipalities with patients waiting for beds for hospitalization in the interior of the state”, he says.

Kemp also makes a reservation about the delay of data in the systems due to the damming of information after the hacker attack on the Ministry of Health at the end of the year and because of the removal of health professionals by Covid in early 2022.

Asked about the number of patients on the waiting list for ICU beds in the state, the state secretary did not say how many are on hold. She said, in a note, only that Cross (Central for Regulation of Health Offers and Services), which helps with the distribution of vacancies, has been dealing, on average, with 500 cases daily.

Also according to the secretariat, the 700 beds announced by the state government at the end of January to meet the new demand “are already ready”.