Aline Camara (CCS/Fiocruz) and Antonio Fuchs (INI/Fiocruz)
In another step of its actions to combat the pandemic of the new coronavirus, the Oswaldo Cruz Foundation (Fiocruz) built in less than two months a hospital unit for severe patients infected by the disease. Located in Manguinhos, headquarters of the Foundation in Rio de Janeiro, the Hospital Center for Pandemic Covid-19 - National Institute of Infectious Diseases Evandro Chagas (INI / Fiocruz) started receiving, on May 19, the first patients. The beds will be occupied gradually, from the daily and joint assessment of the direction with the municipal and state health departments. The measure guarantees the necessary safety conditions for both patients and health professionals.
Built on an emergency basis to join efforts to strengthen the health network, the hospital has specific characteristics that differ from the campaign units being built by the country and which will operate temporarily. All beds, for example, have an insulation system with negative air pressure, specifically for aerosol infections. Inside the rooms, which are individual, a pipe is responsible for sucking the contaminated air that passes through a filtration system before being eliminated by chimneys installed outside the building. There is also a sewage treatment plant of its own, designed to treat waste with the new coronavirus and ensure the safe disposal of the generated effluent.
Operating under conditions of high complexity assistance and with its own diagnostic support system, the hospital center counts with X-ray, ultrasound, echocardiography and computed tomography devices. Bronchoscopy and endoscopy services are also available. The unit is self-sufficient - it has power supply, generators and water reservoirs and all the infrastructure required for a hospital of this size, independent of other areas of Fiocruz on campus. The complex, which occupies a total area of 9,800 square meters, also has an exclusive entrance for ambulances and helipad. In full operation, there will be 195 beds for intensive and semi-intensive treatment.
"At this moment, when we are following with such concern the increase in cases and deaths in our country, and particularly in Rio de Janeiro, it is with great emotion that we deliver this hospital dedicated exclusively to Covid-19 and that will remain as a legacy for the Brazilian Public Health System [SUS, in the Portuguese anacronym]. Fiocruz will continue to work tirelessly to strengthen SUS actions in the midst of this humanitarian crisis that has had such a huge impact on the lives of the population and that brings so many challenges to a continental and unequal country like Brazil”, said the president of the Foundation, Nísia Trindade, during an on-site reconnaissance visit.
As it is a closed hospital unit, that is, without emergency care, patients arrive at the hospital transferred from other health units. The computerized system of the State Health Department allows a mapping of existing beds in order to operationalize the available supply to the population's access needs. Initially, the patient must be seen in an emergency or emergency care unit. After realizing the need for specialized and more complex assistance, the request is sent to the regulation system, which is responsible for checking the availability of the beds and transferring the patients.
Following safety protocols, visits to hospitalized patients are not allowed. As a way of welcoming families, an environment was specially set up to receive them in the attached block. A multiprofessional team takes turns 24 hours a day to provide face-to-face assistance, when necessary. There will also be a call center structure with trained operators to update family members about each patient's medical record. In order to reduce the distance with loved ones during the hospitalization period, video calls will also be made with patients whose clinical condition allows interaction.
The flow of vigilance and monitoring of the professionals involved in the routine operation of the Hospital Center involves, among other aspects, the daily checking of the temperature of all employees on admission, testing and active search for symptomatic people. 26 professionals, including doctors, nurses and nursing technicians, psychologists, social workers and nutritionists are in charge of providing direct assistance to workers, working from surveillance, through promotion, to the approach to mental health.
The new hospital is now part of the National Institute of Infectious Diseases Evandro Chagas (INI / Fiocruz), the Foundation's reference unit in specialized care in infectious diseases, and which also serves as a reference for the care of severe patients of Covid-19. The experience in treating patients at the newly opened hospital will be an important contribution to several research fronts on the disease. "The new center will be essential to speed up the research conducted by INI and the entire collaboration network of Fiocruz in Brazil and internationally. An example is the Solidarity clinical trial, from the World Health Organization (WHO), which studies the efficacy of drugs for treating Covid-19 ”, explained the director of the hospital, Valdilea Veloso.