Spain: from the COVID–19 trenches. Testimony from a nurse at Txagorritxu Hospital (Osakidetza) in Vitoria–Gasteiz

We have received this invaluable testimony from a nurse in Vitoria–Gasteiz at COVID–19 ground zero. She works in the epicentre of the pandemic, in an area that has registered more positive cases per 1,000 inhabitants than China or Lombardy.

Read the original in Spanish

The coronavirus crisis has only just begun and it is already bringing the public health system to its knees. Private healthcare is not affected: they do not accept patients suspected of having COVID–19. Instead, they refer these patients directly to the public healthcare system. Just today, the University Clinic of Navarra (run by Opus Dei) referred a resident of Vitoria who had had an operation at the clinic and was discharged two days ago to the public hospital. This was because the patient showed symptoms of fever, and until coronavirus was ruled out, they would not attend to that patient. The Vithas San José hospital also refers its patients to us because pandemics aren’t covered by private health insurance.

I wonder how long we will allow this... when will the private hospitals actually do something?

Usually, when there’s pressure, the managers of Osakidetza (Basque Health Service) refer patients to private healthcare. This is because the waiting list for surgeons is longer than the acceptable standard. This is just a face-saving measure so that our Basque politicians can boast that Osakidetza has the best healthcare system in the country. In this way, public money is transferred to private healthcare businesses.

We have suffered from a lack of hospital beds for years, which has generated intolerable pressure on the emergency services. This pressure comes, not just from the lack of beds, but also from the long waits to be evaluated by specialists, as well as the abandonment of primary care. If these staff take holidays, or they are off sick, they are not replaced.

The excuse is that they can’t find doctors or nurses to hire. But public universities continue the policy of “enrollment quotas”, hindering young people from a working class background from studying medicine or nursing. This leaves these young people with little future prospects.

With the coronavirus, despite the overwhelming information we had about the crisis in China, not even the epidemiologists saw it coming. It has caught us completely off guard. The situation has forced hospitals to suspend surgeries, office visits, etc. Today in Vitoria-Gasteiz we have public hospitals full of patients with coronavirus. Around 10% of patients with symptoms of coronavirus must be treated in intensive care. Since the ICUs are full, operating and recovery rooms are being used to care for coronavirus patients because the rooms have respirators. The hospital has had to acquire new respirators to attend to people who desperately need them.

Since the peak of the illness is yet to come, criteria for a patient to get a bed in the ICU will no doubt have to be modified. We will have to assess who, among the various patients, has the best chance of survival: again, with the “quota.”

At the beginning of the crisis, they told healthcare professionals not to wear masks at the entrances of emergency rooms so staff did not scare people. More than 100 healthcare workers have had to stay at home, either because of contact with infected people, or due to showing symptoms themselves. Other staff have been admitted; one caregiver has been intubated for 10 days in the ICU, and we hope she will beat the virus.

Every day officials change the protocols we use. Protection equipment that has been adequate for days is the next day considered unacceptable.Staff are told to use the equipment in a “rational” manner. We reuse FFP2 and FFP3 masks, which we keep in envelopes in our locker because we don’t know how long they will last. They tell us that a new shipment from China is coming soon that will fix the problem. We’ll see.

Initially they had week-long contracts for new nurses, which has since been extended to a month. Do hospital management really think the pandemic will be over in a month? We wish! 40 percent of Osakidetza staff and 49.4 percent of staff in Navarre, according to sources from ELA trade union, are employed on short term contracts.

It is unknown how the hospital will handle cancelled surgeries and specialist appointments after the pandemic. We as workers hope that it’s not based on “contract work” that fattens the pockets of some unscrupulous professionals. We also hope that once and for all, public health begins to put things in order: enhancing primary care, using all resources effectively, with specialist consultations and operating rooms available all day, increasing the number of hospital beds, and eliminating temporary employment of health workers.

Fight for quality public healthcare! It works, and it is a great social victory that we must defend!