The morning of Saturday, March 21, 2020, is very much alive in the mind of doctor Maurício Wesley Perroud Júnior, director of the Hospital Estadual de Sumaré (HES). The night before, he had received an email from the São Paulo State Health Department. The message left no doubt. With the pandemic caused by the coronavirus already made official by the WHO since March 11, and cases increasing in Brazil, the response plan drawn up by the hospital, which was ready, needed to come into action immediately.
“That morning we all got together at the hospital and within ten hours we created 24 beds for Covid. It was a huge challenge, but it was necessary because when the first patients arrived [which occurred in a matter of days] we would have nowhere to put them”, says Perroud Júnior, who also works as a pulmonologist at Unicamp's HC.
In retrospect, the Sumaré State Hospital, which is owned by the Government of São Paulo but managed by Unicamp with professionals all hired under the CLT regime, was always, without even knowing it, preparing for large-scale events such as the pandemic that broke out in March. . This has always made the institution, which is celebrating its 20th anniversary this month, a reference in the region. In addition to Sumaré, the hospital serves five other municipalities (the microregions of Americana, Hortolândia, Monte Mor, Nova Odessa and Santa Bárbara D'Oeste) and a total population estimated at more than 1 million people. “One thing that has always helped us a lot was the various training we did over the years to obtain the accreditations that we have achieved in these 20 years. We will complete two decades now, this September 21st”, says the director.
The Sumaré Dr. Leandro Franceschini State Hospital, in its first two years of life, managed to obtain level 3 hospital accreditation, becoming the first public hospital in the country to reach this mark. This is the maximum level of hospital accreditation and indicates that the place offers excellent treatment for patients. “In 2012, we also achieved Canadian international CCHSA accreditation”, says the director of the institution.
According to Perroud Júnior, this memory of always seeking excellence made the hospital join forces to safely combat the coronavirus. “It is a hospital that has always sought to learn, that generates knowledge, and has a lot of experience stored.”
Customized aprons
Even though the coping plan was ready and was considered exemplary by the Department of Health, which even asked for it to be shared with other state institutions, the challenges of facing a pandemic are many. In addition to the beds, still in March, the wards also had to be remodeled. With the changes, an additional 34 beds were reserved for Covid-19 patients. The peak of the disease ended up being reached in July in Sumaré. Of the 399 cases of acute respiratory syndrome treated at the hospital during the pandemic, 167 were confirmed with the disease as of September 8th.
In addition to preparing the necessary infrastructure, reports Perroud Júnior, managing the rising costs of medicines and personal protective equipment for healthcare professionals was also complex. “One of the things that helped us a lot, in addition to budget additions from the State, was the donation from a company in Sumaré. She gave us a fabric used in clothing for tobacco workers. In other words, they are waterproof, because tobacco is toxic, and at the same time light, because they all work when exposed to the Sun.” According to the director, 600 aprons were made with the fabric for healthcare professionals.
The pressure was constant, recalls the Unicamp pulmonologist. According to him, with the supplies used to sedate patients under mechanical ventilation always being in high demand around the world, there was a constant risk that they would become unavailable. “Our clinical teams needed to always review protocols in case something occurred,” says Perroud Júnior. No hospital professional was left without safety equipment and, also, all patients received the appropriate medication, informs the management of Sumaré Hospital.
If the management of supplies and medicines followed an unusual logic even for those most experienced in hospital management, the management of human resources also came to be seen as a possible bottleneck. Even more so because, at first, diagnostic tests took weeks to be ready. With the tests carried out at the Unicamp Clinical Hospital, however, the reality has changed a lot. “As a result, the delay for results fell to a maximum of 48 hours. At no point was there a break in schedules in our hospital”, says the director. Of a total of 1.300 employees, 540 had to be furloughed for two weeks and 221 were infected with the coronavirus. The Sumaré State Hospital became a reference during the pandemic for the treatment of serious cases of Covid-19, which increases the risk of contamination of healthcare professionals.
Births and accidents
Even with an ongoing pandemic, and as it is a reference in the region, the hospital continued to treat serious cases unrelated to the virus. People who were victims of traffic accidents or were hit by bladed weapons or firearms continued to arrive at the emergency room. “This flow continued. But even with the pandemic, we were able to provide this service. As well as the births that needed to be carried out”, says Perroud Júnior. “Everything ended up being an opportunity for us to learn and come out even better”, says the doctor, who hopes that in September the hospital will already meet all the service targets it needs to meet for cases not linked to Covid-19.
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