With the health system focused on treating cases of Covid-19, Ceará had in 2020 a drop in more than 500 thousand procedures elective outpatient clinics, that is, non-emergency ones, such as exams and consultations. The data is from a survey by the Federal Council of Medicine (CFM) released this Monday (13).
The study takes into account the volume of care registered in the Outpatient Information System of the Unified Health System (SIA/SUS), carried out between March (first month of the pandemic in Brazil) and December 2020, with the same period of 2019.
In the period analyzed, the number dropped from 2,406,761 to 1,902,487 in the State, revealing a decrease of 504,274 procedures. In percentage terms, the reduction was 21%.
Despite the expressive number, Ceará had the smallest drop in the Northeast region and the sixth smallest in Brazil – whose system was impacted, in total, with almost 27 million fewer procedures. Of the 27 Federative Units, only Amapá and Distrito Federal registered an increase in the analyzed range.
Suspension of appointments
In 19 months of pandemic, so far, the Health Department of Ceará (Sesa) has recommended the suspension of low-risk surgeries and outpatient procedures in two moments: March 2020, the initial month of Covid-19 records, and February 2021 , which marked the worsening of the second wave.
On both occasions, the recommendation was directed to hospitals, clinics, clinics, laboratories and public and private health units in Ceará. Professionals temporarily suspended services were instructed to compose the workforce in the fight against the coronavirus.
The CFM points out that, in general, the negative impact was more drastic during the first two months after the decree of public calamity. “In April and May of last year, the pandemic halved the elective care offered by the most diverse medical specialties,” he explains.
Among the services most impacted by the reduction, the CFM indicates ophthalmological and diagnostic imaging procedures, in addition to monitoring tests for respiratory and metabolic diseases and others cancer preventatives, such as mammography and Pap smears.
Need to reallocate beds to treat the new disease and fear of contamination in the hospital environment. For Gleydson Borges, master of the Brazilian College of Surgeons (CBC) – Ceará Chapter, these were the main reasons that led to the drop in the number of procedures.
However, prolonged isolation without medical assistance also worsened health condition of many patients. With the gradual return to care, doctors need to deal with the worsening of cases that were initially considered simple.
Cases that could initially be handled with simpler procedures are demanding more complex ones. Several patients who should be treated at the right time have not been and are looking to us with more severe conditions.
With damming, the surgeon also notices the imbalance in the system’s capacity to absorb the demand. “Outpatient care takes place in geometric progression, while surgical care takes place in arithmetic progression. In other words, we serve many more patients than we can operate”, he observes.
Borges estimates that the normalization of services to a regular flow still takes time from four to six months, reinforcing that health professionals “are aware” of situations in which this period can be reduced.
The Department of Health of Ceará reported that it reduced, but did not suspend outpatient care, especially for patients with more severe conditions. According to the IntegraSUS platform, state hospitals are resuming or even surpassing the number of visits in relation to January this year, when the Covid-19 indicators were low.
The folder states that thousands of beds set up until May 2021 to meet those infected with Covid-19 remain activated, both in the Capital and in the Interior, “receiving patients from other medical specialties and also from elective surgeries, which were again performed in July ”, confirms.
And it reinforces that, given the current scenario of reduction of cases of the disease, the moment “requires attention and engagement from society to avoid a new increase in cases”. Also remember that mass vaccination is an effective measure to reduce viral circulation and the emergence of new variants.