Bernardí Comas: “Vaccination has caused the population to lower its guard in this explosive covid wave”

Answer: Over the course of this year things have changed a lot. This latest wave has been different from previous ones and has had a profound impact on the Accident & Emergency Department for three main reasons. The first and most fundamental one is because it has been an explosive wave, we have had a lot of cases in a very short space of time. This has been a very important factor, without a doubt.

Q. And secondly?

A. Because it has affected young people, the highest percentage of infected patients has been under thirty years old, people who are mobile with high potential for infection. And, finally, the third cause that has made this wave special is that non-covid conditions have remained high. That is, we continue to see many cases of vascular disease, heart attacks and polytrauma. This has forced us to organise ourselves in a different way from what we have done up until now.Q. To what do you attribute the increase in A&E attendance?

A. Here there is a key issue and it is that, in relation to covid, the population has lowered its guard.

Q. Why?

A. Firstly because of vaccination, people have a false sense of security after beng vaccinated and they need to be reminded that vaccinated people are also infectious, admittedly less so and with less serious consequences but still infectious. Secondly I would suggest that antigen tests also provide a false sense of security because a negative test doesn’t guarantee you won’t or don’t have covid and, finally, I think that lukewarm information has been given about the use of masks. It is clear that they must be used routinely and this has not been made entirely clear.

Q. Routinely forever?

A. I would wear a mask everywhere except in very open spaces and during personal contacts in our own environment. Except in these cases, I think that we should convey the idea that the mask is here to stay, that it should be worn.

Q. Forever?

A. Yes. I think we should get used to wearing them because it has been shown that, together with other protective measures, they prevents infection.

Q. Let’s go back to the increase in the number of patients in your department…

A. In the last few weeks we have seen an average of 450 patients a day and in the last seven days we have had peaks of more than five hundred. That is very high.

Q. Compared to what?

A. It has increased between 13% and 15% compared to a year ago.

Q. To what do you attribute this?

A. To the fact that during the previous wave people used A&E more responsibly, they only came in for serious cases and I would say that now they are using A&E routinely. I would like to remind people that my service is for serious cases and patients who arrive should do so either after being referred by their primary care physician or by the central 061.

Q. Couldn’t the fact that Primary Care is currently overwhelmed with vaccinations have contributed to this increased use of the A&E?

A. I believe that multiple factors are causing it. Behind this increased attendance will be the high levels of activity in Primary Care, possible delays in hospital outpatient clinics and the floating population. In other words, there are a lot of factors behind the increase in ED attendance.