Dr. Ernesto Guevara hospital

Dr. Ernesto Guevara de la Serna General Teaching Hospital, the main health institution in Las Tunas, reorganizes its services to avoid the aggravation of an active COVID-19 transmission event among its workers and patients, which already has more than 30 new positives.

Las Tunas, Cuba.- From now on, informed Dr. Henry López Jiménez, the director, patients will be admitted first to short-stay rooms where they will undergo the PCR test unless they arrive in a serious or maternity condition, for which cases there will be separate cubicles.

"In the work teams of these wards, the director said, all the clinical and surgical specialties will be represented and will be incorporated according to the demand of the admissions; they will be organized by shifts and all of them will undergo the PCR test before starting their working day". He clarified that they will not work in isolation, but will remain in their homes when they are not on duty.

Those who will go into isolation will be the 74 patients in the hemodialysis ward. In several groups they will remain for five days inside the institution; they will be accompanied by medical, nursing, and service personnel, under a similar confinement regime with PCR studies and observation. "They will not be allowed to be accompanied, with some exceptions," he stressed.

In the rest of the areas, López Jimenez added, circulation routes will be established by differentiated corridors for the transfer of patients, food, linen, and solid waste. "The patient will exceptionally leave the hospitalization room for diagnostic or therapeutic procedures," he said. Likewise, he indicated, the workers in the infectious wards, the surgical or critical care units, hemodialysis, delivery rooms, neonatology, and other risk areas will remain in their places until the end of their respective work shifts.

He pointed out that the surgical work within the center will be limited to surgeries associated with emergencies, maternity, and oncology. Only the outpatient clinics of Cardiology, Gastroenterology, Oncology, Physiotherapy for hospitalized patients, and specialized Ophthalmology will remain in the building; the rest will be relocated to Gustavo Aldereguía and Guillermo Tejas polyclinics, both in the city of Las Tunas.

The director of the "Guevara" hospital explained that stricter internal hygiene protocols are in force, with daily inspections carried out by the state health inspectorate to ensure compliance with biosafety standards in the hospital services and during medical care.

"In the case of the rooms used for hemodialysis admissions, workers will wear face shields, medical masks, overcoats, gloves, and pajamas," he said. Besides, he said, the decontamination of the air-conditioning systems will be reinforced, as well as of the surfaces, mirrors, and face shields, together with the cleaning of the premises, beds, tables, chairs, and objects such as doorknobs, handrails, mattresses, and walls. Other points of greater rigor will be the containment barriers in all hospitalization rooms.

Something similar will happen with the daily inquiry which, he said, "will search for patients with symptoms suggestive of the disease with priority in the focus, in first and second-order contacts, or people with decompensated comorbidities, vulnerable groups, and adjacent risk areas."

Hospital executives will visit the hospital daily "to ensure and demand compliance with biosecurity measures, the use of personal protective equipment and all the indications issued to face the pandemic and the institution's outbreak controls."

In previous weeks, other epidemiological control measures were taken, such as the transfer to the Guillermo Domínguez hospital, in Puerto Padre, of the cases of acute respiratory infections or suspected cases of COVID-19, and the visits to the admitted patients were eliminated, extending also the periods of stay of their companions.

However, in the last 10 days, a total of 33 new SARS-CoV-2 positives have been diagnosed among patients and medical staff at the Ernesto Guevara Hospital, specifically in the Intermediate Care Unit, as well as in the Puerperium, Urology, and Nephrology wards. The sources of these infections have not always been within the largest hospital facility in the province.

However, Public Health, in this territory, has decided to reinforce epidemiological control measures, taking into account the lessons learned after local transmission events occurred in other provinces, commented Dr. Viviana Gutiérrez, head of the sector here.