MADRID (AP) – Once the lifeless body is silently pushed away on a stretcher, a cleaning battalion enters the intensive care box. Within a few minutes, the bed where the 72-year-old woman was moist for more than two weeks for a new breath is wiped clean, the walls of glass isolate it disinfected with a squeegee.
There is little time to think about what just happened, as death gives way to the opportunity to save another life.
“Our greatest source of joy is of course emptying a bed, but because someone is being fired and not because they have died,” said Ignacio Pujol, the head of this ICU in Madrid. “That’s a little space in there for someone else to get another chance.”
As a wave of infections is once again confusing the Spanish public health system, nurse Isabel Zendal hospital that employs Pujol, a project seen by many as an extravagant vanity business, is getting another chance to prove its usefulness.
Named after the 19th-century Spanish nurse who took smallpox vaccination across the Atlantic, the facility was built in 100 days at a cost of 130 million euros ($ 157 million), more than double the original budget. It features three pavilions and support buildings over an area the size of 10 football fields, somewhere between a small airport terminal and an industrial warehouse, with ventilation ducts, medical beds and state-of-the-art equipment. The original project involved 1,000 beds, of which about half have been installed so far.
The Zendal started on December 1 to a roar of competitive fanfare and criticism, just as Spain seemed to dampen a wave of coronavirus infections after the summer. By mid-December it had received only a handful of patients.
But Spain registered more than 84,000 new COVID-19 infections on Monday, the highest one-weekend increase since the start of the pandemic. The country’s total number rises to 2.5 million cases with 53,000 confirmed virus deaths, although excess mortality statistics add more than 30,000 deaths.
While the contamination curve got steeper after Christmas and New Year, the Zendal has gotten busy. On Monday, 392 patients were treated, more than any other hospital close to 6.6 million.
Spain’s rise follows similar increases in infections in other European countries, most notably in the UK after the discovery of a new virus variant that experts say is more contagious. The London Nightingale, one of Britain’s temporary hospitals designed to relieve pressure on the country’s overwhelmed health care system, has also reopened for patients and as a vaccination center.
Spain’s top health officials insist they have found no evidence that new variants wreaking havoc elsewhere are in any way contributing to its own skyrocketing infections. Some experts dispute that claiming the country’s limited ability to sequence coronavirus cases distorts reality and that a new stay-at-home order is necessary.
On the ground, increasing hospital admissions for the virus are already surpassing the peak of the second resurgence. Almost one in five hospital beds has a patient with COVID-19. The new disease also takes up a third of the country’s IC capacity and non-emergency operations are already being called off.
Left-wing politicians and workers’ unions, accompanied by some medical experts, are accusing the conservative Madrid government of spending on voting hardware rather than bolstering a public health system they have underfunded for years. Investing in contact tracking and primary care, they say, could have avoided the need for a Zendal altogether.
“Rather than the success they boast, the filling of this makeshift hospital represents a massive failure of those at the helm of the response to the pandemic, and also a failure of all of us as a society that was better off can do, ”said Ángela Hernández, a spokeswoman for AMYTS, the main trade union for medical workers in Madrid.
The final straw for the unions, she said, is that the regional government has fired medical personnel who refuse to give up their positions in regular hospitals when they are transferred to the Zendal.
“The project has been bullshit from start to finish,” said Hernández. “A few beds without sufficient staff do not constitute a hospital.”
Fernando Prados, Zendal’s manager, says he doesn’t mind the debate, but the 750 patients treated in the last month and a half have already put significant pressure on other hospitals.
“We have already contributed in some way,” said Prados. “We know we will continue to have COVID patients and once the pandemic is over, this infrastructure will be here for any other emergency.”
Beyond automatic glass doors, patients recover in 8-bed modules, leaving little room for privacy but providing better monitoring of potential complications in their recovery, said Verónica Real, whose challenge as chief nurse was to organize staffing teams from other hospitals.
“Some plumbing workers arrive with some anger at all the noise around our hospital,” said Real. “But once here the attitude changes completely.”
Zendal managers say that a modern ventilation system refreshes the air in the entire facility every 5 minutes, contributing to a safer work environment. But they are most proud of the expansion of the intermediate respiratory care unit, where patients are given different types of assisted breathing to overcome pneumonia.
The unit’s chief, Pedro Landete, says that by accommodating potentially deteriorating patients in one of the 50 well-equipped beds, they reduce the number of people who later need the more demanding intensive care.
José Andrés Armada arrived at the facility with mild symptoms after his entire family was infected, despite what he said was a very careful handling of the pandemic. But the 63-year-old’s health was deteriorating rapidly, and last week he was about to be intubated in one of the Zendal’s dozens of IC boxes.
“I know the economy is something to protect, but health is more important. We should be closed now. You can’t have bars and other places open, ”said the former entrepreneur.
“I never thought it could attack you like that.”
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AP reporter Jill Lawless in London contributed to this report.
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