“A maior operação de guerra pela vida”: como o HC de SP corre para evitar o colapso

Hospitais privados e empresas doam recursos humanos ou financeiros para garantir ampliação de leitos antes do pico da pandemia de coronavírus

Jornal GGN – O Hospital das Clínicas (HC) da Faculdade de Medicina da Universidade de São Paulo (USP) montou a “maior operação de guerra pela vida” de sua história, nas palavras da diretora Eloisa Bonfá. Embora esteja com 98% dos leitos de UTI ocupados com pacientes positivos para COVID-19, o superintendente Antônio José Rodrigues Pereira aposta que não haverá “colapso” na instituição. “O hospital está muito preparado para o que está acontecendo”, disse à Folha desta segunda (27).

Em meio à pandemia do coronavírus, o HC apostou na reconfiguração de sua estrutura de atendimento e na parceria com empresas e hospitais privados – que são os maiores interessados em adiar o colapso no sistema público de saúde – para ampliar o número de leitos. Dos 200 leitos de UTI instalados no último mês, 181 já estão ocupados.

Desde o dia 30 de março, o Instituto Central do HC foi isolado para receber exclusivamente pacientes com coronavírus. Tarcísio Barros Filho, que administra o Hospital das Clínicas, disse à imprensa que, nesta operação, dos 2,4 mil leitos totais do complexo, 900 foram reservados para a COVID-19.

“Desses 900, 100 já eram originalmente de UTI. Com colaboração do governo [do Estado], passaram para 200. São insuficientes. A demanda tem sido muito grande.
Procuramos ajuda dos hospitais privados”, relatou.

Beneficência Portuguesa, Rede D’Or, o HCor, Sírio Libanês e Albert Einstein estão entre os hospitais privados que colaboraram oferecendo enfermagem devidamente treinada, médicos, aparelhos monitores e outros insumos para a ampliação dos 200 leitos até agora. “Na próxima semana, [a parceria permitirá que] passemos para 300 leitos de UTI”, comentou Tarcísio.

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Os bancos Bradesco, Itaú e BTG Pactual também doaram recursos.

Segundo Eloisa Bonfá, um mês depois do isolamento do Instituto Central, cerca de 1 mil pacientes de média e alta complexidade já foram atendidos. “Isso só foi possível porque tivemos tempo. Se esses 1 mil chegassem a nossa porta em um dia, nós não teríamos condições de atendê-los. Então eu queria que a população entendesse que nós estamos nos preparando para a maior operação de guerra pela vida que o HC presenciou nos seus 76 anos”, disse ela nesta segunda, ao lado do governador João Doria.

Bonfá afirmou que a demanda por mais 100 leitos de UTI para o final de maio e começo de junho é uma fase “mais complicada”. “Ela tem que transformar enfermarias e centros cirúrgicos em leitos de UTI. Nunca conseguiríamos fazer isso sozinhos no pouco tempo que nós temos para esperar o pico da pandemia. Isso só está sendo possível porque temos aqui representados hospitais privados que nos estenderam a mão, e empresários que nos estenderam a mão.”

O governador João Doria (PSDB) afirmou que o Estado já recebeu um total de 406 milhões de reais em doações financeiras ou serviços e produtos, tudo destinado à saúde e à proteção social. Somente hoje pela manhã foram levantados mais 39 milhões de reais.

Segundo o superintendente do HC, com mais recursos, foi possível fazer um estoque de insumos. O consumo de máscaras brancas cresceu de 150 mil antes do Covid para 1,2 milhão por mês e há estoque para 150 dias. De N-95, o consumo foi de 5 mil ao mês para 45 mil, com estoque para 180 dias. De álcool gel, de 1,5 milhão de litros para 15 milhões, com estoque de 120 dias. De aventais, de 15 mil para 450 mil, também durando mais 120 dias.

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O HC não é um hospital de portas abertas. “Todos os pacientes deverão ser encaminhados pela Secretaria de Estado da Saúde. (…) As pessoas devem procurar, em caso de necessidade, as unidades básicas de saúde próximas de suas casas”, informa a assessoria de imprensa do hospital.

A reconfiguração do sistema de atendimento também ajudou a proteger, na visão do HC, os pacientes com outros problemas de saúde, como vítimas de AVC, infartos e câncer, que agora estão separados dos casos de COVID-19. Foram transferidos cerca de 400 pacientes que ocupavam leitos no Instituto Central para as outras unidades.

O esforço contou com a participação dos Institutos do Coração (InCor), do Câncer (ICESP), de Radiologia (InRad), de Ortopedia e Traumatologia (IOT), de Psiquiatria (IPq), da Criança (ICr) e de Medicina Física e Reabilitação (IMRea).

Você pode fazer o Jornal GGN ser cada vez melhor.

Assine e faça parte desta caminhada para que ele se torne um veículo cada vez mais respeitado e forte.

Assine agora

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  1. vídeo(https://www.youtube.com/watch?v=V7e4f_qSy1s&feature=youtu.be)

    Oxford COVID-19 vaccine begins human trial stage
    Published–23 Apr 2020–Oxford University(http://www.ox.ac.uk/news/2020-04-23-oxford-covid-19-vaccine-begins-human-trial-stage)

    University of Oxford researchers have begun testing a COVID-19 vaccine in human volunteers in Oxford today. Around 1,110 people will take part in the trial, half receiving the vaccine and the other half (the control group) receiving a widely available meningitis vaccine.

    Of the first two volunteers to take part today, one will likewise receive the vaccine and the other the control.

    The researchers started screening healthy volunteers (aged 18-55) in March for their upcoming ChAdOx1 nCoV-19 vaccine trial in the Thames Valley Region. The vaccine is based on an adenovirus vaccine vector and the SARS-CoV-2 spike protein, and has been produced in Oxford.

    The Oxford Vaccine Centre COVID-19 Phase I Clinical Trial Explained

    The study is to test a new vaccine against COVID-19 in healthy volunteers.

    It aims to assess whether healthy people can be protected from COVID-19 with this new vaccine called ChAdOx1 nCoV-19. It will also provide valuable information on safety aspects of the vaccine and its ability to generate good immune responses against the virus.

    What is the vaccine being tested?

    ChAdOx1 nCoV-19 is made from a virus (ChAdOx1), which is a weakened version of a common cold virus (adenovirus) that causes infections in chimpanzees, that has been genetically changed so that it is impossible for it to grow in humans.

    Genetic material has been added to the ChAdOx1 construct, that is used to make proteins from the COVID-19 virus (SARS-CoV-2) called Spike glycoprotein (S). This protein is usually found on the surface of SARS-CoV-2 and plays an essential role in the infection pathway of the SARS-CoV-2 virus. The SARS-CoV-2 coronavirus uses its spike protein to bind to ACE2 receptors on human cells to gain entry to the cells and cause an infection.

    By vaccinating with ChAdOx1 nCoV-19, we are hoping to make the body recognise and develop an immune response to the Spike protein that will help stop the SARS-CoV-2 virus from entering human cells and therefore prevent infection.

    Vaccines made from the ChAdOx1 virus have been given to more than 320 people to date and have been shown to be safe and well tolerated, although they can cause temporary side effects, such as a temperature, headache or sore arm.

    What does the study involve?

    Up to 1102 participants will be recruited across multiple study sites in Oxford, Southampton, London and Bristol. These participants will be randomly allocated to receive either the ChAdOx1 nCoV-19 vaccine or a licensed vaccine (MenACWY) that will be used as a ‘control’ for comparison.

    At the start of the trial we will also recruit a separate small group of 10 volunteers who will receive 2 doses of ChAdOx1 nCoV-19 four weeks apart.

    What is the MenACWY vaccine?

    The MenACWY vaccine is a licensed vaccine against group A, C, W and Y meningococcus which has been given routinely to teenagers in the UK since 2015 and protects against one of the most common causes of meningitis and sepsis. This vaccine is also given as a travel vaccine for high risk countries.

    The MenACWY vaccine is being used as an ‘active control’ vaccine in this study, to help us understand participants’ response to ChAdOx1 nCoV-19. The reason for using this vaccine, rather than a saline control, is because we expect to see some minor side effects from the ChAdOx1 nCOV-19 vaccine such as a sore arm, headache and fever. Saline does not cause any of these side effects. If participants were to receive only this vaccine or a saline control, and went on to develop side effects, they would be aware that they had received the new vaccine. It is critical for this study that participants remain blinded to whether or not they have received the vaccine, as, if they knew, this could affect their health behaviour in the community following vaccination, and may lead to a bias in the results of the study.

    Who can take part in the study?

    Participants must: Be aged 18-55 years old, be in good health, and be based in one of the recruiting areas.

    Participants must NOT: Have tested positive for COVID-19, be pregnant, intending to become pregnant, or breastfeeding during the study, or have previously taken part in a trial with an adenoviral vaccine or received any other coronavirus vaccines.

    How will the trial work?

    The main focus of the study is to find out if this vaccine is going to work against COVID-19, if it won’t cause unacceptable side effects and if it induces good immune responses. The dose used in this trial was chosen based on previous experiences with other ChAdOx1 based vaccines.

    Study participants will not know whether they have received the ChAdOx1 nCoV-19 vaccine until the end of the trial.

    The first few days of vaccinations will be planned as follows:
    Day 1:
    The first two participants will be vaccinated, one with the ChAdOx1 nCoV-19 vaccine and one with the control vaccine.
    Participants monitored for 48 hours.

    Day 3:
    A further six participants will be vaccinated, three with the ChAdOx1 nCoV-19 vaccine and three with the control vaccine.
    Participants monitored for 48 hours.

    Day 5:
    Progress to vaccinating larger numbers of participants.

    What about after the vaccination?

    Participants will be given an E-diary to record any symptoms experienced for 7 days after receiving the vaccine. They will also record if they feel unwell for the following three weeks.

    Following vaccination, participants will attend a series of follow-up visits. During these visits, the team will check participants’ observations, take a blood sample and review the competed E-diary. These blood samples will be used to assess the immune response to the vaccine.

    If participants develop COVID-19 symptoms during the study, they can contact a member of the clinical team, and we will assess them to check whether they have become infected with the virus. If a participant was very unwell, we would call our colleagues in the hospital and ask them to review the volunteer if appropriate.

    When will the results be available?

    To assess whether the vaccine works to protect from COVID-19, the statisticians in our team will compare the number of infections in the control group with the number of infections in the vaccinated group. For this purpose, it is necessary for a small number of study participants to develop COVID-19. How quickly we reach the numbers required will depend on the levels of virus transmission in the community. If transmission remains high, we may get enough data in a couple of months to see if the vaccine works, but if transmission levels drop, this could take up to 6 months.

    What if it doesn’t work?

    A high proportion of vaccines are found not to be promising even before clinical trials. Moreover, a significant proportion of vaccines that are tested in clinical trials don’t work. If we are unable to show that the vaccine is protective against the virus, we would review progress, examine alternative approaches, such as using different numbers of doses, and would potentially stop the programme.

    http://www.ox.ac.uk/news/2020-04-23-oxford-covid-19-vaccine-begins-human-trial-stage

    https://www.youtube.com/watch?v=V7e4f_qSy1s&feature=youtu.be

  2. —-A team of scientists at the University of Oxford are working to produce a vaccine to combat Covid-19. Adar Poonawala’s Serum Institute has partnered with the Oxford vaccine project as one of the seven global institutions behind manufacturing the vaccine.—-
    —–‘In around two weeks, we can produce five million doses a month and scale that up to 10 million after six months,’ he said.—

    This is not a time to make money, says Indian partner of Oxford vaccine attempt(https://www.indiatoday.in/business/story/this-is-not-a-time-to-make-money-says-indian-partner-of-oxford-vaccine-attempt-1669918-2020-04-220
    A team of scientists at the University of Oxford are working to produce a vaccine to combat Covid-19. Adar Poonawala’s Serum Institute has partnered with the Oxford vaccine project as one of the 7 global institutions behind manufacturing the vaccine.
    India Today Web Desk—New Delhi–April 22, 2020—-UPDATED: April 23, 2020 05:00 IST

    Adar Poonawalla, chief executive officer of Serum Institute of India — which is helping produce a vaccine for Covid-19 developed by Oxford, said this is not the time to make money from a vaccine against the novel coronavirus, which has caused a global pandemic. Speaking to India Today TV Adar Poonawalla said that the need of the hour is to make a Covid-19 vaccine accessible to as many as possible. We won’t be patenting any vaccine we produce nor will we take royalties, he also said.

    A team of scientists at the University of Oxford are working to produce a vaccine to combat Covid-19. Adar Poonawala’s Serum Institute has partnered with the Oxford vaccine project as one of the seven global institutions behind manufacturing the vaccine.

    Adar Poonawala was also joined by Oxford professor Dr Adrian Hill, who is leading the team developing the vaccine, in the interview. Dr Adrian Hill said the Oxford University is starting its clinical trials for the Covid-19 vaccine from Thursday.

    The vaccinologist said several vaccines are in the clinical trials stage at the moment. ‘We are starting tomorrow… Have to test its safety, to see whether it produces immune response and what protection the vaccine offers,’ Dr Hill said, while speaking about the challenges ahead for his team.

    When asked how confident is he about the vaccine, Dr Hill said there are several indicators the vaccine being developed by Oxford could be a good one.

    He elaborated, ‘One is that this is a single dose vaccine. It is much more suitable for a pandemic situation. The technology of this vaccine has been used before so we are hopeful this will be safe as well. The scale up process to produce large numbers is achievable. Our Indian partner, Serum Institute, will help us achieve this.’
    On being asked what could go wrong in the vaccine, Dr Hill answered saying there are several risks with any vaccine and it might not be safe, which is unlikely.

    ‘There might just not be enough people to test on to check the vaccine’s efficacy. We need to be lucky in the clinical trials we choose that we get enough people without Covid-19 in the control group to show conclusively that the vaccine is working well,’ he explained.

    Meanwhile, Adar Poonawala said his institute’s team members are working closely with Dr Hill for the vaccine.

    ‘In around two weeks, we can produce five million doses a month and scale that up to 10 million after six months,’ he said.

    Adar Poonawala was also asked how confident is he that the Covid-19 vaccine being developed could be winner compared to ones that the others are making, and he said he cannot speak for others but all he can say is that the scientists at Oxford are among the best in the world. I have a lot of faith If anyone succeeds, I’m sure Dr Hill and his colleagues will be the ones to succeed, Poonawala said.

    But by when can people expect the vaccine? Dr Hill said, ‘Well we are aiming hundreds of millions of doses with our partners by Q4 this year. But a word of caution, a lot of things have to go right for that on the clinical trials and scale up process.’

    https://www.indiatoday.in/business/story/this-is-not-a-time-to-make-money-says-indian-partner-of-oxford-vaccine-attempt-1669918-2020-04-22

    https://www.seruminstitute.com/news.php

    INTRODUCTION(https://www.seruminstitute.com/about_us.php)

    Serum Institute of India Pvt. Ltd. is now the world’s largest vaccine manufacturer by number of doses produced and sold globally (more than 1.5 billion doses) which includes Polio vaccine as well as Diphtheria, Tetanus, Pertussis, Hib, BCG, r-Hepatitis B, Measles, Mumps and Rubella vaccines. It is estimated that about 65% of the children in the world receive at least one vaccine manufactured by Serum Institute. Vaccines manufactured by the Serum Institute are accredited by the World Health Organization, Geneva and are being used in around 170 countries across the globe in their national immunization programs, saving millions of lives throughout the world.

    Serum Institute of India is ranked as India’s No. 1 biotechnology company, manufacturing highly specialized life saving biologicals like vaccines using cutting edge genetic and cell based technologies, antisera and other medical specialties.

    Serum Institute of India was founded in 1966 by Dr. Cyrus Poonawalla with the aim of manufacturing life-saving immuno-biologicals, which were in shortage in the country and imported at high prices. Thereafter, several life-saving biologicals were manufactured at prices affordable to the common man and in abundance, with the result that the country was made self-sufficient for Tetanus Anti-toxin and Anti-snake Venom serum, followed by DTP (Diphtheria, Tetanus and Pertussis) group of Vaccines and then later on MMR (Measles, Mumps and Rubella) group of vaccines.

    The Philanthropic philosophy of the company still not only exists but has been proliferated to bring down the prices of newer vaccines such as Hepatitis-B vaccine, Combination vaccine etc., so that not only Indian’s, but the entire under-privileged children of the world are protected from birth onwards.

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