In mid-October, with the downward trend noted in the spread of the coronavirus, the health authorities had carried out a reorganization in the care of Covid-19 patients by closing almost all the Epidemic Treatment Centers (Cte), except those of Fann and Dalal Jamm hospitals. Which was not a “final closure”! Just a “readjustment” of the response strategy by reducing the system put in place. As there were hardly any more patients, the supervision no longer considered it necessary to leave all the functional centers and to mobilize all the staff.
This was the explanation given by the director of the operations and health emergencies center (Cous), Dr Abdoulaye Bousso about the closure of the treatment centers. “ We have lightened the system. We are not going to open all the centers, mobilize all the staff when there are no patients. Hospitalization of patients is centralized between Fann and Dalal Jamm. But at the level of each region, there is a hospital which has the capacity to receive patients. The staff must be reorganized according to the number of patients. The number of patients decreasing, we have restructured the device and for the moment, there is no problem “, He said not without stressing that Senegal was not immune to a second wave given the small variation in the number observed throughout the month of November.
He held this speech at the beginning of the current month, and had even invited to wait until the end of the week, around December 10, to make a good analysis on the evolution of the cases! As a good scientist, he was not mistaken about the occurrence of a possible second wave when he spoke about the situation of the epidemic on December 3. It was the beginnings of a resumption of contamination at high speed with today 30 cases in intensive care, and 4 to 6 deaths on average per day. Hence the need to reactivate the monitoring system put in place, especially with the reopening of treatment centers dedicated to Covid patients, which were put on hold after the observed drop in cases.
Everyone had noticed a certain lull, and we had almost more serious cases in many areas. This had justified the closure of the centers by the health authorities who, on the instructions of the Head of State, began to welcome a category of patients who tested positive for Covid. Indeed, on Wednesday December 16, during a council of ministers, the Head of State ordered the reopening of the treatment centers by asking the Minister of Health, Abdoulaye Diouf Sarr, to reactivate these said centers, remobilizing and motivate health personnel more and, above all, strengthen emergency and resuscitation services in hospitals.
Speaking of motivation, President Sall had surely received the open letter sent by the nursing staff at the CTE level, particularly the paramedics (nurses, state midwives, nursing assistants, nursing assistants, etc.) asking him to decide on the issue. dispute between them, during the month of July, with the Minister who allegedly refused to grant them a monthly incentive allowance with a large part of the staff who was only entitled to a monthly allowance in lieu of a salary.
Two days after President Sall’s instructions, the minister convened hospital directors on December 18 to discuss the issue of reopening epidemic treatment centers (Cte) for better case management, especially serious ones. Diouf Sarr had also made a field visit to the CTEs of Fann, Grand Yoff and Dalal Jamm.
The case of Touba, a major concern
In less than a week after the Head of State’s instructions, ” all the epidemiological treatment centers in Senegal have been reopened and operational “. At least, this is the statement of the director of Sneips, Dr Ousmane Guèye, according to which, there would be no region today which is not operational. ” Even in Ndioum and Kaffrine where we have technical establishment centers, and where there are no patients, they are operational. “! Except that this assurance from the director of the National Service of Education and Information for the Promotion of Health (Sneips) does not seem to concern Touba where it is difficult to pass the key to the door of their Cte, and where hospitals are now overwhelmed, and who may no longer bear the expenses related to the care of infected patients.
Our source does not go four ways. “ That of Touba (Editor’s note: Epidemiological treatment center) is not open. We are overwhelmed. Our patients are still there. No solution. It is nonsense. Even yesterday, I was called in by the emergency room. Our emergency is full because of the Covid. Our deaths have been notified to the commission. Professor Seydi is right to say that there is excess mortality linked to insufficient and delayed treatment, and not linked to virulence. We must sound the alarm. They said 19 out of 20 centers opened. It would be nice to see what is also happening in the regions. The situation is serious. Some hospitals cannot bear the cost of support or delays. Here, we had a death the day before yesterday, two serious cases in a coma that we cannot transfer, for lack of functional Cte. Some are hostile without isolation. It’s catastrophic. This is no longer medicine », Laments this health specialist, on condition of anonymity.
Still speaking of this Touba center which is not yet functional, he affirms that ” it is certainly the Minister of Health who must give the green light with accompanying measures. According to rumors, they owe money owed to the hospitals that host the centers and take care of their management in relation to the first opening. It is delegated management. If the means do not follow, the hospital goes into debt. So those in charge will be dragging their feet. ».
It must just be said that the Cte de Touba, housed at Matlaboul Fawzayni hospital is still not functional. Touba is one of the areas where the disease is on the rise with severe cases and deaths. Health structures rely heavily on the opening of the Cte for the management of serious cases. What can explain this slowness? Some think it is a problem of resources. The hospital would not be able to support the bill without financial and logistical support from the supervisory ministry. It is to be feared that there will be an increase in the number of cases of death due to delay or lack of care. This situation confirms the professor on the excess mortality noted in this second wave.
The witness
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