Judicial Oversight Council Recommends Use of Private ICUs for Treatment Covid-19

RIO DE JANEIRO, BRAZIL – The National Council of Justice (CNJ), an internal oversight body of all Brazil’s court systems, recommends that private Intensive Care Units (ICUs) be used for Covid-19 patients in order to unburden public health systems, which are now on the verge of collapse.

With the spread of the novel coronavirus pandemic, which broke records and killed 751 people in the country in the past 24 hours, states facing the most critical situation of the disease are struggling to ensure care in the SUS (public health care system).

In Rio de Janeiro, for instance, the wait list for vacancies in ICUs currently exceeds 1,000 patients, and even the private network is nearing collapse. Other states such as Ceará, Amazonas, and Pernambuco have 99 percent of their care capacity in use.

“The scenario suggests that in certain states there is a shortage of ICU beds and health equipment in both the public and private sectors, and in others, there is a shortage in the public sector with idleness of beds and equipment in the private sector,” reads the document.

The CNJ’s recommendation is to set up a specific crisis room comprising Public Administration control bodies, such as the Prosecutor’s Office and the Audit Courts. The recommendation is that the regulation of beds be centralized in the states, rather than individually in the municipalities.

“When, and if, existing resources are exhausted, new resources should be mobilized, such as temporary hospital structures, the opening of new structures within existing hospitals and new hospitals. At this time, preference should be given to the requisitioning/contracting of non-SUS beds due to the speed and cost-effectiveness of this initiative in relation to the construction of field hospitals, while maintaining the use of structures already established, of course”, says the council.

The discussion on the “single queue” for ICUs (where the wait list for public and private units is the same) gained ground this week, including among the private sector hospitals. The CNJ was expected to refrain from deciding on this issue since there was no unanimity among the councilors on the jurisdiction of the judicial body.

The model proposed by the CNJ resembles the single wait list for transplants but has limited application while the pandemic lasts.

“The seriousness of the situation and the relevance of the issues faced warrant guidance from the National Council of Justice to suggest a management model aimed at dialogue in the public and private spheres, seeking to promote the greater good that is the protection of life,” the document states.

Even before the CNJ’s recommendation, states were mobilizing to guarantee a partnership with the private sector. In São Paulo, for instance, Mayor Bruno Covas said last week that private hospital beds could be requisitioned, despite an agreement with the private health network. With the decision, approximately 800 new beds will be available, according to a survey conducted by the São Paulo City Hall’s Health Department.

The CNJ document also points out that the quarantine and lockdown strategies adopted by some states as a means of reducing contagion of the disease “tend to reduce the vulnerability of the system and extend the time for contingency preparation”.

The Sírio-Libanês Hospital is available to help and understands that its role is to assist the government in tackling the Covid-19 pandemic.

“We have extensive experience in medical-hospital care in public health, as we serve more public than private patients. Sirio-Libanês has always worked with the mission of bringing about a more just and fraternal society, and understands that this is the moment for all of us to be socially responsible,” says Dr. Paulo Chapchap, director-general of the Sirio-Libanês Hospital Ladies Beneficent Society, who contributed to the preparation of the opinion.

Source: Exame