María’s history with the Covid began a year ago, two days after the declaration of the first state of alarm. Everyone in his house was infected, including his eldest daughter, then five months pregnant, the only one who entered. María was burned that day: “That image of elderly people, and not so old, entering the hospital emergency room alone, from which many have never left again, had an impact on me in such a way that I will never forget it »Recalls this social worker from a hospital in León, who prefers not to reveal her true identity. The situation of “chaos and despair” that he experienced those days, with wrong diagnoses given the still ignorance of the virus, without tests to certify its infections and with the only recommendation to remain isolated at home, made fear become in his shadow: «I pulled with the situation until I couldn’t take it anymore. Fear seized me. My only outlet were tears ».
He remembers that then “someone” told him about the Comprehensive Care Program for Covid Psychic Sequels set up at the Hospital in León: “I was clear that he was not well, and I accepted the help they offered me,” he says, recalling that his grandson was born and it took time until he took him in his arms: “For months I lost the beautiful sensation of the touch of his skin, gripped by fear.
With the aftermath of the virus passing through her body, today she is “enormously grateful” to the team that promoted the aforementioned program: the psychiatrist Sergio Núñez and the clinical psychologist Esther Turrado. Between first citations and follow-ups, the Covid Team of the Psychiatry and Mental Health Service of the Hospital de León Until mid-March, it had a total of 579 interventions demanded by professionals in the hospital and Primary Care fields. In the eleven areas of Castilla y León, the number of interventions rises to 4,767, to which must be added the people who have participated in group therapies, face-to-face workshops and “on-line Mindfulness” programs. Dr. Núñez explains that in the consultations framed in this program, “those who have suffered from the disease, who have had deaths of close relatives with complicated griefs, or who fear of Covid have disabled their daily life are attended to.” In this sense, it details that they are working with two types of populations: patients who refer them from Primary and “all those workers, health workers or not, who have been exposed during this time to the virus and the uncertainty and workload that it has generated” . The latter have the option of contacting them directly, and in addition to individual, telematic or face-to-face consultation, they offer group sessions for emotional relief.
This psychiatrist considers that the fact that health professionals can have a direct connection to their telephone extensions and that the program has its own email, which can be used by Primary Care physicians and the staff themselves, «speeds up the process of referral »for early care, as we« manage the appointments ourselves ».
Dr. Irene Muñoz León, one of the coordinators of the same initiative at the Río Hortega University Hospital in Valladolid, is satisfied with the results obtained, despite admitting that at the beginning it was very difficult for them to ask the professionals for help. In order to “hook” and learn to recognize their emotions in the midst of daily overexertion at the beginning of the pandemic, the doctor used eight illustrators to develop a guide to facilitate their introspection and self-care. Since its launch, the number of interventions in the West Area of Valladolid framed in this project exceeds 1,200 and nearly a thousand professionals have enrolled in the three editions of the on-line Mindfulness program.
This physician details that if at first those who required her help arrived with symptoms of altered sleep patterns, as well as “anguish, anxiety, fatigue and stress”, right now they are seeing “more adaptive disorders and depressive episodes”, and they hope that they will go away. appearing, “not massively, although we do not know in what quantity, post-traumatic stress disorders”, since these can occur from one week to 30 years after the triggering cause. «The uncertainty that we suffered, and still suffers to a greater or lesser extent, is a source of a very human rational fear, associated with the unknown. If you add to this the limitations at the social level, the imposed isolation, and the constant atmosphere of tension and tension, it is an excellent breeding ground for anxious and depressive pathologies, even reaching the idea of death in times of crisis » , explain doctors Sergio Núñez and Esther Turrado, who add that “currently they have patients with adaptive disorders, very specific phobias secondary to exposure to the virus, but also obsessive disorders that have decompensated or even post-traumatic stress syndromes.”
Profile of the affected professional
Regarding the profile of the healthcare professional who has resorted the most to their help, the psychiatrist Irene Muñoz specifies that in the area of hospital care “yes” they have received more professionals who are on that “front line” in the fight against Covid, but “in the outpatient setting we are seeing a lot of nursing and primary care physicians subjected to a lot of healthcare pressure.” “Not always the most exposed is the most affected, since the functions of many of us have changed to adjust to the health crisis,” says Dr. Núñez: “We see a feeling of guilt in Nursing for not being able to offer care and attention than before they could, just for the mere fact of not being able to be in the rooms; we see doctors with high frustration for not understanding the virus and having very few effective weapons against it … ».
Over the months they have also realized that «the peaks in the demand for our care do not correspond to those of the pandemic itself, the doctors of the Leonese hospital point out:« During the first wave, the requests, although not they were few, nor did they grow at the rate we expected. Interestingly, it was when income dropped, or after the apparent calm at the beginning of the summer, that part of the staff appreciated the effective impact. “
Regarding the type of support they are needing, the professionals of the respective Health Services of the Valladolid and Leon hospitals agree that “each case has great variability.” The first thing, explains Dr. Muñoz, is to assess the type of help they need, “if it is something more psychological, more pharmacological or both.” “In some” they have had an average of five consultations before assessing discharge. “We hope to be intensive, propose guidelines to recover the previous functioning and give the possibility of requesting a new appointment if necessary,” says Dr. Núñez in this regard. The physician Muñoz León confirms it: “We have had everything, long and high follow-ups that then have had to return.”
María admits that “not always” he followed all the doctors’ instructions, “and perhaps for this reason the recovery took longer in time.” However, she believes that the “professionalism” of the team that assisted her gave her “encouragement and strength to continue.” To this day, this social worker has resumed her life and daily routine, “not without doubts, but knowing that they are there and I can count on them gives me great peace of mind.” “We are very proud of the deployment and operation of the program », Emphasize the psychiatrist and the clinical psychologist of the Leonese hospital, recalling the« odyssey »that was to start it up and spread it. Despite everything, “and although somewhat slower than we would like, we believe that we have reached the entire target population and we continue to function in an agile manner.” They highlight the link that has been forged as a benchmark for health personnel: “We think that for a hospital like the one in León it is a seal of quality to have a direct way for its workers to have the necessary support.”