Hospital El Salvador: a novel paradigm of intensive care in response to COVID-19 in central America

• Authors: Manuel Bello, Hospital de Diagnostico de El Salvador; Victor Segura, 81 y 83 Centro Médico Escalón; Luis Camputaro, Hospital de Diagnostico de El Salvador; William Hoyos, Ministry of Health of El Salvador; Mauricio Maza, Basic Health International; Xochitl Sandoval, National Institutes of Health; Magdalena Serpa, Colorado School of Public Health; Craig Coopersmith, Emory University
• Journal Title: The Lancet Global Health
• Publisher: Elsevier | 2021-01-01
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/S2214-109X(20)30513-1
• Subjects: Health Sciences, Health Care Management; Health Sciences, Public Health
• Keywords: COVID-19; El Salvador; pandemic; trends; acute respiratory syndrome; hospitalization; ICU; quarantine

Abstract

On March 18, 2020, the first case of COVID-19 was confirmed in El Salvador.1 Closely monitoring pandemic trends worldwide,2, 3, 4 local experts realised that if El Salvador's cases were to mirror global trends, 20% of people infected with severe acute respiratory syndrome coronavirus 2 would require hospitalisation, and between 5% and 8% would require an ICU bed.5 Yet there were only 94 ICU beds in the public health system, distributed between nine hospitals (1·45 ICU beds per 100 000 people). By March 18, the occupancy rate was already 80%, meaning that only 19 ICU beds were available for critically ill patients with COVID-19 across the country. The profound risk associated with this low bed capacity was highlighted by experiences in Italy, which has 8·42 ICU beds per 100 000 people,6 and yet still had a massive stress put on its health-care system when demand surpassed supply during an early surge of cases of COVID-19.