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Unsustainable

Portugal’s brittle healthcare system is under growing pressure due to an unprecedented rise in coronavirus infections as a result of a relaxation of the measures during Christmas.

Even after a stricter lockdown was put in place on the 15th of January, the number of new cases continued to rise to over 1000 per 100.000 inhabitants. Nearly double that in hard-hit Spain and three times as much as in the Netherlands. This week’s increase is even the biggest in the world!

The health system – which prior to the pandemic had the lowest number of critical care beds per 100.000 inhabitants in Europe – can accommodate a maximum number of 675 Covid patients in ICUs. Currently, more than 95% of the ICU beds are occupied and a further increase in the number of patients is expected over the coming weeks.

‘The impact in hospitals is huge because the number of beds doesn’t increase, the walls are not expandable and health workers are not multiplying’ declared Antonio Pais de Lacerda, a doctor at Lisbon’s biggest hospital Santa Maria.

It is predicted that as many people will die in the next two months as in the last ten and that daily case numbers will not drop before February. Media images of ambulances with patients queuing outside major hospitals in Lisbon waiting for beds, raise fears whether the National Health System (SNS) is on the verge of collapse.

At a recent Infarmed meeting – where government hears the opinion of experts – it was estimated that it will take at least two months for the country to return to pre-Christmas levels. The feeling also was that testing – currently around 47,000 tests a day with around 18% positive results – should be increased, especially in old people’s homes.

With a daily death toll reaching a record high of 218 – one death every seven minutes – and 10.455 new cases, the authorities desperately try to put a lid on the spread of infections. In a country just over 10 million already over 9000 people have died since the start of the pandemic.

In view of the unacceptable rise in the number of cases and deaths, Prime Minister António Costa issued – just 3 days after a stricter lockdown was put in place – even tougher restrictions, similar to the ones during the lockdown of March/April last year. Schools, however, will remain open, much to the dislike of the Ordem dos Médicos, that has called for an immediate closure to save lives.  

It will be clear that protection of the elderly has failed and that until a successful roll-out of the vaccination programme is in place, tension will prevail.

Stay healthy                          Fique saudável             (pic Público/Expresso)


Masks

With more than 3000 new Covid cases and 31 deaths registered in 24 hours – according to figures by Portugal’s DGS (Directorate General of Health) – Parliament decided last Friday that face masks are going to be mandatory in public spaces across the country.

The measure – valid for the next 70 days – obliges residents over the age of 10 to wear masks outside whenever physical distancing of 2 metres can’t be guaranteed. A face shield will not do.
Rule-breaking citizens risk a fine of between 100 and 500 euros.

The decision follows an earlier set of rules – in force since October 15 – in which the entire country returned to a State of Calamity including the prohibition of gatherings in public of more than five people, family events (weddings and baptisms) limited to a maximum of 50 people and fines up to 10,000 euros for anyone breaking rules over physical distancing or numbers of people allowed to meet.

Although with a population of 10 million people, Portugal recorded a comparatively low number of cases (116,000) and deaths (2,300) so far, it is – like most European nations – forced to increase restrictions in order to tackle the second wave of COVID-19. Out of 1455 people in hospital, 221 are currently in Intensive care.

People all over Europe are facing tougher restrictions. Big cities in Italy and France encounter curfews, Greek citizens have been told to stay off the street between 12.30 pm and 05.00 am and Spain declared the State of Emergency as from today.
The Czech Republic, Belgium, the Netherlands, and Spain are currently the worst-hit nations, according to recent figures by Johns Hopkins University.

Brussels – in need of a new approach to ‘free circulation’ of their citizens – proposed last week a ‘set of criteria’ comprising the number of new infections per 100.000 inhabitants over the previous 14 days, and the number/percentage of positive tests performed per 100.000 inhabitants in the last 7 days.

These criteria can be used to define red, yellow and green zones as well as consider restrictions on free circulation. They will also serve to determine areas where people have to stay in quarantine.

The day after Parliament decided on mandatory masks in public places, hundreds of people in Lisbon protested against the measures. They shouted ‘freedom’ and carried banners saying ‘masks create distrust’ and ‘fear is not a vaccine’.


Stay safe             Fique saudável                       (pic Público/Sapo/Observ)





M&M

A morte é a curve na estrade ( death is a bend in the road ) – Fernando Pessoa

According to the 2019 edition of the Bloomberg Healthiest Country Index, which ranks 169 economies by factors contributing to health – overweight, lifestyle, tobacco & alcohol use and quality of health care – Portugal is in 22nd place.
Neighbouring Spain – that now has the highest life expectancy in Europe – tops the list of world’s healthiest nations.

In the past decade there has been a decline in deaths from cardiovascular diseases and cancer in Spain but not in Portugal, where more than half of all deaths are caused by cardiovascular diseases (30%) and cancer (25%).
The main single cause of mortality and morbidity in the country is a stroke (10%).

Portugal has, in fact, the highest prevalence of stroke in Europe. This is probably due to the high number of people with hypertension – one-third of the population has it but only half knows – and the excessive consumption of salt. Every hour three Portuguese suffer from a stroke, one dies and one remains disabled. In particular, women are more at risk as they grow older than men.

A consequence of the widespread existence of stroke and hypertension is the frequent occurrence of dementia.
Of 35 countries investigated, Portugal ranks 4th with respect to dementia as reported by the OECD (Organisation for Economic Cooperation and Development).

Alzheimer is the most common form of dementia in Western Europe. Interesting enough, this is not the case in Portugal. A recent epidemiological study from the University of Porto and published in the American Journal of Alzheimer Disease discovered that vascular dementia (57%) is more common in the Portuguese population than Alzheimer (36%).


The good news is that in Portugal nearly 2 in 3 cases of dementia can be averted by a change in lifestyle with a healthy diet and regular exercise, including a reduction of risk factors for cardiovascular diseases such as obesity, hypertension, smoking, alcohol abuse, high cholesterol, diabetes, excess of salt and stress.


Bom fim de semana      Have a healthy weekend       
(pic Publico/Observador)

 

 

 

Obesity

Waar krijg je nog voor 7½ euro een warme maaltijd met soep, vis, gekookte aardappels en groenten dobberend op een bedje olijfolie en een toetje toe? In Portugal is lunchtijd (“hora do almoço”) heilig en wordt er vrijwel altijd buitenshuis gegeten. Lekker en goedkoop. Maar vaak vet.

25% van de kinderen is te zwaar
Een op de vier Portugese kinderen is te zwaar – bij meisjes is dat zelfs 30% – en hun aantal neemt toe. Natuurlijk moeten kinderen meer bewegen en minder zoetigheid eten. Maar tussen woord en daad bestaat in de praktijk een diepe kloof, waardoor dikke kinderen vrijwel altijd dikke volwassenen worden.

10% van de volwassenen heeft diabetes
Meer dan een miljoen Portugezen heeft diabetes. Complicaties als hart- en vaataandoeningen, kanker en afwijkingen aan nieren en ogen beperken niet alleen de levensduur, maar ook de kwaliteit van leven.

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Zwaarlijvigheid en diabetes: 2 handen op een dikke buik.
Bij te dikke mensen werkt het hormoon insuline niet goed meer. Insuline zorgt ervoor dat glucose (suiker) uit het bloed in de lichaamscellen wordt opgenomen, waar het wordt omgezet in energie. Als de glucosespiegel in het bloed te hoog blijft, spreken we van diabetes.

‘Coca-Cola’ tax
Om de toename van zwaarlijvigheid en diabetes een halt toe te roepen komt er in 2017 een prijsverhoging van 10-20% op alle frisdranken, afhankelijk van de hoeveelheid suiker die erin zit. Coca-Cola Portugal heeft al protest aangetekend en de maatregel ‘ongrondwettelijk’ genoemd.

“Eten geeft me rust. Mijn lichaam heeft geen eten nodig; ík heb eten nodig. Het is een manier om me te vullen met dingen die ik mis”  [ Uit : A Gorda ( De dikzak)  van Isabela Figueiredo, 2016 ]

Geniet van het weekend – Tenha um ótimo fim de semana !