Eighteen users of two homes who entered the rear structure for people who tested negative for covid-19, set up at the Youth Hostel in Porto, had to return to their original social centers a few days after they left there. But, contrary to what the test done before departure revealed, this time they returned infected. After about 48 hours since arriving at the inn, a new test was performed, the result was different from another one performed previously – 18 of the 19 users coming from the Social Center of Lomba and the Social Center of São Martinho de Aldoar, forwarded to the rear structure by the respective local health authorities, they tested positive for the new coronavirus after they had been there.
In this solution created to avoid new contagions among a more fragile population, whoever arrives is not obliged to fulfill prophylactic isolation, but to be segregated by “bubbles”, according to the users’ place of origin. Municipality, Porto District Civil Protection Commission (CDPC-Porto) and coordinator of the fight against the Northern pandemic say that it is the local health authority that decides the procedures to follow during and after the transfer. In these two cases in particular, the question of where the infection originated remains.
It is not uncommon to detect “false positives” in this structure created to welcome, among others, home users who tested negative in a social center where an outbreak was detected. Marco Martins, president of the Câmara de Gondomar and of the District Civil Protection Commission of Porto, responsible for supporting transfers, tells the PUBLIC that more than once users have “positive” a few days after arriving at the inn. When this happens, he believes that there has already been contagion at the place of origin, where health authorities carry out rapid tests before the transfer of users. In the early days, when the virus has not yet incubated, “it may not be detected in a rapid test”. “There is thus a risk of infections with false negatives,” he says.
One wonders if it would not be essential to proceed with a prophylactic isolation or a new test on arrival because there are no guarantees that, days later, the “false negatives” do not become positive. The person responsible for CDPC-Porto says that on arrival at the inn “there doesn’t have to be a quarantine”, because “they have been tested before”. A new test, he explains, “is usually done two or three days after” entering the structure for covid-negative users.
The PUBLIC questioned the Porto Occidental Health Center Group and the Northern Health Regional Administration (ARS Norte), via e-mail, to find out if the procedure adopted does not jeopardize the functioning of the rear structure and the safety of the users who are sent there. But until the end of the edition there was no answer.
Those who decide which guidelines to follow, also underlines Eduardo Pinheiro, Secretary of State for Mobility and coordinator of the fight against the pandemic in the North, are the local health authorities. But, as Marco Martins already mentioned, he confirms that it is not necessary to do prophylactic isolation. “No prophylactic isolation is being carried out at the inn because it is not foreseen, it is not due to non-compliance”, he explains, although a document from the Directorate-General for Health signed by Graça Freitas in March 2020, and updated in July of the same year, where the procedures for Residential Structures for the Elderly (ERPI) and others are listed, refer that in case of transfer of users with negative test to another institution, coming from homes with positive cases, “a 14-day isolation period must be fulfilled”. “Determinant”, considers the Secretary of State, is that the separation of users in the rear structure is done by users “from the same cohort”, as he says is happening.
Fernando Paulo, councilor for Housing and Social Cohesion at the Porto Chamber, who takes over the operation and finances the negative structure (50 thousand euros per month), in partnership with the local health authority, CDPC-Porto and Social Security, says that nobody enters the rear structure “without the health authority to determine”. Then, who decides when to repeat the test, he says, is the health authority. “Depending on the epidemiological study you did and the place of origin, [a autoridade de saúde] will determine when a new test is done. Or not. Sometimes it even determines that it doesn’t, ”he explains.
Regarding the decision not to carry out prophylactic isolation after entering the inn, he added: “Now the isolation is done by bubbles.” In other words, users are isolated by institution, with some staying in rooms, accompanied by another user – they are double rooms.
Given that there are “false negatives”, is it not risky to segregate by “bubbles”, keeping users from the same institution in contact, since there is a probability that there are those who are in the incubation phase of the virus? Fernando Paulo prefers not to answer: “I understand the question. But this is a discussion that I will not have, because I am not a health professional. ” The mayor prefers to underline that everything is going on within the rules defined for the conduct of the transfer processes.
They came out negative, came back positive
On the 18th of January, at the Social Center of São Martinho de Aldoar (CSSMA), three days after the users were vaccinated, a positive case of a user who had visited a health unit was detected. Fernando Pinheiro, of the CSSMA management, says that the rooms were immediately insulated. At the same time, the local health unit was contacted. After testing, 33 people tested positive. Eight users with a negative test were given a walking order to head to the rear structure mounted at the inn.
But the isolation, he says, would have been broken as soon as the users got into the ambulances that carried out the transport – the residents of the home went together. “I only followed users to the door of the inn. From then on, they were in their hands ”, he says. Three or four days later, five users returned infected. “Did they leave here already contaminated or were they contaminated there? This is the answer that we will never know ”, he says.