The Slovenia Times

Healthcare system preparing Covid-19 exit strategy


Because of the coronavirus epidemic, hospitals and other health institutions around the country have limited their services to treating emergency cases, cancer patients, child deliveries and paediatric cases.

But medical experts have been issuing increasingly dire warnings that such a regime must not last too long. Tit Albreht from the Public Health Institute has said a plan should be made before the summer on how to reactivate the healthcare system so as to prevent long-term detrimental effects on the population.

If patients with chronic diseases do not receive proper treatment this will become a big problem, he told the STA.

"You cannot freeze healthcare for 18 months or a year, because you run the risk of losing more patients to various other problems and chronic disease than to the epidemic," said Albreht, who is in charge of the Health Security Centre at the institute.

"A person who needs an operation, which may not be urgently needed right now, will have to be operated in a few months because by then it may become urgent."

In the first phase of the exit strategy, the country's biggest hospital, UKC Ljubljana, plans to start accepting patients with the level of urgency (which is indicated on referrals) 'fast', next to the 'urgent' and 'very fast' that it is accepting now.

UKC Ljubljana kept its hospital activity at 80% throughout the epidemic, according to Zlatko Fras, medical director of the internal clinic at UKC.

Doctors are dealing with some urgent cases alongside emergency cases via telephone or e-mail and the two channels will be used in the future as well.

"The backlog of a month or a month and a half will not be easy to make up but we'll do our best," Fras said. Specialist appointments and diagnostics will be increased gradually, he said.

According to the head of the gastroenterological unit at UKC, Borut Štabuc, endoscopic procedures will be launched again soon, and all patients with the level of urgency 'fast' and 'very fast' should be able to get treatment by the end of the month.

In order for all these patients to receive treatment, afternoon appointments will be introduced just like for cancer patients and patients with inflammatory bowel disease who are receiving biological drugs. The clinic also plans to work on Saturdays.

The head of the nephrology unit at UKC Ljubljana, Miha Arnol, said the epidemic had not changed much for dialyse patients, so 260-270 of them had been receiving regular treatment despite the epidemic. All patients are being tested for coronavirus and three cases of infections have been confirmed so far.

Patients with transplants are a very sensitive group as well. The condition of those in early stages after transplantation is being monitored using telemedicine, while transplant activity for non-urgent cases has been suspended. "We are conducting about 1,500 check-ups a day, which is about a third of all check-ups conducted before the epidemic," Arnol said.

UKC Ljubljana is now taking in the most demanding cases from all over the country, especially in cases requiring specialists in ophthalmology, neurology, dental medicine and otorhinolaryngology. The paediatric clinic is working with the most vulnerable children.

Annually about a million people are examined at UKC Ljubljana and some 100,000 people are hospitalised. UKC Ljubljana has about a third of all hospital capabilities in the country and during the epidemic, about 1,000 patients are at the hospital on a daily basis, about 50 of whom are Covid-19 patients.

Meanwhile, at UKC Maribor, 512 patients with conditions other than Covid-19 are hospitalised at the moment, and the hospital is treating all patients with the level of urgency 'urgent' and 'very fast'.

Several hundred such patients are treated daily, which is three times less than in the same period last year, Matjaž Vogrin, the hospital's medical director, told public broadcaster RTV Slovenija late last night. The number of hospitalised patients is 40% lower than in the same period last year.

Vogrin stressed in the Odmevi late news show that no member of the medical staff had gotten infected with coronavirus at the hospital so far, which showed that protective measures were working.

Currently, special medical councils are going through medical files to determine the order in which the hospital will start admitting other patients that need treatment.

Dušan Deisinger, medical director of the Izola hospital, told Odmevi they had no Covid-19 patients at the moment and were accepting only urgent cases and patients who need treatment very fast. The number of hospitalised patients is about a third of what the hospital had before the epidemic.

The hospital will now start accepting more patients in line with the ministry's recommendation.


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