Estonian hospitals ready for deterioration of COVID-19 situation

TALLINN - The number of COVID-19 patients in need of hospital treatment is growing every day, and in addition to the fact that hospitals have to increase their coronavirus treatment capacity again, they are also struggling with staff shortages, the Estonian daily Postimees writes.

Medical chief at the Health Board's crisis management headquarters Urmas Sule said that at present, he does not see any indicator that would stabilize the state of hospital treatment of COVID-19 patients. "In recent days, we have seen a clear increase in the need for COVID-19 hospitalization. The fact that the infection rates are high and that the infection has reached the elderly and the residents of care homes does not give hope either. In the case of hospitals, we are rather prepared for the situation to deteriorate," Sule said.

When asked if there was a clear limit at which hospitals could operate now, he said no. "Indeed, it is not possible to say such a numerical limit. However, politicians want to show the people where the red line runs," he said, adding that this could be seen indirectly in the risk matrix. "Every hospital has different coping limits, different specialists and doctors, and the course of the disease is different in each county," he said.

While scheduled treatment at the East Tallinn Central Hospital was suspended on Thursday, then according to Sule, other hospitals are not planning it at the moment. The East Tallinn Central Hospital had to make such a decision due to lack of staff and also the increase in the number of COVID-19 patients, Sule said. He added that the hospital now has 59 beds in the first and second intensive care units, six in the third intensive care unit. In addition, the maternity hospital has eight COVID-19 beds and there is one bed in the eye clinic.

Although other hospitals are not yet about to close their scheduled treatment, Sule emphasized that the situation could change in an instant. "While there was one situation last night, it could change drastically the next day, and the hospitals are always ready for that," he said.

According to Sule, the East Tallinn Central Hospital initially had a plan to suspend scheduled treatment for a short time, but when they saw that new COVID-19 patients are coming in every day, they no longer think that the closure is only short-lived. "But there has always been an agreement with hospitals, from the very beginning, that if major changes take place, patients will be informed directly so that there is no broken telephone effect," Sule said, adding that the same applies when the situation on the coronavirus front improves.

Sule said it is also worrying that in addition to the increase in the number of coronavirus patients, the nationwide incidence of COVID-19 is such that the rate of infection among employees of several medical institutions is very high. "This poses great challenges to the normal operation of the hospital," he added. It should be emphasized that doctors get the infection outside the hospital, for example, infection is brought home from school by their children.

Arkadi Popov, head of West Tallinn Central Hospital, told Postimees that the situation of COVID-19 patients is stable in their hospital. In recent days, the number of people in need of hospitalization due to COVID-19 has remained at 70. "The biggest problem is the lack of staff. The morbidity of doctors is quite serious," Popov said. Namely, looking at the part of the infection clinic of the West Tallinn Central Hospital that treats people in need of COVID-19 hospital treatment, a quarter of their staff are ill.

Mari-Anne Harma, acting director general of the Health Board, said on Sunday that as the disease caused by the omicron strain is generally more rapid and milder, it allows people to return to work before the end of the quarantine period in a situation where there is a shortage of staff in hospitals and other healthcare facilities.

According to Popov, such an exception by the Health Board was inevitable. "But the problem is that our people also have to agree to that," the hospital manager said. He explained that as a hospital, they could now assume that after seven days of illness, a person could return to work if the doctor gets tested and uses a respirator, with which the hospital would reduce risks. "But this is only if our employee, our good colleague agrees. We are in a difficult situation, they have worked hard for two years and we cannot expect a person to meet us halfway and return to work earlier," Popov said, adding that in reality employees can stay home for 10 days while on sick leave. "It's a double-edged sword," he said.

In total 438 patients with the coronavirus were being treated in hospital in Estonia on Thursday morning and seven patients infected with the virus died in the past 24 hours. Of the patients undergoing treatment in hospital, 282 require hospitalization due to severe COVID-19, with 186 patients or 66 percent of such patients unvaccinated and 96 patients or 34 percent fully vaccinated.

Altogether 83 new COVID-19 cases were opened in hospitals during the past day, 51 of them regarding patients with symptomatic COVID-19. In the last 10 days, an average of 39 symptomatic coronavirus patients have been hospitalized in Estonia per day. Seven patients infected with the virus -- men aged 82, 87, 92 and 95, and women aged 67, 84 and 89 -- died during the past day. Five of the patients who died were unvaccinated.