Policy responses for Denmark - HSRM


Policy responses for Denmark

3.2 Managing cases

Patients experiencing symptoms may call the emergency phone service or their primary care physician. They are not allowed to visit primary care providers or hospitals directly. The phone consultation determines whether the patients should be referred to quarantine at home or testing and potential further treatment in hospitals. 
The Danish Regions has implemented a ChatBot to guide persons suspecting that they have been infected by COVID-19 (https://www.regioner.dk/services/nyheder/2020/marts/ny-digital-loesning-fra-regionerne-skal-aflaste-laeger-i-hele-landet). The Danish Health Authority has established a telephone hotline for general questions about corona to ease the burden on the regular emergency phone service (1-1-2) and the regions/GPs’ out-of-hours non-emergency services. (https://www.dr.dk/nyheder/indland/politiet-til-corona-bekymrede-ring-til-hotline-ikke-vagtlaegen).

There are national guidelines for triage of COVID-19 patients. They are implemented through the emergency and primary care phone consultations. Mild cases are generally advised to stay at home. There is still a sufficient number of intensive care facilities and the expectation (29th March) is optimistic in the light of the present development of number of patients hospitalized. Clinical protocols are issued by the Danish Health Authority. They are updated regularly based on availability of evidence and experiences from other countries (https://www.sst.dk/-/media/Udgivelser/2020/Corona/Retningslinjer-marts/Retningslinje-COVID-19.ashx?la=da&hash=84942068EA39162A0B8E26A6AAFD6CC256276F14). The National Medicines Agency has approved six clinical trials of repurposing existing drugs for treatment of COVID-19 (https://laegemiddelstyrelsen.dk/da/nyheder/2020/covid-19-se-listen-over-godkendte-danske-forsoeg-med-medicin-mod-covid-19/).

The Government has decided that undocumented/irregular migrants (rejected asylum seekers, etc.), who are tested positive for COVID-19, must stay in isolation in an asylum center.

On April 12, the Danish Health Authority revised a guideline for general practices and practicing specialists. The existing guideline emphasized how GPs and practicing specialists should prepare for a growing number of patients with COVID-19, while the revised guideline emphasizes the need for clinical personnel to prevent infection with COVID-19 to enable them to treat more patients with other diseases (https://www.sst.dk/da/Nyheder/2020/Almen-praksis-og-speciallaegepraksis-skal-oege-deres-aktivitet-efter-paaske).

There haven’t been any reports on rationing care for COVID-19 patients.

Due to an increased number of citizens who want to be vaccinated against flu, the Danish Health Authority has asked citizens to only get a vaccination if they are in increased risk of complications due to flu – but no formal rationing has been introduced

On November 10, the Danish Health Authority reported the results of a survey of the utilization of flu vaccines, and 70% of the vaccine doses were used on citizens where vaccination was indicated. The Statens Serum Institut has made a reserve of 100,000 flu vaccine doses available, and it will be distributed equally based on geographic criteria. Furthermore, the Statens Serum Institut has asked GPs to return surplus doses to the Statens Serum Institut (https://www.sst.dk/da/Nyheder/2020/Status-paa-influenzavacciner).

Several minor outbreaks with locally rising numbers of COVID-19 cases have taken place over the summer. This has led to local (municipality level) measures by the state, such as the early introduction of face masks in public transportation and shops, restrictions in access to old people care facilities, temporary closing of schools and childcare facilities in Hjoerring, Silkeborg, Aarhus and Ringsted. At the same time, there have been efforts to increase testing capacity in these areas. All of these measures are part of a flexible strategy to enable rapid reaction to local outbreaks. This strategy appears to have been successful in containing the number of cases, and the special restrictions have (August 27) now been lifted in all of the affected municipalities. It is, most likely, that similar local outbreaks will be manged in the same way, except that the use of face masks in public transport is now mandatory.

On August 25, the Danish Patient Safety Authority published a catalogue of initiatives that municipalities may introduce to tackle local outbreaks of COVID-19 (https://stps.dk/da/nyheder/2020/covid-19-inspirationskatalog-skal-hjaelpe-kommunerne-til-at-haandtere-lokale-smitteudbrud/).

By September 2, an outbreak at a college of education in the city of Odense led to a lockdown of the college (https://www.tv2fyn.dk/odense/flere-laererstuderende-smittede-paa-ucl-i-odense).

On September 15, the Danish Health Authorities announced that they have established a special committee responsible for developing national guidelines to health services and health professionals regarding the handling of long-term COVID-19 complications (https://admin.sst.dk/da/Nyheder/2020/Staerkt-fagligt-fokus-paa-senfoelger-efter-COVID-19).