Before the crisis, there was already a lack of nurses, primary care providers and certain medical specialists like speech therapists and psychologists. During the crisis, it has been mainly the responsibility of healthcare service providers to train and increase or maintain the availability of health workers. This includes ensuring the safety of the staff.
The Family Physicians Association, together with the Health Board, has set up guidelines for all family doctors about how to protect the medical personnel by changing the way services are delivered. The hospitals have to create a plan about how to sustain their capability to provide services during the crisis, and submit the plan for approval by the Health Board.
At the beginning of March, different providers started banning visitors in hospitals and already took some precautionary measures. Starting from 17 March, hospitals shut down or decreased their outpatient services and only continued to provide essential services, while providing some outpatient services using video consultations. Also in mid-March, the providers started preparing their staff and equipment for the necessary changes in the crisis situation. For example, the hospitals are providing financial incentives to healthcare workers, while hospital staff with high risk are encouraged to work in areas that have no direct contact with patients.
An NGO has set up a database of inactive health workers who might be willing to voluntarily contribute in the case of need.
On 2 April, the Defence Forces field hospital will start working at Kuressaare Hospital, in the island municipality of Saaremaa, in order to support the hospital when needed. The field hospital is normally intended for use in military conflict and is equipped with ventilators and generators. The field hospital can activate a mobile treatment unit with surgery, emergency medicine, intensive care and general ward capabilities. When the field hospital is set up, it will create up to 20 intensive care beds, with an additional capacity of 40 general ward beds in tents.
The Defence Forces will send an 18-member medical team, including a doctor, nurses and paramedics, to Kuressaare, and a support team of approximately 20 to help set up the hospital and provide logistical services. The individuals in these teams include active members of military service, people from the 1st infantry brigade, and conscripts. The Health Board will provide the rest of the medical staff. Thirty percent of the employees of the field hospital are medics from the Defence Forces, the rest are civilian medics. The work of the field hospital will take place in three eight-hour shifts, with three doctors and eight nurses working in each shift. Kuressaare Hospital will coordinate the management of the field hospital, including contracts, accommodation and catering.
The Medical Service of the Defence Forces developed the field hospital in cooperation with the Estonian Defence Industry Association. According to the request of the Health Board, the Field Hospital of the Defence Forces will remain in Saaremaa at least until the end of April.
As of 5 April, eleven voluntary medics (including six doctors and five nurses) were sent to Saaremaa to staff the Field Hospital. The team came from Estonian hospitals, ambulances and the private sector.
The Health Board has decided to close the Field Hospital starting from 30 April in Saaremaa because of the decrease in patients needing hospital care.
In Estonia, medical and nursing students are used to work in clinical practice (especially in primary care settings and Saaremaa region). Different hospitals also work together in staffing the hospitals that lack sufficient staff.