Policy responses for Finland - HSRM

Finland


Policy responses for Finland

3.2 Managing cases

General information on the coronavirus is available by telephone at 0295 535 535 and via online chat. The information service is open on weekdays at 8–21 and Saturdays at 9–15. The service does not, however, provide advice on legal matters or health-related matters, such as acute symptoms but it is based on the content of the website of THL.(1)

Hospital districts and/or municipalities have their own phone numbers for COVID-19 information regarding health. In addition, the recently implemented national emergency assessment and advice number of 116117 is in use, though it is not available throughout the country yet. If a person suspects that they have coronavirus, they are advised to make a symptom assessment using the Omaolo website. (2) If a person needs care, they are advised to first contact their health centre via phone or ring the emergency assessment and advice number above.

The national guidance is that the mild cases should stay home. If the person belongs to a risk group and develops sudden high fever and sore throat or cough, they are advised to contact their primary health centre via phone or ring the emergency advice number.  In an emergency, patients are advised to call the national emergency number 112. If a person with suspected COVID-19 arrives at a health centre, they are triaged in the lobby or possibly already outside of the health centre and separated from the general patient population.

In Finland, home care and long-term care are included in statutory health and social services. Consequently, they are usually organised by the municipalities. While about a half of these services are provided by municipal organisations, the rest is purchased from the private sector. In the municipal sector, home care and long-term care are administratively under the health and social services. For the private sector, the municipal health and social care management is supervising contracted services along with the State Regional Administrative Agencies. To date, there are no special routes for home care and long-term facility clients to be transferred to hospital. Regarding terminally ill persons treated at home and long-term care, several experts have stated that moving these patients to hospital will impact negatively on their wellbeing and likely shorten their lifespan.

On 8th April, KELA, the Finnish Social Insurance Institution of Finland allowed also digital client consultations into reimbursed consultations. This has meant that especially in the private sector, Covid-19 tests are conducted with a physician’s referral, and the referral itself is primarily through digital means (online chats/video calls).

Due to the growing numbers of COVID-19 patients who need inpatient care and ICU care at Helsinki-Uusimaa region the risk of overwhelming of ICU capacity has made the hospital district to transfer some of the COVID-19 patients to Turku University Hospital and Kuopio University Hospital. (3)

Helsinki Uusimaa hospital district has demanded the Government to take stricter measures (including declaring the state of the emergency and the Emergency Powers Act) in order to safeguard the hospital capacity over the holiday season. The national Government and the Ministry of Social Affairs and Health have, however, stated that so far applying emergency powers would not be justified based on assessment on the epidemiological situation and health system capacity. (4)

On Jan 8th 2021 Helsinki and Uusimaa hospital district began recommending early initiation of heparin treatment for Covid-19 patients who are either pregnant, aged ≥60 or both aged ≥40 and in bed care due to fever, cough or dyspnea (5). This experimental recommendation covers also the treatment of Covid-19 patients in outpatient care, when patient has no medical contraindications for it. The hospital district covers the cost of heparin.

On 26th January, THL announced the formation of an international partnership, which aims to develop an artificial intelligence-based prognosis model for COVID-19 patients (5). This development work will operate under research project COVIDprog and it combines existing Finnish individual data with the artificial intelligence model developed by Japanese research institute RIKEN. The aim of these prognostic models is to identify individuals with high risk for either severe COVID-19 or death. This would enable more effective targeting of both preventive measures and treatment.

Helsinki University Hospital announced plans to open an outpatient clinic for long-covid patients. Also, a digital clinical pathway will be developed within the e-health platform Health Village Online Service. Digital clinical pathway offers online instructions for different treatment phases as well as self-care and rehabilitation programs. There is no exact information on the amount of people suffering from long-covid symptoms, yet there is clear demand for this kind of service in the Hospital District of Helsinki and Uusimaa, where the majority (59%) of the COVID-19 cases in Finland have been detected. (7)

A mobile video robot has been used in the COVID-19 ward in the Helsinki University Hospital since November 2020. It enables remote communication with patients when physical contact can be avoided. (8)