3. Providing health services effectively
The section on PROVIDING HEALTH SERVICES EFFECTIVELY describes approaches for service delivery planning and patient pathways for suspected COVID-19 cases. It also considers efforts by countries to maintain other essential services during periods of excessive demand for health services.
3.1 Planning services
All public and private laboratories are allowed to provide tests for Covid-19 since March 7. Research and veterinarians labs will be also allowed to provide tests to increase the capacity after the end of the lock-down (May 11).
There was not an immediate reconfiguration of services, but a care pathway for COVID-19 patients has gradually been defined (see below). There is no designated hospital to deal with COVID-19 patients, and initially patients admitting via emergency departments in several hospitals created tension regarding the risk of contamination. Many hospitals set up tents outside for screening COVID-19 cases. As of week 11, recommendations were to call mobile emergency services (15) rather than to go directly to the hospital. Tele-consultations were already available (reimbursed) in France, and they are highly recommended in the current situation. Their number has exponentially increased over the weeks and in the first half of April, tele-consultations represented a quarter of all consultations, with 70% of all GPs providing online consultation services.
In addition to the national planning of services, some additional services have also been planned on a voluntary and local basis, such as ambulatory care centres dedicated to Covid-19 patients in the particularly affected Eastern region. These consultation centres, run by private doctors and nurses, opened with the support of the municipalities. In Strasbourg, where several networks of practitioners have also been set up with tools for sharing information between professionals, specific protocols for caregivers working in patients' homes or in nursing homes were implemented.