The MoH has developed a case management protocol based on WHO recommendations. People experiencing symptoms or who have had contact with a confirmed case are told to contact the emergency services (tel. 112). The calls are forwarded to primary care doctors who have been specially trained on specific COVID-19 protocols. An online portal (http://ambulatoria.moh.gov.ge) went live in November 2020 which allows Georgian citizens enrolled in the state insurance programme to find out which family doctors and clinics will serve them if they show symptoms of COVID-19. Individuals with private insurance need to ask their insurance companies. The uninsured should phone the MoH hotline (tel. 1505).
Triage of COVID-19 patients occurs at fever clinics. Based on Ministerial Orders in several regions, fever clinics were identified where patients with respiratory symptoms are admitted after going through initial triage. Suspected COVID-19 cases are tested, the others are sent back to their homes and follow the advice of family doctors, including online consultations. If test results are positive for suspected cases, they are transferred to COVID clinics for further case management. There are ongoing discussions that when the number of cases increases and hospitals will not be able to accommodate all positively tested patients, the milder cases should be sent home and managed by doctors remotely. Symptomatic patients can self-refer to COVID-19 services without a positive PCR test or doctor’s referral.
At the end of February, under Ministerial Order #01-62/o, the following protocols had been elaborated for:
o International travellers coming from high risk countries;
o International travellers and tourism companies;
o Self-isolated persons;
o Quarantined persons;
o Airlines and Airline Crew members;
o Disinfection/cleaning of non-healthcare facilities.
Recommendations were provided to the airport staff on the prevention of Novel Coronavirus at the points of entry and the biosafety officer gave instructions on how to implement the recommendations in practice.
Healthcare providers were provided with detailed information on the:
• Contact tracing and case management algorithm for COVID-2019;
• Recommendations for use of Personal Protective Equipment;
• Sample collection protocol;
• Infection prevention and control protocol on suspected case of COVID-19.
In July is was announced that Georgia would be joining the international “Solidarity” clinical trial, with this work being coordinated by the Infectious Diseases Hospital in Tbilisi.
In July, UNDP and the government of Sweden began supporting the NCDC of Georgia to train 4,000 health workers across the country in enhanced infection prevention and control. With $150,000 in Swedish funding, UNDP will assist NCDC in establishing an e-learning platform to provide doctors, nurses and administrative staff with an opportunity to attend training courses and certification programmes, communicate, exchange experience and receive practical advice from NCDC experts.
On 20 August, a memorandum was signed between the UNDP, Sweden and the Georgian Ministry of Health to support Georgia’s efforts to strengthen its medical governance and improve health services for people amid the coronavirus. The memorandum aims to improve clinical quality assurance and the management of public hospitals across the country. Head of the Georgian National Centre for Disease Control Amiran Gamkrelidze says that patients with the coronavirus are exhibiting less serious symptoms and manifestations of the disease than in March and April, and that the number of severe cases has decreased. He added that today it is difficult to say what has caused this change in the dynamic.
From 9 September, asymptomatic coronavirus patients from 18 to 65 years of age with no chronic diseases are treated at home or in quarantine under the supervision of doctors instead of hospitals. Initially there were three hotels (one each in Tbilisi, Batumi and Kutaisi) where patients were placed under quarantine. By 17 November, 211 hotels are being used for quarantine (11,486 rooms in total) and these quarantine spaces employ over 3,580 people from the tourism industry. Underage children, citizens aged over 65, and patients with underlying conditions will not be transferred to hotels for medical treatment. Georgia has spent over 54 million GEL in eight months since early March for quarantine space, says the Georgian National Tourism Administration.
Georgian Health Minister stated in November that the country is able to admit 5,868 Covid-19 patients in hospitals: 5,313 of these beds were occupied as of 17 November. However, within 24 hours an 800-1,000 additional beds (apart from the beds of the patients who will be discharged by the end of the day) will be in place. There are 1,040 ventilators in the country and about 3,400 beds come with oxygen provision systems.