Policy responses for Greece - HSRM


Policy responses for Greece

1.5 Testing

Moving into the second phase (see section 5), the Ministry of Health has developed extensive testing procedures.Testing strategies are aimed to be intensified, taking into account geographical and epidemiological data, with priority given to high risk groups (people over 70 years of age or of any age with underlying serious chronic conditions, such as cardiovascular diseases, diabetes, respiratory diseases and people with immunosuppression).

Plans have been accelerated in preparation for the progressive resumption of tourism services. Αstrategy has been formulated to ensure testing is readily available on all islands whereby samples may be transported to designated laboratories for analysis and results.

In addition, 500 mobile health units have been established across the country in order to increase testing capacity, incorporating mainly PCR testing, as well as antibody testing, particularly targeting the vulnerable and elderly population and closed settings, such as care homes and prisons.

Antibody tests initially were performed on health professionals and all employees who serve in the NHS, starting June 1. In addition health professionals and permanent healthcare structures staff, staff of all kinds (seconded employees, contractors, cleaning crews, security services, subcontractors, etc.),  can be test for a past infection upon request.

Beginning July 1, 2020, the Greek government has determined how the country will open borders while carrying out the necessary diagnostic screening.

The Passenger Locator Form (PLF) is a key element in the planning. All travellers must complete their PLF until the day before entering the country, providing detailed information on their point of departure, the duration of previous stays in other countries, and the address of their stay while in Greece. In case of multiple stays, they are required to provide the address for the first 24 hours at least.
• Travelers will receive a confirmation email upon submission of the PLF.
• Travelers will receive the PLF with their unique Quick Response (QR) code on the day of their scheduled arrival in Greece (at midnight) and will be notified via email (the QR code will be provided in a link in the confirmation email).
• Travelers boarding or embarking on the previous day of the arrival will be allowed to do so upon showing the confirmation email, since they will receive their QR code during their flight or voyage.

Protocol for land, air & sea arrivals
• Arrival at the entry gate.
• Transfer to the area where the screening personnel are located. Travelers are requested to show their QR code either on their mobile phone screen or in print. If travel departure begins prior to the day of arrival, travellers are allowed to board after showing the confirmation email (and not necessarily the QR code which is scheduled to arrive during their trip.)
• Depending on their QR code/confirmation, travellers are directed either to the screening area where they will be tested for the new coronavirus SARS-CoV-2 by a trained health team or to the exit (to baggage claim area or passport control).
• Upon completion of the test, travellers are directed towards the exit (to baggage claim area or passport control).
• The test results are expected to become available within 24 hours. During that time, passengers who are tested are advised to practise social distancing according to local guidelines and self-monitoring for symptoms that could indicate COVID-19. In case of such symptoms, medical advice and/or contact with the National Public Health Organization Operations Centre should be immediately sought. Only in case they test positive, the authorities will contact them and proceed with the health protocol in place. Otherwise, they may continue with their holidays, adhering to the general public health safety guidelines.
• If travellers plan to have multiple stop-overs in Greece, they must declare this and report their initial destination and their travel itinerary for the next 7 days.
• All travellers must comply with all of the necessary preventive hygiene measures (use of masks and physical/social distancing) according to local guidance.

As of Wednesday July 15th, 2020 at 00:01, all travellers entering Greece for non-essential reasons through Promachonas border station, are obliged to present upon arrival a negative molecular test result (PCR) for COVID-19, performed up to 72 hours before their entry to Greece. Passengers of flights from Bulgaria, Romania, U.A.E. and Malta (as of August 11, 2020 until 15 September 2020) and passengers of flights from Sweden, Belgium, Spain, Albania and the Republic of North Macedonia (as of August 17, 2020 until 15 September 2020) to Greece will be required to have a negative molecular test result (PCR) for COVID-19, performed up to 72 hours before their entry to Greece. This does also apply to Greek citizens, permanent residents of Greece, children under 10 years of age and travellers for essential professional reasons.

• Travelers should be laboratory tested with RT-PCR of oropharyngeal or nasopharyngeal swab.
• Only travellers who carry a certificate of a negative RT-PCR test result will be allowed by the border authorities to enter the country. The certificates should be written in English and bear the name and passport/national ID number of the traveller.
• The Laboratories that perform the RT-PCR testing should be:
a. National Reference laboratories
b. National Public Health Laboratories or
c. Private laboratories which are accredited from the respective national accreditation authorities (not necessarily specifically for COVID-19).

Travellers will still have to complete and submit their PLF form and may be subject to random testing upon arrival to the Greek border.

People with symptoms are urged to call the Hellenic National Public Health Organisation on the dedicated number 1135 and report travel or contact history and any alarming symptoms (dry cough, fever, shortness of breath, arthralgia, myalgia, etc.) and receive instructions for referral to any of the 13 COVID-19 reference hospitals across the country for free medical evaluation and smear test for SARS-CoV-2 in the case that the person is evaluated as a suspected case. The medical team may also test for Influenza Flu Viruses, so as to rule the possibility out.

Samples are sent to one of seven COVID-19 reference laboratories. The samples are processed to give the result as soon as possible, during which time people who underwent testing should self-isolate. In case of a positive result, the patient is transferred to a reference COVID-19 hospital in proximity and, depending on the severity of symptoms and underlying medical conditions doctors decide if the patient remains in hospital for treatment or home isolation. Those tested negative should remain in home isolation for at least 14 days.

Alternatively, private diagnostic laboratories and private hospitals carry out tests and medical examinations, with the cost being covered by the individual wishing to take the test (see section 4.2). When a case is confirmed, the Hellenic National Public Organisation is notified, and the patient, depending on severity, gets transferred to a COVID-19 reference hospital for assessment. 

At the early stages of the pandemic, Greece had the ability to perform approximately 700-800 COVID-19 molecular diagnostic tests per day. By June, testing capacity had increased to 6,500 tests daily. Consistent efforts to increase this number even further have been ongoing amid the gradual easing of restrictions and the beginning of tourist season.  By September, daily testing capacity has further increased to accommodate for 13,500 samples (on average), with a maximum of 17,000.