Elective healthcare services were reduced significantly both in inpatient and outpatient settings. Visits to physicians were reduced to a minimum, and consults were shifted to tele-medicine. Patients were instructed not to go physically to healthcare facilities, and have been directed to contact their physicians primarily by phone or email. Regular diagnostic exams were also reduced significantly in order to give priority to COVID-19 diagnostic.
Disabled people living in the community are facing challenges in receiving the regular healthcare and day-to-day assistance that they are used to receiving, and those living in institutions such as long-term care institutions and mental health residences are still being cared for in these institutions. Yet, the latter are not allowed to visit family or receive visits.
In order to maintain regular non-COVID-19 service delivery, health plans transferred most outpatient services to telemedicine platforms including consultations with GPs, paediatricians, specialists and physical visits have been reduced to a minimum. Yet, individuals have foregone treatment.
Health plans have rearranged their clinics to receive patients: prior the entrance to the establishment visitors are symptom tested, including fever; a separate room was allocated to COVID-19 patients, usually a room next to the entrance, to reduce changes of contagion.
Pharmaceuticals are being delivered to patients’ homes and visits to pharmacies were reduced to a minimum.
Inpatient services were also rearranged and COVID-19 patients are treated in separate areas in hospitals. However, patients have forgone urgent treatment due to concerns of infection. Elective procedures are still on hold formally, however hospitals are resuming activities informally in a reduced form. The government has launched campaigns in all mass and social media means calling patients to go to hospitals to receive healthcare, particularly urgent cases.
Some hospital services started being provided at home (such as early pregnancy abortions, births).
Since April 27 elective hospital activities resumed working, as well as dental care in the community and other healthcare services in the community.
22.6.20 – planning enhancing home hospitalizations for winter 2020
The Ministry of Health and the health plans started planning the development of home hospitalization with increased staff and equipment in order to provide non-COVID-19 care during the winter 2020, as hospitals are expected to be overloaded with COVID-19 patients.
30.12.2020 - preparing for a morbid load: elective activity in public hospitals on hold again
As part of the third lockdown, and in view of the expected increase in morbidity in the coming days, the Ministry of Health on 28.12.20 ordered a temporary hold on elective surgeries and the activity of outpatient clinics in public hospitals. This measure was not taken during the second lockdown (in October 2020). The MoH has also requested for public hospitals to get prepared for the opening of additional COVID-19 wards during the third lockdown.
On April 12th the government launched a centralized national plan responsible for responding to COVID-19 in long-term care facilities (LTCF). The main goal was to curb the spread of the pandemic, and provide appropriate care for the elderly living in those facilities.
The national plan’s main actions include:
1. Establishing a centralized work plan at the MoH to manage the COVID-19 outbreak in LTCF on behalf of all governmental offices that provide services or funding to LTC (Ministry of Social Affairs, National Insurance Institute, municipalities).
2. Establishing Covid-19 care units within each LTCF
3. Increasing the availability of COVID-19 diagnostic tests and screening among residents and professionals: from April 15, eligibility for COVID-19 testing was expanded to include all residents and professionals of an institution where one of its members were in touch with a diagnosed patient or those located in high-prevalence areas.
4. Creating clear regulations of work and shifts for LTCF professionals, particularly those who work in more than one institution. Professionals should attempt to work in only one institution if possible, work in regular shifts of 12 hours, composed by the same individuals, and wear personal protective equipment constantly. Strict hygiene should be maintained, and temperature is checked prior entering the LTCF every day.
5. Helping LTCF residents cope with loneliness, since family visits are not allowed.
6. Recruiting additional staff to LTCF including nurses, medical nursing students, unemployed doctors. These professionals were trained to meet the COVID-19 needs.
7. LTCF where a positive COVID-19 case is diagnosed is immediately quarantined. The army assists controlling the access of visitors and professionals, helping disinfecting surfaces, transporting food and supplies; training and guiding professionals on how to behave and treat residents.