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
On May 18, Luxembourg's main hospital, Centre Hospitalier de Luxembourg (CHL), stated that it has its intensive care unit dedicated to coronavirus patients as the number of cases is declining after two months of lockdown measures. The hospital had separated its intensive care unit into two zones, one for patients suffering from the deadly coronavirus and the other for non-corona patients. However, if the number of patients seriously ill with Covid-19 rose it would have to split the unit into two again.
From June 8, the Advanced care centres (Centres de soins avancés, CSA) at LuxExpo and the Rockhal will close their doors permanently. Patients with COVID-19 symptoms can contact their general practitioner or, in case of emergency, the hospital emergency departments.
Meaures due to rising numbers of patients in autumn 2020
On 26 October, Luxembourg opened its “Covid Consultation Centre”. This has been set up to specifically relieve general practitioners from an increased influx of COVID-19 patients, and people with Covid-19 symptoms can use the services free of charge. Furthermore, new testing stations began opening on October 20 in response to increased demand and prolonged waiting periods.
On October 27, hospitals across Luxembourg entered into stage 3 of virus alert preparedness. The move, undertaken by Luxembourg’s chief medical officer, means that hospitals can begin to reschedule procedures not related to COVID-19. In stage 4 (the final phase), hospital beds must be apportioned so that 264 beds are available for regular patients and a maximum of 100 beds for patients in intensive care. As of 27 October, 114 patients were being treated for COVID-19 in a hospital, including 16 in intensive care.
On March 15, the Government Council adopted measures for the reconfiguration of hospitals services. Hospitals will deploy their staff and services mainly to urgent and acute activities that cannot be re-scheduled. Medical, surgical and care activities which are not short-term or indispensable are cancelled.
On March 18, the Government has decided to designate the ‘Maisons médicales’ (GP out-of-hour offices) as advanced care centres (Centres de soins avancés - CSA) with the purpose of channeling patients with symptoms of a severe respiratory infection. The objective is to concentrate these patients outside of emergency departments and general practices, so as to contain the spread of the epidemic, and to provide on-site access to collection capacity for diagnosis of infections by staff with the required protections. These facilities are designed to operate through two strictly separate lines of consultation - the first is designed to accommodate patients with signs of COVID-19 infection, the second is designed to accommodate patients who come to the centre with no signs of COVID-19 infection. In order to limit waiting times as much as possible, each channel provides healthcare to several patients in parallel.
As of March 20, a patient reception structure next to the Centre Hospitalier de Luxembourg (CHL, the main hospital in Luxembourg City) was set up with the support of the NSPA (NATO Support and Procurement Agency) and allows to house up to 100 patients. This new centre is designated for suspected and confirmed cases and allows triage of patients.