Policy responses for Poland - HSRM


Policy responses for Poland

3.2 Managing cases



A special helpline has been created for patients who suspect they have a coronavirus infection or have other concerns (800 190 590) which is open 24 hours a day, 7 days a week. In addition, people can contact the district (poviat) sanitary and epidemiological unit directly. Each unit has a duty call (emergency) phone open 24 hours a day, available via its website. On 27 March a new 24-hour helpline number (+48) 22 125 66 00 was created, and is dedicated to patients located outside of Poland.
The National Institute of Public Health has developed a special algorithm for diagnostic procedures for Covid-19 cases, which has been used since 5 March. According to this algorithm, a patient with an upper respiratory tract infection who does not have shortness of breath and a fever above 38 degrees Celsius, reporting as a potentially infected person, has a test and awaits the result in isolation. If the result of the test is negative and the patient is in good condition, they return home and monitor their health for a minimum of 14 days. If the patient’s health deteriorates, s/he should contact their local sanitary and epidemiological unit and probably take a second test. The person becomes a "probable case" and people with whom they have been in contact are traced. If a person tests positive, the patient is referred to as "confirmed case" and enters isolation. Contact tracing is implemented. A patient who has recovered after having tested positive should be tested twice before their isolation is over (two tests 24 hours apart) and both must be negative.
Another algorithm (updated on 20 March) was issued by the Ministry of Health for people who do display symptoms such as shortness of breath, fever and cough. Such cases are instructed to reach a hospital with an infectious diseases ward using their own means of transport (not via public transport or taxis) or to call an ambulance if this is not possible. If the patient has not been tested previously, this is done during admission.  Depending on the result, and consultation with a doctor, a decision is made on whether the patient should be taken to a dedicated hospital, stay in the exiting hospital or go to an isolation facility (see Section 1.3). If COVID-19 patients require care services after being discharged from the hospital, they are prioritised to receive them.
On 24 April the Polish State Agency for Health Technology Assessment and Tariff System introduced guidance for medical professional with vital information regarding the diagnosis and treatment of COVID-19 cases. The guidance also provides information about effective safety and infection protection measures for medical workers.
Due to numerous infections of medical personnel, which have been ascribed to the insufficient supply of PPE, many hospital departments have been closed or partially suspended, and some operations and procedures have been restricted. Cases of infections of the medical personnel were recorded, among others, at: the Dietl Hospital in Krakow; in two departments (obstetrics and gyneacology department and neonatal department) of the district hospital in Wadowice, which were closed; at the Clinical Hospital No. 4 in Lublin, where admissions, operations and scheduled procedures were suspended; at the neurological ward of the district hospital in Kędzierzyn-Koźle; at the hospital in Nysa, where two hospital departments were closed; and at the neurology and orthopaedics departments and the tomography and resonance laboratory at the Dębica hospital, which are closed until further notice.
It is not known how long the restrictions on the operation of these hospitals will last. Decisions on this will depend on the epidemiological situation and on the availability of human resources.
https://fakty.tvn24.pl/fakty-po-poludniu,96/koronawirus-w-polsce-wiele-oddzialow-szpitalnych-zamknietych,1011421.html?fbclid=IwAR1nMwn_zZjVvag9lgztfehfIZtZJwodXQmoFP6cxHtFX0GlXtibjyo9ZBI [access online 28.08.2020]
https://nysa.naszemiasto.pl/koronawirus-w-nyskim-szpitalu-czterech-zakazonych-pacjentow/ar/c1-7837876?fbclid=IwAR0TsZ2IDakvrL0i9OgsOlnxEzm1gGB8Eg658vwNnnkqmzaJ-eFZKspSoHU [access online 28.08.2020]
https://wadowiceonline.pl/wydarzenia/16667-dwa-oddzialy-wadowickiego-szpitala-zamkniete-u-jednej-z-pracownic-wykryto-koronawirusa?fbclid=IwAR1ljbw3d1L-YuIwIIMJ-belM33JGSAN6vKWXQ_y6yyT1A62pktki2tvioM  [access online 28.08.2020]
https://www.polsatnews.pl/wiadomosc/2020-08-17/koronawirus-w-szpitalu-w-lublinie-od-pracy-odsunietych-zostalo-16-lekarzy-i-31-pielegniarek/?fbclid=IwAR2tcd0xfFOsTa4AebVPD3H46zObCI-g5xpr9ANsTwDhlq1faiWJkF7Gu3U  [access online 28.08.2020]
https://www.debica24.eu/wiadomosci/7870,koronawirus-w-szpitalu-zamkniete-dwa-oddzialy [access online 28.08.2020]
https://www.gazetaprawna.pl/artykuly/1487739,krakow-koronawirus-w-kolejnych-szpitalach-wstrzymane-operacje-i-przyjecia.html [access online 28.08.2020]
New guidelines for managing cases were introduced since the 2nd of September. According to the amended regulation, primary care physicians will be able to decide on the termination of home isolation, taking into account the criteria specified by the law. For sick people ordered to isolate in hospitals or isolation rooms, this will be decided by the doctor who looks after them. Primary care doctors can order tests and conduct medical consultations remotely, using telemedicine solutions. Tests can be carried out only if patient develops all of the following symptoms: fever above 38 degrees Celsius, coughing or breathing difficulties, loss of taste or smell.  
Isolation of a patient who develops clinical symptoms may end after 3 days if there is no fever and no respiratory symptoms, but not earlier than 13 days from the onset of these symptoms. For patients without clinical symptoms isolation may end after 10 days from the date of a positive test result.
In special clinical cases, duration of isolation may be extended up to 20 days. For medical personnel, people providing care services in nursing homes or in clinically justified cases, isolation may be ended after two negative test result are obtained within 24 hours.
At the same time regulations limit time of quarantine to 10 days for people who have had direct contact with an infected person but who did not develop symptoms. The sanitary inspector decides on the shortening of the quarantine.
According to the WHO recommendations, asymptomatic patients diagnosed with COVID-19 should be isolated for 10 days or at least 13 days in case of symptoms.
A number of cases of coronavirus infections in health personnel has been recorded in hospitals across Poland. The affected health personnel has been placed in isolation and some patients had to be transferred to other hospital departments. This includes the Medical University Hospital in Poznań;
the Municipal Complex Hospital in Częstochowa; hospitals in the Kłobuck poviat, where about two-thirds of medical staff are away on sick leave due to the virus; and the University Hospital in Wrocław, where one clinic was closed until further notice.
https://wiadomosci.wp.pl/koronawirus-w-szpitalu-w-poznaniu-zakazone-sa-polozne-6561452848257920a  [online access 05.10.2020]
https://dziennikzachodni.pl/koronawirus-w-szpitalach-i-policji-w-czestochowie-rosnie-liczba-zakazonych-czestochowa-znajdzie-sie-w-zoltej-strefie/ar/c1-15216104 [online access 05.10.2020]
https://wiadomosci.wp.pl/koronawirus-klobuck-szpital-rejonowy-zamkniety-pracownicy-i-pacjenci-zakazeni-6561340368604032a [online access 05.10.2020]
https://gazetawroclawska.pl/zakazenia-koronawirusem-w-szpitalu-na-borowskiej-wstrzymano-przyjecia-do-jednej-z-klinik/ar/c1-15216842 [online access 05.10.2020]