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According to Rasa Isevičienė, representative of the family doctors union, the situation is complicated so far, because there is simply a lack of clarity about what will happen when people, especially children, start to have a fever and where they should be referred.
“The mood is really sad and a lot of anxiety, but we keep thinking and we don’t try to think about the fall. It is understandable that the situation is extraordinary and there is not much clarity on whether there will be a pandemic in Lithuania in the autumn or not.
But still, GPs who work at the primary level lack clearer recommendations on what and how to do. It is already confusing and it is terrible to think about it in mid-September or early October, “said the GP.
Fear that there is no way to manage traffic
According to R. Isevičienė, although in theory a medical institution could accept a person with a fever, perform the necessary tests to assess the state of health, but the reality is quite different.
It is emphasized that this also requires the provision of isolation facilities, the management of patient flows so that they do not meet planned patients without fever.
“Certainly not all institutions can do that, it is just not physically possible. There is no way out and it leaves a few hours only for feverish patients.
In this case, we understand that patients will need to be referred to an admissions department or fever clinic, a mobile point for the Covid-19 test. But do you realize how then everything will crash? ”, Feared the doctor.
Furthermore, he believes that it is naive to expect that all children with a fever can be cared for by fever clinics, since even during rush hours before the pandemic, they all worked in girdles and barely managed to turn around.
Speaking to her, Jurga Dūdienė, a family doctor at the Aukštadvaris Primary Health Care Center, warned that when all this “mass” of patients begins, and even more so if there is no research suspicion that Covid-19 may work By itself, there will be real chaos.
The question of when to conduct an investigation
R. Isevičienė recalled that previously the procedure was normal after the child had a fever.
“Until Covid-19, we knew perfectly well that if a child is alert, eats, plays even when the temperature drops, it is really possible to control their condition, there is no need to rush to examine it, and children often recover in a couple of days. And now the question is, should we test for Covid-19 in that case? “, Said.
According to a representative from the family physicians union, there are more questions than answers at the moment, and the entire responsibility lies with the physicians.
“We don’t have answers for that, doctors from different medical institutions have a hard time imagining work. Everyone keeps thinking, the language is different, as if there are already languages in which the age limit in fever clinics should be abolished, children should also be accepted, but at least the City of Fever Clinic Kaunas only accepts from 18 years, so we have no information. The municipalities of other cities have also been allowed to rotate, as you know, “she said.
The portal tv3.lt recalls that it has written about complaints from residents that in some cities fever clinics have been closed, among these municipalities, also in Vilnius.
Provides fever clinic services
For his part, Skirmantas Mockevičius, mayor of Jurbarkas district and representatives of the Association of Municipalities for Health Affairs, pointed out that although the fever clinics did not remain as a separate unit, their functions were transferred to other medical institutions.
“Even when the fever clinics were set up, there were really problems finding a location. So they worked one way or another, but then it turned out that the patient flows were very small. In some municipalities, there was only one more patient per day, and the staff had to always be ready, on duty in suits and have a mandatory X-ray.
Thus, at the request of the Association of Municipalities from August 14. New options came into force so that the fever clinic service can be performed not only in the fever clinic itself, but also both in the primary institution of outpatient care and in the secondary institution, the hospital. In addition, the municipalities can even negotiate among themselves so that the residents of two or three municipalities can be treated by a single clinic, ”said the mayor.
S. Mockevičius assured that the problem of age censorship is currently solved, so that younger patients can be admitted to fever clinics. However, he agreed that the situation could change again with the increase in fever.
However, we hope that everything is coordinated with the medical institutions and the ministry ”, he hoped.
Specific algorithms would help
The Ministry of Health itself, commenting on the procedure for the admission of feverish children to educational institutions, explained that institutions must ensure that people with a temperature above 37.3 degrees and other acute symptoms of upper respiratory diseases do not get involved in the educational process. Health will have to consult telephone.
However, R. Isevičienė emphasized that not all things can really be solved over the phone.
“It may seem to some that the doctors are not doing anything now, but believe me, deciding over the phone whether a patient can come to the clinic or not is difficult. On the other hand, it is understandable that no one wants to call a patient with Covid-19, because no one wants to close the clinic, “she said.
At the same time, the doctor pointed out that she thought it would be logical to do algorithms at the state level on how institutions should behave in this situation:
“They would partially remove the responsibilities and make it clearer from the primary level to the doctors and patients themselves. After all, it is still difficult for patients to call institutions and communicate with a doctor.”
Minister reassures: will buy more evidence
Family physician J. Dūdienė also raised the question of whether we have enough research in preparation for the fall season, when the scope of testing may increase significantly.
“The question is whether we will have enough to investigate all if we send them to mobile points, because today the scope of the investigation is reduced,” he noted.
Health Minister Aurelijus Veryga explained that some preparations are underway.
“We are talking about that fall all summer long, and it is not news for medical institutions. As more feverish patients arrive, flu season begins, institutions will have to adapt and use the protective measures that were routinely used during the flu epidemic. (…)
It is also very important to try to differentiate patient flows until it is determined if it is Covid-19 or not. Therefore, in the case of larger institutions, it is planned to acquire rapid PCR tests in order to more quickly determine the origin of the fever in certain situations, when a patient needs to be hospitalized quickly, acquisitions are already planned ”, he commented at a press conference. he.
He recalled that when a person has a fever, the first thing to do is not go to work or send the child to school, but stay at home:
“You have to act responsibly and go to medical institutions only when you need help, not go talk to a doctor. So the medical institutions will really try to separate the flows, so there may be some dissatisfaction.”
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