Corona furious: more than 30,000 people in self-isolation, almost 300 cases per patient

“Since the beginning of March, 201 chimneys have been registered in Lithuania, of which 26 were in medical institutions and 11 in nursing and care institutions. There are from 2 to 92 people in an outbreak, and the highest number of contacts who were in contact with the patient was 298, “said Daiva Razmuvienė, chief specialist of the Communicable Disease Management Division of the National Center for Public Health ( NVSC).

At the national public health conference “Lithuania and COVID-19: Experiences, lessons and perspectives” held on Wednesday, Mr. Razmuvienė spoke about the involvement of NVSC specialists in the management of COVID-19.

The exercise came true

“This year is truly exceptional, which can be described by the two words ‘all new’: a new virus, new findings and evidence from scientists, new recommendations. Our work has been redistributed in such a way that we never thought it was not my job, nor my role: I had to do everything quickly and, despite some problems, correct mistakes, move on. NVSC was able to adapt to this whole situation “, – D. Razmuvien about spoke about the year 2020 affected by the coronavirus.

The specialist recalled that last December a functional exercise was carried out, whose objective was precisely to see how prepared the different institutions were before the appearance and spread of a new pathogen of one or another infectious disease.

Less than a month later, the simulated scenario was repeated in reality: Lithuania was effectively hit by a new pathogen, began to spread, and fundamentally changed the daily lives of NVSC specialists.

D. Razmuvienė highlighted 8 main areas of COVID-19 management: epidemiological investigation of cases and outbreaks and monitoring of exposed persons; initial information of exposed persons (including assessment of places of isolation, issuance of certificates of incapacity for work, registration for examinations); better control of medical quarantine; consultancy for natural and legal persons; monitor compliance with COVID-19 preventive measures; preparation and issuance of permits to leave the place of isolation, shortening the duration of isolation; preparation and provision of information to the public, as well as monitoring and evaluation of the epidemiological situation.

“All these 8 bars are very interconnected and very important. They could not be without each other, because there would be empty space ”, the epidemiologist did not doubt.

Call the NVSC and take a nap

In total, some 600 NVSC workers participated in the fight against the coronavirus. Of these, 59 are epidemiologists, 408 are specialists in other fields, 104 are other specialists in the management of communicable diseases, and 24 are agricultural workers.

During the pandemic, new working groups were formed in the NVSC to perform functions that did not exist before, such as leaving permissions to leave the isolation site or shorten it. Such group employs 35 professionals who perform only this work. They receive around 800 requests per day to leave the isolation space or shorten the time.

The NVSC has also created a High Risk People Registry and Initial Information Group, which employs 30 specialists and is still in reserve. These specialists carry out epidemiological diagnoses of each case, identify those who have been in contact, assess the risks and work with institutions and companies.

Currently, an NVSC employee can and does provide an average of about 60 phone inquiries per day. A separate group of people has been appointed for this purpose. At the same time, residents are consulted by 16 specialists and three on weekends. They receive an average of 1,500 calls a day and respond to 200 to 300 inquiries sent by email.

“It just came to our knowledge then. Other people want not only specific help, but also psychological help, to have fun, to talk,” said D. Razmuvienė.

The epidemiologist regretted that the NVSC is currently short of specialists, which reduces the quality of epidemiological diagnosis of cases.

“People who come don’t pass the trial period and leave because they probably expected an easier job. Due to the lack of specialists per day, at least in the Vilnius department, it is possible to investigate no more than 50 cases qualitatively, ”said D. Razmuvienė.

NVSC specialists do not have enough time for detailed analyzes and the management of other diseases is complicated.

The training paid off

According to the specialist, a very important area of ​​NVSC’s work is the dissemination of information. You often have to work overtime here too.

NVSC constantly prepares and updates information on the latest static data, epidemiological studies, and changing requirements. Most of this information is translated into English and Russian.

“The formation of specific groups in society has given good results. They were attended by representatives of various companies. There is a lot of participation in distance education, but there is not always enough time for each organization to dedicate as much as they want to listen to that training, ”said D. Razmuvienė.

Look at the border

NVSC also regularly conducts quarantine medical checks at three airports in the country (Palanga, Kaunas and Vilnius), as well as at the international port of Klaipeda. In the past, these controls were also carried out at land border crossings.

“Our specialists are no longer awake at the land border posts. But on duty in January. This really yielded a lot of positive things, as the health status of everyone who arrived was assessed with a thermal imaging camera, the temperature was also measured with contact thermometers, they were surveyed, registered and, of course, their advice. Those people had many questions. If we remember at the end of January, they were only citizens returning from China, then the geography expanded. In this way, I needed more people to be able to accept each trip, explain it to each passenger, register it ”, remembered D. Razmuvienė.

When COVID-19 is suspected at an airport, the person is usually called immediately to isolate himself in a separate room and then transferred to a hospital. There have been many such cases where sick people have been identified at the airport.

NVSC currently employs not only full-time staff but also 82 volunteers. There were 220 in the summer to July Volunteers monitor people in isolation and provide them with the necessary information.

Efforts are being made to explore the fireplace on a daily basis

As mentioned, since the beginning of March, 201 chimneys have been registered in Lithuania. According to D. Razmuvienė, every effort is made to explore each fireplace as soon as possible, already from day one.

The focus examination is mainly done by interviewing the sick person. More efforts are being made to identify those who have been in contact with her.

A call is then made to each person in contact. This requires the help of volunteers. Volunteers are in constant contact with those who have been in contact and are interested in their health.

“Each case requires 30 to 40 minutes. That information is not always collected at once. We also have to talk on the phone 3-4 times,” said D. Razmuvienting, lamenting that there is sometimes a lack of goodwill on the part. of people, correctly answering the questions that are asked.

Only institution-specific inspections are carried out

Currently, only unplanned, institution-specific inspections are performed. In other words, only the agencies involved in certain incidents or complaints are inspected and recommendations are made to them, and then the implementation of the recommendations is verified.

NVSC specialists inspected a total of 2,098 objects. Violations were identified in 137 of them.

2,808 complaints from police and neighbors about possible non-compliance with the quarantine regime were also examined.

Observed more than 3 thousand. people

According to data from Tuesday, there were 5,000 confirmed cases of the disease in specific people. 366. 27 thousand were also observed. 670 low-risk people who came to Lithuania and 3 thousand. 730 high risk.

“We need to have personal contacts with all these people. So sometimes that job asks for help. If the cases can still be contacted by specialists, then there really is a lack of physical hands with the contact persons,” the epidemiologist did not hide.

Mr. Razmuvienė is pleased that new information systems have been introduced in Lithuania which greatly facilitate the work of epidemiologists. In these systems you can see the entire epidemiological situation that has happened. There is also the COVID-19 platform, which contains all the important information about what is currently happening in the country and what the changes are.