Consequences of the COVID-19 pandemic: staff and resources are already scarce, money is late, cancer mortality is increasing

Feliksas Jankevičius, CEO of Santara Clinics, stated that the situation in the institution is tense, it is necessary to expand the number of beds for patients with COVID-19. They now treat 651 patients on oxygen and 73 in the intensive care and resuscitation unit.

In assessing the prognosis for the spread of COVID-19, the number of beds for these patients in the Santara clinics is expected to increase to 771, the director said.

“How to do it? We have a reserve of beds: the Vilnius City Clinical Hospital could be expanded to another 200 beds, using the entire building, the entire building. Extra beds may also appear in the Alytus Hospital,” said F. Jankevičius .

The biggest problem he mentioned is a lack of staff. Legal regulation is also an obstacle to solve it. The head of the Santara clinics assured that the institution did not have the tools to transfer non-volunteer doctors from other specialties to work in the COVID-19 wards.

Soon there will be a shortage of evidence

Furthermore, according to F. Jankevičius, there is a lack of nursing beds in the institution. Nursing patients with mild or asymptomatic COVID-19 could be treated at home, he said.

“In Lithuania, it is difficult for us to persuade the population. Usually it is argued that there are no conditions at home and there is probably a fear of taking that patient home,” said the manager.

According to F. Jankevičius, the scope of the provision of planned services in the Santara clinics is decreasing, but, for example, they are still offered to cancer patients.

F. Jankevičius stated that clinics may immediately begin to lack the rapid PCR tests used for COVID-19 testing.

“In the Santara clinics today there are 300 tests left, they will be enough for the best week, perhaps we will do – it is promised – another 300 tests, but that is a problem,” he said, ensuring that the institution is not unprotected, it has at least one month.

F.Jankevičius assured that he could have more security measures, but he has nowhere to keep them.

Narimantas Markevičius, director of the Vilnius City Clinical Hospital, has now identified the lack of staff as one of the most important problems.

“Currently, we have 30 employees of polyclinics in the city of Vilnius. All volunteers, “he said.

“If 30 inpatient beds require about 40 employees, then in treating COVID-19 patients, they need three times more,” N. Markevičius noted.

You may need to close even more sections

The director seconded F. Jankevičius, saying that there should be a legal basis for transferring doctors from other departments to COVID-19 patients.

“It would be very important to have some legal regulation for emergencies, which allows the use of employees from other specialties, because, as you well know, there are not many infectologists,” said N. Markevičius.

He noted that the Vilnius City Clinical Hospital is probably the largest support hospital for COVID-19 patients. He has 184 patients with the virus.

In total, the hospital, according to the manager, has prepared 210 beds for COVID-19 patients.

N. Markevičius said that the Vilnius City Clinical Hospital generally provides many therapeutic services, but due to the COVID-19 pandemic, five therapy rooms and two day surgery rooms had to be closed. The manager predicts that the department will have to close more.

“If it had to be closed, that would probably be the number of cases, and Antakalnio str. 57, because it is not possible to ensure infection control in any other way, we would lose the three remaining therapy departments, the abdominal surgery and urology services. ”Taught N. Markevičius.

Jonava Hospital: reserves to expand sold out

Jonava Hospital would also have difficulty expanding the COVID-19 ward. Gediminas Ramanauskas, deputy director of the Hospital de Derecho y Calidad, said that there are currently 25 beds for COVID-19 patients, two for resuscitation. Increasing the number of beds for COVID-19 patients would not be possible unless it was decided to suspend scheduled services for the population.

“It just came to our attention then. The first problem is the staff, the second is the infrastructure itself. The COVID-19 unit is installed in a completely separate room, which provides benefits, allows to maintain planned services for residents and not disturb them in this way, ”commented G. Ramanauskas.

Paulius Vasilavičius, director of the Jonava Hospital, supported him, adding that in such a case some of the services could only be provided by second-level doctors.

“We are looking forward to confirmation from the Ministry that the costs incurred will be reimbursed, so we can look to the future again. The extras are definitely for the employees to count on. Yes, we don’t have any big problems yet, unless we buy equipment personal protection at special prices, because there is no other option ”, continued P. Vasilavičius.

It is true, he assured that the hospital – as a support hospital – also receives personal protection equipment from the state reserve.

S.Jarmalaitė: patients do not come

Sonata Jarmalaitė, Deputy Director of Science and Development of the National Cancer Institute, Acting Director, also participated in the Health Committee hearings.

“When it comes to oncology, we have been overlooked something,” he said of the situation as the ongoing COVID-19 pandemic.

The institute’s acting director said the facility is trying to focus on cancer treatment, even though it has several COVID-19 patients in addition to cancer.

He said he noticed that the number of patients arriving at the institute after quarantine was decreasing, and those who applied were already suffering from late-stage cancer.

We really have a 20 percent increase in deaths.

“We have a 20% increase in deaths, but I am afraid most patients cannot communicate with us. <...> I’m afraid that early-stage patients just don’t go to hospitals. What chain is stuck … We do not have such an active communication with the primary chain, what situation in polyclinics I do not even understand. But we could really do diagnostics, “said S. Jarmalaitė.

Less revenue for PSDF budget

Kęstutis Štaras, director of the Center’s polyclinic, who participated in the hearings, pointed out that the institution lacks funds because it does not receive payments from the State Health Insurance Fund.

“I am not saying that it is only here in Vilnius, there are delays in payments for services provided with health insurance funds. And knowing that under the tripartite agreement we have to reach an agreement with the employees on the 10th of the current month, pay the salary, in addition to the agreements with providers, we feel the lack of funds “, said K. Štaras and suggested or shorten the term. resolved with medical institutions, or offered to pay up to 50% to medical institutions. looking for an advance .

Gintaras Kacevičius, director of the State Health Insurance Fund (VLK), admitted that the payment of services to the institutions is late and explained the reason: the revenue collected in the budget of the Mandatory Health Insurance Fund (PSDF) is decreasing.

PSDF’s revenue decreased, decreased by approximately 10 percent.

“I can confirm that the settlements now take place later than the medical institutions were used to. My information this morning, we are not late yet, we are not breaking the deadlines of the law, but we are really close to the limits. And the The reason is very simple: For all known reasons, PSDF’s revenue dropped about 10 percent. I mean, the flow of funds to VLK is reduced. I have no idea how we could deal with that problem and talk about financing. Just we have to adapt, “said G. Kacevičius.