The epidemic will last for about 3-5 years, and if we do not stop the development of new types of the virus, this period will be longer – says the Covid-19 advisory group at the head of the Polish Academy of Sciences. Government officials have already acknowledged that the fourth wave has already begun, and will gain momentum in September and October. Adam Nidzelsky, the health minister, estimated on August 19 that in the most pessimistic variant, there would be 15,000 infections per day. However, he hopes that thanks to vaccinations, fewer patients will end up in hospitals. As a result, little is said about their preparation for the fourth wave, and there are no exact scenarios for action. Those, in turn, would be well liked by hospital administrators and the local governments that run them.
Only a few counties speak to hospitals, and there are no systematic procedures
How are local government hospitals prepared for the fourth wave of the epidemic? – I don’t know – Marek Wojcic from the Polish Towns Association answers honestly. – Voivodes should talk to us, because they are responsible for regulating health care at the regional level, they decide to put the hospital. However, the practice is very different, Some people talk, but not all of them. surely There is no systematic work – says Wójcik.
Adam Nidzelsky’s statements show that we have 11,000. A family for covid patients. Ready for the so-called second level of hospitality is maintained at 6 thousand. bed. In addition, each hospital also has 3 to 5 so-called isolation beds for patients who have been tested for the virus. This gives about 2.5 thousand. bed “to hold”. In addition, there are 12 temporary hospitals operating about 2.5 thousand. bed.
Managers want to know what awaits their hospitals
Niedzielski also confirms this to Each county has a plan to expand the covid infrastructure, detailing step by step the specific units that will be added to the covid infrastructure system in the event of an increase in the number of infections. However, hospital administrators want to know if there is a risk of replacing regular wards with others for the virus. In their opinion, this should not be the case, so as not to prevent other patients from being treated. Paweł Grzesiowski, an expert at the Supreme Medical Council, believes that one district hospital should now be equipped to which patients will go when there are no places in infectious disease wards. Moreover, another 2-3 hospitals should be ready. What are the facilities that everyone, including patients, should know so that they can prepare. You must build walls, waterways, collect equipment and personal protective equipment.
It’s just that hospital administrators in Śląskie, Małopolskie and Wielkopolskie districts we spoke to claim no one has contacted them. – We used to be a hospital of the same name, but today we do not have information about how the system is organized in the fourth wave, there is silence on this – says Jaroslav Madovich, medical director of the MEGREZ Regional Specialist Hospital in Tychy. – We do not know the strategic plans of the state, although we have to know what to prepare for. We would like to know what is the organization of the health care system at the state, as well as at the regional level, which the state administration is planning in case of the next wave. It is important to indicate which medical entities will have to accept infected patients first – He adds. It is different in Mazowieckie and Opolskie.
At the moment, one temporary hospital per county, then more
The Opole Voivodeship office has already contacted the directors of hospitals that will accept patients during the fourth wave. There, the Medical University Hospital is responsible for managing the temporary hospital. Its director has already been directed to prepare for the next wave. In turn, a meeting of hospital directors with Masovian Voivode was held on Wednesday. Find out All patients will be referred to the Southern Hospital in Warsaw. If there were no more places there, the temporary hospitals in Radom, Siedlce, Ostrołęka and Płock would be launched, just as they had during the third wave. If the wave is big enough that these facilities are not enough, Covid hospitals will be restored. Every hospital should also have so-called isolation beds for patients during testing, Minister Niedzielski mentioned. Is this plan enough? Marek Wojcic thinks that’s not the case. – It is true that it is difficult to predict how the fourth wave will proceed. That’s why you need several scenarios. First of all, you need to create a precise mechanism to direct patients to the right place – he says.
There may not be enough employees and departments
Jerzy Wielgolewski, director of the district hospital in Maków Mazowiecki, who took part in the meeting, believes that now, with 20 patients in the district, it is impossible to answer the question of whether hospitals are ready for the fourth wave. However, it highlights another problem: the staff shortage. The employment situation in hospitals is bad. It flows into primary and ambulatory care, because working conditions are more comfortable there, working hours are friendly, and telecommuting is possible. In addition to After three waves of the epidemic, employees are exhausted, even burnt. These people no longer want to work as much as before and do not have to, because thanks to COVID allowances they have already earned a lot. As a result, there will be hospitals, but there will be no one to take care of the sick and there is no plan for this – notes Director Wielgolewski. Jaroslaw Madovic adds that his hospital is able to standardize it within 48 hours, if the staff take it and take on such a burden again. – I notice that the medical staff is currently reducing the number of working hours and no longer works more than 300 hours per month. – Currently, the salaries are decent enough that no one wants to remain on duty for 300 hours anymore – he adds.
Marek Wojcic thinks similarly. There is also a shortage of workers in infectious diseases departments, because this specialty has not been popular so far. Doctors won’t be around overnight because it takes 12 years to train. Therefore, the problem should be solved differently – he adds. True, as of December 20, 2020, simplified regulations have been implemented to grant the right to practice medicine in Poland, but they do not work perfectly. Marek Wojcic believes that a long-term strategy is also needed. – As you can see, the epidemic will not disappear soon, everything indicates that it will remain with us for a few years. Therefore, it is necessary to determine how many branches we need, define criteria for them and adjust financing for them – he adds. For example, there are currently three hospitals for infectious diseases in West Pomerania, eight in Podlaski and 10 in Malopolsky.
There are no guidelines for doctors
Director Wielgolewski also draws attention to the absurd situation with the guidelines for treating Covid patients. – We received the first document when the epidemic was waning. Meanwhile, this information should appear regularly so that doctors know how to act, but also talk to patients and their families. For the first three waves, they decided among themselves whether to use an antibiotic or a steroid, and had to find answers to questions about amantadine or remdesivir. This is a huge psychological burden. Today, for example, there should already be guidelines for the treatment of vaccinated patients who have contracted the disease – confirms Wielgolewski.
There is also the problem of procedures. During the third wave, affected patients often end up with the same HED as the others. Therefore, it is important that every hospital has pathological procedures that provide, for example, an area for rapid testing of patients in HED. Since July 1, the regulations regarding hospitalization of patients with COVID-19 have changed. Hospitals must be prepared for the fact that they will have to take care of them, because they will not be transferred to another hospital and it will be necessary to create safe conditions for them. Many hospitals do not know this.
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