Great pressure on the health system from the outbreak of viruses – Difficult months February and March

Tremendous pressure on the Health System is created by the significant number of people resorting to hospitals due to the large and simultaneous spread of respiratory viruses (SARSCoV-2, influenza viruses and respiratory syncytial virus – RSV) in the community. Hundreds of citizens with respiratory infections visit the Emergency Departments (ED) of the Hospitals, causing a “heart attack” in the operation of the Institutions, mainly in Attica. However, this situation could be avoided if the Primary Health Care System (PHC) was functioning, the professor of Pulmonology – A Clinic of Intensive Care, EKPA Medical School, “O Evangelismos” Hospital, reports to APE-MPE. Yannis Kalomenidis.

The majority of those who come to the Hospitals do not need special care and in fact the statistics of 2022 from the flagship of the hospitals, “Evangelismos” showed that 82% of all those who came to the TEPs did not need hospital care. This phenomenon creates a vicious circle which at some point must be broken, emphasizes Mr. Kalomenidis. Long-hour delays in EDs and on-calls that start with fullness are daily images in the Hospitals of Attica and it is still January… In the next period with the prevalence of hyper-contagious sub-variants (Kraken, Orthros) of the “Omicron” mutation, the phenomenon will intensify, he notes the professor.

“From the middle of December onwards, mainly from the days of the holidays onwards, the pressure is evident in the general emergency which has now become extremely difficult and dangerous at times, while there is great difficulty in finding places to treat patients”. But he emphasizes that the picture is not the same as it was two years ago. Today, people who belong to high-risk groups are seriously ill and need intubation. It is a big surprise, he notes, to see an otherwise healthy, vaccinated 60-year-old become seriously ill. He emphasizes the booster dose with the updated vaccine, noting that the data from the US on its effectiveness in preventing severe disease is very good and it is estimated that the vaccine will even protect against the new variants.

The absence of primary health care drives citizens to Hospitals

Mr. Kalomenidis explains that a significant number of people come to hospitals who in practice do not need hospital care, noting with emphasis that it is something we have been discussing for 20 years and this is because there is no serious primary care network in the Basin to turn to, such as a Health Center in their city to be on duty, as the Health Centers are on duty in the region.

“Due to the absence of a primary structure on-call, people crowd the hospitals’ emergency rooms. The citizens suffer, the operation of the hospital is burdened and this is a vicious circle that must be broken at some point.” According to the statistics for 2022 of the “Evangelismos” hospital, he emphasizes, 82% of the people who asked for help at the TEPs were ambulatory, that is, they came alone and “normally, in a system that works rationally, these people should not have arrived at the hospital. They should have gone to the Health Center of their area and the doctors of the primary structure should have evaluated them and judged the minority who will eventually need hospital care”.

Difficult months February and March

The emergence of highly transmissible subvariants is a cause for concern and puts health systems on alert. An increase in infections is expected in the coming months and more people will need hospital care.

As can be seen from foreign data, the new subvariant “Orthros” of the “Omicron” mutation does not cause a more severe disease, Mr. Kalomenidis points out. He adds that none of the sub-variants shown by Omicron, although the dominant ones are more contagious, appeared to cause more severe disease. So from this side we have no alarm. “The problem is when we have too much dispersion, and now we have covid-19 as well as other viruses. It goes without saying that statistically we will see more and more people, especially among the vulnerable population, needing hospital care. When all of them need care at the same time and for a short period of time, one understands that this creates a big problem for the hospital and the service of these people”.

It is comforting that the flu has subsided for the second week in a row and this may mean that this year we have actually peaked about a month earlier than other years. But at the same time we have other viruses, we monitor the respiratory syncytial virus – RSV, where for the second week its positivity shows an increase. There are others that we do not monitor and who are circulating and we do not have a picture, says Mr. Kalomenidis. SARSCoV-2 is also increasing and the concern not only in our country, but throughout Europe is whether the new more contagious strains (Kraken, Orthros), may cause an increase in infections in February and March. The other side is the health system and especially its people, who have already been exhausted for 2.5 years with the pandemic. “The winter started very badly, the climate is very bad on duty and really if something is not done that can lighten duty and that is in the hands of the ministry I don’t think things will be good in February”. The pandemic taught lessons at a global level to strengthen public health and it is necessary to revisit the issue, “what public care we have in Greece and what we want to have”, concludes Mr. Kalomenidis.

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