The massive and simultaneous spread of respiratory viruses (SARSCoV-2, influenza viruses and respiratory syncytial virus-RSV) in the community forces a significant number of people to go to hospitals, which places a huge strain on the healthcare system. Hundreds of citizens with respiratory infections visit emergency departments (EDS) of hospitals, causing a “heart attack” in the work of institutions, mainly in Attica. However, this situation could have been avoided if the primary health care (PHY) system had functioned, Yiannis Kalomenidis, Professor of Pulmonology – 1st Intensive Care Clinic of the EKPA School of Medicine, O Evangelismos Hospital, told APE-MPE.

The majority of those who go to hospitals do not need special care, and in fact, 2022 statistics from the flagship hospitals, Evangelismos, showed that 82% of all those who came to TEP did not need hospital care. This phenomenon creates a vicious circle, which at some point must be broken, emphasizes Mr. Kalomenidis. Hours of ambulance delays and on-call calls that start when full are daily pictures in the hospitals of Attica, and it’s still January… In the next period with the predominance of super-contagious sub-variants (Kraken, Orthros) of the Omicron mutation, the phenomenon will intensify, professor notes.

“Since mid-December, mainly due to holidays, etc., there has been pressure in the general ward, which has now become extremely difficult and at times dangerous, with great difficulty 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 to be intubated. He notes that it is a big surprise when a healthy, vaccinated 60-year-old man becomes seriously ill. He highlights the booster dose of the updated vaccine, noting that the data from the US on its effectiveness in preventing serious illness is very good, and it is expected that the vaccine will even protect against new variants.

Lack of primary health care forces citizens to turn to hospitals

Mr. Kalomenidis explains that there are a significant number of people admitted to hospitals who, in practice, do not need inpatient care, specifically noting that this is something we have been discussing for 20 years, and this is because there is no serious primary care network in the basin. sanitary assistance. contact, for example, the on-duty Health Center in their city, as Health Centers are on duty in the region.

“Due to the lack of an on-duty unit, the emergency departments of hospitals are crowded with people. The citizens are suffering, the work of the hospital is burdened, and this is a vicious circle that must be broken at some point.” According to Evangelismos Hospital statistics for 2022, he emphasizes, 82% of those who applied for help at the PVP were outpatients, that is, they came alone and “normally, in a system that works rationally, these people should not have ended up in the hospital. They had to go to their local health center and primary care physicians assessed them and identified a minority who would eventually need inpatient treatment.”

Difficult months of February and March

The emergence of highly contagious subvariants is worrisome and puts health systems on alert. Infections are expected to rise in the coming months and more people will need hospital care.

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

The consolation is that the flu is subsiding for the second week in a row, which could mean we actually hit our peak this year 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 has been showing an increase. There are others we don’t track that are circulating and we don’t have a photo,” Mr. Kalomenidis says. The spread of SARSCoV-2 is also growing, and not only in our country, but throughout Europe, there are concerns about whether newer more infectious strains (Kraken, Orthros) could cause an increase in the number of infections in February and March.

The other side is the healthcare system and especially its people, who have already been exhausted in 2.5 years by the pandemic. “The winter started very badly, the climate on duty is very bad, and indeed, unless something is done that can make the duty easier, and this is in the hands of the ministry, I don’t think that everything will be fine in February.” The pandemic has taught lessons at the global level to strengthen public health, and the question “what public assistance do we have in Greece and what do we want to have” needs to be revisited, Mr Kalomenidis concludes.

Source: RES-IPE