On Sunday ETV's "Aktuaalne kaamera" news programme spoke to hospital staff and family doctors about how the health system is coping with the coronavirus (COVID-19) crisis, additional measures and workloads.

Karmen Joller, a family doctor in Tallinn and board member of the Estonian Society of Family Practitioners, said: "Because of the pandemic and the government's decision to raise the level of risk, the health system is completely reorganizing itself. The key is to stop scheduled work or work that can be postponed."

Family doctors are trying to do as much work as possible by giving patients advice by phone or email.

"We welcome people who feel that home care does not help or that it is not possible to determine by telephone whether home care is sufficient," Joller explained. 

But she urged people to come to appointments if they make them and be on time, and for their part, doctors are also trying to keep a schedule so that people are as unlikely to be in the health center as possible.

Family doctors will continue to deal with infants, but sick notes will not be issued. While a sick patient usually has to go to the doctor to open a disability or sick note, an e-solution should be launched in the patient portal in the coming days.

"We are working very quickly with the EHIF and the Health and Wellbeing Information Systems Center to enable people to send a digital application request," said Joller.

Hospitals will cancel admissions

The North Estonia Medical Centre (Põhja-eesti regionaalhaigla) announced on Friday that it will restrict scheduled elective treatments as of Tuesday. 

Agris Peedu, head of the North Estonia Medical Centre said: "Our physicians will contact each patient over the phone and then agree on how future treatment will be. Whether admission is delayed, whether the patient will still be called for examinations or delivered remotely, such as a prescription."

Sick patients will be called a few days before the cancellation. However, if a patient is overlooked by a hospital for some reason, Peedu said it would not be wise to come in, but contact the hotline to clarify the situation.

Those in need of emergency care will not be sent away and the hospital's emergency room is still open. 

"First of all, go to the emergency room or call the ambulance and then go to the hospital through the ambulance. But if it really comes down to it, then of course we take the patients, but that person should think clearly about whether they need to come to the emergency room," Peedu said. 

Patients with suspected coronavirus should go to the yellow tent in front of the emergency room.

Doctors are banned from going abroad

At West Tallinn Central Hospital (Lääne-Tallinna keskhaigla), workers are temporarily banned from traveling outside the country. Workers' in-hospital and out-of-hospital training have been temporarily suspended. 

Liisa Suba, a spokeswoman for West Tallinn Central Hospital, said: "Planned holidays will be interrupted if the number of patients in need of hospitalization increases significantly and there are not enough staff on the job."

Patients' scheduled work is halted if the number of hospitalized infectious patients increases significantly and there is a shortage of staff or beds, or both. In this case, the released staff and the available rooms can be used for infectious patients.

The clinic prepared the new wards

Priit Eelmäe, head of Tartu University Hospital (Tartu Ülikooli Kliinikum), said doctors' holidays have not yet been canceled but the vast majority of non-emergency treatments have will be suspended from Wednesday, March 18.

"We are reorganizing our planned treatment. In the long run, we are ready to have people recalled," Eelmäe said.

"It certainly does not affect pregnant women; it does not affect dialysis, chemotherapy or radiation therapy. It may be added, but the vast majority of outpatient and inpatient care will be suspended," Eelmäe said. The hospital will akso continues to receive patients in need of emergency care.

He said there are currently enough wards in the hospital and they are ready to increase the number of wards if needed. "By the end of next week, there will be 30 extra beds and if needed we can double it," said the hospital manager.

The clinic has canceled all outbound trips for staff and training outside of the hospital. Teaching at the hospital has been suspended except for clinical practice for 6th year students and for the students of health care institutions. In the spring semester, external trainees will not be admitted to the clinic regardless of the trainee's country of origin. 

The service of the mammography bus, which performs checks for breast cancer, has been suspended.

Good to know

Health system readiness levels:

Level 1: There is a real risk of a crisis

Level 2: Expected number of persons in need of assistance beyond the capacity to provide conventional care in and around crisis areas

Level 3: The estimated number of people in need of care significantly exceeds the capacity of at least half of the health care facilities in the country.

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