The island of Saaremaa is at the epicenter of the outbreak of the coronavirus (COVID-19) in Estonia with 359 cases of a total 961. ERR News spoke to Kuressaare Hospital's medical chief Edward Laane about the situation on the island and how the hospital is coping.
The situation in Saaremaa
Saaremaa is Estonia's biggest island with a population of approximately 33,000 people. The hospital is situated in Kuressaare, the capital, in the south of the Island.
The outbreak of coronavirus on the island occurred after a volleyball team from Milan played a match in Kuressaare at the start of March. Soon after the first cases were diagnosed. The head of the Saaremaa VK volleyball team tested positive as did several players. So did the mayor, and later a conscript who returned to barracks.
From mid-March the island, and several others, has been closed to non-residents. Only people who have permanent residency on these islands can stay there during the emergency situation, which is due to last until May 1.
Last weekend additional measures were introduced for Saaremaa and the closest island Muhu, which closed all non-essential shops, restricted residents' movements and introduced spot checks by police. Anyone found to be breaking the rules can now be fined by police.
On Sunday, President Kersti Kaljulaid authorised 40 volunteer members of the Defence Forces to work together with the police to enforce the measures. This week a military field hospital was erected outside the hospital which will offer additional capacity if needed.
As of Friday, April 3, there have been 359 cases of COVID-19 diagnosed on Saaremaa. According to data from the Health Board, which is displayed on koroonakaart.ee, a total of 2,151 tests have been carried out on residents of the island. Of those, 1,792 were negative and 359 tested positive, approximately 17 percent. Per 10,000 citizens the rate of infection is 108.43.
In comparison, Harju County, which includes the capital Tallinn, has 303 cases and a 5.07 infection rate per 10,000 citizens.
Of the 12 people to have died due to the coronavirus at least four have been from Saaremaa. The virus has also be found in care and nursing homes.
ERR News spoke to Kuressaare Hospital's medical chief Edward Laane by phone on Friday at 9.30 a.m. He said staff are preparing for things to get worse next week as models are forecasting additional cases and patients needing hospitalization.
He also recommended people stick to the physical distancing restrictions and said that families should stay at home as much as possible.
This interview was lightly edited for clarity.
ERR News: How many people are being treated at the hospital?
Edward Laane: Inside the hospital, there are 23 positive COVID patients and there are few others [non-COVID patients] in surgery and seven patients in internal medicine. So I guess its 34 patients, in total. Plus we have a nursery ward and there are 22 patients and the hospital is also linked to the care home and I think there are 45 patients there too.
How many COVID-19 patients are in critical care? Do you treat critical care patients at the hospital?
We have second-level care so we can incubate patients and right now there is one patient.
How many staff members have contracted the virus, been isolated for it, or recovered?
So far working in the COVID patient wards, the so-called separation wards, there have been 42. Two physicians have returned to work.
(The hospital announced on it's Facebook page after the interview that in total 67 of its 359 employees were sick or had been sick and recovered in the last three weeks - editor)
Do you have enough protective equipment at the moment?
Yes, we calculate the amount of protective equipment every day and I think, from today, it is enough for two weeks.
How many volunteers do you have? Where are they from?
They are mainly from Tallinn, but they are from all over Estonia. There are 12 doctors, 24 nurses, 6 paramedics or ambulance technicians, nine- care personnel, one cleaner - in total 52, including Estonian Defense Forces (EDF) field hospital medical personnel
How are the local community supporting you?
The local community has given us great support they have brought us food, drinks, honey, sometimes candy but the most important thing is donations. So far already we have raised more than €160,000 in donations and we are very grateful for those. They are very supportive.
What will the money be spent on?
Two mechanical ventilators to give oxygen at high volume, to intubate patients, and protective equipment.
Have people been making masks?
Yeah, yeah, exactly, people have been making masks too. Kuressaare Regional Training Centre (Kuressaare Ametikool) gave us over four hundred masks, I think, which was initially a great help. Now, we also have many more surgical masks but initially, this was really a big help for us.
So, we actually, when the outbreak started, we recommended [that people] wear masks. The main reason is, in Kuressaare, that we do not know who has been infected and who has not been infected because it is quite widespread. And we have seen situations where people have tested negative but then they come back after five days and they have pneumonia and we retest and they are positive. So that is why we recommend masks for everybody.
And we have been recommending people to wear a self-made mask if others are not available.
How are you getting through it? Do you think about the future or just take it day-by-day?
I think we take it day-by-day we are a little bit worried because the model says that the outbreak, or the hospitalization rate, will increase in the next week and it might be 100s or even thousands of patients who need hospitalization. So we hope it is not the reality but we are preparing bed capacity and oxygen.
What support does the military hospital bring?
It gives 20 extra beds, and oxygen, so in a critical situation it is very important and we are working together and the first patient came in yesterday at 10 p.m. in the evening.
How is the hospital trying to keep up the morale of its staff?
We have meetings every day and I also have rounds with the COVID wards and the nurses and emergency staff and we try to raise their motivation level, and of course, the food and donations are really important.
Are your staff feeling scared?
Some do, but some don't. It depends on the personality.
What is it like to work in the protective clothing?
I think it is difficult, to be in it for three hours - you start to feel a little bit dizzy. So it is not easy.
Is there anything that you would like to say?
I would like to say, for this kind of epidemic, the whole of mankind is not really prepared for the challenge that the coronavirus brought. When I was in medical school we were taught that infectious diseases are almost gone - and we can treat everything and we are so powerful. But this virus… it is just something else that [shows] we need to respect viruses, be very careful because we are just a part of nature.
Anyone interested in donating to Kuressaare Hospital by phone can do so automatically by calling the following donation hotlines and remaining on the line until the end of the prerecorded message:
9000 405 for €5
9000 410 for €10
9000 450 for €50
Should anyone be interested in donating larger sums, the hospital can be reached via email at firstname.lastname@example.org.
The hospital is also accepting direct donations via online bank transfer:
To: Kuressaare Haigla SA
Account number: EE322200001120090627 (Swedbank) or
Editor: Aili Vahtla