County hospital buildings' age hinders coronavirus treatment close to home

South Estonia Hospital in Võru.
South Estonia Hospital in Võru. Source: South Estonia Hospital

Patients infected with the coronavirus in South Estonia are often treated at the University of Tartu Clinic. Although some patients remain in a hospital close to home, it is not possible to create adequate wards in smaller hospitals.

There are eight patients in intensive care due to the coronavirus at the University of Tartu Hospital. In addition, there are 37 patients in general care there.

Juri Karjagin, the head of the Southern Medical Staff, told ERR that if there was no risk of infection, many of the 37 could also be treated in smaller county hospitals.

"In itself, this treatment is not so complicated. In milder cases, extra oxygen is needed and certain patients need certain medications, but it would certainly not be overwhelming for smaller hospitals. It is overwhelming to create isolation," Karjagin explained.

Karjagin says that wards and corridors generally do not have separate ventilation. Thus, five places cannot be opened in a 20-seat department for the treatment of infectious diseases. The whole department must be separated.

"In order to create an isolated zone in such a department, it is necessary to physically build a wall and create a separate department with a separate entrance where people put on protective clothing and go in," he said.

Those who are infected in Võru County are treated in the towns of Tartu or Põlva. This is also because half of the internal department at the South Estonia hospital is under repair until February, in order to improve infection safety.

On Wednesday, however, the South Estonia Hospital will also open eight beds for coronavirus treatment. Arvi Vask, a member of the hospital's board, said that the concern is wider, as there is a shortage of beds for infectious diseases in all hospitals.

"It is known that the last such major outbreak of infection was in Estonia in the 1950s and 1960s. This was an outbreak of polio, with a completely different scenario. This is the thing, we have forgotten that infectious diseases exist and need hospital treatment," Vask said.

Agris Koppel, head of the health system development department of the Ministry of Social Affairs, says that the danger has not been forgotten. A conscious choice has been made to concentrate the treatment of infectious diseases in large hospitals.

Decades ago, separate infectious disease houses were built both at Võru Hospital and at Viljandi Hospital, and in fact at other larger hospitals. "In today's world, where we have very effective antibiotics, it is basically not necessary to treat such a large amount of infectious diseases in a hospital. These houses at Võru and Viljandi hospitals would be completely empty today," Koppel said.

Koppel added that individual isolation wards are made in general hospitals, so that an infectious patient can be isolated as soon as he arrives. The new hospitals will be built to make it easier to create separate beds.

Smaller general hospitals, located in relatively old houses, require very large investments to renovate wards, entire departments to ensure the construction of all new ventilation.

Such investments have already been made in large hospitals in Tartu and Tallinn. However, Koppel stressed that epidemics are rare and that medical staff are successfully coping with the distribution of beds today.

The Southern Medical Staff discusses the number of beds every week. Jüri Karjagin said that the University of Tartu clinic has 44 places for general treatment and 11 places for intensive care. In South-Estonian Hospital, there are eight beds for general treatments and in Järva County four places. Viljandi Hospital is looking for ways to find additional places. Today, 10 places were added to the Põlva Hospital, i.e. there are now 18 places in total.

At the same time, the in-hospital spread of the virus has occurred in Valga Hospital, and the 18-bed ward will be isolated until Friday, until the results of the tests of patients in close contact are known. According to the plan, Valga should currently have six beds.

Ida-Viru Central Hospital has 12 general treatment places and two additional intensive care beds. Narva Hospital has 20 places.

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Editor: Roberta Vaino

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