However, the Tallinn ambulance service's (Tallinna Kiirabi) chief doctor disagreed, stating that Tuesday's events indeed do bear the hallmarks of a crisis.

PERH specializes in treating critical patients, including those with burns and severe multiple traumas.

Speaking at a press conference Wednesday, Health Board Director General Birgit Lao said that in cases like Tuesday's, where eight patients all presented at PERH with similar symptoms, then callouts triaged lower down the list are automatically redirected to the East Tallinn (ITKH) or West Tallinn (LTKH) central hospitals, or if necessary to hospitals outside of Tallinn.

The latter case would require special permission, though Lao confirmed in this case the use of these hospitals had not been needed.

Lao characterized Tuesday's events as a logistical challenge for the ambulance service, the hospital, and its ER, logistics which can always be improved.

She said: "Information must flow via the correct channels, and it is always viable to request additional help if there is a sense that patient needs cannot be met."

The incident did not represent a crisis in the sector, Lao added.

"This is a warning, and not a crisis," she said. "The situation was becoming critical, such that all monitoring systems were activated, very intensely. After lunch until late at night, the crisis coordination team was at its station."

However, Raul Adlas, Tallinn ambulance service's chief doctor and also taking part in Wednesday's press conference, said he views the incident as much more serious.

"This is clearly a crisis," he said.

Adlas noted that 30 percent of Tallinn's ambulance resources stood idle for five hours.

"The legally mandated time for the handing over of patients was overshot tenfold," he added.

Speaking to ERR, Lao noted that on Tuesday, the ambulance service did not see the need to deploy additional units, but PERH could have always made available extra bed spaces, which in fact it did, in addition to triaging less critical patients to be transferred to other hospitals.

Lao, when asked if a communication breakdown had been the root cause, said that changes are always welcome, but it was good communication and cooperation which had gotten to the bottom of the issues and resolved them.

Essential medical care was not interrupted, and patient services continued, even as certain risks emerged – including the emergency response center (Häirekeskus) having to place lower-severity calls on hold.

Adlas however said that even in Estonian towns with just the one hospital, often municipality-owned, wait lines such as those seen in Tallinn on Tuesday do not occur.

A coordinator is needed to address the matter in the capital, he argued.

"In times of crisis, this is the role of the Health Board," he added, alluding to the Covid era.

"We now need to agree on whether what happened yesterday was indeed a crisis, which would permit the Health Board to issue directives, or if this is a regular situation within our tolerance limits, in which case this is what we can expect in the future," he went on.

Lao added that lowering the crisis threshold needs to be considered in relation to a situation and when the signs of strain start to emerge, and not purely in legislative terms.

The topic needs to be revisited in conjunction with Tallinn City Government, she added.

Starting 2 p.m. Tuesday a line of ambulances formed at PERH's ER doors, creating a knock-on effect on the operations of ambulance services in Tallinn.

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