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Covid Crises in the Health Care System

27.11.2020

 
Manana Vardiashvili

The daily rate of coronavirus infections in Georgia has long exceeded four thousands. The Georgian healthcare system has met such a high spread of the disease completely unprepared - people are unable to call an ambulance, receive family doctor's consultation or do receive them late, hospitals are overcrowded, and places are no longer available even for the patients in critical conditions. The medical staff is also in a difficult situation. Since the beginning of the pandemic on February 26, 10 physicians have died in Georgia and several hundred have been infected with the coronavirus. Covid hospitals are short on personnel. 

However, the opinion that the health care system cannot cope with the situation created against the background of the coronavirus pandemic is not shared by the Minister of Health of Georgia, Ekaterine Tikaradze. In an interview with Imedi TV on November 23, she said that the beds mobilized in Georgia today could provide services to the population of any country twice as big as Georgia.

According to the Minister, out of 7,363 beds mobilized across the country, 5,952 are used for the treatment of Covid infections, of which 5,741 have already been occupied.

Amiran Gamkrelidze, head of the National Center for Disease Control, says that the hospitalization rate for Covid patients in the country is very high, however not because all these patients really need to be taken to hospital: "Internationally, under adequate management, inpatient treatment requires 10-15, maximum 20% of active cases of Covid infections. The hospitalization rate with us is unfortunately large due to various factors. Here works some Georgian phenomena which I would not specify, also fear, and some other factors,“ said Amiran Gamkrelidze. 

By "Georgian phenomena" the head of the National Center for Disease Control was probably referring to the instances of "clientelism" characterized to Georgia, for according to doctors, there are currently many patients in hospitals who do not need to be there, but have influential relatives or acquaintances who jawbone. 

People with symptoms of covid-19 or infected with coronavirus tell humanrights.ge what they had to go through in the current situation.

Story N1 - Natia D.

Natia lives in Gurjaani. On November 10, she, her husband and 4-month-old child were diagnosed with the coronavirus. Although the PSR test showed that all three had covid-19, they were feeling well. The mother-in-law and father-in-law of Natia showed all the symptoms of Covid.

"They are in the risk group. For 9 days, they have a fever. For three nights they could not sleep. They are weak and find it difficult to get up from beds. Symptoms are compounded by respiratory failure. We are all in isolation. We want them to be examined in a clinic, but because they are in contact with those infected with the coronavirus, they are forbidden to leave the house. We called on phone to every agency we could reach, but could not receive answers on how to act,” said Natia. 

The endless circle started after contacting the emergency and healthcare hotlines. 

We called 112. They promised us to assign a family doctor, so the doctor would call us and decide the issue whether they are to be transferred to a hospital or need a treatment at home. We waited for half a day for a call from the family doctor and then we called the hotline of the Ministry of Health. They told us to wait for 24 hours and if we would not receive a call then contact the hotline of the Ministry. I asked them: what if in this 24 hours something goes wrong? They replied they could not help and we had to wait for 24 hours. We called Geohospitals in Gurjaani and they told us to call 112 to get a permission from the patrol police to violate the regime of isolation to move the patients to the clinic and in this case there would be no problem. I called 112 again and they told us they could not give us  a permission and we had to call the healthcare hotline. We called the healthcare hotline again and from there I was redirected to 112 again. For two days, we have been going round in circles, calling to the hotlines and there was no one to tell us how two persons can approach the clinic to be examined. It is clear that there is a pandemic in the country. It is understandable that we do not have the resources and that our health care system is devastated, but should a person obeying the law and not violating the regime of isolation  die? We are not asking the time of ambulance crew to be wasted on us, nor to occupy the small resources of the beds available in the clinics. We just want them to arrive to the clinic with our car, at our expense, to take the necessary tests and return home, and they do not allow us to do that, because it turns out that they do not have a protocol!”

Story N 2 - Ia S.

Ia also lives in a region. Covid-19 was also detected to her in early November. Ia believes that she and her husband got infected on the day of elections of October 31. Covid-19 was also confirmed to her two children, the eldest of whom is 7 years old and the youngest is 5 months old. The adults managed to recover from the decease relatively easy at home.  The doctor had some concerns regarding the health status of the 5-month-old baby and the baby was taken to a hospital in Tbilisi. 

"He was coughing and was bad, he could not sleep. The doctor said they could not take responsibility for the child themselves and I had to take the baby to the hospital. In the ward, where there should normally be 1 child, three children were at beds. I understand the situation in the country and we did not complain about it. I was in the hospital for 6 days and during this time no cleaning personnel entered the ward and we were cleaning the ward ourselves. We did not complain about that either. They are short on medical staff. Young people came in who had neither knowledge nor experience. Probably they were students of medical schools. They could not properly introduce a catheter to the child damaging the baby.  Two days after being taken to the hospital, the child developed a rash on his hand. The rash is one of the symptoms of Covid. The hand was in a terrible condition. I could not tell whether this was a corona symptom or an irritation caused by the catheter. When I called the doctor at 11 o'clock in the morning and asked him to see the child, no one came until the next day 8 o'clock in the evening. In the meantime, I was forced to refer to another doctor for an online consultation, and I bought the medications following  his recommendations. Although I was in the hospital, I was getting a doctor’s consultation over the phone and online and most importantly, from the doctors outside the hospital. 

Moreover, the medical staff worked without gowns. When I asked why they did not wear special gowns and masks, they told me that it is difficult to work with gowns. We left the hospital already. On the day of leaving, I learned that three more doctors at the hospital had been infected. I do not know how the rest of the staff could suffice for so many sick individuals."

Story N 3 - Eka Lomidze, Lawyer at Human Rights Center (HRC)

"My close relatives have a confirmed diagnosis of COVID-19. They have been treated at home for 9 days already. 2 days ago the condition of my grandparents worsened treated by a family doctor. The ambulance crew took them for a test 2 days ago. One was confirmed to be infected, the other was not. One of them who was coronavirus infected was offered to be taken to the so-called Covid hotel. It turned out that the grandpa of 72 with a severe respiratory failure and the grandma of 70 who cannot stand on her feet and almost cannot eat are not subject to transfer at all. Indifferent attitude towards people when they need help the most is tantamount to a crime. Everyone has the right to life and health. This right is laid down in the Constitution and it must be real and tangible,” said Eka Lomidze.   

HRC issued a special appeal to the authorities with regard the systemic crisis amid the spread of the new coronavirus pandemic.  The appeal states that recently, there has been a particularly high number of referrals from people with health problems who are unable to receive the necessary medical care. Due to the overcrowded referrals, shortages of beds in hospitals, health and lives of more and more people are at risk. The situation is particularly critical in regions where signs of crisis are already being observed due to insufficient infrastructure and a shortage of medical staff. 

HRC called on the Georgian authorities to take all measures and adhere to the principle of equality to provide assistance to all those in need and to mobilize medical personnel in all  hotbeds of crises so that the residents in the regions are also able to receive appropriate medical services, further to immediately put in operation additional hotlines in order the operation of 112 not to be interfered so that the other cases of violations of laws or other cases of emergencies not to be left unresponded. 

As of November 27, 118,690 cases of coronavirus infection have been confirmed in Georgia, of which 3,801 in the last 24 hours. Of those infected, 98,781 have recovered and 1124 died. 

According to the decision of the Coordinating Council, some  measures introduced to stop the spread of the Coronavirus pandemic shall be further tightened from November 28: Subway, municipal and intercity transports shall stop. Large shopping malls, all types of fairs shall be closed. Restaurants and catering facilities shall be closed shifting to delivery services.  Public schools and universities also shift to distance learning. 

Authorities hope that the results of the new restrictions will appear in 2 weeks and the number of daily coronavirus infections and deaths will be drastically reduced. 

HRC implements the project Free Legal Advocacy and Human Rights Monitoring after the Coronavirus Pandemic, with a support of the Embassy of the Netherlands to Georgia. The goal of the project is to identify and raise awareness of the alleged facts of human rights violations during the state or emergency aimed at the prevention of spread of the Coronavirus pandemic in five regions of Georgia: Shida Kartli, Kakheti, Kvemo Kartli, Imereti and Samegrelo.

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