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HEALTH

How the spread of the coronavirus has hit Europe

European Union chiefs have urged the public not to panic, but the spread of the coronavirus across Europe has forced some countries to take drastic action. Here's a look at what's happening around Europe.

How the spread of the coronavirus has hit Europe
Italian Finance guards (Guardia di Finanza) officers patrol by a check-point at one of the entrance of the small town of Zorlesco, southeast of Milan. AFP

The novel coronavirus is concerning for Europe but there is no reason for alarm. 

Those were the words of the EU's health commissioner on Wednesday as Italy battles the world's third-biggest outbreak.

“This is a situation of concern but we must not give in to panic,” Stella Kyriakides told reporters in Rome after meeting Italian Health Minister Roberto Speranza.

“We must also be vigilant when it comes to misinformation and disinformation as well as xenophobic statements which are misleading citizens and putting in question the work of public authorities.”

At the moment it is not recommending the reintroduction of border controls in the Schengen area.

Countries including Austria, Britain, Hungary, Luxembourg, Romania, Spain and Ukraine have warned their citizens not to travel to the affected areas in Italy.

Italy Europe's worst-hit country

The country by far the most affected by the coronavirus outbreak is Italy where the number of confirmed cases hit 374 on Wednesday and the number of fatalities rose to 12.

The country has seen a surge in cases since last Friday – when only three cases had been confirmed.

The worst affected area is the northern Italian region of Lombardy, where there are more than 250 confirmed cases. Nine of the patients who died were in Lombardy.

All 12 of the victims in Italy were elderly, with some having underlying health conditions.

While there is no need for the public to panic the outbreak has severely affected life in the country. 

Wide-ranging measures to halt the spread of the virus have affected the lives of tens of millions of people in Italy, with schools closed and cultural and sporting events cancelled.

Since Saturday, 11 towns in Lombardy and neighbouring Veneto, thought to be where the outbreak began, have been under lockdown with shops and public areas closed and police roadblocks preventing people from leaving or entering the area without a permit.

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France too is beginning to feel the impact of the spreading the virus.

Authorities announced the death of a 60-year-old teacher in Paris on Wednesday, the second fatality since the start of the epidemic after the death of a Chinese tourist earlier died this month.

The latest victim, who worked at a junior-high school in the town of Crepy-en-Valois, about 80 kilometres (50 miles) northeast of Paris, is not believed to have travelled to an area affected by the global coronavirus outbreak, the education ministry said.

Le Parisien newspaper quoted the mayor of the teacher's hometown of Vaumoise as saying he had “begun to feel ill at the start of the (mid-term) holidays and had been quickly hospitalised.”

France has reported four other new cases of COVID-19 in the past 24 hours – two in people returning from Italy – bringing the total number of infections to 17.

Eleven of those have recovered from the disease.

The French government has vowed to keep the border open with Italy despite fears of a similar surge in cases.

“Closing the border doesn't make much sense,” said Jérôme Salomon, Director General of Health. “Not to mention that you can travel by land, sea and air, or go through Italy and Austria.”

Nevertheless authorities and hospitals across the country are stepping up preparations for a major rise in the number of cases.

An extra 70 hospitals are now prepared to receive and treat coronavirus patients.

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Coronavirus: What are the rules around self-isolation and quarantine in France?

The first case of the virus was confirmed in Switzerland this week.

The case is a man in his 70s who was infected near Milan where he attended an event on February 15th, federal health office chief Pascal Strupler told reporters. 

The man is from the Italian-speaking canton of Ticino, on the border with Italy, and has been with his family since suffering the first symptoms on February 17. 

Prior to this case, Switzerland had tested some 300 suspect cases that were all found to be negative. 

The government said on Monday that it had stepped up testing on patients with flu-like symptoms and was working to raise awareness at all border points.

Switzerland on Monday said the country was in a state of “heightened vigilance” because of a surge in Italy.

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Spain too saw jump in the number of coronavirus cases this week with five people testing positive on the mainland as well as four Italian tourists in Tenerife. 

All of the cases currently confirmed in Spain are either in Italians or people who travelled from northern Italy.

A Tenerife hotel remained on lockdown on Wednesday after the tourists tested positive.

According to one guest at the hotel, a note was pushed under the door of each room advising guests to stay in their rooms. 

It read: “Dear Guests, We regret to inform you that for healthy (sic) reasons, the hotel has been closed down. Until the sanitary authorities warn, you must remain in your rooms.”

READ ALSO:

In Germany, three new cases of the virus were confirmed in the west of the country on Wednesday.

On Tuesday evening, two new cases of the coronavirus were confirmed in Baden-Württemberg and North Rhine-Westphalia – both marking the first incidents in the two western states.

An additional case was confirmed in North Rhine-Westphalia on Wednesday afternoon.

Local authorities are now discussing how to proceed, a spokesperson for the Ministry of Health in North Rhine-Westphalia told dpa early Wednesday morning.

READ ALSO:

Neighbouring Austria also confirmed its first cases this week.

The two 24-year-olds have been quarantined in a hospital in Innsbruck, the capital of Tyrol province, which borders Italy, according to Tyrol Governor Guenther Platter.

One of them was from Lombardy but it was not yet clear how the two contracted the virus. Both were suffering a fever but are in a stable condition.

A hotel was placed under lockdown in Innsbruck after an Italian receptionist working there contracted the virus.

“No one can get in and out of the hotel to make sure that if other infected people are staying in the hotel, the virus won't be spread,” Interior Minister Karl Nehammer told a press conference.

“All these measures have one purpose – to stop the virus and its spread. There is no reason to panic,” he said, adding that Austria was prepared for such a case.

The lockdown was then lifted on Wednesday.

There have also been cases confirmed in Croatia and Belgium.

Sweden raised its risk alert this week over the spread of coronavirus.

So far there has only been one confirmed case of the coronavirus in Sweden, and this person is not thought to have infected anyone else after a self-imposed quarantine.

“In Sweden and in Europe, there is extensive testing going on in order to be able to find suspected cases and prevent spread of infection early on.

“So far, the Public Health Agency has carried out around 200 tests, of which all have come back negative except one. A further eight laboratories in Sweden now have the capacity to carry out analyses for the new coronavirus,” the country's public health agency wrote.

Countries step up measures

In Denmark, the country's foreign ministry has advised the country’s citizens to be cautious when travelling to a number of countries with confirmed coronavirus cases.

Britain has requested travellers returning from affected areas in northern Italy, China, South Korea and Iran to isolate themselves and inform the authorities.

Six schools were closed in the UK while others asked pupils or staff members who had visited northern Italy to remain at home.

Several countries have extended airport screenings for passengers with fever symptoms arriving from Italy.

Such screenings are done in Budapest and Debrecen, Hungary's second-largest city, as well as airports in the Ukrainian capital Kiev and on buses at Ukraine's land border with Hungary.

Meanwhile, Ukraine International Airlines onboard personnel will wear rubber gloves and masks on flights from Italy.

Czech capital Prague's airport has also earmarked special gates with targeted screening and “increased hygienic measures”.

In Poland's capital Warsaw, medical personnel are boarding planes from Italy for temperature checks before allowing passengers to disembark.

In Croatia, people returning from the virus-hit Italian regions will be questioned by border police, epidemiologists and sanitary inspectors.

And Serbia said it would introduce interviews and medical checks for passengers coming from “areas with a high transmission rate of the virus” in the past two weeks.

The country has earmarked 40 million kronor ($4.1 million) for the World Health Organization (WHO) to help countries cope with the spread of the virus.

Denmark has set aside 8 million kroner ($1.2 million) for the WHO crisis fund.

 

 

 

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HEALTH

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 

No. 

What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone. 

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