Greece’s conservative government is facing regular criticism from doctors and nurses over staffing, capacity, testing and equipment in the fight against COVID-19.
By Apostolis Fotiadis
At the beginning of April, staff of the Sotiria Public Hospital in the Greek capital, Athens, issued an open letter complaining they had been supplied with “defective” masks to guard against infection from patients with COVID-19.
Sotiria has handled the majority of those hospitalised with the virus in Greece, which has roughly 1,735 confirmed cases, of which 76 have died.
The conservative government, however, was unimpressed.
“We buy equipment certified and appropriate for medical use,” Deputy Minister of Health Vassilis Kontozamanis told a regular coronavirus press conference later the same day, dismissing the letter as “the fake news of the day”.
Responding to concerns raised, the Greek PM visited the hospital on April 6 during the delivery of large quantities of protective equipment including 5,000 masks of high standards.
But the complaint from the staff of Sotiria was only the latest salvo in a row between the government and frontline health professionals over the protection afforded them in the fight against COVID-19 and the overall response of authorities to the pandemic.
Similar complaints have been made by doctors and nurses at hospitals across the country, including the northern cities of Thessaloniki, Serres and Kastoria, the latter among the worst affected by the pandemic.
So far, over 90 nursing and administrative staff are believed to have been infected while on duty. Hundreds have been quarantined.
Doctors have asked for additional nursing and medical staff to be hired. The government has started increasing numbers but on short term contracts, a measure characterised as inadequate by Afroditi Retzoy, president of Federation of Greek Hospital Doctors, OENGE, which represents more than 10,000 doctors in the public health system.
“If the appropriate measures are not taken, lives will be lost, lives that could have been saved” Retsoy told a news conference on April 1.
Equipment: ‘They tell us to save as much as we can’
A gradual lockdown imposed by the government of conservative Prime Minister Kyriakos Mitsotakis since early March is believed to have had some success in limiting the spread of COVID-19, so far sparing Greece the kind of infection rate seen in fellow European Union members Italy and Spain.
Quick action was seen as crucial in sparing a public healthcare system decimated by a decade of painful austerity in exchange for a series of international bailouts to keep the Greek economy afloat.
Having only recently turned the corner, the economy faces a return to recession given the blow to the vital Greek tourism sector, but officials are warning against relaxing the coronavirus restrictions too soon.
But hospital staff say protective equipment remains a significant issue.
On April 1, a plane from China delivered 250,000 protective masks, 125,000 protective uniforms and tens of thousands of pieces of protective gear. Others have arrived from the United Arab Emirates.
Greece has also imported five tonnes of the anti-malarial drug chloroquine from India.
Private and public companies as well as business associations have chipped in with more than 10 million euros for the purchase of ventilators, intensive care beds and other equipment. The Greek parliament has also offered to cover the cost of 50 new ICU beds to be installed at Sotiria hospital.
But Despoina Tosonidou, doctors’ union leader at the Asklipio Voulas hospital south of Athens, said the deliveries had done little to change the situation on the ground.
“These numbers of protective equipment have not appeared at the hospitals,” Tosonidou told BIRN.
“In a number of reference hospitals for COVID cases people on the frontline do not have adequate gear. In the hospital where I work they have told us to save as much as we can.”
Ominously, Tosonidou said medical staff who speak out publicly haven been taken to task by management.
“There are reports from colleagues that they have been addressed personally or on the phone about statements they made,” Tosonidou said.
“The director of the biggest hospital in Athens has circulated a letter warning personnel they could talk to the media only with permission.”
Public officials can face disciplinary action for statements made unless they are union representatives, who are protected by law.
Testing still an issue
There are also question marks over the government’s testing strategy, an issue for countries the world over.
Doctors have asked that the public be given full free access and have questioned the government’s decision to earmark 30 million euros for testing in private clinics.
The testing strategy appears still to be in flux, though the National Centre for Blood Sampling is gearing up to take on most of the burden.
“The Ministry has asked us how many samples and how fast we can deliver it and we are now at the phase of completing the necessary adaptations to be able to deliver diagnoses,” Kostantinos Stamoulis, the centre’s scientific director, told BIRN.
The centre has the potential to issue 1,000 diagnoses per seven-hour shift and has an established network for collecting samples across the country.
“The capacity will be in place in a matter of days,” Stamoulis said, “but it also depends on how effectively authorities can acquire necessary material like reagents from the market.”
Disagreements over ICU capacity
PM Mitsotakis said in parliament there are 3,400 hospital beds and 870 ICU beds available to use against the COVID-19 epidemic and that nursing staff numbers will increase.
But Athens surgeon Panos Papanikolaou, a member of OENGE, said the figure of 870 ICU beds did not give “an accurate picture.”
“Twenty days ago, the country had 560 ICU beds,” he told BIRN. “Under pressure they have put into operation another 100, getting the number around 660. Of those close to 250 are suitable for treating Covid-19 at the moment, with 93 of them already in use.” Potentially all ICU beds can be adapted to treat Covid-19 cases.
The rest are beds the government says it will use in private clinics. These will take other urgent, non-coronavirus cases in order to free up ICU beds in public hospitals for COVID-19 patients. But its decision to double the payment for each private sector bed from 800 euros to 1,600 euros per day has come under fire.
“Instead of the government requisitioning private sector beds, the private sector has requisitioned the government,” said Papanikolaou.