Confession of the medical staff: These are the amateur instructions which were given at the outbreak of the corona crisis, during the time of Marjan Šarec’s Government!

Nina Pirnat and Marjan Šarec – the two people who bear the greatest burden of responsibility for inaction before the start and after the declaration of the epidemic. (Photo: STA)

The documents we received in the editorial office of our media outlet only further confirm that during the time of the Government of Marjan Šarec, there was complete confusion, regarding the instructions to those who spent their winter vacation skiing in Italy, where the coronavirus epidemic was already beginning. What is especially scandalous about this is that even the doctors who returned from a vacation in the neighbouring country did not receive precise instructions. Many even received the recommendation from their superiors, to continue to work normally, if they did not notice any signs or symptoms of infection.

Yesterday, an article was published on Nova24TV’s web portal, which claimed that RTV was preparing new accusations of the Government regarding the infections in nursing homes. The article also emphasized that the previous Government, led by Marjan Šarec, and the National Institute of Public Health (Nacionalni inštitut za javno zdravje – hereinafter referred to as NIJZ) instructed doctors who were returning from Italy, to continue to work as per usual. Our editorial board has received evidence, proving this. And this is how coronavirus came to nursing homes. After a week of vacation, the medical staff in the clinics had a lot of work to do, and the doctors could have only postponed it if they got the explicit recommendation from the experts.

One of the doctors asked her superiors what to do in the situation. In an e-mail, she wrote that she returned from a skiing trip in the Veneto region on February 22nd, 2020, and that she stopped in a restaurant and a shopping mall on her way home. “I was not in direct contact in any patient with respiratory illness symptoms,” she wrote. She also stated that she returned to work on February 24th. She works as a private doctor in a pulmonology clinic in the public healthcare sector, where they have a large number of patients. “Should I cancel my work at the clinic for two weeks, due to my stay in the Italian province of Veneto? I am not showing any symptoms of the disease, though,” the doctor also wrote.

In response to her questions, she received a message that reads as follows: “Currently, the instructions are that if you are healthy, you should continue doing your job as per usual. Pay close attention to your health for the next 14 days. If you notice signs of a respiratory infection, stay at home, call your doctor, tell them you are sick and that you have travelled through the Veneto region.” The message also said to monitor NIJZ’s website, in case the instructions change. In addition, the message included the link to the mentioned website with NIJZ’s recommendations for healthcare professionals. She also learned that she could contact the NIJZ epidemiologist at the telephone number provided, at certain hours of the day, for any additional information. Similar instructions were given to other healthcare professionals.

The doctors were completely confused about how to act when returning from Italy, as there were no specific instructions
For example, one person wrote that due to the spread of the coronavirus, she felt obliged to inform her superiors that she was on holiday in Lombardy, where she was skiing with her family. “Given all the instructions of NIJZ and the Ministry, I would like to know what exactly does this mean for my return to work?” She added that the situation there seemed to be normal, and there has been no panic so far. “The shelves in the stores are also normally stocked. My family and I are healthy.” The person also added that they followed the basic hygienic approaches, such as washing and disinfecting their hands, and so on. However, her immediate superior also did not know exactly how to act. “Dear Sir or Madam, what is the position of the Ministry of Health and NIJZ regarding cases as the one described below?

In this case, the medical staff should be treated differently, as we urgently need them now, and we cannot quarantine them just in case, and we will also need them later, but there is also the fear of them being asymptomatic and therefore infecting their co-workers. In short, a pat position…” the concerned superior wrote. At the same time, in his message, he stated that of course, he wanted to write that if she is showing no signs of infection, then she should come to work, because in the situation at the time, every missing worker meant a lot of trouble, as the superior was then responsible for reorganizing the work. “But on the other hand, I am worried that this employee will get sick in, say, 14-21 days, and later, a bunch of others will get sick as well, and I will once again be responsible for a big portion of the medical staff being away.” He also suggested that some guidance on such issues should be adopted at the national level, adding that he believed that they were not the only ones with such a dilemma and that everyone would do the same.  

Healthcare officials were not sure whether to send some of their co-workers to a 14-day quarantine due to possible infections
The answer to his question was: “Other countries have also been discussing challenges like this one, with cases in China appearing when the healthcare workers were returning from their trips/vacation in South-East Asia and China. We were informed of their practices and positions through the EWRS. Most countries have NOT RECOMMENDED self-isolation for healthcare professionals, or any other absence from work, after returning from China, for 14 days,” the explanation read. Further, it was written that a great deal had already been written about asymptomatic infected people and about their potential for transmitting the infection to the people close by.

“One thing is very clear – asymptomatic infected people are a reality, there is no doubt about it, and the second thing is – the potential for transmission to other people probably also exists, but it may be much less important than from a symptomatic person,” the message read. “The instruction that anyone who has been in areas with SARS-CoV-2 transmission in the community should self-isolate for 14 days, including the healthcare professionals, is an attractive decision at first glance, in terms of virus retention,” However, the answer further warns that very soon, if and when the people start staying at home for 14 days, there will be disruptions in the functioning of important systems, as there will be more and not fewer of the areas affected. “It is much easier to close the universities for 14 days than a healthcare facility with a daily influx of patients in need of urgent medical care.”

“We are at a time when decisions are not easy, as we do not have solid scientific evidence to rely on,” the message said, adding the opinion that any healthcare worker showing no symptoms after returning from the areas with SARS-CoV-2 spreading in the community, does not need to self-isolate for 14 days. “We are mainly relying on the recommendations of other EU/EEA countries,” the message reads, also asking for the opinion of other staff. At the same time, the message suggests that very experienced colleagues from the Department of Infectious Diseases should take a stand on the issue and that national guidelines be drawn up on the basis of their opinion. “Perhaps the University Medical Centre of Ljubljana already has some guidelines which could be summarized.” However, the author of the message also proposes to ask the opinion of some other experts and professionals of this specific field, so perhaps a consensus could be reached on these extremely important issues, leading to a document of national recommendations.

Some time ago, Slovenian doctor, dr. Igor Muževič, revealed the truth about the responsibility for infections in nursing homes in Slovenia. “Ok, given that I am really involved in the work of nursing homes, I can say, first-hand, that the truth is quite the opposite. The infections came to the nursing homes because of the recommendations of the previous Government, and there was no equipment at all when the new Government took over the power,” Muževič responded. Some nursing homes became severe epicentres of the coronavirus in Slovenia. The worst were the nursing homes in Metlika, Šmarje pri Jelšah, and Ljutomer. Since the memory of many people is very short, even though these events happened in the very recent past, it is important to draw attention to the situation at the time, as part of the politics and the media are persistently trying to lie about the truth.

Jožica Vodopivec