Covid-19 treatment at home problematic in Latvia

There are several problems with the treatment of Covid-19 at home in Latvia due to lack of guidelines and limited resources of family doctors, Latvian Television reported November 6.

Family doctors surveyed by LTV, when asked about the guidelines to be followed when treating patients at home, refer to recommendations developed last December. In addition to general recommendations, they indicate cases when the patient should be viewed on site, preventing possible hospitalization. Some of the signals are dyspnoea, risk factors, low oxygen, blood pressure or blue skin.

The family doctors surveyed acknowledged that they did not follow the recommendation, specifically in regions.

“I consult via WhatsApp. Both phone calls, WhatsApp and text messages. Of course, it will never replace face-to-face consultation. [..] If I suspect the patient's condition is deteriorating rapidly, I can only call 113,” family doctor Māris Nātra from Valka said.

“If he's infectious and Covid-19 positive, I don't go on a home visit. If I can't assess how severe symptoms the patient has if he tells me, for example, about low oxygen levels, I report to the emergency service. And in Rīga it is more accessible than in regions,” said family doctor Ilona Timčenko in Rīga.

In the meantime, the Ministry of Health pointed out that an infectious patient should not be denied care if needed. For example, a family doctor or practice nurse can go on a visit to the patient. However, everything depends both on the doctor's own interest and the availability of services in his patient region.

Maris Nātra from Valka acknowledged that the availability of the tests is more difficult, but an X-ray is done when needed. “For example, this week, when I sent to an X-ray exam, I found Covid-19-induced pneumonia for two patients. Due to an X-ray, a diagnosis of Covid-19 pneumonia was detected. The main indicators are controlled. Blood oxygen, blood pressure,” Nātra said.

On the other hand, Ainis Dzalbs, from Jelgava, said that it is difficult to get tests for Covid-19 positives because there are few medical establishments that offer them in Zemgale. Only Jēkabpils regional hospital offers laboratory services and X-rays to Covid-19 infected patients.

“I have to understand that it's often not close to patient residency, then they're forced to go and do something there. Taking blood tests for a Covid-19 positive patient in such an official way is also pretty difficult because they can't go in a general queue. Then we can apply for this service at home, but knowing the capacity of the laboratories, it is also a pretty big challenge to get the service,” explained Dzalbs.

The Ministry of Health also acknowledged to LTV that the offer on the part of medical treatment institutions is not equal throughout the country. No solutions were proposed, though. 

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