By Nino Tarkhnishvili, RFE/RL Journalist
(The outbreak of the novel coronavirus (COVID-19) has laid bare shortcomings of many developed healthcare systems. The rapidly-spreading disease has already infected 25 Georgian nationals and kept hundreds in self-isolation. The number of confirmed cases continues to rise daily. Given the usual crush of seasonal cold and flu cases, many fear whether Georgian hospitals are up to the task facing a yet unknown challenge. – Civil.ge’s note)
The Ministry of Health has already developed contingency plans depending on how far the disease spreads. In a best-case scenario, Georgian healthcare system would have to provide treatment for a small number of patients, a burden it could shoulder with little effort. If the number of infected individuals exceeds double-digit margin, the Ministry will put plan B into action. The third, the worst scenario envisages providing care for several hundred severely ill patients, which entails making use of entire spare capacity.
Hospitals and Beds
As things stand, Georgia has nine hospitals that have been adequately equipped to handle the novel disease. Countrywide, a total of 350 acute-care beds are earmarked for the infected patients. Experts deem that coronavirus-infected patients should be placed in specially designated hospitals, reducing risks of contagion within the healthcare facilities. Below is the list of medical facilities charged with managing the COVID-19 outbreak:
- Tbilisi Hospital for Infectious Diseases;
- Bochorishvili Clinic (in Tbilisi);
- Tbilisi Republican Hospital;
- University Clinic (in Tbilisi);
- Gori Military Hospital;
- Sachkhere Hospital;
- Kutaisi Hospital for Infectious Diseases;
- Batumi Hospital for Infectious Diseases.
- Zugdidi Hospital for Infectious Diseases.
Health Ministry officials claim that, despite the scale of the outbreak, they are not planning to deploy army-style field hospitals. The total number of hospital beds stands at around 14,000, which, if counted per capita, is higher than in many European countries.
Georgia has roughly 2,000 mechanical ventilators in working order, life-saving equipment for those in need of additional respiratory support. However, half of these ventilators are occupied by patients infected with other respiratory diseases. At present, around 40 ventilators are ready for use in three medical facilities, which, the Ministry reckons, “is sufficient as less than 5 % of infected cases are critical (go into respiratory or organ failure).”
The World Health Organization recommends that a country should also stockpile life support machines for extracorporeal membrane oxygenation (ECMO), which is used in treatment of viral pneumonia (caused by COVID-19). Countrywide, there are three pieces of this sophisticated machinery available. The Ministry claims this is also enough, as modern ventilators can perform the same assisting functions as the ECMO equipment.
There are around 150 licensed infectious disease doctors in Georgia. As a rule, ID physicians are first to take care of the infected patients. In case of a dramatic rise in their demand, doctors with other specializations may be called into action. In total, Georgian medical workforce counts well over 20,000 specialist doctors and general practitioners.
On the other hand, Georgian healthcare system is plagued by a shortage of nurses, who provide first-aid care for the sick and frail. The Ministry has taken measures to bring into service licensed, but unemployed professionals.
Any Spare Capacity?
Currently, the Ministry is not planning to ask hospitals to postpone scheduled surgical operation in order to free up space in intensive care units. But this may change if the number of emergency admissions continues to rise.
Some specialists have floated ideas to provide home-based care for patients with mild symptoms (such are 80 % of all cases), which means bigger role for primary care system. To this end, the Health Ministry plans to train 2,000 home physicians (GPs) and task them with taking care of self-isolated patients.
As of March 13, around 300 people were put in mandatory 14-day quarantine (mostly those travelling from high-risk countries). Existing facilities offer another one hundred isolation wards to enforce the use of quarantine. The government plans to bring the total to 900 by the end of next week.
In order to fend off spread of the infection, Georgian government suspended flights and land travel with Iran. Later government suspended direct air travel with Italy and introduced border restrictions for Georgian and foreign nationals.
On March 12, the government unveiled a set of urgent measures to combat the global pandemic. Due to government’s decision, classes at secondary schools and universities are to resume after a month-long break in April. Spring conscription into the army will also be deferred for a month. Prime Minister Giorgi Gakharia issued a recommendation for government agencies to adopt remote work policies whenever possible.
As maintained by the precautionary measures, Georgian nationals returning from China, Iran, South Korea, Italy, Germany, France, Austria and Spain (countries gravely affected by the disease) will be subject to a 14-day mandatory quarantine. As for the foreign nationals, they will be obliged to present PCR certificates confirming that they tested negative on COVID-19 while crossing the state border. Otherwise, they will also be subject to a 14-day mandatory quarantine.
Follow the COVID-19 spread timeline in Georgia:
- February 26: Georgia Confirms First Case of Coronavirus
- February 28: Georgia Confirms Second Coronavirus Case
- February 29: Georgia Confirms Third Case of Coronavirus
- March 5: Georgia Confirms Fourth Case of Coronavirus
- March 5: Coronavirus Cases in Georgia Total Nine
- March 7: Coronavirus: Georgian Cases Total Twelve (one more case was confirmed later that day increasing the number to thirteen)
- March 9: COVID-19: 2 New Cases Bring Georgia Confirmed Total to 15
- March 10: COVID-19: Georgian Cases Total 23
- March 12: 25th Patient Tests Positive for COVID-19 in Georgia