Dear Neil and Colleagues,
In Hungary, although the first wave of the epidemic was quite moderate, the state of emergency was ordered, so the exacerbation of the epidemic was prevented. During this period experience was gained to treat the epidemic. Outpatient care has been reduced and referred to online counselling. Hospitals and hospital wards were designated to treat severe COVID patients. Health workers over the age of 65 have been excluded from acute patient care. Protocols for testing, diagnosis and treatment of COVID have been developed.
Sadly the test policy and capacity are insufficient so the official data do not correspond to reality. Due to overburdened public health care, many people try to perform tests in private laboratories. As the first wave calmed down the state of emergency was withdrawn, so during the summer the life went back to “normal”. The “result” was the increasingly severe second wave.
Fortunately the data on children are very favourable, as are the international trends. Less than 1% of the COVID patients were children in the first wave and only a few needed hospital treatment. In the second wave 1-2% of infected persons were children. Less than 1% of hospitalized patients were children and for the time being none of them needed respiratory treatment and there were no fatalities among them and only one COVID-infected pregnant woman underwent caesarean section due to preterm birth.
In the primary care in the case of mild symptoms the first step is an online counselling. If COVID infection is suspected, the GP will order an official test and if the test is positive or if the diagnosis is clear based on the symptoms, the quarantine is ordered. The patient is treated through an ongoing online relationship with the family.
If the patient's condition worsens, they are referred to a COVID hospital. Since the beginning of the epidemic, on-line consultation has also been the first step for other diseases followed by a personal examination if necessary. The introduction of a public electronic health care system has made it easier to order medicines and order specialist examinations.
We have successfully maintained the vaccination schedule and the age-related check-ups with concentrating the official vaccination appointments. Unfortunately, social inequality is also a feature of health care in the country. Access to health care in disadvantaged areas, especially in rural areas, is very difficult, but vaccination is also satisfactory in these regions. Because of the priority given to the care of COVID patients, the cares of chronic patients suffer from disadvantages.
As a result of the epidemic, the role of the on-line doctor-patient relationship has come to the fore, and this is likely to continue. Online health care methods are not yet uniform. We would like to know what policies other countries have on this field?
Zsuzsanna Kovács, Dóra Scheiber
Primary care pediatricians
Budapest, Hungary
CHIFA Profile: Zsuzsanna Kovacs is a paediatrician, based in Hungary.
She is a CHIFA Country Representative for Hungary http://www.hifa.org/support/members/zsuzsanna
Email: drkovacszsuzsa AT freemail.hu
