Novartis in Slovenia and healthcare professionals warns about the syndemic: the coronavirus pandemic has not replaced other diseases

After a year of dealing with the Covid-19 pandemic, it is now possible to analyze and summarize its impact on the healthcare system, both in terms of work organization and the treatment of patients. In the first place, the altered way of working mostly affected general practitioners, who treat the widest range of patients on a daily basis. Nena Kopčavar Guček, PhD, emphasized that in the event of a pandemic, human and material resources had to be redeployed, and the burden on doctors and other healthcare workers increased due to Covid-19 related activities. In her opinion, the health care system did not, stop operating; however, during this time the way patients are treated has changed slightly. There were more phone calls and e-mails, video call treatments were introduced, and there were fewer personal contacts with patients. Despite all the necessary adjustments, the offices and clinics remained open for patients requiring medical treatment. However, Kopčavar Guček pointed out that many medical conditions deteriorated during the pandemic, as especially chronic patients did not want to pose additional burden to the system. She believes that various circumstances, including the “fear” of the virus and lack of knowledge and skills on how to get to the doctor’s office, many people decided not to visit a clinic, even though it was  necessary.

Prof. Janja Ocvirk, PhD agreed and said that almost one in three cancer patients have not been diagnosed since the onset of the pandemic. During the first wave of the pandemic, certain diagnostics were not available; however, the Institute of Oncology provided necessary treatment to all existing and newly referred patients throughout the pandemic. The fear that in many patients the disease will be detected at a later stage is very likely, which will make the prognosis worse. She appeals to anyone noticing symptoms that could indicate cancer to present the symptoms to the GP to decide if the patient needs to be referred for further diagnosis and treatment.

Prof. Aleš Blinc, PhD, has made similar observations. He said that Slovenia is already facing the consequences and complications due to poorly treated and missed heart attack treatment. Many chronic patients were waiting too long and not seeking help. Therefore, during the second wave of the pandemic, the healthcare system was also facing a higher number of chronic patients in addition to the burden caused by Covid-19. . As in oncology, the situation is slowly improving in cardiology, but it will take some time for the diagnostics to reach the level before the pandemic.

During the online discussion, a video with Duša Hlade Zore, the patients' rights representative for the Ljubljana region was also broadcasted. She said that the patients asked for help mainly because of a difficult or even no access to a doctor. Due to social distancing, patients feared the doctor might miss an important information or symptom, which may lead to a misdiagnosis. To her, the major problem are the waiting lists to see a specialist, which she attributes not only to the Covid-19 pandemic, but also to modified organization at hospitals, so that they were able to treat coronavirus patients.  

The additional burden on physicians and the entire healthcare system due to the Covid-19 pandemic caused many concerns and dissatisfaction among patients. However, the fact is that the capacity of the system is limited. The guests also discussed the impact of the pandemic on the healthcare system. They agreed that the Slovenian healthcare system was already facing problems with a lack of general practitioners, extended working hours of many specialists and poor work organization across many institutions. These cracks in the healthcare system were further exposed by the pandemic. Despite all the challenges, the Slovenian healthcare system has proven to be flexible enough to withstand the pressure of the pandemic.

There is much room for improvement. Therefore, a critical assessment needs to be made. According to the guests of the discussion, the system is underfunded in terms of staff and finances. We need to strengthen the cooperation between general practitioners and specialists, and leverage the opportunities presented by digitalization and telemedicine. “During the pandemic, we were facing many problems. By understanding them and having patience, things have been resolved and will continue to be resolved in the future, "concluded prof. Janja Ocvirk, PhD.