Polish hospitals struggle with Covid surge while government shifts blame onto doctors

“Are we supposed to dump him outside the doors? Because they don’t want to open the doors. The doors to the emergency room are locked when you drive in.”

These were the words of paramedics in Warsaw this week as they tried to find a hospital in Poland’s capital that could accept a patient in their ambulance. The recording of their increasingly desperate conversations with a dispatcher were obtained and published today by TVN24.

“They’re blocked off because there is Covid in the emergency room,” said the ambulance crew, after trying another hospital. “No, you leave the patient for [that hospital]. We’re not going somewhere else. A fourth hospital which refuses to take the patient,” replies the dispatcher.

Eventually, 89 minutes after the first call, she informs the ambulance that the provincial governor’s officer has ordered a hospital to accept the patient – the same one that had refused to admit him an hour and a half earlier.

In a second recording, an ambulance crew report that they are transporting a patient in serious condition with symptoms of coronavirus, but who has tested negative. She was reported as having an oxygen saturation level that would require immediate use of a ventilator.

“Stępińska [Street hospital] says that it is closed, they don’t have staff, they’re not accepting [patients],” says one of the paramedics. “They’ve dug in. Crocodiles are in the moat. And our patient is suffocating. Where are we meant to go?”

The dispatcher then informs the crew that, because the patient does not have a positive coronavirus test, she cannot be taken to the hospital designated for COVID-19 patients. But, almost 40 minutes after the first call, she says she has found another hospital to take the patient.

“The statistics are a fiction”

The audio recordings, both from Wednesday this week, offer a raw, inside picture of the increasing difficulties faced by parts of Poland’s healthcare system in dealing with record numbers of coronavirus cases.

On Tuesday, Tomasz Siegel, the head of the anaesthesiology and intensive care department at Czerniakowski Hospital in Warsaw – the one that initially rejected the first patient mentioned above – published a post on Facebook describing the difficulties.

“There have been no places for COVID-19 patients in the whole country for a long time,” he claimed. “The statistics are a fiction.” While the government maintains there are still many available ventilators, “the number doesn’t matter”, wrote Siegel, because there are not enough staff able to operate them.

A report published yesterday by the Dziennik Gazeta Prawna daily cited hospital directors saying that, even if the government makes more ventilators available from its supplies, training enough personnel to use them would take months.

The problems in Warsaw had already begun last week, with images and reports emerging of ambulances standing in a queue outside Wolski Hospital. One suspected coronavirus patient had to wait nine hours for admission.

Two weeks ago, reports emerged that intensive care units in Kraków and Toruń were fully occupied with coronavirus patients. In the latter city, a 70-year-old man with coronavirus died after medical staff were unable to find him an intensive-care bed.

“We don’t have any places for patients with coronavirus who require the use of ventilators. We can’t admit anyone,” said Marcin Jędrychowski, the hospital’s director, at the time.

This week, residents of Kraków who require coronavirus tests have had to queue for hours in the street. A hospital in Gorzów Wielopolski, a town in western Poland, issued an appeal for nuns to help nurse coronavirus patients.

The National Health Fund (NFZ), which funds the public health system, yesterday recommended that hospitals limit the provision of scheduled medical services “in order to provide additional hospital beds for patients requiring urgent admission to the hospital”.

In Poznań, after the MSWiA hospital was reportedly ordered to convert itself into a facility exclusively for coronavirus patients as part of a government restructuring designed to tackle the pandemic, doctors expressed concern that its existing patients had nowhere else to go.

“We have nowhere to send [them],” said the hospital’s head of surgery in a video widely shared on social media. “If we don’t carry out some of the [planned] procedures, these patients will die.”

Today – after some the hospital’s cancer patients and their families had also issued appeals – the provincial governor announced that the hospital would not be converted to a Covid-only facility, and claimed that it had never been ordered to.

Staff from the hospital, speaking anonymously to local newspaper Głos Wielopolski, reject the governor’s claim, and say the director was ordered to transfer all patients elsewhere in preparation for coronavirus arrivals.

Already last week, the health minister, Adam Niedzielski, admitted that the government “does not have everything under control”. It had “not expected such a large escalation” in cases, he said.

Poland escaped the first wave of the pandemic relatively unscathed, after one of Europe’s earliest and toughest lockdowns helped keep infections low. Yet it has now been hit harder than most by the second wave.

In late September, the head of the Chief Sanitary Inspectorate (GIS) predicted that by mid-October there would be around 1,000-1,500 new cases a day, and that the figure would then go into decline.

But yesterday’s figure was a record 8,099, and today’s only a little lower at 7,705. The number of cases is rising “exponentially”, admitted Niedzielski yesterday. Figures for deaths, hospitalisations and occupied ventilators are all at their highest since the beginning of the pandemic.

“Unfortunately some medics do not want to perform their duties”

Politicians from the ruling camp have maintained that there is still enough capacity in the Polish healthcare system to deal with the current number of patients – but they admit that that capacity is not always in the right places to meet localised outbreaks.

“In general we have free hospital beds, it’s just that getting to them is difficult,” Stanisław Karczewski, a senator from the ruling Law and Justice (PiS) party, told TVN24 today.

Some in the government have also sought to shift blame for the current situation in hospitals onto doctors themselves. They claim that, although most medical personnel are dedicated to their jobs, some have been unwilling to help in the fight against the pandemic.

On Tuesday, deputy prime minister Jacek Sasin told Polskie Radio that the government has provided enough equipment to deal with the situation, but “the problem is with the engagement of medical personnel”.

“Unfortunately there is a lack of will from part of the medical community,” said Sasin. “They do not want to perform some of their duties…[This] may result from fear of the epidemic…[but] that should not exist in the medical environment.”

In response to Sasin’s remarks, the head of Poland’s Supreme Medical Council, Andrzej Matyja, demanded that he apologise and withdraw his “harmful and extremely irresponsible” remarks.

Many doctors took to social media to express indignation at the criticism. “I let out a few swear words” after hearing Sasin’s comments, one doctor in Kraków told Notes from Poland.

Yet over the following days, other figures from the ruling camp have continued to point the finger at doctors. “The fact that some medical personnel disregard [requests] or fail to appear is a real problem,” Michał Dworczyk, the head of the prime minister’s office, told TVN24 yesterday.

Some provincial governors – who are appointed by the central government – have said that their requests to medical bodies for personnel to join the struggle against the pandemic have been met with a disappointing response, reported state broadcaster TVP, which is under the influence of the government.

TVP’s news report also blamed the former government, which ruled until 2015, for its “neglect” of Poland’s healthcare system. Public spending on healthcare in Poland has long been among the lowest in the European Union, and it also has among the fewest doctors and nurses in proportion to population.

Today, Karczewski, who is himself a medical doctor as well as being a senator, said that doctors currently complaining that they are not paid enough “are telling falsehoods”. They “earn really good wages”, he claimed.

“These doctors who are criticising the government, check how much they earn,” Karczewski told TVN24. “I am outraged by some of the remarks of young doctors who say, for example, that [coronavirus] data are being falsified.”

The average salary of a doctor in Poland is 9,910 zloty (€2,200) gross per month, which is around 50% more than the average wage of 5,000 zloty across the whole economy, notes fact-checking service Konkret24.

Main image credit: Cezary Aszkielowicz / Agencja Gazeta

Daniel Tilles

Daniel Tilles is editor-in-chief of Notes from Poland. He has written on Polish affairs for a wide range of publications, including Foreign Policy, POLITICO Europe, EUobserver and Dziennik Gazeta Prawna.