Treatment of long Covid patients

In order to keep up with this topic, we would kindly ask for a follow-up to REF 14 (07/06/21):

• How does your country organise the physical and psychological treatment of long COVID patients, especially with regard to Mental Health?
• Are there specialized clinics/departments/centres in place or are specialized clinics/departments/centres currently being developed?

       If so, please provide details, such as:

       - Which professional groups (specialists, nurses, psychologists, …) and disciplines are involved?

       - How can individuals access the clinics (walk-in, referral …)?

       - Are the clinics stand-alone entities or part of larger institutions such as hospitals or primary care centres?

• Are there specific pathways in the treatment of children and youths established?

       If so, please provide details, such as:

      - Is there a publicly funded facility for parents to obtain publicly funded long Covid consultations with specialised physicians?

      - Have any day care centres been set up for children affected by long Covid?

• Is there any available data on waiting times or information on bridging measures during the waiting period for a specialized programme?
• Is there any legal protection or special support for employees (not to get terminated or pressured, e.g. helpline) in the process of diagnosis-finding?

Vision on resilience indicators

• As COVID-19 measures has been lifted or relaxed around Europe, which COVID-19 indicators, if any, are foreseen to be measured long-term in your country, and are there any thresholds defined that would trigger reintroduction of measures or emergency action?
• Have analyses been performed in your country regarding population adherence to NPIs (e.g. via mobility data, surveys), and/or has there been a weighted analysis of effectiveness and economic viability of measures on another basis?
• Have strategies/tools/mechanisms for measuring or evaluating the improvement of health system resilience been set up or are there plans to do so?

Analysis of telemedicine and/or artificial intelligence 

Is there an analysis of the use of telemedicine and/or artificial intelligence in your countries' inpatient sector (published or ongoing)??

If yes,

• Who has carried out/is carrying out this analysis? Which authority (or other partner) is or has been commissioned to carry out such an analysis?
• What conceptual framework do you use for the definition of telemedicine and/or artificial intelligence (e.g. functions like storage and forwarding/monitoring/interaction for telemedicine; prediction/diagnosis/treatment for AI))
• What were the methods used (literature search, web search, expert interviews, etc.)?

If no, are there plans to carry out such a study?

Has there been an increase in the use or implementation of telemedicine and/or articifals intellegence since the beginning of the pandemic? If yes, please give examples.

Waiting list for scheduled hospital care / Data on waiting times

Are waiting lists and/or wait times for the following types of scheduled hospital care an issue in your country?

• Inpatient/Day Case procedures
• Outpatient appointments (i.e., specialist assessment?

Does your country publish data on waiting lists and/or wait times for scheduled hospital care? This may include total numbers currently waiting on the list and numbers waiting over certain time bands (e.g., 12 months) for

•  Inpatient/Day Case procedures
• Outpatient appointments

If yes, what breakdowns does your country report for waiting list data, which may include e.g.

• Categories of waiting lists (e.g., patients waiting for an appointment date, patients who have received an appointment date and are waiting to come in)
• Time period waiting (0-3 months, 3-6 months etc.)
• Geographical disaggregation
• Any other disaggregation

How are wait times measured? For example,

• Outpatient waiting time: time from GP referral to specialist consultation
• Inpatient waiting time: time from when the patient is added to the treatment waiting list to when they are treated
• Referral to treatment waiting time: time from GP referral to treatment.

Does your country publish data on the level of inflows to and outflows from waiting lists (i.e., the numbers being added to and removed from waiting lists)?

What formats are the data published in (e.g., open data, PDF reports, others)?

Diagnosis Coding

Are the health care providers (hospitals and publicly/privately funded outpatient care centres) in your country obliged to use a coding system for diagnoses?

If yes,

• Did the implementation predate COVID-19, or has it only been implemented since then?
• Please describe the coding system in place (e. g, ICD, ICPC, SNOMED, CT, other or combinations).
• Please describe the usage of the data (who’s the data holder, COVID analyses, analyses in general, scientific studies regarding COVID...).

Update on Long COVID management

• Have there been any major changes in your country following your possible original response in early 2022 (29 REF) when it comes to existing or planned processes for coordinated management of care for long COVID patients in your country?
• Specifically, do these processes also relate to tools for (differential) diagnosis / symptom screening for clinicians, and standardised treatment pathways for long COVID patients?
• In addition, could you briefly describe how your country organises the treatment/management of long COVID patients? Specifically, are there specialised clinics/departments/centres and are these clinics stand-alone entities or part of larger institutions such as hospitals or primary care centres?
• Does your country have a registry of Long COVID patients?

Digitalisation - going from a paper death certificate to an (100%) electronic death certificate

• Could you describe the dataflow, from the source filling in the death certificate to the final destination (statistical institute or others)? The different stages through which a death certificate passes would be of interest.
• If necessary, could you describe the process of making this transition between paper registration and electronic registration? What were the specific periods & phases? Have you planned a hybrid situation (paper/electronic) or an exit from the paper system and a direct transition to electronics?
• Have you implemented direct cause-of-death coding using ICD-10 codes in the registration tool or does the doctor have to type? If you implemented direct ICD-10 coding in the tool, who set it up and is there still manual code checking? Does it contain a kind of decision tree to fill it out/to avoid obvious errors?
• Is there a real time use of this digital data? And if not, have you planned a direct use of the data in case of epidemiological emergencies (such as COVID-19).

​​​​​​Vaccine priorites and trials addressing public health needs

• Which of the following issues have the highest public health priority in your country in relation to future COVID-19 vaccination strategy and vaccine trials: Vaccine efficacy, vaccine development, specific populations, or any other?
• Is there any example in your country of COVID-19 vaccine trials that are addressing public health needs?

Upcoming school and kindergarten year 2022/23

With regard to the upcoming school and kindergarten year and as follow-up to the situation in 2021:

• Are there still mandatory measures in place or only voluntary initiatives? Are voluntary measures publicly supported?
• If there are mandatory measures in place or planned for autumn/winter season what is foreseen in regard to quarantine / mask wearing / testing strategy in schools and kindergartens?

Cost-effectiveness of vaccines and NPIs

• What kind of research are you developing in terms of the cost-evectiveness of vaccines and non-pharmaceutical interventions (NPIs) in your country?
• In the past since start of the pandemic, has existing evidence on cost-effectiveness of interventions already factored into political decision-making (if so, please provide details)? For future strategies on NPIs in your country, is evidence on cost-effectiveness forseen to play a role (if so, please provide details)?
• Will it be sustainable economically to keep vaccination to the entire population? Will there be priority groups as forseen in your country?