Latest Greek strategic Covid update

Information for authors by the Deputy Minister of Civil Protection and Crisis Management N. Hardalia and Professor G. Majorkin


Athens, September 29, 2020

COORDINATOR:  Good evening from the Ministry of Health. The briefing begins by the Deputy Minister of Civil Protection and Crisis Management Nikos Hardalia and the Assistant Professor of the Medical School of EKPA and member of the Committee of Experts of the Ministry of Health, Gika Majorkinis.

The Deputy Minister of Health Vassilis Kontozamanis also participates in the briefing, in order to answer questions concerning the Health system.

Mr Majorkin, you have the floor.

ΓΚ. MAGORKINIS:  Good evening. We will start with the epidemiological surveillance of EODY. The new diagnoses of the disease in our country are 416, of which 114 are associated with confluences and the entrance gates of the country – 55 the confluences, 59 of the entrance gates.

The new deaths of our fellow citizens are 5. The median age of the patients who died is 78 years. The number of patients treated by intubation is 79. Of the cases reported today, 240 are in the Attica Region.

Globally, the number of diagnoses has exceeded 33 million and the number of deaths 1,000,000. More than half of the cases are outbreaks in the United States, Brazil and India. The second wave of the epidemic is still troubling worldwide and creating difficulties in the normalcy to which we are all accustomed. The intensity of the second wave remains at high levels in our country, with the number of new diagnoses exceeding 300 most days.

The number of our fellow citizens who need mechanical support, those we call intubated, while it showed a temporary slight decline, returned yesterday to over 70, today we are 79. At the same time, we see the seven-day rolling average number of people ending up, remain at levels of 5 people per day.

The profile of our dying fellow citizens still concerns ages over 78 and / or with serious underlying diseases. Attica still has the lion’s share in the number of new diagnoses and is still the epicenter of the epidemic, with a particularly large load in the center of Athens.

To deal with the epidemic, the Municipality of Athens and the Ministry of Health, in collaboration with EODY and the General Secretariat for Civil Protection, are strengthening their coordination with a series of actions announced yesterday.

In this context, the intervention actions of EODY continue with epidemiological controls, with rapid antigen testing in neighborhoods of Attica, in order to speed up the outbreak of the epidemic. Today, specifically, in the action of EODY in Koumoundourou, in 574 tests were found 23 positives, 6 Greeks and 17 foreigners.

It should be mentioned that the World Health Organization seems to be moving in the same direction, where yesterday it announced the provision of 120 million fast tests, which will be available in low and middle income countries, in order to quickly encircle the epidemic.

The reliability profile in those tests that are considered reliable, is that they have great specialization. For example, their positive results so far have all been confirmed in Greek laboratories.

Regarding their sensitivity, when compared to molecular ones, they seem to lag behind by about 5% -8%. However, the majority of those who lag behind, who have differences, seem to be old or non-contagious costumes. In any case, their use has specific indications and should be performed and interpreted by qualified personnel.

Regarding the confluence reported in the last 24 hours on the cruise ship, it should be mentioned that in a routine sampling of the company, initially 12 asymptomatic individuals with marginal results were found, which then appeared to be false positive, which due to the epidemiological The history of overburdening that we have on cruise ships rang the alarm bell.

In order to minimize the possibility that this is indeed a possible ascending confluence, all the necessary measures were taken, and more specifically: In a molecular test performed on the ship, they came out negative, then in a second one with the antigens, 12 of them and their 24 contacts came out. all negative and in the last check which was completed a while ago in “Attiko”, all of them came out negative. Also, the surfaces were checked and all the surfaces checked are negative. So, there is no fear regarding this particular cruise ship.

Now, I would like to say something about vaccines. It is worth noting that the Pfizer vaccine, as announced by the company on Friday, is likely to have efficacy data even in October.

The vaccine has started phase 3 studies, in which about 30,000 people will participate. This is an MRNA vaccine, as well as the Moderna vaccine, which will be provided in two doses.

If the company manages to complete the study by October, it estimates that it will be available even in 2020 with several million installments, while by the end of 2021 they estimate that it will exceed 1 billion installments.

Thanks a lot and I will be available at the end for questions.

COORDINATOR:  Thank you, Professor. Mr. Hardalias has the floor.

HARDALIAS Prefecture:  Good evening from the Civil Protection. The planet is facing a second wave of coronavirus, with a significant number of cases being recorded daily in many European countries and beyond.

It must be clear that we will live with the virus and we must do everything we can to fight it, until the vaccine and its cure are found. Until then, the situation will remain difficult. And that must be our common conscience.

We have saved time, we have saved lives, but the struggle continues to be daily and continues to be difficult.

The latest global coronavirus data confirm the outbreak. Although our country still records lower cases compared to other European countries with similar populations, such as the Netherlands, Belgium, Portugal, we are already facing a significant increase in cases but also intubated, which allows no one to be complacent.

Regarding the overall picture from the beginning of the pandemic on February 25 to September 27, ie Sunday, a total of 17,444 cases have been recorded in our country, of which 5,379 are currently active. 9,793 of our fellow human beings recovered at home, while 1,893 were discharged from the hospital.

1,504 cases were detected from July 1 to September 27 at the country’s gateways, where a total of 569,212 targeted checks have been carried out.

The inspections of the observance of the measures by the competent bodies continue with undiminished rates, which from July 1 to September 27 have proceeded to 352,640 inspections, during which 12,814 violations have been identified, a percentage of 3.6%.

13,991 fines totaling 5,810,480 euros have been imposed, as well as administrative sanctions for suspension of operation for a total of 4,290 days for non-compliance with the person / square ratio and 444 total days for non-compliance with the opening hours of health stores in epidemiologically burdened areas.

In addition, from 31 August to 20 September, 101 inspections were carried out in nursing homes, during which 20 interventions were recorded and 24 fines totaling 92,000 euros were imposed.

It is also worth noting that from 12 to 27 September, 11 inspections were carried out in the schools, during which, fortunately, no violation was detected.

Regarding the image in our schools, I would also like to mention that until Sunday, the operation of 10 school units nationwide has been suspended, while departments have been closed in 113 schools throughout the country.

It is worth noting that the majority of schools where there has been a case, with the result that the school or part of it has already closed, are located in Attica, 93 out of a total of 120 schools.

And this is not accidental, as the epidemiological burden in Attica is increased, with the center of Athens being one of the areas most affected.

For this reason, EODY crews, as the main Professor said, have started for a few days now targeted inspections in epidemiologically burdened neighborhoods of Athens and of course this will continue their work in the coming days.

At the same time, the Government is proceeding with the utilization of quarantine hotels, in order to accommodate, with the necessary medical care, our fellow human beings who are infected with the virus, are asymptomatic and are hospitalized, so that the hospitals can be decongested and the diarrhea can be surrounded in the community.

In addition, in order to limit the spread of coronavirus in the center of Athens, at the initiative of the Municipality of Athens and the Mayor, Mr. Bakoyannis, and together with the Civil Protection with the Ministry of Health and EODY we proceed to a package of actions that are added to the measures already taken.

More specifically, the eight Friendship Clubs of the Municipality of Athens are formed and transformed into small diagnostic test centers for Covid-19. Rapid tests are intensified by EODY ladders in overcrowded areas of Athens. In order to increase the controls in the two accommodation structures of the Municipality, ie in the Multipurpose Center for the Homeless and in the Hospitality Center for Drug Addicts, more rapid tests are added. The teams of the Municipality of Athens that provide support and care to the homeless, the so-called street work, are strengthened with nurses to take more samples, but also to provide more specialized health and welfare services. Two new temporary isolation structures are also being set up to accommodate substance abusers,

It is worth noting that yesterday’s meeting and the new package are the culmination of an extremely fruitful cooperation of many weeks with a focus on protecting the health of residents and visitors to the city of Athens.

Next, I would like to inform you about the cases that were identified yesterday in the Municipality of Evrota. In the first 850 samples that have been examined in foreigners, and not only, land workers, 39 positive cases were identified, with the epidemiological burden being located spatially at the moment in two communities.

The positive cases have already been isolated with the care of the Municipality of Evrotas and the Peloponnese Region in separate structures, where they are under medical supervision, while all their close contacts have been placed under house arrest. In order to prevent further spread of the virus, the following were decided.

For land workers:

– Conducting tests on all foreign land workers in the area, ie about 1,300 people.

– Their abstinence from work until the tests are performed.

– The obligatory use of a mask by them indoors and outdoors. It is noted that a sufficient number of masks are granted to land workers by the Municipality of Evrotas through KEDE.

And finally, we decided to control the movement of land workers to and from the area in question.

It was also decided for the residents:

Conducting tests on those who work with or have been in contact with land workers and

– The mandatory use of a mask by them in all interiors.

The Government closely monitors the developments and takes the necessary measures for each moment and each region. That is why I would like to emphasize once again – why are we constantly hearing the question: what other measures will you take? – that the issue is not to talk constantly about measures, especially new measures, but to implement the measures that have already been taken. And that is the responsibility of all of us. No measure can work unless its necessity is realized by the citizens themselves. If some people think that they are invulnerable to the virus, they will see the measures as unnecessary coercion and will try to find ways to implement them.

But experience shows that there are no citizens who are not at risk of contracting the virus. Younger people are obviously less at risk, but they can transmit the virus to their parents and especially to their grandparents. So, those who consider precautionary measures as unnecessary coercion, put themselves and those around them in danger.

It goes without saying that no measure can be effective if it is not followed by all. And this is now the big bet for all of us. Things can be made better. But they can get worse. And that depends solely on us.

I will repeat that until vaccines and treatment are found, we must get used to living with the virus and adapting our lives to the new data.

Mask, distances, observance of hygiene rules. For as long as needed. Thank you.

COORDINATOR:  Thank you, Minister. Let’s move on to questions.

V. AGGOURIDI:  Good evening. Now anyone who wants to can answer, because Mr. Hardalias also mentioned some specific procedures for increasing the tests, targeted. Is there a need for a more organized testing strategy? So is it necessary, are these announcements you made in a context of redesigning our strategy as a country in the tests we conduct? Consequently, with the history of the cruise ship, there has been a lot of discussion about the reliability of the tests performed in individual laboratories. Are there procedures that guarantee these results? Is it something that concerns you in any case?

N. HARDALIAS:  Obviously we were troubled by what happened to Mein Schiff 6. From the first moment the mechanism based on the protocols was activated.

It is clear that the protocol followed by the laboratories in relation to the positivity of a sample, was not followed and is something we are investigating.

From there, however, the mechanism was activated, the procedures were followed properly and we were able from the first moment to have an idea of ​​where we are going and what we are trying to do.

I think that the end of the alarm comes to prove that in the part of the tests there are the safety valves that ensure that we can check in each case every sample and every result from whatever laboratory it comes from.

ΓΚ. MAGORKINIS: I  should add that the interpretation of the result is also very important. Sometimes the results are clear and sometimes they need follow up, so to speak.

Over there, at that point a small wrong call was made, of course it was repeated inside the cruise ship because the cruise ship had a molecular weight and came out negative. Just because the situation inside the cruise ships is tense, as you understand, if something happens the prevention should be done quickly.

That’s why this whole scenario worked and it worked very fast. That is, think that it has been checked 4 times and has been exhaustively checked.

V. VENIZELOS:  Thank you very much. Ministers, Professor, how can we, how do we achieve satisfactory tracking when the data of EODY show that almost 5 out of 10 cases are of unknown source of infection?

N. HARDALIAS:  This is not the case. I have said it before. I do not know how it turns out this 5 in 10 is an unknown source of infection. From the moment that excel comes with all the data, the tracking that is done is exhausting. Through the procedures, I have said it before, it does not concern this phase we are going through, but from the first moment, there are some that do not appear 100% where they may have stuck, there are indications.

In these cases we are forced and take more strict, more horizontal measures in relation to the spatial behavior of the case, but also with the data we have.

That is, if we see that he is moving in a very specific workplace that does not result in their contact with certain people, we prefer to close the whole wing.

This was done in banks, it was done in large private companies. In other words, there are no cases that we do not end up with, even through indications, that may have stuck.

And beyond that, of course, almost every day we do various analyzes, because when we see that we have 10 cases, I say an example, which have come from an island – we have encountered this recently – and in fact are associated with a visit to a specific bar, to it I say, obviously there is a red flag in us.

And at the same time we do the necessary checks, if the measures are observed in the specific bar and in the specific health interest store.

Tracking is a dynamic process. The “under investigation” you see, is the time it comes out and before it comes to us, in the tracking. When it comes to us, in every way, exhausting every possibility we have, we end up. There are also some cases where the data that have been declared, these small cases, a small number, are not real.

However, the Greek State has the ability, through the inspections it can do, even on-the-spot inspections, to find out what these cases are, where they live and to be able to cross-check the data they give us in relation to people. hosted in the space we are called to enforce isolation, if the data presented to us is valid.

P. ANTONOGIANNAKIS: Good Evening. I would like you to inform us how many tests were done yesterday, how many of them were done in the private sector, how many in public hospitals and what you will do, finally, for their prescription, so that the citizens who need them are not burdened, but also are wasted by those who do not need them but have the money to do so in the private sector. And also, Mr Kontozamani, I would like you to tell us how to convince people of the need to comply with restrictive measures against the epidemic, when they see that compared to last year when there was no epidemic the NSS has 5% less staff according to the data of the Ministry of Interior.

V. KONTOZAMANIS:  Regarding the number of tests, I am not in a hurry to give you yesterday’s number. I can find it and let you know.

In any case, we have made it clear that if someone meets the criteria they can take the test for free in public structures. Once someone has entered a public structure, they have not paid for the test. We have said it too many times.

The tests are not done by chance. There is a specific plan, there are criteria and if these criteria are met, the test is carried out by the State, which covers the entire cost.

Now, when it comes to prescribing. When someone comes to a public structure there is definitely an order for the test. So now whether or not he will be compensated in the private sector is another conversation that at the moment since the public health system has the productive capacity to cover the test I do not think there is a reason to have this discussion.

Let me remind you that from the beginning of the pandemic until today, we have increased the number of tests performed five times a day and we have reduced the cost of the sample for the State almost five times since the beginning of the pandemic.

Therefore, there is access to the diagnostic test, there is adequacy and in fact we increase the production capacity with new equipment, new machines. We now have at our disposal the rapid tests, which we are one of the first countries to use and are used in specific cases and mainly in epidemic situations, as was done successfully on the island of Lesvos.

As for the staff, let me disagree. There are no less people today. We received less, there are more people. Let me just remind you that out of 2,000 recruitments of auxiliary staff that we had planned, we have exceeded 6,200. By the end of the year, 1,243 permanent doctors will be in the National Health System.

We have proceeded with announcements of 400 positions, 185 of which concern the Intensive Care Units. 943 positions are completed within six months, and we have to say this, because in the past, to get a permanent doctor in the National Health System, we could reach 18 months. And they have advanced, the 2K announcement is completed by ASEP with 1,116 people and last August we announced 1,209 people with the 6K announcement of ASEP.

In addition to the auxiliary staff, we have the 2250 nurses who have started and will continue in the coming days to join the National Health System, in order to do their specialty.

When it comes to financing hospitals, I think you have the wrong idea again. At the moment the amount of funding, we are talking about the funding of the State to hospitals, is at 75% of the regular budget. We are in 3/4 of the year. So the flow of funding to hospitals is normal and I must also remind you that we have increased spending.

This year public spending on health will be increased for a number of reasons, including emergency financial assistance to the National Health System to tackle the coronavirus pandemic.

Therefore, in any case the system is strengthened, both in personnel and infrastructure and there are the necessary financial resources in order to deal with any event.

ΓΚ. MAGORKINIS:  Let me mention the number we have, over 13,000 tests were done yesterday. For the private ones we estimate it is less than 4,000.

A number that a colleague of mine asked me last week and I promised to give it. Since the beginning of the epidemic we had 487 patients in the ICU, 470 had been intubated.

M. TSILIMIGGAKI:  Thank you, good evening. The question is for the Professor, Mr. Majorkinis. We know that each country has its own characteristics and its own, say, pandemic rhythms. At the moment, where is Greece in relation to how many tests are performed, how many cases are finally proven to have, how many admissions we have to ICUs and deaths? I mean, are we good at this equation?

ΓΚ. MAJORKINIS:  The thing is, this is a huge debate right now, because right now most countries are doing relatively well, with a few exceptions I mentioned earlier. So any nuanced differences, which are small, I explain to you, it is extremely difficult to put the countries and make a ranking, so to speak.

One day you may have 5 deaths in Greece and the next day you may have 10. The profile changes. In general, Greece currently has a relatively good profile. Of course we are in the second wave, we expect increased intensity. If maintained at this level we will be relatively well, but our epidemic profile I would say allows us to be in a good balance for now.

And the discussion regarding the ranking at the moment I think has small differences, at least for European countries. If we want to compare it, say, with the United States, we are at a much better level. Compared to other countries, depending on what index we want to see, number of deaths per million population, which is perhaps the most standard, we are in an average situation at the moment compared to other countries.

. TSILIMIGAKI: Also a question about the masks. Was there again an issue with the masks in the schools, that there was a problem again with the specifications, were the wrong masks sent? Will you tell us if this is true and what happened?

V. KONTOZAMANIS:  No, it is not true. There is no issue with the masks. You know that specifications have been sent by the National Commission, clarifications on the specifications both in terms of the perimeter dimensions of the mask fabric and the dimensions of the final product. In fact, samples of a finished product, a final mask product, were sent to the Ministry of Interior, so that there is no ambiguity regarding the final product.

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