Health situation, measures to cope with epidemic, investments in health system

Press conference on policy responses to the COVID-19 outbreak, health situation in the country and investments in the health system:

 

We have come together at the weekly press conference focusing on the economy. Today we are going to converse about the country’s health system, health situation, and investments in the health system and take stock of what has been done and we plan to continue doing so for the health system.

First of all, allow me to share with the public the feeling of disgust and contempt for the leaders of the co-called opposition, who are chaotic and are at a loss to the point where their forlorn hope to seize power hangs by a thread as they dream about a health catastrophe. They have actually become a sort of spokesperson for the panic, psychological confusion and spokesperson for a totally fabricated pessimism aimed at triggering desperation and unhappiness among people through lies, fabrications, abuses of a rampant propaganda that seriously affects the confidence of doctors, nurses, health experts who are at the forefront of this battle through their commitment and professionalism in a front where Albania, being a tiny country,  has just a small part to play along a line that includes all countries on the planet.

It is inexcusable that people are told on a daily basis that the country’s hospitals are overwhelmed and they have collapsed, which is absolutely not true. This could have been of course the case, just like it has already happened in many countries with a much more advanced health system, but the hospitals have not collapsed;

That people lie on the floor, which is absolutely not true. It could well have been the case, as it has already happened in many more developed countries with internationally known hospital centres, but this is not true;

That people are being treated in ambulances, thanks also to any irresponsible media outlet has reported such a news story, which could well be the case, but it is not true;

That the government is stealing and that’s why the number of infections is soaring, the number of fatalities is increasing, which is an absurd allegation, because, unfortunately, the truth is that the number of infections and deaths is growing exponentially all over the world. Are the German Chancellor and the government stealing? Are the British PM and his government stealing? Are French President and the French government stealing?

It is an absurdity that, unfortunately, is not outcome of ignorance, but it stems from the sinister intention to stir up panic and sow desperation and alienate people and incite a hostile environment against the government. It is quite an obvious, quite vulgar and condemnable political strategy to gain power that they stand not a single chance to regain after extremely misusing power down the drain that – thank God – this virus didn’t emerge when they governed the country and it didn’t find the county’s health system in the poor state we inherited from them; the virus didn’t find doctors and nurses without the white coats they use in their everyday work, let alone the doctors protective gear and equipment; it didn’t find the hospital wards facing shortages of sheets and blankets, let alone the state-of-the-art equipment being used everywhere around the world today; it didn’t find patients facing shortages of aspirin supplies in hospitals, let alone the health protocols and guidelines currently used all over the world, because we would have then seen what a real national tragedy and catastrophe means.

How one can possibly lie this way!

How can one possibly organize such a daily onslaught for the opposition’s sake without offering facts and figures, but instead by employing all sorts of charlatans who pretend to be experts, doctors, nurses, and who make irrelevant statements?!

How can one possibly come up with the assumption that people are committing suicide because of the hospital conditions?! Do you know why you too fall prey to this trick?

It is for a simple reason. This is because you don’t take the trouble to conduct a very simple investigation to establish that figures actually indicate what has been already openly and consistently warned and hinted by experts worldwide that one of the effects of this invisible enemy in the human body is that it makes people contemplate suicide and causes suicidal thoughts that have been unfortunately materialized in figures.

A total of 71 people have committed suicide between March and August in Italy, while a considerable number of suicidal attempts have been also recorded there. Likewise, the number of suicides in France has increased because of the COVID pandemic. The suicide of the renowned Reims club doctor after coronavirus diagnosis made the headlines all over the world. Four people in Germany, Saudi Arabia, and Great Britain have committed suicide because of anxiety and fear they have experienced after contracting COVID.

Suicides among physicians and healthcare workers have taken place in the United Kingdom. A young nurse committed suicide at London hospital during her night shift.

A 37-year-old man in the United Kingdom attempted to kill himself on the fifth day after experiencing COVID symptoms.

Three Russian doctors have committed suicide by jumping from the hospital windows after the COVID-19 diagnosis and they have experienced emotional stress of fear, a condition about which health experts are constantly warning amid the ongoing pandemic situation.

Four patients committed suicide in Ukrainian hospitals between September 21st and October 20th. The first two cases involved two men, 63 and 42-years old respectively, who jumped to their death from the Kiev hospital window. Reports show that the two had contracted the virus and were through extreme stress that has pushed the two to this tragic action. On October 19, a sixty-year old woman leaped to her death from the window of the Infectious Disease Hospital in the Ukrainian capital, where she was treated for coronavirus and a day later, on October 20, another coronavirus patient committed suicide by jumping from the Kiev hospital window.

Is the Albanian government triggering these suicides around the world?

Or are these suicidal actions caused by the so-called bad conditions at Albania’s hospitals?

I even heard one of your colleagues and I didn’t know whether to laugh or cry. He is an individual who claims to be a health expert and who said that it is thought that suicidal thoughts and attempts are triggered by “the unbearable humming noise of the obsolete oxygen machines.

Do you realize the responsibility in today’s pandemic situation, to be a reporter and provide information when it comes to a disease that also includes the anxiety component?!

In April alone, the federal emergency hotline in the United States of America has recorded more than 1000% emergency calls from the family members of persons experiencing emotional disorder due to the COVID-19 infection. A doctor has committed suicide by jumping from window in New York.

The findings of an international survey published in May showed that the number of COVID-related suicides have increased by 32% around the world.

Members of the health staff in Poland have also committed suicide.

In neighbouring Greece too, suicides have taken place at a social housing centre because of the COVID infection.

I provided such a list that you can easily find, along with many other findings all over the world, while refraining to cite suicide incidents in Japan, where I believe nobody can allege that the equipment are outdated and that they hum when delivering oxygen. And I don’t want to take you to Africa, or Australia, but just to Europe and the U.S. and bring to attention countries with a care service and health science level, which can be questioned only by that journalist who blamed the oxygen machines for the suicides rate. He also said that another reason for suicidal thoughts and attempts is believed to be the stress that patients go through when a roommate passes away after having developed friendship while hospitalized together and once his roommate is gone, he also leaves by leaping to death from the window. Do you realize this kind of talk is this, while a high sense of responsibility is needed when reporting a news story?

Nobody is asking people to think twice when it comes to levelling criticisms and unfounded allegations and accusations, but do you ever think about the number of people who might have been gripped by anxiety because of this disease today?

Do you ever think how many people have contracted this disease today and they do not dare to turn on the television, because every news report start with Lulzim (Basha), continue with Ilir and Monika, and everyone has then to cope with the stress caused by the COVID analysts and reporters, who have no idea what they are talking about?

To be very clear, we haven’t worked miracles in Albania. We in Albania, like the rest of the world, face a major challenge. Yesterday, the US President-elect warned that another 200,000 people could die because of the coronavirus in the United States. The infection and fatality rate in the U.S. are soaring to figures that haven’t been recorded even during wars the President-elect warned of another 200,000 deaths.

Why is the U.S. is failing to break the infection chain by taking advantage of “Lulzim’s formula”  or the psalms of Ilir Meta, calling for more tests in order to cut the infection?

Why is Germany failing to break the infection chain although it is the country with the highest number of tests and the country with an excellent government in every aspect, including the aspect of handling this disease?

Why German Chancellor acknowledge that tracing of COVID cases has encountered difficulties due to the surge in the number of fresh infections and epidemiological teams are unable to trace the chain of infection?

Why the President of France – who leads a country whose health system is considered the best in the world, but keeps imposing restriction measures – appears on the media to acknowledge that the infection is now out of control.

Why is the virus out of control even though France carried out millions of tests in a single day?

Why did Slovakia that launched a program to carry out millions of tests a day still failed to break the infection chain, stop the increase in new coronavirus cases and fatalities?

Are they all stealing through PPPs too?

This is a humiliating mockery to politics. This is a dog barking that, when by individuals who represent a group of people, who should have been there to offer serious alternatives and who are there to speak of truth, is definitely a criminal offence. It is a criminal offence when inciting panic through lies, inciting despair and hopelessness through fabrications and it is the most meaningful of despair of the losers. They are losers and that’s why they are unable to find a way out of the impasse and the dead-end they have plunged themselves into. It was not us to plunge them into an impasse. It was not the people, but it was they to do so.

It is a company of jesters and buffoons, with one claiming to cut the infection chain if elected, the other urging people to go to mosques and churches because COVID doesn’t exist, while another one appearing to announce the number of medals he is going to award to dead people.

Yesterday alone the number of fatalities in Italy was equal to the number of deaths recorded in Albania since day one of the pandemic. If we were to consider the population size and compare the number of fatalities in Italy, we would have been recording 30 deaths each day. Does this mean we are more capable of coping with the situation? No!

Does this mean that authorities in Italy are stealing a lot more than we do and that’s why they record a higher number of deaths?

What is this kind of language? What is this stupidity?!

This is their politics.

Please, help people, because just like we share the heavy responsibility to resist, you, too, share the responsibility to report amid this chaotic situation, amid this situation with the most serious problem in terms of reporting and providing information being closely connected to the people’s emotions, their straight and clear thinking and provision of the right advices. That’s why we have told you and we repeat that it is crucially important, just like it is the case everywhere else around the world, that people should refer to the official data and, of course, you should also provide data about situations in other countries, because this is becoming a serious problem. It is as if COVID has hit Albania only, as if people die of coronavirus complications in Albania only, as if the number of the fresh infections has increased only in Albania and people leap to their death from windows only in Albania. Therefore, many focus so much in the wrong direction as they call it just propaganda, a video ad or a movie when you show them actual footage showing the situation inside the hospitals, but thinking that the nonsense stories they are told every day is actually the truth. This is because a lie is much more effective than the truth in drawing somebody’s attention and the evil has a stronger impact on the people’s mind than the goodness. Because evil is dangerous and danger immediately prompts another attention.

As of today, 30% of the bed capacities of the COVID-designated hospitals remain unoccupied.

Please, you are all invited to visit COVID 4 hospital tomorrow together with the Minister of Health because no patients are hospitalized there and therefore you and the staff are not at risk of contracting the virus. Visit the hospital and show people where the beds, wards and the facilities are available to the patients.

What does it mean that hospitals have collapsed? This could have certainly been the case and – God forbid it – it may happen even tomorrow, yet hospitals are now overwhelmed. Take a look at pictures, videos right at the heart of the European Union, in Brussels, showing patients lying in hallways. What are we supposed to say then? Are we going to say that we are better at it? No! Are we going to say that their system is comparable to the health care systems in Africa? No! We should note that the daily infections number exceeds the system’s capacities and Belgium has been working a lot to double its capacities during the period between the two waves of the COVID-19 pandemic.

Take a look at our dear Netherlands, which is by no doubt one of the world champions in terms of wealth, science and progress. Germany has opened a green lane for the COVID patients from the Netherlands, because the country’s hospital capacities are exhausted.

Do you realize what you are doing to these people by fabricating insane stories like the one by your colleague who blamed the old machines’ noise?

Which machines and equipment are old? There could well have been old ones, but these are all equipment and machines especially imported to cope with this situation and we still have spare equipment that still need to be used, because – thank God- the number of the patients who are being treated in intensive care units is much lower than we had anticipated.

What do they mean by suggesting home oxygen therapy to the patients? How can oxygen therapy possibly be provided without a doctor to assist and without controlling the patient every day?

On the other hand, if we are to comment on the budget, we should note that all front-line doctors are receiving an extra EUR 1000 a month, nurses and supporting staff are receiving an additional EUR 500 bonus each month until the end of the pandemic. A total of 550 doctors, 1130 nurses, 134 epidemiologists and 754 supporting staff members receive this monthly bonus. You do the math and for this you can cooperate with Lulzim (Basha) and estimate the amount of the budget fund allocated to support an army of frontline health professionals working around the clock. What do they mean that hospitals face shortages of doctors and nurses, because they have migrated to Germany! But in addition to the current frontline doctors and nurses a whole group of doctors and nurses are ready to spring into action if needed.

Meanwhile, Ilir (President) keeps claiming that the government lacks a plan and a strategy. And the one levelling this accusation is he whose only plan is how to divide martyrs into the grand masters at work, masters at sport and masters at stealing votes.

I would also invite you to visit the ambulances and see what is to be found inside them. The ambulances are fully equipped with all instruments needed to treat patients, the oxygen machines and everything else.

What do they mean that people lie in ambulances because hospitals’ bed capacities are full? This is not true. It is a lie.

Ambulances drive to the hospitals and there is a certain procedure to be applied before patients are admitted to the hospital, because this is not a usual health emergency when someone has broken his leg while playing football – and don’t forget that African football player who has become a national value after obtaining the Albanian passport in eight hours only – but there is an hospitalization procedure to be observed. While the hospitalization procedure completes, patients are provided the entire care and treatment in the ambulances. You may go and take a closer look at the ambulances, since when we show them, they are always considered video ads, and show people what happens inside the ambulances.

What do you mean by saying that ambulances are parked 100 meters away, because there are no free beds in hospitals? This could have been the case, just like it is in Brussels, but hospitals’ capacities have yet to be occupied. This is a fact.

What do they mean by claiming that patients are not allowed to use mobile devices while hospitalized in COVID wards? In which countries patients are allowed to keep mobile phones while hospitalized? Italy, England or the United States?

Is a COVID hospital a stadium? Or is it a wedding party for everyone to shoot videos?

Not only we have a plan, not only the written and updated strategy has been forwarded to President Meta, whose suit is the only remaining presidential feature, but we have also committed financially to providing the vaccine as soon as it becomes available as part of the strategy.

We have allocated the due funding for the vaccine, just like every other country has already done, and the next year’s budget for the education system is estimated in the amount of 55.3 billion lek or 9.4% of the state budget. It represents the highest public funding for the country’s health system in the past 30 years.

Take a look and verify the figures to find out whether this is the highest funding or not.

This budget includes the pay hike for health-workers, a decision which will be implemented not only during next year, but forever, because we don’t decide to increase salaries next year and lower them again just a year later. Around 18.000 health workers will benefit a 40% pay hike, since we face a shortage of doctors and nurses. 18.000 health personnel, while thousands others are awaiting to join the system and take up jobs as physicians and nurses and, just for you to know, they are not in Germany, but here in Albania.

Likewise, a new specific package of EUR 15 million has been provided by the World Bank. Plus, the package of 1.7 billion lek to support the continued fight against COVID by providing personal protective gear, medicines, oxygen, as well another amount of one billion lek to cover the bonus for physicians and nurses. So, with the new salary rise and the extra monthly bonus, our doctors and nurses in the COVID-designated hospitals, thanks also to the lower taxes, they will send home more money than they would be able to save if they were to work in Germany.

You can verify these facts and make a calculation of their salaries, because if they migrate to Germany they are not hired as ward heads, but they work as assistants.

The government has planned an amount of 650 million lek for the health workers who will be employed to boost the human resources on the frontline of the fight against the virus. They are doctors and nurses ready to spring into action if necessary.

Another amount of 1.2 billion lek, or $12 million to support lab capacities of the public health institute and 1.4 billion lek to cover the vaccine cost through the COVAX alliance. We are closely monitoring the situation, but a decision has yet to be made.

The Technical Committee of Experts has developed its projections and we are monitoring its dynamic to predict the potential infection rate and we have of course prepared another support package, which will be announced very soon and the package is designed to support coronavirus patients for the essential medication, also to support the families currently receiving unemployment and social benefits, because things can take different directions.

We haven’t imposed restriction measures of a nature similar to the ones already in place in other countries. We have imposed restriction measures of minimum stringency, because we don’t want the economy to shut down, and this doesn’t mean that we will keep the economy open and let people die, but because we think there is an opportunity to keep a balance and we want to maintain it and that’s why we appeal constantly to people to do their part and comply with a set of very simple rules. But in any scenario, the situation is not easy at all when it comes to the vulnerable social categories and we want to provide additional financial support to the needy families until the pandemic is over.

Yes, this is all money and in these circumstances, do not forget what I said before, it is not a matter of planning a road you know its end. You plan keeping in mind that things can take an unexpected turn, as it is the case with the second wave. The second wave is harsher than the first one and if we look at the experience in the past, a third wave may ensue, which of course is not like the second, it is weaker, but, nevertheless, it is possible. Nobody knows whether this will come or not, but we must be prepared.

I would like to give the floor to the Minister of Health now to provide a general outline of the situation. As I already said, this is not a press conference focusing on COVID pandemic only. We will then continue the Minister of State, who is also responsible for the financial measures and he also coordinates work about the government support for the health system, along with the reconstruction process. It will then be your turn to ask all the necessary questions.

The Minister of Health and Social Protection, Ogerta Manastirliu: Thank you Mr. Prime Minister!

Allow me first to provide a brief outline on the health situation amid the pandemic, but I will also dwell upon the accomplishments in the health system as part of our vision on development of the health sector. The universal health coverage, about which we have never decided beyond the major priority not only for Albania, but also the rest of the world in the wake of the Covid-19 pandemic.

I would like provide some simple, probably rarely highlighted facts, because we are not offered the opportunity to provide more concise information but simply daily information that often fizzles out in the multitude of information, sometimes and unfortunately false, but the truths should be known to all citizens and I want to highlight three important international reports on the situation of the Albanian health system in recent years.

According to “the Lancet” Albania scored an impressive 70 points for the treatment of diseases and the provision of healthcare without high costs and it rated better than the countries of the region for the effectiveness in provision of healthcare services. And we have pledged to further improve the country’s ranking.  In the meantime, Bloomberg’s Global Health Index has ranked Albania among top 50 countries with the healthiest population in the world. And this is actually one of the indicators that have significantly improved in our country thanks to the support for maternal and child health and the health system as a whole, the support with medicines and medical materials, as well as in terms of the disease prevention policies.

Focusing on our disease prevention programs, it is worth mentioning the fact that program has completely changed the primary health care approach and the international institutions have particularly praised the basic medical check-up as a program that has radically transformed the health care approach and this is a direct government care for the citizens, because protecting the citizens’ health and investments in the health infrastructure are top priorities.

And I mean not only the check-up programme that is provided for free to all individuals aged 35–70 years, but also two other programmes, namely the breach cancer and the screening program on early detection of the cervical cancer and they constitute three essential basic programs for the prevention of non-communicable diseases, which are essential to our vision towards provision of health services that rank Albania 39th out of 195 countries for pandemic response preparedness.

These are not reports that are drafted in party headquarters and by non-certified organizations, but they are international documents that evaluate the health system’s performance on basis of a series of indicators.

I would now like to focus on the efforts to cope with the pandemic, because if we were to fail in implementing a series of investments in the country’s health system in the past seven years, if we were not to increase budget spending for health system, and I would include the new state budget for 2021, to affirm that the state budget funds for the health system has increased by 55.36 % compared to 2013. The 55.36% increase in health spending means that provision of health care services has improved significantly.

Around 600.000 citizens without health insurance coverage today receive free medical check-ups, free visits at family doctor, free diagnosing and they also have access to the package of reimbursed medicines, which has expanded by 30%.

The amount of EUR 30 million more than in 2013 is translated into broader access to care provision for people with chronic conditions, a funding benefiting around 450.000 Albanian citizens each year. While focusing on the investments in various sectors, I’d like to point out the investments in our most precious asset, our doctors and nurses, whose salaries have risen by 27 % between 2013 and 2019 and they will see their monthly salaries increase by 40%  in January 2021, in a direct support for the physicians, nurses and all health professionals and I mean not only financial support, but also support through better working conditions with a direct impact on development of the health sector, also serving our goals to make sure that doctors and nurses choose to work and live in Albania and provide care to Albanian citizens.

Definitely this is a challenge facing not only Albania, but other countries as well, including Italy, North Macedonia, Croatia, Romania, Bulgaria that are struggling to prevent physicians and health workers from immigrating. We are certainly working around the clock about it, even though we are facing this global pandemic.

It is a challenge to our health system and its capacities and we haven’t stopped even for a moment working to press ahead with investments in the sector and the health structures, including the investment program to build 300 health care centres all over the country, investments to modernize the University Health Centre, starting with the Surgical Hospital, the Internal Disease Hospital already being built and due to complete soon, the Paediatric Hospital, investments in the maternity hospitals in Saranda, Korca, Berat, Lezha, the regional hospital in Kukes and the maternity hospital in the north-eastern region, while other construction sites are being launched to totally transform the country’s health system.  And in terms of services, since infrastructure is one thing and the other side is what sort of services we provide, how much Albanians pay for health care services today.

Another important element, I believe, since it has drawn particular attention in the wake of the pandemic, as well as after the devastating earthquake last year, is the national emergency medical service we have set up for the first time.

A unique system built for the very first time, a service that has been modernized, with every citizen dialling the unique emergency number 127 receiving health care on time. We have reduced patient wait time to only 19 minutes from an average of 45 minutes previously.

All these have been our promises as part of the government program. We have continued work to strengthen capacities of the health system despite the pandemic and the earthquake that hit our country last year.

The National Emergency has been strengthened with a new fleet of ambulances. The teams have been trained and citizens are no longer forced to transport themselves to the hospitals. I believe everyone remembers how you were transported to the hospital when in emergency condition, when people had to hire taxi service, or be transported by family members or relatives. The health emergency service was almost nonexistent just few years ago or the ambulances resembled to minivans that simply transported patients to the hospital. Today the ambulances are equipped with life-saving equipment, from oxygen cylinders to the defibrillator and all the basic medicines needed in an emergency condition.

Albanian citizens are today safe in the hands of the doctors and nurses of the national emergency service. They are safe in our health service structures.

I would briefly inform about the pandemic response measures. A total of EUR 25 million has been allocated for the period between March and November to support three main pillars of our anti-pandemic strategy.

Based on facts and facts only, I would like to emphasize that not only an pandemic response strategy and action plan have been in place, but the country’s best experts have guided us in every step we have taken to cope with the situation. We have been relying on science and the experts. We have built and we have been working based on this strategy designed to cope with each phase of the COVID-19 pandemic, which is not a disease we encounter every year. It happens once in a century and we have built strategies for each phase of it.

The COVID-29 preparedness and response plan is a document drafted with the assistance of best Albanian and international experts.

The reopening strategy following the first phase of the action plan to go on then with the reopening strategy and the response strategy for the fall and winter period, which includes all elements, components, targets and the action plan on every step to cope with the pandemic situation.

Not only do we have a plan, but we have a budgeted plan. We know where we are. Of course, what we would wish is a slowest possible evolution of the epidemic curve. However, the situation is under our control and we have doubled the hospital capacities with two new COVID-designated hospitals, namely Covid 3 and Covid 4 hospitals. These two new facilities were not part of the system previously. The COVID 3 hospital, built in the old building of the surgical hospital, has a 150-bed capacity. The old hospital premises were adapted and a new facility, which has been supplied with all required equipment, is now operational. The Covid 4 hospital has been well-equipped and ready to become operational after the team of doctors and nurses have been trained and are still undergoing regular training sessions. We can go on highlighting other components, be it about testing strategy, tracing and isolation of the infected individuals, with the number of tests increased fourfold compared to the number of tests conducted in June. They claim that we should have conducted more tests in May, but is it wise to increase the number of tests to identify a single coronavirus case? The number of tests could have been much higher, yet we would have identified one case only and this is because we prevented the first wave of the virus and we didn’t go through the tragedy that our neighbouring Italy experienced.

We made the right decision to prepare and enhance health care system’s capacities. As I already said, the number of tests has increased four times. We plan to introduce the rapid antigen tests based on the guidelines issued by the Technical Committee of Experts. We expect to provide these tests through open public procedures, as well as through the international mechanism Albania has adhered to and that is the EU’s centralized procurement, through which we have also purchased antiviral medication Remdesivir and we expect to also provide the rapid antigen tests.

Likewise, we are closely cooperating with the World Health Organization (WHO), with which we have established excellent relations and we are working hard to deliver on all aspects of the strategy.

I have already said and I want to reaffirm that therapeutic treatment will be provided in every hospital. Just like we have guaranteed such treatment since day one, we are prepared to continue providing it in each phase of the pandemic. We are also prepared to access and purchase any potential novel therapy, just like we have done in the case of the flu vaccine, with a total of 368.000 doses already purchased. The flu vaccines were commissioned since the first months of the pandemic and they were not purchased today.

All doctors and nurses have already received the seasonal influenza vaccine, while vaccination for high risk groups is underway. A quantity of 30.000 doses has been delivered recently in addition to more than 70.000 doses provided earlier and the vaccination of 368.000 people is underway.

On the other hand, as the Prime Minister already affirmed, we have prepaid an amount of $3.9 million to gain access to a safe vaccine through the vaccine alliance GAVI or the Covax facility. We will continue joining international facilities in order to be on par with all other developed countries.

The situation in the next four months is definitely very challenging; it is challenging to the government and to the citizens. But what we can assure you is that entire health system will work around the clock and the teams on the ground will be on high alert and we will response by providing both human and financial resources, which have been available as of today and will be fully available under the next year’s state budget.

Management of the COVID-19 cases that need home treatment or hospitalization is an important element. A total of 36 best-equipped ambulances will be delivered by end of December to join the existing anti-COVID ambulance fleet that provide assistance through an approved protocol on home treatment of the COVID-19 patients. With the increased number of ambulances, we will be able to further reduce the 19-minute wait time at a national level, transfer patients to hospitals, deliver the needed care services and handle the growing influx. Because these are the foreseen capacities under the expected projections during the pandemic. With the measures we have already taken, which are actually measures of average stringency, and which will enter into force starting at 10 pm tonight, plus the mandatory mask use, the personal hygiene and the social distancing rules we expect to limit or curb the spread of the Covid-19 infection.

– Mr. Prime Minister, don’t you think that the media live streaming cameras should have been allowed instead of the images aired under your exclusivity and under the ERTV logo since the media’s mission is to inform the public? Secondly, does the new support package, you referred to a little bit earlier, include the reimbursement of the COVID-19 patients who are currently being treated at their homes and, if yes, would you provide a figure about the reimbursement amount?

PM Edi Rama: First of all, it has happened also earlier when media has been allowed under special authorization. Media is not denied access, but of course you are not allowed to enter just like you can do in every other place. So, it would take just submitting a request, which is then taken into consideration and an authorization is issued, just like we did when we were forced to gather this information after taking notice of the countless fake news stories and disinformation. Of course, any authorized media would do its job inside the hospitals too, but as long as you are outside these hospitals you can help by making sure that no fake stories, frequent misinformation and fabrications are not aired through your TV channels.

As for the question about the medicines reimbursement, I said it earlier; this is in line with the strategy and the financial plan. As soon as we will be ready, based on the financial plan, because what is worth repeatedly stated is that this is not a simple, short and predictable war. It was not in vain that we were constantly urged to commit all available financial resources during the first wave of the pandemic. If we were to do that, we would have now been short of any capacity to cope with the second wave. Therefore, we need to consider things under a medium and long-term plan and we also need to win the challenge of the unpredictability of this war in terms of its duration. Nobody knows for sure how long this war is going to last. Nobody, nowhere around the world, even those on top of the world science are not sure about it and they make various predictions.

-Over the past weeks, we have witnessed an upward trend in the number of fresh coronavirus cases, while delays are also being witnessed regarding the test results. We all know cases from our friends, colleagues or relatives who have waited for two weeks for the test results. Have you taken measures to increase laboratory personnel where tests are conducted? New anti-COVID measures enter into force today. Do you think that, if the number of cases increases and the situation deteriorates, a third relief package or sovereign guarantee fund will be made available?

PM Edi Rama: It would be best for everyone to keep in mind, especially you as the bridge between the reality of facts and people, that nowhere, in no country around the world, despite the test kits, regardless of the number of tests, regardless of fame, regardless of the economy, regardless of the health system we have seen there is a curb or reduction in the number of fresh cases. Nowhere and this rejects theory that increased testing helps to prevent infection. Tests are conducted by the expertise, the Committee of Experts. It is not the government the one that conducts tests and it is not the government to tell the Committee of Experts to order increased testing for political purposes or reduce the tests number. It is very simple, people should keep in mind that whatever they see in Albania – since this is the good side, we are in a world war – to look at other countries too.

This is the big parking lot in Monza [photo]. This is a news story on Nov 10, 2020, and this is the hospital’s checkpoint.

This image shows Milan, an excellence hub in health care services in Europe. As you see, this is an ambulance and patients receive first aid inside the ambulance.

This is a picture shot on November 5 in Turin. This is the long queue of the ambulance fleet that cannot one or two hours and they are forced to relocate patients because of hospital bed shortages.

Worse still, COVID-19 patients in Milan, on the same date I told you earlier – this is because we are doing your job – are waiting for the ambulances to show up and they are not waiting in the ambulances. This is because there is no sufficient number of ambulances for the people who need hospitalization (photo).

This is a picture showing Rome today, on November 3 [photo]. This is perhaps what has convinced your colleagues to report there aren’t enough hospital beds and that’s the reason why ambulances are parked in front of the hospital. Or this is what Lulzim has been reading when waking up to fall again asleep after providing your this information and you rushed to report it immediately.

Health Minister will answer about the number of tests, the delayed test results or health personnel.

Health Minister Ogerta Manastirliu: It is true that we encountered a large influx of demands for COVID testing last week due to the soaring fresh cases that, as you have seen for yourselves, have been confirmed positive for the virus later. Not only have we increased fourfold the number of COVID tests, and this is a fact, through the Gold Standard or the PCR tests, but we have also made the University Hospital laboratory operational that is carrying out examinations for the COVID-designated hospitals, namely COCID 1 and COVID 2, but, at the same time, we are building a backup lab, which means an extra laboratory to strengthen the Public Health Institute capacities to further increase capacities and ensure what the Technical Committee of Experts consider as golden standard to provide test results on time ranging from 24 to 72 hours. This is the standard considered by the Committee of Experts as the best one in terms of the test results. We have been applying and will continue to apply this standard, despite the large influx we came across at a certain point and we are working to recuperate. Thank you!

– Ms. Minister, what mechanisms possesses the Ministry of Health to control how the oxygen cylinders are distributed, because this is has become a thriving business recently. I am referring to a case reported by Top Channel TV three days ago, while the Tirana Prosecutor’s office has launched an investigation to look into this specific case.

Health Minister Ogerta Manastirliu: Thank you! It is a very pertinent question indeed.

I would like to inform you and every citizen that the ambulatory or home-based treatment of the patients showing COVID symptoms, because we all know that no specific treatment is available, is recommended by family doctors only. I beg everyone not to fall prey to any abusive practice that may cause health effects or risks. Oxygen is not a therapy that can be used without proper health assistance at home. That’s why I would like to appeal to everyone to see the family doctors only. The family doctors are the only ones to have been provided the guidelines on treatment of the patients showing COVID-19 symptoms, along with the respective therapies and then if the patient’s conditions worsen then the National Emergency Service comes into action through the emergency number 127 that assesses the patient’s condition. The Emergency Service team, in collaboration with the family doctor, decides whether to continue home treatment by receiving more specialized assistance or to hospitalize the patient. So, again, I would like to call on every citizen to immediately contact the family doctor. Of course, not only have we conducted, but we will keep carrying out continued inspection actions in various private companies. Not only the Ministry of Health, but other state institutions and inspectorates too are verifying the health guidelines on treatment of patients at home, or instructions, because genuine guidelines have yet to be determined. Thank you!

-Mr. Prime Minister, the U.S. President-elect stated a day ago that a vaccine will be distributed for free to every American citizen one once an effective vaccine becomes available. Has the Albanian government made a decision to provide the vaccine to the citizens for free as soon as the vaccine is available?

PM Edi Rama: Yes.

–Since I paid attention also to the outline provided by the Health Minister, you stated that three anti-COVID strategies have been adopted and that intense work has been done during the summer season. I would like to insist on the issue concerning the delayed test results. I don’t fully agree with what the Health Minister said, because the delayed test results problem has been a common phenomenon also during the summer months. My relatives have been told that the test results will be delayed for another week, so, in short, there are long delays regarding the test results. Linking it to the strategy, you say that a lot of work has been done to boost the hospital capacities, but it was an expected influx. Don’t you think such capacities should have been in place much earlier? The same question goes to the Prime Minister too, as he earlier announced the relief package for the needy and vulnerable social categories didn’t you? You already knew this problem has been evident and the cost is really high.

PM Edi Rama: What is the problem?

– The surge in new cases.

PM Edi Rama: The surge in new cases has nothing to do with what I said.

– What were the strategies for?

PM Edi Rama: I explained that we are working and mulling plans to provide an additional relief package for the rest, and this is planned to happen next year, not now.

–Could you provide more concrete figures?

PM Edi Rama: You will learn about them as soon as the package is ready.

– The treatment costs are really high.

PM Edi Rama: I didn’t refer to any treatments. I talked about an intervention regarding the medicines, while the relief package to support social categories it has nothing to do with medicine. It is about the overall dynamics that is associated with the measures too. Given that other measures could be imposed, we will be ready to act and help the vulnerable social categories. You should also bear in mind the fact that a vast part of them are part of the informal employment. This is the reason. In other words, they are two different things.

Health Minister Ogerta Manastirliu: The testing strategy is determined by the Committee of Experts and other experts working in the field, including epidemiologists who conduct the epidemiological investigation, which involves a series of tactics in tracing the new cases and their contacts. Based on the Committee of Experts’ guidelines, high priority is given to the risk groups when it comes to testing, including individuals who show symptoms, teachers, and new virus outbreaks in a bid to curb the spread of the infection as much as possible by tracing the contacts too. I didn’t deny that there have been test result delays due to the large influx of the fresh infection cases that have been already solved and are being solved through the capacity building efforts, precisely as part of this strategy. A strategy should be in place for you to define targets. An action plan should be in place for you to take further steps that are then translated into results. I believe we all agree that we wouldn’t have this performance without a strategy in place. One should not forget that we recorded around 100 fresh cases a day in July, August and September and the coronavirus replication coefficient was below one, whereas this coefficient is 1.3 now.

What does this mean? Does it mean that we expected this? Certainly we did and that’s why strategies are drafted, projections are prepared and the scenarios are developed.

Did we make preparations to respond? We did. We made preparations and the today’s hospital capacities are sufficient to cope with at least 1600 cases, including also treatment in regional hospitals that are part of this strategy. If you have enough time, and if you really wish, you can read the strategy and explain citizens about what is causing confusion amid the multitude of inaccurate information. I believe that not only have we taken the right steps, but we have prepared and we have not lost a single moment during the summer months, when it was said that the situation was catastrophic and I do not know where this disaster came from, while the R was below 1 and while today it stands at 1.3. We are successfully coping with the increasing number of the hospitalization cases thanks to the increased hospital capacities and we will continue to do so because we are prepared. We have built the capacities and of course we have the appropriate financial support.

–Mrs. Minister, the Premier provided earlier concrete figures on the number of people who have committed suicide in Italy and other countries. Have you thought about providing psychological care for the hospitalized patients in order to avoid any other possible suicide action at the COVID-designated hospitals? Another question: Do you have any information on the quantity of the antibiotics that has been removed from pharmacies during the years when the sterilization concession contract was active and the quantity of the antibiotics that have been removed from the medicines centre in Albania?

A question for you Mr. Prime Minister; Is there a procedure that is being assumed by the Assembly of Albania to set up a specific parliamentary committee of inquiry to probe Dick Marty’s report? If yes, what this committee contain? Based on the Albanian Constitution for the protection of Albanians residing in countries across borders, does Albania plan to file a genocide and war crimes case against Serbia?

Health Minister Ogerta Manastirliu: Allow me first to underline that we are really sorry and sad about the tragic cases that have taken place in hospitals, but I don’t want to further comment on that because of the fact that the relevant bodies are looking into each of these cases, while an administrative investigation is also underway. What we have done from the very beginning, but which, in fact, during has also been consistently raised by international bodies such as the WHO, are mental health issues related to the COVID-19 pandemic, for which we in most of the time have reflected by responding not only through specialized working groups for the evaluation of multidisciplinary teams working at hospitals, but also by including the psycho-social aspect in the package of treatment of hospitalized patients. The integrated psychological service has been always operational at all wards of the University Hospital Centre and the Shefqet Ndroqi University Hospital. The psychological and psychosocial care is needed in all services, including Oncology, Neurology, Paediatrics and Epidemics related to COVID-19. To this end, we have strengthened the psychosocial teams at the University Hospital Centre, and these teams have been always operational also at the Shefqet Ndroqi University Hospital.

Regarding your question about the sold quantity of antibiotics and about the sterilization concession, let me say that the simple fact that the successful partnership for new instruments, sterilization service, the wards disinfection service, single-use protective gears and all other aspects of a service integrated with European CE standards have significantly reduced the postoperative infections from 30% to 15% and I believe these facts fully answer your question about the percentage of antibiotics saved by this service. Thank you!

PM Edi Rama: I have no comment about the other question.

Mrs. Minister, could you provide a figure on the number of tests conducted by the Public Health Institute and the number of tests conducted by the private laboratories?

The other question goes to the Prime Minister. You provided figures and drew comparisons between the pandemic management by our country and other countries. Countries like Italy, Spain, and Sweden have reimbursed COVID treatment. A COVID-19 patient in Albania receives a treatment often costing one million lek. How many COVID- patients have received reimbursement for treatment here in Albania?

Health Minister Ogerta Manastirliu: Regarding your question about the number of tests conducted by the Public Health Institute lab and private labs, let me inform you, in case you are not yet informed, that two days ago the Technical Committee of Experts has made a decision regarding the total reporting in relation to diagnostic tests and screenings to update the COVID situation. Since yesterday, we have reported the total number of tests. More than 2700 tests were conducted a day ago, with 900 of them being diagnostic tests. What I would like to say is that until two days ago, the tests number included the tests conducted by the Public Health Institute only, plus the tests conducted by private labs but that have been confirmed by the Institute and mostly about suspected cases or confirmed cases that have undergone retesting and have been reconfirmed by the Institute.

PM Edi Rama: I feel really privileged when you draw comparisons with Sweden and Italy. I don’t draw any comparison with either Italy or Sweden in terms of the financial capacities to cope with the situation. I make such comparisons to state a simple fact that even those countries have failed to curb the surge in fresh cases; that when Germany too, a champion in terms good governance, is unable to break the increase in new cases and when the German Chancellor appears to the public and acknowledges that it is impossible to trace the infection chain due to the spike in fresh cases, then help the public, help people so that they are not told nonsense so that they see what happens in Albania in the overall context, because this is not a war fought by Albania only. We should of course do our part. These are my comparisons and having said all these, I want everyone to realize we are not working wonders, and I don’t either think that everything is perfect at any moment. There are of course a lot of problems, including the one concerning the delayed test results you already highlighted here, but what I can proudly state about the work we have done on health sector and the efforts we have made to cope with this disease, about which, as you might read in international reliable resources, we don’t rank among the unprepared countries, is something completely unimaginable in the years when we took office. This fight was unimaginable with the hospitals we inherited, with the misuse of the human resources and catastrophic shortages. And the today’s discussion focuses on the quantity of the antibiotics that have been saved thanks to the sterilization. This is a very pertinent question now, but not long ago we faced the dilemma whether aspirins, sheets and blackest were to be found in our hospitals. This was the situation we inherited with the health system. The today’s situation is certainly far from being perfect, but the COVID-designated hospitals lack nothing from the hospitals in France, Italy and England. I would invite you to visit the COVID-designated hospitals and I challenge you to find a single medicine and equipment that are hospitals are short of.

As for the medicine reimbursement, I already said and I repeat. Going back to what the Health Minister said, first, people should refer to the health authorities only and they should consult doctors before deciding to buy medicines that could also harm them. It is not a common flu and it is not treated as a common flu. There are specific medicines that can help to treat other health conditions, but they might turn out to be useless in treating this disease. One cannot take away oxygen just like taking away bread and oxygen treatment should, by no means, be recommended by doctors and the physician’s assistance is a must in this cases. The common use of oxygen may cause severe harm. The list on the basic treatment at home is available for home treatment only and when the condition worsens then the patient should be hospitalized. One cannot turn home into a hospital and one cannot provide the care that is delivered when hospitalized. There is a group of medicines that come at a certain cost and we are preparing to act and provide our support, but don’t forget this is not a plan running through a certain deadline. This is the problem. We cannot draw a plan to be operational along a certain defined timeline, because we don’t know how long the virus will be among us and we don’t know its behaviour. Did you see what happened in Denmark? Did anyone predicted that the virus was to be transmitted by animals and could be transformed into something else and infect people again and efforts are now underway to discover the nature of the virus after having been transmitted to animals. It is all a war with a lot of unpredictability. We can’t afford doing mistakes and act on Lulzim’s recommendations. Whenever you take part in a press conference of Lulzim Basha you all think he is awake, but he is actually asleep and he is on a daydream path he shares with you. We can’t act that way, because we are the government of Albania and we are not the Democratic Party. We can’t afford acting on the suggestions by Ilir Meta who awards medals to the dead and accuses government of letting everyone die. We should prudently consider our potential in every aspect and consider the financial means so that we are able to fight and maintain this front to the end, as we have done to date and, at the end of the day, everything can be questionable, but one thing is for sure.

The surge in the number of new infections in Albania is within our predictions and it is not a pessimistic forecast, and it is absolutely not a unique phenomenon, but part of the overall trend.

The number of the fatalities in Albania is by no means beyond the predicted deaths and Albania is not on top of the countries with highest death rate per population.

Hospitals in Albania have not been overwhelmed and they still have unoccupied capacities compared to many other countries I mentioned during this communication.

These are the results and this is the current situation, but the war goes on.

We haven’t done what many other countries actually do. We haven’t disclosed all tests conducted in the Republic of Albania as we have announced the number of tests conducted by public health institute only and not the ones conducted by private labs. However, we have disclosed the number of people who have contracted the virus, including the ones identified through tests by private laboratories. This, for example, has been the frequent question I have asked the Committee of Experts and I haven’t been able, or I have never crossed my mind to order them to increase number of tests conducted each day in Albania, which they have decided to actually do, but, as they have earlier stated this is not the right moment for doing that.

Therefore, I am telling you one thing and I challenge everyone, the experts of the Albanian Technical Committee are experts of international level. This is undisputable. I have not heard anything extraordinary from the leading international experts and which differs from what I hear and what I have learned and from our experts. They are definitely experts on an international level. And their international experience is not accidental and it is not an accident that their communication with leading international institutes, including German Institute, take place in a real time and they are on par with world’s leading experts. Respect for them internationally is enough to say that we are in safe hands.

I would like to conclude with this sentence unless there are other questions. A set of new measures will enter into force today. I have seen many “intellectuals” writing comments on my social networks page that “virus goes to bed from 10 pm to 6 am.” What I am telling you is that we will do whatever it takes to avoid a second national lockdown and we will do utmost efforts to make sure that the severe restrictive measures are not reintroduced. It would be wise for everyone to respect the rules and everybody doesn’t think he or she can break a rule, because they won’t become the reason for a second total lockdown, which would turn out to be extremely severe, because as many are struggling to cope with the COVID-19 only, we should also heal the wounds inflicted by the devastating earthquake and we done utmost efforts in this respect. We should also stimulate the economy and we have spared no efforts of doing so. We want them give up nonsense and respect the rules, because the reason why not only Albania, but many countries have imposed a curfew between 10 pm and 6 am, is that this is the time span when the nightclubs are open and going to nightclubs is like partying with the COVID. COVID is waiting for everyone in these parties as people stay close to each other and they can then transmit the virus to their parents and grandparents. This is the reason why the curfew is imposed at 10 pm. There are countries where the curfew begins at 8 pm and even at 6 pm, but we want to believe that everyone is respecting the rules and the restrictive measures.

We haven’t come across any negative effect that could force us to reconsider the decision about the schools. We haven’t seen any effect and this is actually what other countries confirm. And this is the reason why the universities in other countries have gone virtual, whereas the high and primary schools are open. Contrary to what is said, for the sake of truth, the pedagogical staffs are doing a fantastic job in keeping the situation under control and respecting the measures. Also, contrary to what is said about hospitals, the truth is different.

Thank you so much for this conference and exhaustive communication of today and of course we remain in constant contact to provide information. Help us as much as you can, try as much as you can not to help spread false news, fabricated information and the desperate cries of those who are asleep and dull.

Thank you!