December 28, 2020 – Amidst the difficulties of a second lockdown, a socially distanced Christmas and yet more earthquakes, have we forgotten about Croatian healthcare workers? TCN decided to interview a doctor working on the front line of the fight against COVID

During the first lockdown, it was all about the balconies. Saxophonists, DJs, opera singers – we were entertained on social media by a string of balcony-based stunts that somehow showed resilience, community spirit, humour. Zagreb was no exception. A trend of clapping on balconies in appreciation of healthcare workers passed from country to country and was picked up in Zagreb. After the applause finished, people went back inside. Nothing much had changed. It was a nice enough gesture.

Since the start of summer, no such applause has been heard. Perhaps the release from lockdown gave the signal that the lives of Croatian healthcare workers had also become much easier? That certainly wasn't the case. Though the number of people infected with COVID has grown significantly over recent weeks, Croatian healthcare workers have been treating people sick with COVID since springtime.

Croatian healthcare workers are currently busier with COVID patients than at any time before. And yet, there are no more trips out onto the balconies to show our appreciation for them. Perhaps it's now too cold outside? Perhaps some aren't aware how busy Croatian healthcare workers currently are with COVID patients? Are we perhaps guilty of taking Croatian healthcare workers for granted? Or, maybe we have simply put Croatian healthcare workers to the back of our minds as we struggle with our own challenges?

Throughout this year, TCN has been pleased to report many instances of generosity and innovation directed towards the fight against COVID. Certainly, not everyone in the country is guilty of forgetting about the Croatian healthcare workers who are on the front line fighting this disease. But, how much impact do these instances have on the general lives of Croatian healthcare workers? What is it like to no longer hear the nightly appreciation from our balconies? And, just what is life like as one of the many Croatian healthcare workers battling COVID in the year of the pandemic? TCN decided to interview one to find out.

The doctor we spoke with is a resident physician, working at a smaller community hospital in the continental part of Croatia. They agreed to speak with us on the condition that they do so anonymously.

Looking back at the first lockdown, we didn't know so much about COVID back then. We didn't know exactly how it was spread, the different manifestations of the disease, what course the disease took, nor what the recovery could be like. I think the government did a really good job of responding to the threat as they saw it. We had a small spike in cases, but that is minuscule to what we have now.

I think people generally did what they were told because they thought it would be temporary and they could see the sense in starving the disease out.

At the hospital, we were at first caught a little off guard with the amount of PPE we had and some other resources that we needed. For ICU and ventilators, we were well equipped.

Some of the residents were given some paid leave. It was important to put human resources into tiers. Croatian healthcare workers were certainly more predisposed to catching the disease, simply because they were around it every day.

After such great early successes, I was surprised that everything was relaxed later on to allow the tourist season to take place how it did, and for events like the Vukovar commemoration. It felt like it was a calculated risk. The lockdown we are now in is perhaps too little, too late. The disease is out there now, wild. The numbers of infected people are significantly higher.

The difficulty with this disease is that people can be infected and have very few or no symptoms at all. They might not know they are spreading the virus. You might not know you're sitting next to someone who has it.

Even though we're not at the centre of care for a major population area or city, we saw cases of the disease almost immediately. Our community hospital services an area containing around 150, 000 people. The first cases in April came from nursing homes – elderly, vulnerable people, many with pre-existing conditions. We were well equipped to handle it. Now, we are stretched on a daily basis. We fill the beds with sick people as soon as we empty them.

We wear masks and PPE all day, all the time. All Croatian healthcare workers in hospitals currently do this. Every patient who comes in, regardless of their symptoms, we treat them as though they are carrying the disease.

A lot of residents like me, who are working towards getting their specialty, go to do some periods of work in larger hospitals in the bigger cities. Now, many of those residents have been called back to their community hospitals – we are short on human resources.

The hospital has had to restructure itself significantly. Lots of doctors have been asked to provide cover in the emergency department. Over half of that area is now fully dedicated to COVID.

What do COVID patients look like in regards to their symptoms? It depends on their age and risk group, but you see people who look like they have flu or bacterial pneumonia, you see people who are in acute respiratory distress. Sometimes they have neurological changes, some of them look like they have had a stroke. Some people who have been infected and have supposedly got over the worst of the symptoms, come back in after a month or two with blood clotting problems – blood clots in the legs, which have a tendency to travel up to the lungs and cause a pulmonary embolism. That's a pretty big medical emergency. Some who have pre-existing heart conditions come in with a heart attack triggered by them catching COVID – it's more complicated trying to revive someone when you know they have COVID. The presentation of the disease is so variable.

It's not only older people. I've seen young people be admitted with serious reactions to COVID - young, healthy people who have no pre-existing conditions. I've seen young people come in with mild symptoms, they are sent home with antibiotics and steroids. That is the standard treatment – antibiotics to prevent a bacterial super-infection and steroids to prevent an acute reaction by the body's immune system to COVID. - that's what can cause big problems later on, in the course of the illness. But, sometimes that's not enough. I had a young patient just last week - super healthy, worked out regularly, no pre-existing conditions – and his lungs just looked awful. He had to go to the ICU immediately (sadly, this patient later died). That's like no disease I've ever seen before. Really, COVID is a completely new kind of animal.

The new strain of COVID? There is evidence that it can be spread more easily, and that it can affect more younger people, but there is no evidence that it is any more severe. The vaccines will work against it.

We're short on ventilators now. Really, we need two free ventilators at any time, in case there is an emergency admission. We are not currently in the position where we always have two free ventilators – sometimes they are all in use. That's a worry. I worked one shift where the anaesthesiologist said “We just don't have any more space for them – we will just have to put them in the hallway”. I've never seen that before.

I've heard of Croatian healthcare workers, colleagues in other hospitals getting sick with COVID and the hospital asks them to prove they got sick at work. It's pretty clear that's the most likely place they would have got sick because they're working with COVID patients. They were forced to be off work, but only on a lower level of sick pay. If you get ill because of being at work, you get full pay. But, they couldn't prove it, so they didn't get that.

I've been lucky – I haven't caught COVID yet. Well, as far as I know. My pay hasn't gone down, it's gone up – but only because I'm working so many double shifts. I volunteer to provide cover when other members of staff get sick. The specialists – the consultant doctors – they have it worse than us resident doctors. They are more responsible, so they are expected to work more hours. Nobody is pressured or threatened into picking up extra shifts, it's just something that almost all of us just do.

I've read some nice stories about fundraising efforts and donations to Croatian healthcare workers and hospitals in different parts of the country. Everything is appreciated. But, I personally haven't seen any effect of that on our day to day lives at work. Not at our hospital. Maybe there were PPE donations or cash donations, but it hasn't impacted the daily lives of me and the Croatian healthcare workers who are my colleagues. I think I heard that a local garage was giving free cups of coffee if you show your medical ID. Every little is appreciated.

For me and the Croatian healthcare workers who are my colleagues, instead of any kind of personal discounts or donations to staff, we would much prefer if people just took this disease more seriously. Things look very different when you work in a hospital compared to someone outside who maybe doesn't know anyone who got sick.

I came off a particularly difficult double shift a couple of months ago – it was just non-stop COVID admissions, some severe cases. As I was walking home, I walked past a bar that's near to the hospital. They had signs on the walls telling people to keep their distance. But, the bar was absolutely packed – full of young people. It just felt so disappointing. I couldn't help but think of the older relatives they would come in contact with, some who might get really sick.

Instead of people clapping on balconies, I think Croatian healthcare workers would just prefer more general vigilance and personal responsibility – wear your mask, wash your hands regularly, no more parties in the basement. Clapping on balconies is a nice gesture, but ultimately it's an empty one.

How does it feel to know that there are some people out there, in every country, all around the world, who believe COVID is a hoax, or a plot, or not so serious, or that the vaccine is dangerous or something other than what it is?

Well, it's not always the content of the conspiracy theory that appeals to these people as much as it is their inability to accept facts – the truth – because they have little faith in the authorities that are telling them this. Here in Croatia, I think that distrust is quite high – a lot of people are disillusioned with the state and politics, because of corruption. Sometimes over 50% of the population choose not to vote. The dissemination of misinformation over social media doesn't help - if that's where people get their news from. If you look at that example from your own country, where strict measures about movement were put in place by your government, and immediately afterward, the Chief Advisor to the Prime Minister, was caught breaking them to travel across the country with his family to a second home in the countryside, going out on day trips. And he was defended by his colleagues after he was found out! When people see those kinds of things happening, the distrust between people and the authorities just grows.

All of the images in this article are used as illustrations only. None of the places or people depicted are in Croatia or Croatian, except for the first image, a panorama of Zagreb

December 4, 2020 – Accepting all known knowledge of the Coronavirus risk and the announced vaccines, security and risk experts International SOS have published their latest, annual Travel Risk Map. It says Croatia is one of the most safe countries in 2021 for visitors

With the end of the life-halting Coronavirus in sight, thanks to several effective vaccines announced, which country would be best to visit next year? Well, Croatia is one of the most safe countries in 2021 for visitors.

It's been a long, difficult year for everyone. It's maybe hard to believe if you live in Croatia and haven't much travelled outside the country, but the residents of Croatia have had it no more difficult than anywhere else. With only around 4 million inhabitants, there's lots of space in Croatia to move around.

Take in comparison Britain's London. That one city (1,572 km²) alone has 9 million people. Croatia has 56,594 km² for less than half the number of people. But, this generous amount of space in which to move around is not the only reason Croatia is one of the most safe countries in 2021 for visitors.

On 2 December 2020, Total Croatia News published the annual report based on the Global Terrorism Index, identifying Croatia is one of the most safe countries in 2021 in regards to the absence of terrorist threat and effect. Now, according to the latest annual Travel Risk Map, it has been designated that Croatia is one of the most safe countries in 2021 for visitors.

Security and risk experts International SOS's Travel Risk Map for 2021.

The map, created by security and risk experts International SOS , ranks the safety of countries across the globe taking into account medical, security and road risks. It assesses the risk of political violence, social unrest, and the threat of violent and petty crimes – and, most importantly this year, the impact of the pandemic.

For the first two categories, countries are given a rating out of five, while road safety is rated out of four based on the mortality rate per 100,000 people. The places with the highest risk level for security issues are mostly in Africa, with South Sudan, Mali, Yemen, Somalia and the Maiduguri region of Nigeria listed under the most dangerous, along with the Donetsk and Luhansk regions of the Ukraine.

International SOS's map showing the countries with the most and least Covid-19 disruption. Very low-risk countries are marked in white, low risk in grey, medium in blue, high in purple and very high in pink.

Very few countries rank above Croatia in the new safety map, New Zealand, Tanzania and Nicaragua among them, meaning Croatia is one of the most safe countries in 2021 for visitors.

For the residents of crowded cities elsewhere in Europe, Australia or the USA who have felt more than restricted in 2020, it might be worth remembering when planning next year's escape that Croatia is one of the most safe countries in 2021 for visitors.

ZAGREB, Sept 14, 2020  - HND protests against the Constitutional Court's decision not to allow reporters to attend its session discussing decisions of the national COVID-19 response team.

"The Croatian Journalist Association strongly protests against the Constitutional Court's decision which prevents media from covering its session focusing on the lawfulness of decisions made by the national COVID-19 response team on epidemiological measures during the coronavirus pandemic," the umbrella journalists' association said in a statement.

It noted that the court's decision was contrary to democratic standards, media freedoms, and the right of the public to be informed of all court decisions, notably the latest one.

Earlier in the day, the Constitutional Court decided that its session discussing the legality of measures introduced to fight the coronavirus epidemic would not be attended by media representatives.

Court secretary-general Teodor Antic said that once the court made a decision, it would issue a statement, and once its decision was published and sent to the parties that had put forward the proposal for a public debate, the court president would hold a news conference.

The HND said it did not believe the Constitutional Court's promise that all questions from the press would be answered fully and in a timely manner, noting that preventing reporters from following the court session "leaves one with a strong impression that the Constitutional Court is hiding something from reporters and the public."

"And all of that is happening in an EU country which until recently chaired the EU," the HND said.

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ZAGREB, September 3, 2020 - The coronavirus epidemic, which has lasted in Croatia for slightly over six months, has cost the Croatian Health Insurance Institute (HZZO) HRK 258,200,823, the Jutarnji List daily reported on Thursday.

Most of the money spent was spent on testing, with as many as 175,346 tests having been peformed, which so far has cost HRK 200,154,907.

Medical treatment of COVID-19 patients has cost HRK 33.614 million, while the disease itself and isolation have cost HRK 24.431 million.

HZZO director Lucian Vukelic would not comment on how much more money Croatia could spend on the fight against the disease and he sees a widely applied vaccine as the only solution.

"The HZZO budget amounts to HRK 27.5 billion so the HRK 258 million spent on the coronavirus is not a big amount... but it has to be clear that COVID-19 and this epidemic is not something we had counted on, so every amount spent is important," he said.

The entire system and the economy are at risk and every drop in GDP is very problematic, he said.

"If people lose jobs, no contributions will be paid into the budget... the budget is not being filled, and money is being spent," Vukelic was quoted by the daily as saying.

(€1 = HRK 7.522517)

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