November the 7th, 2021 - Six KBC Zagreb (Rebro) employees have been fired after refusing to be vaccinated against the novel coronavirus, SARS-CoV-2, as well as for refusing to be regularly tested for the virus' presence.

The ongoing coronavirus pandemic is once again biting hard here in Europe as the season changes and people begin spending more and more time indoors as a result of the colder weather. Infections here in Croatia have climbed to numbers never seen before during the entire pandemic and new measures are now in force to try to combat the rapidly escalating situation.

Hospitals are fearing the same situation we experienced last year and some are already having to make enormous alterations to the way things function to try to deal with the current wave of infections, which are alarmingly high. The vaccination rate in Croatia is still very poor, and a lack of respirators for those with a more severe clinical picture is once again a huge concern. 

Most medical staff across Croatia have been fully vaccinated, some have recently accepted their third dose, all with the aim of protecting the most vulnerable and unwell people in society they are typically dealing with. That isn't the case for all, however, and given the fact that vaccination against coronavirus isn't mandatory, some have refused. Those who refuse must then agree to be very regularly tested for the presence of the virus, but some have even refused that. As a result, they've lost their jobs.

As Poslovni Dnevnik writes, three nurses, a medical technician, an assistant and an administrator were fired from their employment positions at KBC Zagreb because they did not want to be vaccinated or tested, as was announced on Friday.

“The reason for the dismissal of these individuals is their refusal to be vaccinated or, alternatively, be tested for COVID-19 twice a week. They, after being told they could not come to work without a COVID certificate, used their rights to leave, and partly went on sick leave. However, when they exhausted all of their legal 'leave' possibilities, and still didn't want to be vaccinated or tested, they were handed an extraordinary dismissal,'' said prof.dr. Ante Corusic, the director of KBC Zagreb, in conversation with Jutarnji list.

Corusic also confirmed that the process of terminating the employment contract for four more employees is underway for the exact same reason.

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November 6, 2021 - ''We are not far from a situation when we will have to choose who will take a respirator'', warns pulmonologist Saša Srića, as he announces that many Croatian hospitals have already reached 90% percent of their capacity as the number of positive cases continues to grow.

Minister of Health Vili Beroš stated on Saturday that there are more than seven thousand newly infected with coronavirus in Croatia today, we are at the peak of the fourth wave, and that we do not know what awaits us.

Record numbers worried many, and pulmonologist Saša Srića, who was a guest on the show New Day on the H1 television station, also spoke on the subject, reports Net.hr.

A potentially catastrophic scenario

"It is a worrying situation that at the moment can, given the trends, represent a potentially catastrophic scenario. The measures that have been adopted are overdue. These measures that come into force, which from today, and again from 14 November, is a big step back. A lot of time will pass, I think it could have been faster.

I think that the measures are not adequate and should be extended to other sectors. The virus does not know the difference whether it is in schools, cafes, restaurants, shopping malls. The measures should have been much stricter", expressed Srića, and continued:

"Constant balancing and the system 'we will not resent anyone, let's be good to everyone' has cost us such situations, such epidemiological pictures. And what we need to fear the most, the overload of the health care system, is already present".

Pulmonologist Saša Srića (Photo: Robert Anic/PIXSELL)

"When we talk about the younger population, compared to previous waves, there is now a much larger number of the younger population. The delta strain attacks the younger population more for one reason: it is poorly vaccinated. The theory 'it won't hurt me, we are young and healthy' is an escape from the truth, an escape from reality, he emphasized and continued:

Fear for the health system

Young people like to get together, that’s logical, but we need to be aware of the current situation. The younger population who end up with a more severe clinical picture are, as a rule, almost all unvaccinated", said Srića, adding that so far we have not had a death of a person under the age of 50 who was vaccinated and in full health.

"We are already in over 90 percent of capacity in many Croatian hospitals, and only now are we taking care of those from two weeks ago when we had two thousand infected. What will be in the next two to three weeks?

I am afraid that with such a trend, the health care system, despite the fact that we hear some optimistic assessments from the Headquarters, will hardly survive. Even estimating the collapse of the health care system and Croatian hospitals in two to three weeks is not something that is unrealistic'', said Srića.

"I don't think the numbers will fall for a while. The winter is still going on and will last. I don't think we're at the peak yet, and that's especially worrying. What worries me the most is when the situation starts to collapse. We are wondering how many places we still have, not to mention the situation we will have in ten days. That is why I say that the measures are too weak", said Srića and answered the question: what if there is no place in Croatian hospitals, are there any protocols?

"We haven't worked out the protocols, I think we need them. We should first of all try to find enough capacity. The capacities of the beds and respirators are, I am convinced, not completely spent, I think there will be too few people. Many people are already exhausted, tired, the possibility of error is present.

And you want to get into a situation where you choose to take a respirator, you don't… We must not get into a situation like that, and I am afraid that we are not far from there", pointed out Srića.

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November the 5th, 2021 - Croatian hospitals are once again busy preparing for the worst as the coronavirus infection rate climbs across the country and threats of a similar situation to what we experienced this time last year looms. With nowhere near enough of the population vaccinated, worries for the healthcare system reign strong.

As Poslovni Dnevnik writes, it was recently reported that just 31 percent of the population in Split-Dalmatia County have been vaccinated with two doses of the vaccine against COVID-19, making it the worst county in all of Croatia. This means that out of about 450 thousand inhabitants of this county, only about 150 thousand of them have been vaccinated, while 300 thousand of them, for whatever reason, haven't.

''It's a real shame and those are extremely poor numbers. I have nothing more to say, I've been "blunt" for more than a year now when saying that people should and must be vaccinated, but people obviously don't have enough understanding of that appeal. Whatever people say and no matter how much they convince people that they have to be vaccinated, they constantly think someone is trying to lie to them or do harm to them. And, believe me, I personally know quite a few of them who are now in Croatian hospitals, in a serious condition and now they strongly regret that they didn't get vaccinated. But when a man ends up in the hospital, then it's too late for him, by that point, he's got nothing to do but try to think about how he can remain alive,'' stated prof. dr. sc. Zlatko Trobonjaca, an immunologist from the University of Rijeka.

The newer Delta strain of the novel coronavirus spreads much more efficiently and quickly, it is much more contagious than previous variants.

''That's why I expect that in fifteen to twenty days there will be chaos going on in Croatian hospitals. If we know that hospitals are ''behind'' with those hospitalised with COVID-19, as those infected and needing urgent care usually arrive two to three weeks after having been initially infected, it should be very clear to you what awaits us soon.

Currently, those in Croatian hospitals with COVID-19 arrived when the number of total infected in Croatia was much lower than these numbers have been over more recent days. Recently, we've had more than four thousand people infected a day, and the more infected there are, the more hospitalised people there will be. The National Civil Protection Directorate knows that in two to three weeks, there's going to be a huge blow to Croatian hospitals,'' warned Trobonjaca.

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ZAGREB, 4 Nov 2021 - Health Minister Vili Beroš said on Thursday that statements by individuals about the deterioration of the health system were not true and that all COVID and non-COVID patients were being taken care of without delay.

"I wish to appeal to the media that statements by individuals about the deterioration of the health system are simply not true. Indeed, large resources are being redirected towards the treatment of COVID patients, which could have been avoided by timely vaccination. However, all COVID and non-COVID patients are being taken care of without delay," Beroš told a cabinet meeting.

National COVID-19 response team considering a possible new set of measures

The head of the national COVID-19 response team, Interior Minister Davor Božinović, said that they were considering a possible new set of measures to contain the spread of the virus. He said that interdepartmental talks were ongoing and that the public would be informed of any new measures in due course.

Beroš said that today's number of 6,310 new cases in Croatia was by far the largest daily number recorded to date.

"The causes of this surge lie in ourselves alone, in our refusal to comply with the basic epidemiological measures, and in our insufficient awareness of the benefits of vaccination," Beroš said.

7 in 10 new cases and 8 in 10 patients on ventilators unvaccinated

He said that the test positivity rate was 43.90 percent, and 233 infected people had been hospitalized in the 24 hours alone. In the past week, of the total number of new cases, 72.8 percent were not vaccinated, and 77.2 percent of the patients on ventilators were not vaccinated, he warned.

"However, the newly-awakened interest among citizens in getting vaccinated is encouraging. As many as 14,379 persons were vaccinated yesterday, the largest number in a single day to date," the health minister said.

Beroš said that 29,627 people had so far received a booster shot against COVID-19, adding that three percent of children aged 12-14 and 18.6 percent of young people aged 15-19 had been vaccinated to date.

"Insufficient compliance with the epidemiological measures and refusal to get vaccinated are the main causes of the rapid spread of the virus. We are seeing consequences at all levels of the health system," Beroš warned and once again appealed to citizens to get vaccinated.

He said that the ministry had instructed local coronavirus response teams to ensure additional capacities for medical treatment in their counties.

Božinović said that 11,578 inspections had been carried out in the past week to check compliance with the epidemiological measures. He said that the irregularities mostly concerned the provision of catering services after midnight and failure to wear face masks and maintain a physical distance in enclosed spaces. He said that 27 infringement notices, 176 written warnings, 14 oral warnings, and 17 fines had been issued in that regard.

For all you need to know about coronavirus specific to Croatia, make sure to bookmark our dedicated COVID-19 section and select your preferred language.

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ZAGREB, 28 Oct 2021- The Croatian Chamber of Nurses (HKMS) on Thursday asked the Ministry of the Interior to deploy police patrols around medical institutions more often and the Ministry of Justice to amend the criminal code and grant health workers the status of officials.

That would increase security for health workers and provide them with a safe working environment, the HKMS said in a statement prompted by a recent assault on patients in the accident and emergency area of the KBC Zagreb hospital.

"The incident at KBC Zagreb is not an isolated case of attack on nurses in the course of their duties. Cases of psychological harassment, shouting, and threats directed at health workers by patients, their families, and other people have become part of everyday life for many health workers," HKMS president Mario Gazić said.

He warned that violence against nurses and other health workers was an increasing problem that might escalate to the point of becoming a threat to their lives.

Citing the results of an HKMS survey conducted in 2018, Gazić said that 95 percent of nurses considered the present physical protection and security in medical institutions to be inadequate and that 73 percent of institutions reported attacks on nurses.

The survey revealed that 89 percent of nurses had experienced verbal or physical violence in the course of their duties, half of the institutions did not have a 24-hour security service and nine percent had such a service only during the night.

For more, check out our politics section.

September the 26th, 2021 - You won't be able to enter Croatian hospitals unless you have a covid certificate, regardless of who you are and even if you work there as a medic, with the exception of just one particular circumstance.

Croatian Health Minister Vili Beros has been quite clear in his recent messages issued to the country's healthcare workers - if you don't have a covid certificate proving you're either fully vaccinated or have a recently obtained negative test result, don't bother coming into work. While he has stated that testing for those who don't want the vaccine will be free for a while, that won't continue for long, and they therefore have a choice to make.

As Poslovni Dnevnik writes and as N1 has since unofficially found out, aside from this being needed for healthcare workers and employees in other activities within Croatian hospitals, all hospital patients, except in cases of emergency, will have to have their obligatory covid certificate proving that they have previously contracted the novel coronavirus and since recovered, have been fully vaccinated against it or have a very recently obtained negative test result.

The profession has prepared two documents in this regard, the first is already known and has been discussed quite extensively - these are the mandatory covid certificates for employees within Croatian hospitals (regardless of whether or not they're medical staff) and the healthcare system itself, and the second concerns hospital patients coming for treatment.

As N1 unofficially learned from the Ministry of Health - everything is now ready for the mandatory introduction of covid certificates for all non-emergency patients at Croatian hospitals. Therefore, only those who have been vaccinated, have had coronavirus and have since recovered, or those with a negative test will be able to enter the hospital for examinations, scans, treatments etc.

To prove that this time he is thinking and speaking very seriously, Minister Vili Beros has warned unvaccinated healthcare workers and those who don't want to frequently test for the virus - absence from work will not be paid.

For all you need to know about coronavirus in Croatia, make sure to bookmark our dedicated COVID-19 section and select your preferred language.

September 21, 2021 - Covid certificates in Croatian hospitals will be needed for all employees in the health system and those who are not hospital employees but work within the hospital. They will also be required for employees in homes for the elderly and infirm. But how will it work?

In ten days, all employees in the health system and those who are not hospital employees but work within the hospital, and employees in homes for the elderly and infirm will be able to work only by presenting a Covid certificate. In particular, they will have to present a document proving that they have been vaccinated, have overcome COVID-19, or have been tested.

However, how this will be controlled is still unknown, as the legal services of the Ministry of Health and the Ministry of Labor and Pension System have not yet completed the instructions. Two questions are key: how will testing be organized and how will those who refuse to test be penalized?

As Jutarnji List unofficially finds out from several Zagreb hospitals, everything is ready as far as the organization is concerned.

Hospitals have testing points, and they have enough tests. Jutarnji also learned that the hospital plans to decentralize the verification of certificates, i.e., that the confirmation of the covid status of employees is not done in one place (hospital entrance) but at the entrances to individual departments, and the head nurses of the department will most likely be in charge. There are several reasons for that.

First of all, it would not create crowds in one place. In addition, the head nurse of the department knows all the employees and easily distinguishes them from the patients. Once they have checked the covid status of the employees, in the next few days, they will know which of them have been vaccinated and which needs to be tested, and the vaccinated will not have their certificates checked daily. The situation is also facilitated by the fact that hospital employees were among the first to be vaccinated in an organized manner in their institutions. It is more or less known who was vaccinated.

In the health care system, about 70 percent of the total number of employees have been vaccinated, and some have overcome COVID-19, so the organization itself should not be a problem. In addition, per department, there would be relatively few people to check daily.

And while hospitals are ready as far as internal organization is concerned, they have not yet received instructions from the authorities on what to do with employees without covid-confirmation if they refuse to test.

That is precisely what the lawyers are currently working on, and although the sanction will certainly not be a dismissal, the question of how to penalize it is still open. The same rules will apply to both health and social services, but when the document is ready is unknown, although it should take effect in ten days. According to the information Jutarnji has, it was said that it would be ready by yesterday. Still, the latest information says that the document with all the administration instructions should arrive today or tomorrow.

Another open issue is the expiration of covid certificates. As health and social workers were a priority, they were vaccinated first, in early January. However, their covid certificates begin to expire in mid-October, meaning that 15 days after introducing the certificate, 70 percent of those vaccinated in healthcare would be left without a certificate and would be required to be tested like the unvaccinated.

As a solution, Minister Vili Beroš last week announced possibly extending the validity of the certificates from the current nine to 12 months.

As for the revaccination, it seems that for now, there will be none of that. Namely, the US Food and Drug Administration (FDA) has given guidelines that only those over 65 and immunocompromised should be vaccinated with the third dose. On the other hand, the European Agency (EMA) has not yet made a decision. Allegedly, the Croatian Institute of Public Health has already decided to extend the duration, and it should come into force this week.

What do we know so far?
1. What will happen to health care workers who have not been vaccinated or have had COVID-19?

- They'll have to be tested every three days. Initially, the system will pay for their expensive PCR tests, but, according to the announcements, they will have to bear those costs themselves after a while.

2. How will employees without a covid-certificate who refuse to be tested be punished?

- The competent Ministry has not yet agreed on possible penalties. However, it has been confirmed so far that the dismissal will not be among them. In neighboring countries, such employees are suspended and do not receive a salary for the days of suspension.

3. Will the same rules apply to other public sector systems as for healthcare employees?

- For now, it is confident that the same rules will apply to social welfare employees, probably as early as October 1, as well as to the health care system. Education was also mentioned, but it is not planned yet.

For all you need to know about coronavirus specific to Croatia, make sure to bookmark our dedicated COVID-19 section and select your preferred language.

August the 31st, 2021 - As autumn approaches and despite the good epidemiological picture, preparations in the healthcare system are occurring. Five Zagreb hospitals will be accepting coronavirus positive patients, while two hospitals in the capital will be solely for negative patients.

As Poslovni Dnevnik writes, a meeting was held between the Minister of Health, Vili Beros, and the directors of Croatian hospitals and an expert group from the Ministry of Health. They discussed the current situation with the spread of the novel coronavirus and the redistribution of care for coronavirus positive patients, HRT has learned.

Five Zagreb hospitals will be ready and waiting to accept coronavirus positive patients, while two will be off limits for all except lab proven negative ones.

The hospital in Dubrava, known as the ''covid hospital'' last year, will continue to take care of all patients regardless of what result they return on a covid test, and capacities in other Zagreb hospitals, as well as other hospitals across the country, are being prepared for people suffering from coronavirus, HRT reports.

The vaccination of healthcare professionals with a third dose, which should begin soon, was also discussed.

Jutarnji list has found out that an agreement has been reached on which Zagreb hospitals will receive coronavirus positive people, and which will remain only for negative patients.

KB Dubrava will no longer be exclusively a covid hospital, but will be joined by KBC Zagreb, KBC Sestre milosrdnice, the Fran Mihaljevic Clinic for Infectious Diseases, and the Lung Clinic on Rockefellerova. Two Zagreb hospitals, namely KB Sveti Duh and KB Merkur, currently remain only for the treatment of coronavirus negative patients, Jutarnji has learned.

All Zagreb hospital directors agreed with this ''schedule'' at a recently held meeting of the expert group for the organisation of the hospital system of the Ministry of Health. This would provide about 400 covid beds across all Zagreb hospitals, which should be enough to cope with any new wave of infection, with the provison that in case the number of hospitalised people with coronavirus grows significantly, KB Sveti Duh and KB Merkur would be ready to step in, reports Jutarnji.

For all you need to know about coronavirus specific to Croatia, make sure to bookmark our dedicated COVID-19 section and select your preferred language.

August the 6th, 2021 - After a long, hard 288 day slog of being used solely as a covid hospital, the Zagreb KB Dubrava emergency room is now open for all patients once again, with just four covid patients with severe clinical pictures currently being treated there at the time of writing.

As Poslovni Dnevnik writes, as of yesterday, after almost one entire year of caring for only covid patients with severe clinical pictures, the KB Dubrava emergency room has been reopened for all patients in the Eastern part of the City of Zagreb and the surrounding areas. The move marks a significant point in Croatia's own battle with the pandemic.

The currently much more favourable epidemiological situation across the Republic of Croatia and in Zagreb itself, and the reduction in the number of covid patients in hospital, enabled the KB Dubrava emergency room to finally open its doors and offer its medical services to all other patients in the Eastern part of the Croatian capital and beyond.

There are about 350 thousand such patients, and on average about 56 thousand examinations, 11 thousand emergency hospitalisations and more than three thousand emergency surgeries are performed in KB Dubrava.

"Everything is absolutely ready for the reception of patients with other issues. The enrollment of patients is at the counter where the administrative part is resolved, after that the patient goes to the triage itself where the category of urgency of the patient's admission is determined,'' said KB Dubrava's Sanja Kristo in conversation with RTL.

As stated, there are currently only four covid patients being treated for severe issues due to coronavirus infection at KB Dubrava (at the time of writing this article), and the hospital hopes that as autumn approaches, things won't take a turn for the worse again and turn the hospital back into a covid hospital housing hundreds of extremely unwell patients.

"KBC Zagreb, our largest institution, has formed its own covid department, they have their own intensive care unit, so I believe that a calmer autumn awaits us with more regular work," said the hospital's director Ivica Luksic. He added that he hopes there will be no need to go through what they went through again last year.

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July the 29th, 2021 - The Croatian Medico Hospital, which is a special hospital, is the first in the entire world to develop an innovative and quite remarkable method for the treatment of the spine.

As Poslovni Dnevnik/Marija Crnjak writes, the Croatian Medico Hospital is starting a project to invest in the application of an intervertebral disc patch (IVD patch), a new personalised method of treating damaged spinal discs, as well as the introduction of a software solution for the early detection of lumbar spine damage.

This scientific research project was positively evaluated and funded within the IRI project from European Union (EU) funds, and the obtained funds will be invested in further research and development of this minimally invasive method of treating lower back pain, the hospital reports.

The total value of the project carried out by the Croatian Medico Hospital amounts to a massive 14 million kuna, of which more than half is paid for by grants.

The special hospital's collaborating institutions are the Department of Biotechnology, the University of Rijeka, the ''Martin Horvat'' Special Hospital for Orthopedics and Rehabilitation from Rovinj and their project partner, Penta d.o.o. from Pula. The project is being implemented within the Competitiveness and Cohesion Operational Programme, within the program for research, development and innovation (IRI).

As one of the leaders in the introduction and application of new, modern technologies in diagnostics and treatment, the Croatian Medico Hospital noted the need for the profession to step forward in the treatment of lower back pain, which is frighteningly common, it also noted a lack of available solutions in treatment and diagnosis of spinal disc damage.

Although research/scientific projects are a specific feature of university hospitals, the Croatian Medico Hospital, as a private health institution, is one of the few that has received European Union funds for its scientific research to invest in the further development of its innovative method.

In addition to the research process focused on the IVD patch - an innovative combination of stem cell injections, the uniqueness of this project is reflected in the development of a software solution (AI) - a form of artificial intelligence that will improve the standardisation of radiological results/findings. The functioning of the software in practice has been conceived on the principle of the early recognition of degenerative changes.

The basic expected role of the software will be to alert radiologists and neurosurgeons so that they can observed damage to the intervertebral discs between the five existing lumbar vertebrae and to provide an optimal assessment of whether a patient is a candidate for a minimally invasive intradiscal method of treatment to regenerate the disc.

"We're extremely proud of the project and the recent start of this innovative method, which aims to improve the overall treatment of patients with damaged cartilage of the spinal discs, but also shorten their rehabilitation period,'' said the project leader and neurosurgeon Zlatko Kolic, the director of this special hospital.

In the preparation and implementation of clinical research and application of autologous IVD patches, as well as clinical and neuroradiological monitoring, the Croatian Medico Hospital will work closely with Antonija Jurak Begonja from the Department of Biotechnology, University of Rijeka, and Marinko Rade, the director of the "Martin Horvat" facility.

"I see the opportunity to work with experts at Medico Special Hospital on the application of IVD patches as progress in researching non-invasive methods for the treatment of the spine and I'm proud that here in Croatia, we have the opportunity to develop this innovative and complex project that I believe will benefit patients and doctors who deal primarily with spinal injuries in their work,'' said Marinko Rade.

The regenerative method and the outcomes of its application in treatment will be monitored through an eighteen-month-long clinical study and will be compared with the treatment outcomes of other, previously known, intradiscal methods.

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