- Details
The triage and testing centres have a dual function[1]:
- The triage function is intended to prevent emergency departments from being unnecessarily overwhelmed and to prevent too many potentially infected patients from showing up at the general practitioner (GP) for a consultation. By setting up triage centres, the aim was to reduce the risk of spreading the COVID-19 virus. The patient is initially examined by a doctor, who determines whether a referral to the emergency department is necessary or whether the patient may be allowed to recover at home, possibly after a COVID-19 test. This is organised by the GP groups in close cooperation with the emergency services and can, under certain conditions, be (temporarily) stopped when the need subsides.
- The testing role was assigned to the centres as a second function to better meet the needs of population screening. Indeed, it must be possible to meet the demand for testing for any person who meets the predefined testing criteria. These include symptomatic individuals as well as asymptomatic individuals who have had a high-risk contact or who have returned from a red zone. Due to the easing of the measures for travel abroad, the centres have been requested to test travellers.
One centre per 100,000 inhabitants has been set up, with medical coordination being entrusted to a GP group (i.e. an association of representatives of GPs within a specific region). The triage is located in one site, but the testing can be organised in different locations to make both the testing and screening more accessible.
As the epidemiological situation became more favourable, the number of centres were reduced. Activity at the centres was highest between November 2021 and January 2022. About 100 centres were active during this period, running an average of 29,532 tests per day. This corresponds to one-third of all tests performed (34%) during this period. Between July and October 2022, the 33 active centres averaged 1,001 tests per day. This represents around 10% of all tests performed during this period.
AVERAGE NUMBER OF TESTS TAKEN PER DAY IN TRIAGE AND TESTING CENTRES (INCLUDING TEST VILLAGES)
The graphic above shows the average number of tests per day in the triage and testing centres and the testing villages. Most of the tests were taken during wave 4 and wave 5. The reason for this lies in the fact that the testing capacity was at the maximum at these times. In addition, the Omicron variant – which dominated in wave 5 – was very contagious. As a result, more people were infected with COVID-19 and more tests were taken. Unlike in other waves, no restrictions were imposed at these times regarding which individuals were tested. Both symptomatic individuals and asymptomatic individuals with high-risk contacts were systematically tested. We also saw an increase in the number of tests taken in waves 2 and 3. In addition, we saw an increase in the number of tests taken in the summer of 2021 as a result of passenger testing. Since February 2022, we have observed a sharp decline in the number of tests taken at testing centres.
MARKET SHARE OF TRIAGE AND TESTING CENTRES (INCLUDING TEST VILLAGES)
The graphic above shows the proportion of tests in triage and testing centres compared to the total number of tests taken in Belgium. We see that this proportion varies between 10% and 40%. The average market share for the period 29/7/2020 to 31/10/2022 is 26%. In addition, we note that the proportion is higher on Mondays, Sundays and public holidays. This is partly because many people wait until after the weekend to consult their doctor and consequently get a referral for a test on Monday. The reason for a greater market share on Sundays and public holidays is because there is less or no testing at that time in other places (e.g. GP and hospitals).
Find out more about the locations of triage and testing centres: doclr - Covid test
To ensure sufficient capacity for analysing samples and test materials, a federal platform was set up in addition to the conventional testing circuit, organised in and by clinical laboratories. The federal platform is responsible for supplying test equipment, collecting and transporting the tests to the laboratories and forwarding the test results. A total of 63 out of 139 triage and testing centres and alternative testing centres used this platform. The other centres work with a hospital laboratory or a private laboratory. In such cases, the laboratories themselves are responsible for supplying test equipment, transporting the tests performed and forwarding the results. A centre can switch to the federal platform if the laboratory is no longer able to complete the analysis of the tests within the predetermined time frame or if the demand for analysis exceeds the laboratory’s capacity. Once a centre has switched to the federal platform, this cooperation will continue as long as the capacity of the conventional circuits is exceeded.
You can find out more about the current procedure for when you have to be tested and where this can be done at www.info-coronavirus.be
[1]Source: Royal Decree of 13/05/2020 No 20 on temporary measures in the fight against the COVID-19 pandemic and to ensure continuity of care in compulsory medical care insurance.
[2]Source: DG Health Care, FPS HSFCE (31/10/2022)
- Details
A transitional care centre formed a ‘link’ (an intermediate step) between the hospital and a return to living independently[1]. These centres were set up to maintain sufficient capacity in the hospitals. The transitional care centres provided support to patients testing positive for COVID-19. The patients in these centres:
- were previously hospitalised;
- or were previously examined in a triage and testing centre or an emergency department where it was decided that admission to hospital was not necessary.
However, these patients were either found to be unable to comply with the strict rules of isolation, hygiene and keeping away from high-risk individuals when they would return to their normal living situation. Or these patients still needed specific care. For these reasons, they could be admitted to a transitional care centre for a stay of up to three weeks. There, they could recover and receive the necessary care and support before returning home.
The transitional care centres were staffed by (general) practitioners, nurses and healthcare assistants, and financed by the National Institute for Health and Disability Insurance (NIHDI). The federated states were responsible for providing the necessary additional support. To this end, they developed partnerships with the social services of the municipalities or the ‘Social Work’ departments of various health insurance funds.
In the period from 2 April 2020 to 30 May 2021 a total of 18 transitional care centres were opened. These 18 centres received 605 patients (476 in Flanders and 129 in Wallonia). The operation differed in duration of the opening period of the centres, but also in number of patients. Some centres only treated 4 or 5 patients, while one centre received 123 patients. The activity of the centres was concentrated in two periods: from April to May 2020, and from November 2020 to May 2021.
[1]Source: Royal Decree of 13/05/2020 No 20 on temporary measures in the fight against the COVID-19 pandemic and to ensure continuity of care in compulsory medical care insurance.