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HEALTH

How will Denmark’s health reform change country’s health services?

Junior doctors will spend more time in general practice during their training and 25 new local hospitals will be opened under a new health sector reform announced on Friday.

Danish Health Minister Magnus Heunicke presents a new health reform
Danish Health Minister Magnus Heunicke presents a new health reform agreed on by political parties on May 20th 2022. Photo: Nils Meilvang/Ritzau Scanpix

An agreement for the reform was presented by the government on Friday with the backing of a parliamentary majority.

The deal had been delayed with the Covid-19 crisis among the obstacles which drew out its completion.

It provides for 6.8 billion kroner of spending on the Danish health service over the next eight years, Health Minister Magnus Heunicke told media on Friday.

“We have an agreement for a health reform that will support local health services. Many parties are with us. (The deal) could not have broader support,” he said.

Parties on both sides of Denmark’s political aisle are in agreement over the deal, with Martin Geertsen, health spokesperson with the opposition Liberal (Venstre) party, calling it “a good little deal”.

“Does this agreement solve all the challenges faced by the Danish health service going forward? No. Certainly not. It’s a good little deal. It’s a step in the right direction,” Geertsen said.

The health spokesperson with the left-wing party Red Green Alliance, Peder Hvelplund, likewise characterised the reform as a small but positive step that does not solve all of the problems within the health system currently.

In an earlier version of the deal, proposed by the governing Social Democrats, up to 20 local hospitals – around the size of extended, large health centres – were proposed. The location of the centres that will be opened or built under the reform is not clear at the current time.

The new, local centres could potentially be located in former hospital premises.

The government also proposed a form of compulsory service which junior doctors would have to complete as part of their training, involving working for an experience GP. This will be undertaken as part of doctors’ studies under the terms of the reform.

This means that young doctors will spend an extra six months working at GP surgeries and spend less time at hospitals.

Earlier health proposals by the government related to additional restrictions on tobacco and alcohol sales do not form part of the agreement announced on Friday.

Negotiations over those proposals will take place separately, Heunicke said.

“Next week we will open negotiations on the remaining elements relating to prevention (of smoking and excessive alcohol consumption). It was the right thing to do to split things up because we got this broadly-supported agreement,” he said.

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HEALTH

Ticks in Denmark: How to protect yourself and what to do if you get bitten

Thousands of people in Denmark are bitten by ticks each year, especially during the summer months. Although most people are left unaffected, an estimated three thousand cases a year in Denmark turn into Lyme disease.

Ticks in Denmark: How to protect yourself and what to do if you get bitten

The humid and warm weather Denmark has experienced so far this year could make ticks even more common than usual this summer, an official said.

Ticks (skovflåter) can be found all over Denmark in forests, meadows, and long grass. They are particularly active during the summer months and increase in number if the weather has been warm and humid. So if you’re hiking, camping or berry-picking this summer, there’s a risk of getting a tick bite (skovflåtbid).

What are ticks?

Ticks are small, spider-like creatures which vary in size, usually between 1mm to 1cm long. They do not fly or jump but climb on to animals or humans as they brush past. Once a tick bites into the skin, it feeds on blood for a few days before dropping off. In Denmark, ticks are often found on rodents or deer and they are particularly prevalent between May and October. 

Lyme Disease (Borreliose

In Denmark, the most common disease ticks transmit is Lyme disease and around 15 per cent of ticks in Denmark’s forests carry this.

It is not known exactly how many people in Denmark get Lyme disease every year, but it is estimated that there are a few thousand cases.

However this is a very small percentage of those who have been bitten by a tick. Broadcaster TV2 has reported that in 98 per cent of cases, people do not get ill from a tick bite.

“If you remove the tick within 24 hours, you most likely won’t get Lyme disease, as it takes longer than this for the bacteria, called borrelia, to transfer to the bloodstream,” Peter Andersen, senior medical officer at the State Serum Institute’s Infectious Disease Epidemiology and Prevention department, told The Local.

Andersen said that humid and warm weather in Denmark so far this year has caused a high number of ticks.

For those who do develop Lyme disease, the symptoms usually appear between two and six weeks after the bite, but sometimes longer.

Some people can get flu-like symptoms a few days or weeks after being bitten by an infected tick. Children may complain of stomach ache, lose their appetite or lack energy.

But the most obvious sign of Lyme disease is a red circular rash around the bite.

“If you’ve had a tick bite, observe the area to check you don’t get a circular rash, which can indicate you’ve been infected. If this happens, contact a doctor to get treatment. Most infections will be treated with penicillin,” Andersen said, adding that treating Lyme disease is straight forward.

“But the danger is if you don’t acknowledge the rash, then the disease can spread to the nervous system,” Andersen warned.

This is called neuroborreliosis and occurs in around one in ten of of Lyme disease cases.

The symptoms of neuroborreliosis typically appear as headaches and neck or back stiffness and radiating nerve pain or muscle paralysis, typically in the face.

People with neuroborreliosis need to be treated in hospital.

There were 216 cases of neuroborreliosis in Denmark last year, according to the State Serum Institute, the country’s infectious disease control agency. That’s an increase from 197 cases in 2020 and 171 cases in 2019.

Most cases each year are detected between July and September and neuroborreliosis most frequently occurs in children aged 5-10 and adults aged 60-70.

TBE – Tick-borne encephalitis (flåtbåren hjernebetændelse)

This is more rare and is a viral brain infection caused by a particular tick bite. Flu-like symptoms can occur a week or more after the bite and can develop to include nausea, dizziness, and in around a third of cases, severe problems. 

In Denmark, TBE cases tend to only occur on Baltic Sea island Bornholm, where there are around 3 cases a year. There have been two reported cases in North Zealand in 2008 and 2009.

In Denmark, a TBE vaccination is recommended for people who travel regularly in areas with TBE. There isn’t a vaccination for Lyme disease.

What if I get bitten by a tick?

If you do find a tick, you should remove it quickly with a special tick remover (available at all pharmacies), tweezers or your nail. The sooner you can do this, the lower the risk the tick will be able to infect you.

The important thing is making sure you remove the whole tick, by grabbing it as close to the skin as possible and pulling slowly. Then wash and clean the bite, and contact a doctor if you’re worried.

Prevention

If you’ll be spending time in wooded areas with long grass, especially those known to have a high tick presence, you should wear boots along with long sleeved light clothing so you can see the ticks, and tuck trousers into socks. Mosquito repellent has also been proven to help deter ticks.

“Proper clothing is a good prevention but it’s not always realistic to wear long sleeves and trousers when it’s warm. So if you have been outside in nature, you should check yourself in the evening or get a family member to check you for ticks,” Andersen suggested to The Local.

Ticks tend to bite around thin areas of the skin such as kneecaps, groin, armpits and hairline. In children, they can often be found on their scalp and behind the ears.

“Ticks are very small and look like a tiny dot so they can be easily missed. They start to enlarge when they suck blood and then the red rash can appear,” Andersen said. 

Despite their high presence, ticks shouldn’t put you off enjoying Denmark’s nature this summer; keeping vigilant to the tiny black insects should keep any tick-related illness at bay.

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