Covid-19 marks a before and after in the life of the SNS24 line and its health professionals, who in addition to the struggle to win the pandemic also try to overcome the fatigue of nine months of unrelenting calls .

In the ‘call-center’ located in the center of Lisbon, a few dozen professionals distributed throughout an ‘open space’ seek to respond to people’s concerns, while a monitor is charging the numbers of the service in real time. Calls do not stop, but you cannot hear phones ringing incessantly with the demand for an answer; everything is digital, fast and repeated by professionals to the point of seeming mechanized.

At the age of 51 and since 2003 in the contact center of the National Health Service, the nurse José Gouveia, who also works in the general surgery service of Hospital Garcia de Orta, in Almada, admits to Lusa that this was “a very complicated year” and that the first wave of the pandemic confronted the SNS24 with “total despair”.

“We are the first line in serving and meeting people’s doubts, since there were limitations for health centers and emergency rooms. We were almost the only possible help, albeit with difficulties ”, he says, calmly, in contrast to the busy days due to the impossibility of responding to all problems.

And it was not just on the other end of the line that changes took place. José Gouveia responds to calls over the course of the shift with his mask on, in the image of all his colleagues, now a few meters away from security and with many in teleworking situations. When you leave, it will be time to head to the hospital to continue the fight and be replaced by another colleague, who does not sit down before disinfecting the work area.

New procedures were instituted, new guidelines were defined and everything had to be assimilated without wasting time, in a context in which information about the new coronavirus challenged even the most experienced professionals and generalized uncertainty about the future.

“It is necessary to have some experience, which counts here, but sometimes it is difficult with some tricks. It means having the experience of screening and trying to understand what it really is: if they are symptoms related to covid-19, anxiety, etc. It is the experience that gives us this ‘feeling’, this proficiency ”, explains José Gouveia, guaranteeing to have“ the same principles and the same dedication, but with more effort ”.

In the workspace next door, Manuel Mourão, a 52-year-old nurse with almost 30 professional experience, reviews in the days lived with this pandemic its beginning in the SNS24, in 2009, with the flu epidemic A. However, even with the accumulation of work in the emergency department of Hospital de São José, in Lisbon, refuses to let down.

“As I am in an emergency, the burden has been enormous and obviously health professionals are a little exhausted, but that is no excuse for us. As I usually say, every day I take my shower, wear my nurse’s uniform and go to the fight ”, he summarizes, naming knowledge as a weapon to“ calmly clarify and give some very assertive guidelines ”so that the pandemic is under control.

Unlike most days in the past few months, Manuel Mourão is in the building providing service instead of doing it from home. Although he misses living with friends created over 11 years, this nurse specialized in the field of psychiatry assumes the comfort of the option and recognizes the advantages in reducing the risks of contagion.

“The teleworking experience has been very positive. The pandemic has hurt many people, but for us it has also brought some benefits; we were already talking about it: ‘why not be at home with a computer doing this?’ There was never that opportunity, but the pandemic ended up pushing us more quickly towards that ”, he says, before completing another journey and leaving his post.

Catarina Rebelo, a 25-year-old nurse, arrives to fill the position. After disinfecting the table, the computer and the kit, he puts his rubbers on the headphones to start answering calls. This is the routine he embraced about a month ago, after deciding to reply to an email from the Ordem dos Enfermeiros asking for applications for the SNS24.

“I felt that there was a need to want to participate in helping the front line of the pandemic and that I was unable to exercise at my workplace. So, I opted for this place, being a place where we are very in contact and we help people, despite not being directly cared for ”, confesses the young woman, who still lives in her parents’ house and also works in a private clinic.

Without hiding that coming to SNS24 was a purely “personal” choice and driven by the desire for a “new adventure”, Catarina Rebelo already recognizes the tiredness in her colleagues after a “scary” November that she marked in her early days the peak of the second wave of the pandemic in the country.

“In fact, there were a lot of calls on hold when I joined and it was a completely new thing. It was quite scary ”, he recalls, although later on“ loving ”the experience:“ It is very motivating that we are here to help people and they show even during the calls that they are satisfied with our help and our support. And this is gratifying ”.

A few lines ahead, Carla Miguel continues to answer calls beyond the end of the shift. In this case, a father asks on the other end of the line how to deal with the fever of the 12-month-old baby and the nurse, 56, punctuates each question with his left hand, as his right hand clicks on the mouse to enter data on the computer. “If you run your hand over her neck, you feel ganglia,” she asks, while she herself runs a hand over her neck.

Already with two children also involved in the “front line” of the fight against covid-19, Carla Miguel highlights the impact that the pandemic had on people’s feeling of security in relation to their own existence, both individually and collectively.

“The human being has become very weak in this context, all the certainties that we had … There is nothing acquired, we are all very afraid and the instability of insecurity is what concerns me the most. It is a ‘bug’ that nobody sees, a micro-organism with statistical data that leaves us completely defenseless ”, he says.

Before going on to another phone call, he introduces some more information into the system, in a process that he fears to increase again from January, because of the easing of the restrictions on the Christmas season.

“We were able to control and keep a lot of people at home, but this is a time when there are people who think from the outset that with a negative test it is all safe and this will cause hospitalizations to increase in this third phase in January. I’m scared out there ”, she confides, in a 2020 that was“ very hard ”and left her in service“ from eight in the morning to ten at night ”in several days.

“It is a permanent effort”, completes the director of SNS24, Maria Cortes, for whom the expectation of “light at the end of the tunnel” launched by the start of vaccination against covid-19 reinforced the determination.

“We have to consider that the effort was worth it and that we are motivated to continue until there is a time when we will live our lives again in a free and more relaxed way”, notes the official, who has been at SNS24 since 2017. Until When that moment arrives, it highlights the fact that “no outbreak occurred in the ‘call centers’” and that the system resisted the changes introduced throughout the year.

From a capacity for 200 calls simultaneously up to 2,000 in just nine months, the SNS24 has also grown in the number of professionals and in its automation of service processes, with the entry of two ‘bots’ to collect responses and which, according to Maria Cortes , allowed significant efficiency gains in call times, not only in the present, but also for the future: with or without covid-19.

“SNS24 started in 1998 with a line called ‘Dói Dói Trim Trim’, evolved to Saúde 24 and has a whole tradition of telephone screening in the most diverse areas. It has not yet emerged for the covid ”, he stresses, envisioning a positive horizon for the service:“ Due to the role it had in the management of the pandemic, the visibility it gained and the trust it generated in the population, the SNS24 will continue to have a determining role at the level access to health care ”.