For several days in a row, Odesa Oblast leads the number of new cases of COVID-19. In addition, the number of fatal cases has also increased. What age category gets into covid hospitals? Are there resuscitation facilities in Odessa hospitals? And why Ukrainians do not want to be vaccinated? Boris Voloshenkov, the first deputy head of the Odesa regional state administration, told about all this and much more in an exclusive interview with ElitExpert.
Today, the Odesa region is among the "leaders" in terms of the incidence of COVID-19. What is this anti-rating connected to?
— This is a feature of the course of this disease. Now the conditions for the virus are created in such a way that at this time and in this environment it begins to actively enter society. Naturally, we fix all these indicators and distribute them according to the conditional hierarchy. As you say, today Odessa is in the leaders.
Now three regions are preparing for the red zone. So far, the Prime Minister has not named them. 12 regions are in orange. This trend is growing - including Odessa.
Therefore, the question of the races that are going on is related to the peculiarity of the virus and the fact that we have a small percentage of vaccinated people. We have a city of millionaires and a large concentration of people. Therefore, the biggest problems arose in Lviv, Kharkiv, and Kyiv, where the population density is high. And now we return to our citizens: minibuses are running full, people are without masks, mass events are being held.
I believe that if there was a city or region in Ukraine where the number of vaccinated people was over 80%, then we could say that this is the last city in the ranking of the incidence of COVID-19. And yes, the situation in our country is practically the same.
What is the current vaccination trend in our region? How many were vaccinated? What about vaccination of doctors, teachers and civil servants?
— More than 680 thousand people were vaccinated in Odessa region. This is approximately 25% of the total population of the region. There are a small number of regions that have crossed the 1 million mark. This is Dnipro, Kyiv, Kharkiv. Below us is Poltava with a small gap. Although the population of Poltava is smaller, they have practically the same indicator as ours. The smaller the population and the more vaccinated, the better the indicator. An average of 5 people are vaccinated per day. Although we had a record - 000. Our people are steadily vaccinated, so we were even in the lead for a few days. But then again Dnipropetrovsk and Kharkiv - 10, and we remained at the indicator - 000 vaccinated per day.
In our region, 86,5% of doctors have already been vaccinated, representatives of educational institutions – 67%. In general, 130 schools work remotely in the region, the rest are offline. The situation is worst in the Bolhrad and Reny districts. Here there are people who stubbornly do not want to be vaccinated, trusting various rumors and legends.
I believe that when the fight against COVID-19 began, then everyone had to unite: teachers, doctors, leaders of public opinion, the church, politicians, and so on. These are people who have an invisible influence on society. What were some of the leaders of public opinion doing at that moment? They often talked about things exclusively for "likes", but they should understand the responsibility of influencing public opinion and encourage them to think about vaccination.
I compare COVID-19 to deserts. Imagine that you need to cross the desert. An oasis awaits you ahead. But a situation arises when there is no water in the path and no strength at the end. A spring with mineral or distilled water appears before you. What difference does it make to you, what kind of water? After all, if you drink, you will have the strength to reach the oasis. And if not, then the weak will not have a chance to reach it.
These are the vaccines we are talking about today - life-giving water in the desert. But why did the people who died from the coronavirus not take advantage of this opportunity? I am against the fact that you get into the covid department and see a patient with a severe degree of COVID-19, with respiratory failure. This is a terrible picture. He cannot tear himself away from the concentrator, from the oxygen mask. For him it is panic.
You can try to close your nose for one or half a minute and still not breathe. Trained people can do it and nothing will happen. But in an ordinary person, by the minute of holding his breath, the throwing starts. And in sick people, a similar thing occurs even more, turning into panic fear.
They are attached to the hospital and to oxygen. They are told, "you have 94% saturation, you can go home now." No, he says, I won't go."
When will we expect the next peak of morbidity in the region?
— The peak of morbidity is expected at the end of October - beginning of November. We see the characteristics of the virus, the spread of which has a wave-like shape "above the basic tsunami". He rises to some heights, and then falls. The virus spreads in the absence of serous barriers created by the immune systems of the population. Already three times after the rise in morbidity in the world, a decline began. And it accelerated in those countries where the number of population vaccinations was increasing. 80% of the vaccinated is already a barrier to its spread.
Panic was raised on social networks that there are no places for reanimation of seriously ill patients in covid-XNUMX hospitals. Is that so?
— In the classical sense, intensive care is a place where there is constant monitoring of the patient's condition, where there is a XNUMX-hour intensive care physician who can correlate all the patient's life support systems. As a rule, there are about ten intensive care beds in the hospital. Because a patient in intensive care - as a rule, he gets there after the operation, about a day later, two of them are transferred to an ordinary ward. There is no such thing as a regular hospital where a patient is in intensive care all the time. But the COVID patients who were in the first and second wave on ventilators had to stay in intensive care for a long time. They differ from post-operative ones, in which all life support functions have to be controlled. And in patients with coronavirus, as a rule, only the function of breathing and tissue saturation with oxygen are controlled. Therefore, this is a slightly different form of resuscitation. And in practice, the possibility of deploying resuscitation points at the bedside of a patient with a ventilator is used, which does not fit into the picture of classical resuscitation. If there are no complications, after some time the patient recovers his breathing and the disease recedes.
It is known that now the rather dangerous Delta strain is more prevalent in the region. In this regard, has the age category of patients changed? Earlier it was said that COVID-19 “rejuvenated” people, because of this they began to vaccinate when necessary from the age of 12.
— The classics say that when the pandemic ends, then the most accurate statistical studies will be announced. Now it's all "on the march". These numbers are dynamic. But we can say that both the first and the second waves were easier to tolerate by children. They practically did not have early post-covid syndrome. But now in clinics there are children who have covid accompanied by such pathologies as diabetes, obesity and immunopathies. Against the background of mild symptoms of the disease, children can often be carriers and bring the virus into the home.
Among which age category are the most common fatal cases?
— Today we see that the category of people over 60, and especially 70-80 years old, is suffering. During August and September, all age categories, starting with 21, were affected by the virus. But if you look, in August and September, the 21-41 categories were almost the same. Among them are some who died. But there is growth in the 51 and older category. For example, 51 patients died between the ages of 61 and 13 in August, and 23 in the following month. If in August there were 61 deaths at the age of 70-17, then in September - 55. If 70 people over 34 died in August, then in September - 98. The older people are, the higher the risk of severe disease and, unfortunately, fatal outcomes.
You previously stated that almost 98% of hospitalized patients are unvaccinated. Will this trend continue?
— There are practically no vaccinated among the seriously ill and dead. In some clinics, 100% of hospitalized patients are unvaccinated. I would ask these people, why didn't you get vaccinated? Right now you are in an infectious disease hospital and you are in a serious condition, but in our country vaccinations started in April, haven't you heard anything about covid vaccinations? You see, if these people were vaccinated now, they would watch and worry about heat, light, and gas, and then they would rejoice at how quickly a warm spring is coming.
Earlier, you stated that second-wave hospitals have already begun to be prepared in the region. When will they earn? What is the occupancy rate of beds in the region?
— It is necessary to understand that we offer these hospitals, and it includes Kyiv. The financing system comes from the National Health Service, which pays for this service. They evaluate whether the proposed clinic can provide this service. There should be certain requirements for it: what should be the oxygen supply, how many resuscitation teams should there be, how many places in the intensive care unit, etc. Today, 67% of beds in the Odessa region are occupied. For example, Belgorod-Dniester Hospital - 94%, Danube Regional Hospital - more than 80%, Odesa Eye Hospital for the Disabled - 87%, Odesa Center for Socially Significant Diseases - more than 60%.
We have 12 covid hospitals of the first wave in the Odesa region. Now 50 beds are additionally included in the Jewish hospital, then another 30 will be added. Razdelnyanskaya hospital has been submitted for inclusion. Further - the regional hospital, the Ovidiopolskaya hospital, the 8th geriatric hospital. This will provide us with an additional 400 beds.
But there is a nuance here - these hospitals will be included, the doctors will start working, and their salaries will be paid in a month, because after each patient is filled, payment for the service will then come. That is, the Ministry of Health allows us - we start providing the service, and they pay for it in a month.
And so we will have about 50% occupancy of the bed fund. You see, this figure of more than 50% scares people. They begin to fear. If we say that we are 50% busy, it is due to the fact that we are connecting new hospitals.
The Odessa City Hall stated that the main problem of the covid-XNUMX hospitals is the lack of personnel, including intensive care specialists, anesthesiologists, middle and junior medical personnel. Is there such a problem in the region?
— This is a deep social problem. Every time has its heroes. There was a time when people "in white coats" were heroes. In Soviet times, there were 10 people per place for the medical institute competition. This year, they barely gained, because now in Ukraine, the burden of a doctor's work is proportional to his salary... Do you understand, it turns out that you have to wait for the coronavirus to get a salary of more than 25 hryvnias and for work with a health risk? When, on average, doctors receive 000-6 thousand hryvnias. Therefore, many of them are looking for where they can get a higher salary for their knowledge.
We know that our doctors work in Poland, Slovakia, and the Czech Republic. And we feel the lack. Almost 40 thousand doctors and more than 80 thousand nurses left Ukraine. For example, I know of a case where there is a hospital in Poland where 8 doctors and nurses work from the Kirovohrad region. Here they are happy that they have the opportunity to live in a European way.
Nevertheless, how are you going to look for missing staff in hospitals?
— In these conditions, we will act more aggressively and consider, as an option, the mobilization of resuscitators from the departments of the Odessa Medical University. We will also transfer intensivists from other hospitals to covid clinics. We are talking about the 8th hospital, so that there would be a full set of staff - not only oxygen and wards - but also doctors. This work is carried out in close connection with the city council.
What vaccines are available today?
— We have CoronaVac, AstraZeneca, Moderna and Comirnaty/Pfizer. Everything is there.
What does the population of the Odesa region prefer to be vaccinated against?
— We started with AstraZeneca. 62 thousand people were vaccinated the first time, and 52 thousand people the second time. 130 people used one dose of the Chinese CoronaVac, 99 people used two doses. Then Pfizer once – 122 thousand, second time – 89 thousand people. That is, he is in second place, after CoronaVac. They are followed by Moderna and finally CoviShield (Ed. – the Indian analogue of the AstraZeneca vaccine).
How to vaccinate? This question never diminishes its relevance, because there have always been and still are sofa critics who say: "I will not go, get vaccinated, because Pfizer has a large list of side effects, and CoronaVac is not recognized in Europe."
— I chose this analogy of desert and water for myself. You see, the best vaccine that exists today. Throughout the vaccine campaign, I talk about people going to their family doctor and getting a recommendation from him.
There must be a family doctor between me and the patient who came for vaccination. Here he heard information from me on some TV channel, drew conclusions, and then went to his doctor. And he will say, you may have some contraindications, give me this vaccine. And maybe you don't need anything, just observe social distance. It is impossible to say so simply.
And you yourself, what did you get vaccinated for?
— I was vaccinated with the CoronaVac vaccine. But look, this is a question of my choice. For example, I talked to a doctor who recommended me. He said, taking into account your age, that you have not been sick with anything, that you have been on a business trip to China many times and have seen how more than a billion Chinese people have been vaccinated, then I recommend that you get vaccinated with CoronaVac. And I followed the doctor's recommendation.
How does the vaccine affect immunity? And how long does it last? Since the validity period of vaccination certificates was at first six months, and then it was increased to a year.
— Medicine is an inexact science. And immunology, as a science, is very young and has not yet been studied much, which is why it contains many "surprises". Different tactics are used in the fight against covid. For example, at first there was such a thing: they administered the first dose of the CoronaVac vaccine and watched how "antibodies went up." And in some, it was introduced - and the titer does not increase. I entered again - there is also no growth of antibodies, but there should be! And at the same time, the person does not get sick. Here is one of the riddles. In the vast majority of cases, the immune system reacts to the antigen by synthesizing antibodies, which should block the virus when it hits it. All vaccines are different: traditional, vector RNA vaccines, they are all aimed at preventing the virus from multiplying in the human body, triggering the immune system.
Previously, it took five years for a vaccine to be launched, but today, during the pandemic, newly created vaccines have already been used... Now they are being monitored, but some are being rejected, changed, complications are seen, but there is simply no other way out. Today it was determined that most often, the vaccine lasts for six months. The death of more than 4 million people on the planet from covid-XNUMX requires the search for more effective methods of protection and a vaccine, which is still the only means that can stop the pandemic.
Will the vaccine against COVID-19 be annual?
- The answer to this question can only be "vanguated". Because in the 60s, the coronavirus was classified as one of the varieties of the virus in the general flow of viruses that caused respiratory diseases and were the background of ARVI, in which there were about 20 pathogens. Among them are four types of coronavirus. But the "old" and this "young" coronavirus are brothers. Although they belong to the same group according to typology, the "new" has a completely different characteristic of its actions, which is unusual and unique.
Perhaps, in some people, the mild form of covid-2020 is due to the fact that their immune system is ready for it. The person simply got sick with this coronavirus, just like the one who was in the ARVI pool earlier. And he does not react to this, topics with reactions that lead to a cytokine storm. This may be the explanation why there was no total defeat by the virus in XNUMX.
As of today, 2,6 million people in Ukraine have been infected with covid. Although no one has encountered this particular type of virus before. A significant part of the population experienced the disease in a mild form, or the symptoms of the lesion were not recorded at all. So, the rest had a possible reaction due to the fact that their immune system recognized similar antigens. And with these people, during the first and second waves, nothing happened. But it is not a fact that this will be preserved when meeting with new waves.
In your opinion, what needs to be done in order for us to finally defeat the coronavirus pandemic?
— It should be the efforts of the whole world, because this is a pandemic. If the vaccination of the population is stretched for 10 years, nothing will work. It is necessary to vaccinate quickly and en masse. As I said earlier, "get drunk with everything to reach the oasis." But now, look around. These people are fearless. They are afraid only when their relatives are hospitalized, when there is no oxygen.
It is necessary to turn to other "cultures of vaccination". For example, to Israeli. There, the doctors said "if this summer you sit on beaches, in bars and cafes, and then you ask us to perform a feat in the fall, it will be very difficult for us to perform this feat." So what are you waiting for now from Odessa doctors? Now they must wear protective suits around the clock. Because someone thought only about rest in the summer! In Israel, such a call for doctors ended with mass vaccination, which now results in a minimum of complicated and fatal cases. China and many countries of the EU after mass vaccination are in other conditions of everyday life. We still have such a chance: it's up to the little ones - a trip to the family doctor, consultation and vaccination!
