“If not us, then who,” say the teachers and students of UzhNU Medical Faculty, who are currently fighting the virus in Uzhgorod medical institutions. Our conversation with Stepan Karabinos, Vera Sparrow and Yevgeniya Dankanych, who work at Transcarpathian Regional Infectious Diseases Hospital and know from the internet what is COVID-19 and how it can be countered.
– What is the current situation in the hospital that is experiencing dynamics?
Stepan Karabinos, Assistant Professor , Department of Microbiology, Virology and Epidemiology with Infectious Diseases Course, Doctor of Transcarpathian Regional Hospital:
– The dynamics look like this is just the beginning. In principle, there are people who have recovered, and collective immunity begins to take shape. It is difficult to talk about the percentages that are in the world, that only 10% are severe. We do not have the full screening that we should have. For example, in the US, screening is conducted without exception. Therefore, one can see who is infected, who is mild, and who is severe. We only test those patients who have been admitted to us. For the most part, family doctors do not test, so we mostly do not know how many patients are mild or generally asymptomatic. Recently, we have a two-year-old baby, she is almost asymptomatic. And we have a lot of kids on the streets playing in the playgrounds, in front of the house, high floors. They can transmit the virus to each other and then bring it to their grandparents, who have comorbidities and, accordingly, have severe forms. We are now expecting an outbreak after Easter as there was more contact between people during this period.
– How do you deal with emotional stress, exhaustion?
– It seems to me that we do not feel yet because we have constant stress. And you just don’t feel it. I had three days of Easter and somehow seemed to be aware of what was going on and I was a little “sore”. But the situation is – we have to hold on, because no one else is.
On April 1, we got a job at an infectious hospital, because there were actually two doctors, for the whole hospital, for 200 beds. Accordingly, we decided not to drop ours and stay.
– How are you doing in your free time, rest?
– After work, I come home just “shut off”. Then morning and again it all starts again. Unfortunately, there is a lack of staff in the hospital, many people have gone, even there is no X-ray technician, I take pictures of my patients myself, there is a lot of work, so it is obviously not easy.
In addition, the conditions themselves are special. It’s not just that you went to the patient. First of all, you wear a protective suit – this process takes more than 10 minutes. You have to make sure that you are safely dressed, look at the patients in this outfit, then, after working with the patient, there is still a bunch of paper work – writing medical records, appointments, submitting them to an electronic database, etc. That is, when you come home, there is no more effort.
– How to deal with equipment, medicines and protection?
– It reminded me of 2014-2015, the beginning of the ATO. If it weren’t for the volunteers, there were times when we realized that we would be wearing gauze masks and going to patients. We are already equipped with suits, respirators, masks, shields.
In addition, there is such a point that the purchase of medicines must occur under certain procedures. For example, we would like to buy certain medicines or equipment, but given that the prices may not match the permitted prices in Transparent, we cannot buy them accordingly. We had a moment when antibiotics, meropenem, were urgently needed, and we had to buy it for charity because the price had doubled since the epidemic began. There has also recently been a case where paracetamol disappeared from pharmacies. Therefore, accordingly, the price has risen at once, and even if it is 1 hryvnia higher, we cannot buy it already. Until we have 2 weeks security.
– What was your motivation to go to work in an infectious hospital at this time?
– It should always be remembered that the same people work with you as you, who, together with you, grew, developed, and to leave them on the battlefield and flee, to sit somewhere is not an option. I think our employment is still temporary, it is more of a time requirement than a personal desire.
– What would you recommend to Uzhgorod, Transcarpathian? I, subjectively, see quarantine fatigue, many people walk in the streets, children play on the playgrounds.
– To be honest, it’s amazing to see this. I read comments on the internet, some people need proof, they write “why not go”, “why not open a cafe?” etc. and they say it’s a lie, it’s a theory of global conspiracy. It seems to me that you will not prove anything to these people. Conscious citizens are advised to stay at home and not put themselves and their loved ones at risk. And the unconscious – well, it’s their choice.
Vera Sparrow, Assistant Professor , Department of Microbiology, Virology and Epidemiology with Infectious Diseases Course, Doctor of Transcarpathian Regional Hospital:
– In early April, there were two resident doctors at the infectious hospital, together with the head. Therefore, purely for human reasons, my colleagues and I remained, and were decorated as employees of the university, and in combination – doctors of the infectious hospital.
It was scary at first, but it’s our job. In fact, for two months – March and April, we operate in constant voltage mode. So all this time we are in those suits, respirators, glasses. In the morning, we have five minutes, organizational matters, and then we change clothes and go to our patients. I can say that the last week has been psychologically difficult for me. It is also worth adding that in recent times, other medical institutions – regional hospital, tub-dispensary, have also taken the load recently.
Yevgeniya Dankanych, Assistant Professor , Department of Microbiology, Virology and Epidemiology with Infectious Diseases Course, Doctor of Transcarpathian Regional Hospital:
– Now the dynamics are stable – consistently bad. We see an increase in the number of cases of coronavirus disease, especially since many health care workers from different institutions are among the patients. In addition to older people with comorbidities, patients with complex cases of young age – 37-42 years are included in this category.
We, the employees of the department, collectively made the decision, “one for all, all for one” and to move even to the minimum 0.25 rates and to get an infectious hospital. There are many volunteers who help us, but we will always need respirators, protective suits, because no one knows when this epidemic will end – either in June or July. That is why we always need support. We are now provided with PPE for two weeks, but it all depends on the epidemic.
In addition to direct treatment, we also have online training at UzhNU, for example, I have Ukrainian students and foreigners, so we are engaged in non-stop mode. We do tasks with them when they have free time, even do Google meetings, Hangouts.
The first two weeks were very morally difficult, because you don’t know what you’re working with. First, when you read about the disease course, as an infectious disease doctor, you understand that it is a viral infection that is transmitted in most cases by contact. But you are experiencing literally everything – whether it is a properly dressed suit or whether you accidentally touched yourself when dressing. It was the first 2 weeks until we started discharging people from the hospital. With the permission of the chief physician, we are periodically PCR-diagnosed, our tests are negative. So it got a little easier for us to understand how we were doing and what the complications were.
I am very grateful to the staff of the department, the infectious hospital. We try to support each other, read the treatment protocols, we advise. You see, when we have a person of young age, he is heavy, he is suffocating, he has heart or lung failure, then you think “non stop”, day and night, that you should add to treatment. So far, there is no single clear mechanism for treating the pathogenesis of coronavirus infection.