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© Nadezhda Chipeva, Capital
The photo is from the archive, from spring 2020.
Sorry, but I have a patient who needs oxygen, I have two to consider for discharge, I just don’t have the opportunity …
These are the first words of Dr. Aneta Milusheva when answering the call. We close immediately. Call someone who has a few minutes to spare.
Milusheva is the head of the department of infectious diseases at Karlovo General Hospital.. At the time of the conversation on Friday (November 6), the hospital was housing 32 coronavirus patients. The hospital’s central oxygen facility does not reach his ward, so the doctors tend to the oxygen cylinders. “They end in the middle of the night, we drag them from room to room, the valves change,” says the doctor.
About a week ago, the Pirogov director predicted that some 4,000 people would be hospitalized in the country over the next ten days. The prediction almost came true, but it was made before the new records of around 4,000 new infections per day were recorded. Some of them will have to go to the hospital and the Minister of Health ensures that there are places. According to official data, on average in Bulgaria only about 30% of the beds for COVID patients are occupied. However, the media and social networks continue to report difficulties in difficult situations, overcrowding of medical personnel and lack of equipment.
Dnevnik talks to several doctors about his problems and impressions of front-line work in the current situation. We learn about Dr. Milusheva and the difficulties in Karlovo from various states from her daughter Maria on Facebook (more here). In one, he also asked the municipality specific questions related to the hospital’s preparations for the epidemic and a new COVID ward.
The situation with the sisters is desperate. There is no way that one nurse can see 32 patients.
head of the department of infectious diseases at Karlovo hospital
According to Aneta Milusheva, the hospital does not have an anesthesiology and intensive care room, where it can house patients in serious condition, with respiratory failure. So she is also a telephone operator to find them a place elsewhere.
“I am very concerned about calling one phone, another, one hospital, another. I don’t have anyone’s support in this regard,” the doctor told Dnevnik.
He also said that the only anesthesiologist at the hospital was COVID-19. The rest are half the staff, they travel from other places and come to help, but they are not in the hospital all day. “There are days when there is no anesthesiologist“Says Dr. Milusheva, noting that this interferes with the work of the hospital and beyond the crisis with the coronavirus.
Dr. Milusheva is, in fact, the leader of two people: Ekrem Hatip, a medical student and paramedic, and Maria Strugareva, a quarter-time paramedic, who travels from Plovdiv to help in Karlovo. The boss wants to mention them by name because she is grateful to them.
Since the beginning of November, a pulmonologist, a gastroenterologist and a neurologist have been helping Dr. Milusheva’s ward for ten days each. “More or less, it is very difficult, but let’s say we can handle it. But the situation with nurses is desperate. There is no way 32 patients can be treated by a single nurse,” says the doctor. I expected a regrouping of resources and solidarity from the hospital.
“Currently this is not happening. People are writing resignations, notices. My older sister insists that she will not work under these conditions. Another very kind and skilled nurse who works part-time also has a notice,” says Dr. Milusheva. and sums up that “we are on the brink of disintegration.” He was ordered to move the infection room to another floor so that all COVID patients could be in one place, but according to the doctor, there would be no room for new coronavirus patients.
I ask him if he wants restrictions on people against the spread of infection to be tightened, but he does not follow official orders. “It is time for people to reach out in good faith. Although everyone is a potential patient. And when the time comes, but there is no place to be accommodated and treated … ”, says Dr. Milusheva and sighs without finishing his sentence with words.
People describe it as a state of war, but unlike war, which begins with the preparation of not only personnel, but also ideas and plans, things are chaotic here.
This comparison is made by a specialist in anesthesiology and intensive care in Ruse, who wishes to remain anonymous. According to him, there are 60 patients in the infectious room of the hospital where he works, and before the outbreak of the epidemic there were 20 beds. COVID patients, as well as those awaiting PCR results, are available in other rooms.
Distribution starts from the hospital emergency department, where there is a doctor for internal medicine patients. “People are waiting a long time. And they don’t just have a choroanvirus. At some point, the currents can’t help but start to mix. It becomes physically impossible to isolate them, “says the doctor. His personal opinion is that the time is long past when calls for compliance with the three D’s – distance, disinfection and discipline – were enough.
“It really is happening now that people are dying on the streets,” he said. He talks about a patient who died in front of the administrative structure of the hospital where he works. According to him, the man had concomitant diseases, he was sent due to lack of places in another medical institution. “During the resuscitation measures, they found his documents: the referral for hospitalization and the positive result of a PCR test.”
“I have the feeling that we are abandoned. Not only from society, but also from the government, which no longer takes any initiative to limit the spread of this. For the past two weeks I have not been on duty where at least one patient does not die. There are cases where four people die during a 12-hour shift, ”said the young doctor, convinced that once the hospital beds for patients are filled without complications, there will be an even greater workload in the intensive care unit .
In them, the vital parameters change literally in minutes. It is not about visiting in the morning and afternoon to clear things up. Here the doctors and nurses are next to the patients every minute.
Head of the Anesthesiology and Intensive Care Clinic at St. Anna Hospital – Sofia
This is the description of Associate Professor Maria Atanasova, Head of the Clinic of Anesthesiology and Intensive Care at St. Anna Hospital in Sofia, for work in intensive care. According to her, 11 seriously ill COVID patients are in the clinic at the time of the conversation on Friday (November 6). In addition, about 80 patients with milder coronavirus are staying at the hospital.
“During the last two days, between 20 and 30 pneumonia have gone through the emergency room and are hospitalized,” says the doctor. As “little or insufficient”, she defines available for 12 hours on call in intensive care: one doctor and two or three nursesI. He hopes that from now on it won’t happen that ten new people to his clinic need intensive care at the same time.
“Do you remember how in Italy and Spain triage was carried out on who should be intubated, who should hang on a device, who should be admitted to a hospital? I hope this does not happen to us,” said adjunct professor María Atanasova .
However, he acknowledges fears that the scenario is not impossible given the growing coronavirus epidemic in Bulgaria.
