Doctors are more concerned about the risk-free group: this disease is a chameleon, the patient’s condition changes in an instant

Even more worrying is the fact that the severe course of the disease is affecting more and more people of working age who do not have comorbidities. According to data from the Department of Statistics, the highest morbidity per 100,000 population remains in Alytus and Panevėžys. What is the situation in the hospitals in these cities and how everything looks in the eyes of doctors was discussed in the program “Delfi Tema”.

There is no decrease in patients in Alytus

Rūta Juknelienė, chief of the second department of Covid-19 infection at Stasys Kudirka Hospital in Alytus County, associates such high morbidity in Alytus with large volumes of testing both in the city and throughout the county. The doctor noted that Alytus has also started testing company employees, which is why many infections are detected.

“Therefore, compared to other counties, we have between 5 and 8 times more people tested in other cities,” emphasized the interlocutor.

According to the doctor, Alytus County Hospital is currently a support hospital with three COVID-19 wards.

According to R. Juknelienė, the flow of patients in the hospital is not decreasing. Currently, there are patients aged 40 to 90 in the physician-led unit.

“In the resuscitation and intensive care unit, I looked in the morning, from 59 to 63 years old. years. These are middle-aged patients without a more serious concomitant pathology ”, shared the doctor.

The unpredictable course of the disease is concerning

R. Juknelienė states that in his department there are even around 50 percent. patients who are not at risk but still develop a severe course of coronavirus.

“We are generally afraid of them because the condition can change very suddenly. This disease is a chameleon, we can never predict how a patient’s condition will change. The patient begins to visit in the morning, the patient seems stable, ends the visit in two or three hours, runs back and calls Dr. Irena to the intensive care unit, that the patient already needs to be transferred and we ask for her help “, – about situations that are increasingly encountered, spoke a doctor who worked at the front.

Such patients, admits the interlocutor, are the ones that most worry doctors because it is never clear in which direction the entire course of the disease will turn.

“These patients complain of a lot of weakness, shortness of breath, anxiety. The maximum oxygen supply is required in the conditions of our therapy room and we usually try to transfer them to the resuscitation and intensive care room because those therapeutic options They alone will not help the patient survive.

It is very difficult for us as doctors and middle staff to see such a patient because the reserves of that care are limited. As I mentioned, all places in resuscitation are currently occupied, so if a patient should be asked, then the question – what to do with those who are (in resuscitation – “Delfi”) “- R. Juknelienė spoke about the dilemmas doctors diaries.

The doctor admitted that doctors are already choosing who needs access to resuscitation: “During the first wave of coronavirus, I looked at Spanish and Italian doctors because they said that patients who need oxygen therapy should be selected for resuscitation-intensive care. It seems that this could also happen to us, if patient flows continue ”.

When you can no longer do anything, try to suffer less

According to R. Juknelienė, in practice there are also situations in which, after evaluating the human condition, doctors understand that the patient will no longer be able to help, he is doomed to die. According to R. Juknelienė, it is mostly elderly patients who have severe comorbidities.

“However, we do everything possible so that the person does not suffer, not to hurt them, to be calmer. You just see that you can’t help a person, but you do your best to make them suffer less, “the doctor admitted. Such negative emotions, he says, have already become a daily routine for doctors.

R. Juknelienė states that the work in the COVID departments is organized in 12 hours, and she, as the head of the department, comes every day. “It was like I was working non-stop for a month, but what you will do is that job,” he said.

The nurses, the doctor says, work in the red zones of the COVID unit for three hours, then rest for three hours in the so-called green zone. Meanwhile, doctors work in the most dangerous areas for 2-4 hours, if necessary, repeat visits to patients with serious conditions.

Staff passed out, lying in the red zone.

When asked if doctors and other hospital staff working at this rate and load have time to at least eat, R. Juknelienė admitted that after a few hours, his appetite in protective suits disappears.

“With that food, you know … until you come, you don’t want to, because we can sweat our pajamas with sweat. We sweat a lot with that jumpsuit, at the beginning there was everything, the staff was climbing and lying in wheelchairs in the area red, but we have to work, someone has to help ”.

The head of the COVID-19 department assured that doctors are trying to save energy as much as possible.

“In that red zone, everything, like in slow motion, has to be in a hurry, think everything, so that when you enter you can do all the work. That you don’t have to go back to the same thing a second time. You can cry, but something will change ”, asked the doctor rhetorically.

R. Juknelienė opened that since the doctor is also her husband, it is a little easier for both of them, because they can comfort each other.

“It is difficult today, but we cannot say it will not be. You just got through the day, all the patients survived and we are happy about that,” said the doctor.

R. Juknelienė admits that due to such a workload, the family also suffers, the son’s wife claims that she has not seen her since the beginning of October.

“We do not speak with my mother-in-law when we speak on the phone, by other means, we simply say hello through the window because the people are older. We take food, everything we need, but since they were doctors, they understand that it will not be otherwise” said the interlocutor.

The doctor will also give Christmas at work. So far, two business days are planned, but if necessary, he says, you may also need to take care of patients on a daily basis. “Our situation changes every minute,” added the interlocutor.

In an emergency, I would still do my best

Speaking about the situation at Panevėžys Hospital, Arūnas Valikonis, Head of the Department of Resuscitation and Intensive Care of the Republican Hospital of Panevėžys, emphasized that the possibilities of the medical institution are not limitless, since the activities of the resuscitation department depend so much on the team as well as specialized personnel.

“For example, nurses, anesthesiologists, resuscitators, because, of course, it would be very difficult to replace them with doctors from other specialties who could ensure quality treatment in the resuscitation department,” said A. Valikonis.

The doctor acknowledged that providing quality resuscitation care would be difficult if it had to expand to the point of needing the help of doctors and nurses from other specialties.

“Nurses are still coming in from other wards, but they work with resuscitation nurses who help and teach a bit. But, of course, the problem of staff shortages is already significant. If the number of COVID-19 patients increases, then that problem will obviously only increase, ”said A. Valikonis.

The head of the resuscitation department said the worst thing was that the hospital had nothing to look forward to. When asked what it would mean if the hospital simply could no longer admit new patients, Valikonis said the doctors would continue to work with the maximum regimens and do their best.

“There are not many options, all the hospitals in Lithuania are overcrowded,” he said.

Quarantine measures were needed before

Unlike most Lithuanians, A. Valikonis will find himself at work. His wife is also a doctor.

“After that, I hope to spend a few days off with my family, with my children,” the doctor expected. When asked how he himself reacts to learning that Lithuanians are flocking to shops, trying to reach other municipalities, A. Valikonis admitted that there is anger.

“Perhaps these measures could have been introduced earlier, because it is absurd to expect that the medical system has unlimited possibilities to treat seriously ill patients. Whatever we take, all services have their limits, when it is almost impossible to increase volume,” he said.

The doctor was surprised that the public still does not understand this. A. Valikonis agreed that a part of the unprotected people will contract a mild form of the virus, but the chances of rescuing another part, the patients in resuscitation, will depend on the situation of the entire health system.

The doctor emphasized that there were always patients in resuscitation even before the pandemic, and most of the time it had nothing to do with scheduled services.

“Partly planned services, planned operations lead to the need for resuscitation sites, part of the patients go into resuscitation, but the main flow of resuscitation patients is not planned beds. The exacerbations of chronic diseases have not disappeared, the serious injuries have disappeared, we still have those patients and we must also serve them, ”said A. Valikonis.