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This week it was announced that the old 2nd, also known as Infectious Hospital, has already reached a critical threshold. Some scheduled services will not be provided, entire rooms will be adapted for COVID-19 patients, human resources will be lacking, and volunteers will even be invited to help. A conversation with Saulium Tvirbutas, communication specialist at LSMU Kaunas Hospital, on current issues.
– This week it was announced that at the Kaunas Hospital, according to the old name, at the 2nd Kaunas Hospital, located in Šilainiai and its subdivisions, critical limit reached.
– I would say an analogy – we are like a battleship in the fight against this pandemic. We swim, viruses bombard all sides, holes are drilled, we repair them, we fix them. There is no panic in the crash team, but there really is a lot of worry, problems, sweat. In fact, the human limits of some workers have already been reached. We need both reinforcements and more forces to combat this. We see that support hospitals alone are no longer enough. It is good that the district hospitals have already started, that I know of: Prienai, Jurbarkas, Marijampolė.
– The biggest problem: the human factor? Many doctors are also ill, some of them already in isolation. How much do you get sick in total, how much do you isolate yourself?
The most serious patients stay with us for up to a month. They are more complex, their comorbidities are acute.
– In total, our hospital has 30 employees. In the Department of Infectious Diseases, where the fight against COVID-19 is being carried out, I think it has been a great success and a high level of medical qualification that no one is sick there, there have been no outbreaks fall is this chapter. But other chapters fall out. And there are 100 people in self-isolation due to close contacts, not necessarily in a hospital, but also in society, as the prevalence is very high, as we all know. There are no major outbreaks in the infectious disease department, but the burdens are very high, reinforcements are needed from other departments, which means that other medical services must be limited. More planned.
– You are a hospital with one of the largest flows covidinių patients. How many people are currently in your hospital’s intensive care unit?
– Currently – 102. Of these, 50 with an oxygen mask, need an additional supply of oxygen. And completed the COVID-19 resuscitation in the same home. The resuscitation force will be expanded starting next week. Unfortunately, in another department, also in Šilainiai. The doctors call it clean Y dirty zonom, is there clean Resuscitation and fifteen beds will be delivered to COVID-19 patients.
In the same building, in Šilainiai, an additional 30 beds are also provided for COVID-19 patients, neurology, cardiology, geriatrics, gynecology are temporarily suspended; operations only, but obstetrics and delivery services will continue. Planned gynecological surgeries. Obstetrics are likely to remain in the Šilainiai unit, and there are fewer and fewer patients with COVID-19. In addition to surgical, urological patients in need of intervention, and those with COVID-19, this will be a position left specifically for these patients. And COVID-19 will provide emergency assistance there.
Fortunately, we have other units, in the city center, Laisvės Alley, Hipodromo Street, the former Kaunas Republican Hospital or, for an even older generation, the 3rd Hospital. All services are provided there. However, outpatient services are also offered in Šilainiai. They have not yet been discontinued, there is a polyclinic and a consultation polyclinic for skin and venereal diseases.
Saulius Tvirbutas. Photo by Vilmantas Raupelis
– But as I understand it, is the number of beds for COVID-19 patients decreasing?
– The Infectious Diseases Unit was completed only for COVID-19 patients. Long ago it reached the limit. There is still a reserve there, dozens of beds will be available, but it is intended primarily for COVID-19 patients. And negative development is planned in other buildings in Šilainiai.
We continue to improve, we are coping with it, but the situation is heating up, so in Šilainiai part of the services are intended for patients with COVID-19.
– Probably a problem with the doctors? It’s no secret that people with COVID-19 who go to the hospital also have comorbidities that also need treatment. This requires proper medical qualifications. Won’t you run out of specialists?
– We need specialists. In fact, infectologists are needed. In the body where I mentioned, in the Department of Infectious Diseases, its capabilities are also exceeded. They work beyond their means. In the past, during the cold season, there was a natural increase in the number of patients with complications from the flu, various other acute colds. At the same time, we accommodate patients with gastrointestinal and intestinal infections. There was also a section with about 30-40 seats for children. At that time, there were between 50 and 60 patients and the doctors were thought to carry a great burden. Although compared to the current disease, with what they are doing now, it was relatively easy: such a complex and level of protection was not required, other care, those patients stayed shorter, up to a week, the most serious patients were ten days , then the symptoms were relieved and they were released home. There was rotation.
The most serious patients stay with us for up to a month. They are more complex, their comorbidities are acute. Some people need or may need oxygen at all times because the amount of oxygen in the blood can decrease. In a word, the details of the job are completely different, and there are already twice as many of them as during the peak season.
The workload of doctors is enormous and infectologists are working beyond their means. They are also strengthened from other wards, but again, those doctors also have their own patients, the bed occupancy of the other wards is 80 percent. This means that the entire hospital is operating at full capacity, there is also a need for people and work capacity. So, unfortunately, we are already rejecting some services, in some departments we are reducing that number.
– Now is probably not a good time to contract other diseases.
– I’ll be open, not favorable. We continue to improve, we are coping with it, but the situation is heating up, so in Šilainiai part of the services are intended for patients with COVID-19.
– And epidemiologists are unanimous in agreeing that the peak of COVID-19 has not yet been reached and that the situation could be much worse.
It is a serious and acute disease, some of which also require artificial lung ventilation, but it is not a mystical infection. There is no specific treatment.
– It’s scary. Our doctors say that we should consider the disease more broadly, not to pile everything up for an infectologist. It is a serious and acute disease, some of which also require artificial lung ventilation, but it is not a mystical infection. There is no specific treatment. More treatment for symptoms and exacerbated comorbidities.
Not surprisingly, the Ministry of Health has issued an order so that COVID-19 patients can also be treated by other institutions authorized for therapeutic diseases. That is why district hospitals have been incorporated. More hospitals could participate in that fight. It is simply necessary to provide isolation rooms and continue treatment for these acute comorbidities. Our infectologists face challenges, inviting various therapists. We have seriously ill patients who are not as much at risk from coronavirus as from exacerbated diseases. Even some therapists, we may not all have some diseases; for example, we don’t have oncologists.
– I try to imagine how doctors who work all day in overalls, masks, work beyond human capabilities and hear rumors that the coronavirus is a burst bubble. This is what the insiders look like „inflated bubble“?
– They probably don’t listen much, because if you react emotionally, it’s both angry and funny. In fact, we have filled the chapters. Now it is fashionable to film other hospitals, but in these times of technology, you can create, fantasize and talk about anything. In fact, the situation is complicated, I myself am involved in the emergency team of the hospital, which is already in place throughout the period of the pandemic. All kinds of questions arise: how to reorganize the infrastructure, guarantee entrances and exits. There is more than just medical issues: a variety of equipment is needed to transport patients to avoid a lack of protection; they should be placed in special hooded beds so that they do not spread the virus when transported to other facilities.
I’ve mentioned that those conspiracy theorists would be happy, if they did, that there’s nothing here. We would not choose and we would go crazy, we would not save that ship by making holes so as not to drown and provide assistance not only to COVID-19 patients but to all other patients. Other diseases have not disappeared anywhere. There are many of them, there are also many patients.
Photo from Freepik.com
– You mentioned safeguards. Were spring lessons learned when patients lacked practically everything?
– Now we are self-sufficient and purchases practically do not stagnate. It was apparently here that there was China and production was stopped. Now those tools are there. Of course, it costs money; It is also painful for hospitals, they are not cheap. And many of them are exploited, hundreds a day. Approximately 4-6 protection kits for one patient: bathrobes, coveralls, glasses (they are real, disinfected and for repeated use), respirators, gloves. All of this is ruled out after a visit to the patient.
– Probably the first hospital in Lithuania to seek help finding volunteers. What is the situation? Are there lifeguards already and what volunteers are needed?
– Berods responded to 70 people a day. There are many noble people who are willing to help voluntarily. So far, we have stopped because that does not mean that we have assembled a platoon and sent it where it is needed. Some instruction is still needed. I think we will not be in a rush to send volunteers to the Infectious Diseases Corps, because the details of the work there are different. But they would be very useful when not only the specialists but also the support staff, the nursing assistants are employed in that corps, working full time in other departments. Perhaps those vacancies can actually be filled by volunteers. There is a lot of work with patients who have difficulty moving, need help, and are placed in a wheelchair. There are also overweight patients, a lot of physical strength is needed.
– The work is definitely not pleasant and it’s fun to hear 70 people respond every day. They are ready to help the doctors. We remember that there was also a meal in the spring, and those masks could try to help with those masks. It turns out that the spirit of solidarity is still present in society.
– Some are always those who develop conspiracy theories, but here perhaps as self-defense, psychological fear. There have always been such people, believers in conspiracy theories and their propagators. Some out of curiosity, others out of fear or other psychological problems. And when crises arise in society, they are likely to get worse. And social media allows such bizarre ideas to develop further. But at the same time, there is a silver lining that is perhaps less visible, less pronounced. Everyday things may not cause us as much feeling as frightening knowledge. There really are people like that, that’s gratifying.
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