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When, in early spring, despite signs of an impending pandemic, the doctor still decided to go on a long-planned trip with friends, it was still difficult to predict the conditions in which daily life would soon have to be organized.
Still, the doctor says that the patient first wanted to encourage everyone, to tell them that although it is a serious disease, but with all the requirements, he can get sick like a common viral infection.
Still, the doctor is skeptical of those brave people who declare that the virus does not scare them.
“Because it happens that at first he denies the danger, he does not protect himself or others, and when he gets to the doctor he asks for help,” he noted.
About all this and what work looks like in the conditions of a pandemic: a conversation with the main doctor in otorhinolaryngologist of the Center for Ear, Nose and Throat Diseases of the VUL Santara Clinics dr. D. Rauba.
How has the pandemic changed your daily work? When we talked about the interview, you said that we can plan our time quite freely because now you have a lot less operations.
The field of pathologies I work with is more nasal problems, long-standing problems due to shortness of breath, growing polyps, tumors in the nose. This work was quite intense at first. There were people who really wanted to solve problems as quickly as possible because it affected their quality of life. All the more so since it was not clear how the situation would develop further.
However, some patients who planned surgery after the news that Covid-19 outbreaks appeared in hospitals canceled operations for fear of the virus and thinking that their disease was less important today. Furthermore, they feared a postoperative period in which the course of the virus infection would be much more difficult.
It’s been more than 2 weeks since that rate dropped due to the scheduled surgeries being discontinued. Because, as I said, some of the procedures we do have to do with quality of life, not the vital ones that need to be addressed “here and now.” Of course, I am not talking about extreme and complicated situations here. Cancer help cannot wait, so surgery is performed at the same rate in all areas.
Is work stopped due to the need to transfer all forces to the Covid-19 division?
He didn’t explain too much to us why everything is being done, but I think for several reasons. In particular, the goal is to make some of the beds available so that Covid-19 patients can suddenly have them when they need them.
On the other hand, given that there is an increasing number of infected people in society and the probability that such a person will enter a hospital ward and lead to a situation where doctors who have been in contact have to isolate yourself, is high. Therefore, the goal is to avoid such situations.
For example, although there was a procedure to undergo a Covid-19 test 48 hours before surgery, strangely enough, some people did not look at the results. So, there have been several cases where the system did not report that the patient’s test was positive and that person comes in for elective surgery. Okay, when the sisters check the system and see that the test is positive …
In the spring, you were one of the first to say publicly that you got sick. At the time, doctors in particular were considered near-lepers who brought the virus on vacation abroad. Although the number of people with diseases is growing rapidly, sadly they are still viewed in a crooked way.
The reality is that many people, even when a loved one is sick, do not want to go for a checkup because there is fear and mistrust. Here I recently met my patient who says he has recently been in solitary confinement and returned to work after 10 days, but everyone clings to him within one meter, not wanting to communicate.
So if everyone is already watching closely, and what about spring, when it was scary, no one wanted to announce it. But one of the reasons I came out sick was that there were so many fears.
I wanted to say that this is a serious disease, but if we meet all the requirements, we do not treat unassigned drugs, we can get sick as after another viral infection. Many will get sick easily or moderately, others will become more difficult because no one is immune to such a stormy reaction of the body.
How do I understand that you are lucky with a milder form of the disease?
Now that I see how others are sick, I can say that I am lucky. It was probably not asymptomatic, but mild to moderate. Because, I think, the average already occurs when the respiratory system is vulnerable, it is difficult to affirm in the presence of multi-organ damage. So when my condition recovered, it can be said that it was that lighter.
Have you heard that a situation arose during isolation and when the wife even threatened to call the police?
There were so many nuances that the alarm went off at home and the wife couldn’t cope, so she kept blaming him. This is me, even though I was in isolation, I mean, I will sit in a car that is near the isolation point, and without coming into contact with anyone, with a mask, I will go home, just put my hand through the door, turn on the remote control, ordering and all.
But at that time there were so many fears, that is, because the quarantine was very strict, as we remember, and the streets were empty, and so was my wife. Even more so when she was a little girl at home, an older mother-in-law, so she didn’t want any contact, nor for the neighbors to see her or whatever. It was so scary that threats even emerged (he smiled).
Not long ago, they did an antibody test. How much immunity do you have after more than half a year?
As you know, even against the flu, which in addition to “family” and vaccines are available, but get vaccinated every year because immunity passes. As with any other infection, it could be assumed that that immunity will not last long after the onset of Covid-19.
And, as the research shows, both for me, who got sick easily and for those who returned from the same trip and were ill, there were equally few antibodies. So, obviously, that reaction won’t last forever.
We invite you to see a more comprehensive report on antibodies after Covid-19:
So are you as careful now as the others?
I don’t feel very calm either, but I’m not very scared. I live in a way that I can trust my immune system as much as possible. I try not to break down, sleep at night for more than 3-4 hours, go out to exercise, follow the rest regimen. This is necessary to be prepared for any viral illness that is easier to overcome.
Although now people are encouraged to be at home, but it means being in their own circle, so it is necessary to go out somewhere to run, to walk through the forest. Now is the heating season, dry, all the mucous membranes are drying up and viral infections just wait to be in such a state that we will be at home as long as possible. Therefore, indoor ventilation and access to the outside is necessary. Clearly not in groups and without contact with others.
One of the characteristics of Covid-19 is the loss of taste and smell. Is this a distinctive feature of the virus in your specialty? After all, a person may have lost their taste for a long time after catching the flu.
When we do not smell colds, the sense of taste is also often altered. However, in the case of influenza and other viral diseases, the receptor itself is more vulnerable, so it is sometimes the case that the sense of smell does not fully recover after such diseases.
In the case of the coronavirus, it is believed that it is not the receptor itself, the neuronal cell, that is most vulnerable, but the surrounding mucous cells that “support” it. As a result, we are less likely to lose our sense of smell. And realistically, after a week, the two of them are back, from what I’ve heard.
Clearly, if a patient has a chronic disease, has nasal polyps, suffers from allergic rhinitis, it is more difficult for him to pass the disease because the barrier of the nasal mucosa is already damaged.
What would you say to those who have rushed to extremes and generally deny the existence of this virus?
Compared to what was in the spring and now, there has been much more courage, and there is talk that restrictions restrict freedoms. But people are already like this: until something happens to them, everyone is very brave, it can be very clear on social networks that it does not make sense, but when they get sick, that anger evaporates somewhere, especially if the course of the disease is aggravated. This can cause panic and fear in the bravest. And then we already demand help.
And then next time in the admissions department, if a situation arises, if you had to choose which patient to rescue first, maybe you could “get up” on social media and refer the one who was very brave to treatment at home?
So it is very elusive and easy to criticize the government and its decisions for a reality such that there will always be dissatisfaction.
Outgoing Minister Aurelijus Veryga also spoke about the forced transfer of doctors to the Covid-19 wards. What do you think about that?
Yes, there was such an explanation that if an emergency is declared, just like in the case of a nuclear power plant explosion, no one asks what specialty you are, how much you will earn, everyone is in a hurry to help.
So while it may appear that there is some question as to whether such a measure is necessary, if a situation arises where there is a labor shortage, it would probably be necessary to go. Because even now, from what I can imagine, there is a real draw, which, for example, will have to move from the therapy department to working in the Covid-19 department. Or maybe the manager appoints you. Because there are not many of those volunteers either.
In my opinion, the most important thing is to be clear about what would work in such cases, defined schedules, arranged so that doctors can also plan life. After all, in the spring we heard stories of this kind when the doctors did not want to go home so as not to bring the infection to the family, so they lived in hospitals or other facilities. So I would like to have time to prepare, not come in the morning and hear that you will have to go there to work.
Doctors in your neighborhood are also invited to work on the front line.
Our department specifically did not have a direct link and we stayed in reserve. But I still think that a large number of our specialists have a rather limited specialization, which is related to serious pathologies: chronic pathology of the ear, nasal surgery, surgery of the skull base.
Therefore, it would be unwise to send people to such a risky place in the hands of such professionals. In that case, they might be left without your help at all.
On the other hand, that specialization is very different, one of our young specialists was also assigned to help there. However, it faced challenges because patients with serious pathologies (blood cancers, kidney disease, diabetes) needed specific knowledge to help them.
In reality, these patients should only be treated by specialists in certain areas who can really help, because otherwise it is more of a mechanical aid. If these patients were treated in the room where they belong to the pathology, perhaps survival would be different. Here, I think, is the problem.
Thank you for the interview.
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