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Infectious disease doctor Adrian Marinescu explained what people infected with coronavirus must do at home to avoid reaching serious forms that threaten their lives.
The doctor from the Hospital for Infectious Diseases Matei Balș spoke about the stage we are in but also about the invisible dangers of the coronavirus pandemic.
Are there differences between the first wave, in spring-summer, and the autumn wave of coronavirus?
Adrian Marinescu: “This is good news and bad news. The good news is that there is no evidence that the virus is more aggressive at the moment and that it would take more severe forms, the less good news is that it is transmitted more easily than in the first wave, which It explains why there are several cases around the world. If it is easily transmitted, even in a relatively small percentage of severe forms, it will be seen in hospitals. “ said the infectious disease doctor.
What do you advise people to do to help limit the spread of the disease? When should you be concerned about symptoms?
Adrian Marinescu: “I think they need an evaluation done in the first phase at the GP, or whatever doctor they contact, it can also be by phone. It is important for that doctor to guide him and make sure that the person has risk factors, is elderly and then has to get to the hospital faster, or on the contrary, if these situations are not, he can be monitored by the doctor. But be careful, the follow-up means that during the two weeks, being in isolation, you keep in contact with the family doctor, if some complications occur, even if the one who after the evaluation showed that he has no risk factors, can intervene and get to the hospital. “
What is the critical period for such a patient?
Adrian Marinescu: “I would say between the fifth and the tenth day, so practically when ten days have passed since the beginning, the probability is definitely lower if the follow-up was done in the meantime. My advice is to have a pulse oximeter at home, I know that it has been talked about very often, next to the thermometer, and to measure oxygen saturation, it is very important because in general we will not notice if we have an air shortage fast enough, so it is much better to see the oxygen saturation, because otherwise we could fool ourselves, not realize that we have a low saturation and arrive too late at the hospital ”.
Adrian Marinescu also spoke about the death rate, which is closely related to the health status of the population before the pandemic.
“There are several explanations, depending on how the reports are made, it is clear that most of the deaths are in people who had chronic conditions, they were older people. It is very rare, but it happens, to be patients who had nothing associated with it, apart from the health of the population. When a pandemic arrives, the state of health that it finds in the population and in our country matters, we are not so well in terms of cardiovascular diseases, diabetes, chronic diseases, and it should be better evaluated as it happens in the West. There is another explanation, it matters what happens until the patient arrives in true shape, the way in which the follow-up is done from the moment of diagnosis until the patient degrades and reaches the hospital is a very important interval ”.
What do you think the next winter holidays will be like?
Adrian Marinescu: “I do not think we should be afraid, we will be worried, of course, in the end we have a rich experience in these months, but there will be a vacation that will be in the soul, but made with great caution, and we will celebrate it with the family. restricted, because there is a clear risk of transmission if we refer to acquaintances and even relatives ”.
Dr Adrian Marinescu believes that extended quarantine measures would be more successful in fighting the spread of the infection.
“There are many cases for a longer period of time, think that those that are positive come into contact further, it is the lumps that roll, it is very difficult to stop it when there are measures that are strict or act, in some way, to greater scale. It is very good that there are specific actions around Bucharest, but let’s still think that it is difficult to make a delimitation between Bucharest and the surrounding towns, people move from one place to another anyway and this happens everywhere. It is very difficult to do a specific quarantine. “
The number of tests reflects the actual number of diseases. Why not test at a maximum capacity of 50,000 tests per day?
Adrian Marinescu: “It is obvious that those diagnosed every day are a minority, unfortunately, in relation to the real number, the real number may be, not necessarily ten times higher, but there is a significant difference, if we did the test at 50,000 it would probably be a required minimum , we should get to test more, probably at least 100,000 tests a day. Why is thorough testing important? Because what we can really do now is to identify those who are positive and I mean asymptomatic, and isolate them and the people who represent direct contacts, epidemiological investigations carried out quickly and correctly together with the tests ”.
Compared to the actual number of diseases, the death rate would be lower, consequently …
Adrian Marinescu: “Certainly the rate is lower, because all this means severe cases, most of them are diagnosed. The great problem is related to asymptomatic patients and with mild forms that generally escape the tests, go through the disease easily and are not diagnosed, but unfortunately they transmit it ”.
While waiting for the vaccine, the infectious disease also spoke of a treatment available in Romania, considered effective: that of monoclonal antibodies.
“When treating with monoclonal antibodies, the patient denies much faster, and also does not reach complications, for medium and severe forms these monoclonal antibodies could represent, I don’t know if the miracle therapy, but it is the most effective therapy that we have during the pandemic It will be a difference from what we had until now, especially since the antiviral drugs used were not new, they were effective drugs but they were also used in other viral infections.
Without critical forms, in the case of critical forms without antiviral drugs, or Remdesivir and any variant that we tested, it was not shown that we reduce mortality and we reached the following conclusion, that we must act so that the patient does not reach a critical form, to make an initial evaluation and prevent these complications, because then it is much more difficult to intervene. Unfortunately, when the critical patient is intubated and ventilated, the probability of going in the right direction is very low ”.
