The
Covid-19 pandemic is hitting Romania with a fourth wave, stronger than the
other three. The number of cases is higher, the same with mortality, and the
pressure on the medical system has long exceeded the limits which it can take.
In these
conditions, a maximum effort is necessary from the ones that work in the
medical system but, at least in an equal measure, from political
decision-makers and, least but not last, from the entire population.
It's been
almost 2 years since the debut of the pandemic and various unknown elements,
and as many various controversies continue to persist regarding the origin of
the pandemic, the manner in which the virus has spread, the physical pathology
of the infection, treatment methods, etc. Vaccines, which were relatively quick
to appear after the beginning of the pandemic, were not exempted of
controversies, especially given the fact that there are several types and based
on various principles (from the "classical" ones, as modified virus,
to the modern ones, based on Messenger RNA).
In the face
of all these controversies, it can be disorienting for the population,
especially given the fact that the manner of communication of the authorities
has not always been the most adequate.
Therefore,
what should we do?
I think
that, now, we can formulate a series of recommendations based on the prevalent
conclusions drawn in the two years of the pandemic:
Prophylactic
recommendations:
-
Due
to the fact that it is very clearly known, beyond any doubt, that the disease
is being transmitted from one person to another, any potential contact can be
dangerous and, insofar as possible, must be avoided. We must especially avoid
large crowds and events with lots of participants.
-
Although
mask wearing started several controversies and some countries did not include
it in their prophylactic measures (Sweden), I believe that this recommendation
must be observed.
-
Testing
is not easy nor cheap, but the more it is practiced, the more safety it gives
us, but also to those whom we are in contact with.
-
Vaccination:
has probably caused the most controversies. Nevertheless, the data show beyond
any doubt that the populations which have been immunised are more protected,
even against new strains. This is why the recommendation for vaccination is
strong. As we already know, all vaccines can cause adverse effects, some pretty
serious ones, and this is also the case for anti-Sars-Cov 2 vaccines. But, if
we put in balance the benefits which the vaccine can bring compared to its
potential adverse effects, the conclusion remains the same, we have known for
over 200 years (since the British Jenner introduced vaccination for humans as a
method of disease prophylaxis): vaccination protects us and it is recommended.
Regarding
the type of vaccine, it seems that messenger RNA vaccines manufactured by
Pfizer and Moderna have already proven to stand the test of time.
Therapeutic
recommendations:
-
We
must take into account the fact that access to the hospital can become more and
more difficult, so we start by assuming that treatment can also be taken at
home for mild and even medium cases. Among the medicines tested during the
pandemic some have stood the test of time:
o
Umifenovir
(Arbidol)
o
Favipiravir
Both can be
found as tablets. Consulting the physician before starting any treatment is
mandatory, but, if access to a hospital is not possible, the patient can
isolate at home and can begin treatment under the guidance of the family
physician.
-
Among
injectable treatments, the following have proven to be efficient:
o
Tocilizumab
o
Monoclonal
antibodies as the cocktail manufactured by the Regeneron company (REGN-COV2
Antibody Cocktail)
o
Remdesivir
Their use
is recommended in the hospital because they require strict medical surveillance
regarding the manner of administration, as well as their potential adverse
effects.
The same
thing can also be said about the use of oxygen, when it's necessary, although
it can be used at home too.
However,
cases that need injectable treatment and oxygen administration can become at
any time severe cases which need orotracheal intubation and mechanical
ventilation, which is why sick patients must go to hospitals.
During all
this period, a maximum discipline is required, in order to protect ourselves
and others. This is why the population must prove to have maximum
responsibility: to monitor the evolution of the pandemic, in order to be
updated about new data and about everything that, eventually, can be
implemented as prophylaxis and treatment and to comply with official strict
recommendations.