"There Will Be A Third Wave, And A Fifth, And Tenth." Famous Doctor Spoke About What To Expect From COVID-19 Next

"There Will Be A Third Wave, And A Fifth, And Tenth." Famous Doctor Spoke About What To Expect From COVID-19 Next
"There Will Be A Third Wave, And A Fifth, And Tenth." Famous Doctor Spoke About What To Expect From COVID-19 Next

Video: "There Will Be A Third Wave, And A Fifth, And Tenth." Famous Doctor Spoke About What To Expect From COVID-19 Next

Video: Параметры поиска 2022, November
Anonim

The Karelia.News portal again talked with Dmitry Aizikov, our fellow countryman, doctor, deputy chief physician of the Odintsovo Regional Hospital of the Moscow Region. In the spring, he entered the operational headquarters for the fight against coronavirus of the Ministry of Health of the Moscow Region and headed the Patriot hospital. Many Karelian physicians remember him as a senior lecturer at the Department of Pharmacology at Petrozavodsk State University. - Dmitry Lvovich, half a year has passed since our interview with the title "Everyone will have to get sick." It seems that your prediction is now coming true. Did you understand that there will be a second wave? None of the doctors had any illusions - everyone understood that, according to the laws of the epidemiological genre, there would always be a second wave. And it will certainly differ from the first in severity and duration. When waves come, no one can predict exactly, but there are models that allow you to calculate approximate numbers. And so far we are moving in accordance with these models. Yes, we have entered the second wave, the pace of development shows that it is in full swing. Then it will naturally decrease. This is normal. I would also like to note that now the growth rate of cases is high, but we must clearly understand that, compared to the previous period, the number of people tested is constantly growing. And, accordingly, more carriers of covid infection are detected. - Six months ago, all carriers of the infection were hospitalized. It’s not like that now. - Now, of course, it's different. Not all covid infections are hospitalized. She's not all "heavy". Therefore, we now see fewer mistakes when all the infected were hospitalized, which caused "traffic jams" at the stage of hospitalization. After analyzing the last wave, conclusions were drawn, and we restructured our work. Now only those who have high risks of complications and those who initially have a difficult course of the disease are immediately hospitalized. We no longer hospitalize everyone in a row. - Whom are they hospitalized? - Persons with a temperature above 38, while their respiratory rate (shortness of breath) should be above 25, cough, and saturation (blood oxygen saturation) below 95 - we immediately hospitalize such patients. And then we are already deciding on the treatment. And the second group of people who are immediately hospitalized are people who may not even have fully expressed symptoms, but this is an older age group, patients with diabetes mellitus, with a severe course of COPD (chronic obstructive pulmonary disease - ed.) in combination with the previous indicators - they try to immediately hospitalize such patients. - What is the difference between the second wave and the first? You can argue in different ways. Now the scenario of the development of the disease is being realized a little more severe than it was expected. More infected people are detected, but not more severe cases. Yes, hospitals are full, but this does not mean that we have a shortage of beds. In each subject, the situation develops differently. If you look at the graphs, we can see that earlier the increase in morbidity and mortality was due to the contribution of Moscow and the Moscow region. Now the regions are in first place in terms of morbidity and mortality. This may indicate that population immunity is beginning to form in Moscow and the Moscow region. - What is “population immunity? - Population immunity is a term that means that the population living in a certain area already has antibodies to this infection, and this population is not susceptible to the disease.It is likely that over time, the strength of immunity in a particular region will decrease and there will again begin an increase in the incidence. The spread of coronavirus across the country was uneven: there are regions with manifestations of population immunity, there are regions where it is not yet available. It is in these regions that the wave must necessarily pass. Figuratively speaking: the covid must take off his harvest. Whatever the infection needs, she needs to get it. Therefore, the baton of diseases is passing from Moscow and the Moscow region to the regions, including, as we can see, to Karelia, where many cases are now being detected. A large number of cases will also be detected in the capital, but due to the fact that there are simply more people living there and testing is carried out more often. - Are there any data on secondary diseases? - Yes, such data exist and we have patients who get sick again. But the question is - is it new (repeated) or reactivation of the old? Alas, we cannot yet answer this question. - There is a lot of talk about antibodies and their properties. But it seems that few people understand what it really is. Will you tell? - Antibodies, if correct - immunoglobulins. These are protein molecules, rather large and complex. They are produced by B-lymphocytes, these are blood cells. Antibodies have the main task - to attach to pathogens (viruses or bacteria) and signal the cells of the immune system that "they have attached to something bad, it must be urgently destroyed." Antibodies radically help the cells of the immune system to detect and destroy pathogens. Without them, we would not be able to resist any infection. Since each person has his own immune system, then the strength of the immune system is different for everyone. After the disease begins to produce antibodies, but the "quality" of these bodies depends on the state of the human immune system. People who lead unhealthy lifestyles are likely to develop immune cells with insufficient resistance to infection. There are two main points - the duration of the existence of these antibodies and their activity (quality) to the pathogen. It is this in the aggregate that is responsible for the period when a person becomes "immune" to infection. Take diphtheria as an example. A person who has had it develops antibodies, but for a very short time. Then he can get sick again. However, when he receives the diphtheria vaccine (booster vaccination every five years), the person does not get sick. In this case, the developed vaccine can actually prevent the development of the disease. At the same time, a person who just suffered from diphtheria can easily get sick again in a year. Or the worst infection is smallpox. The person either survived or died. If he survived, he was disfigured, but the second time he never got sick again. But then there was a high mortality rate. Smallpox is the most terrible infection on earth, which claimed the greatest number of lives, it has the highest lethality. - The press reported the lifetime of antibodies - from 2 to 6 months. Is this already scientifically proven? Say, he had been ill and you will not get sick again until six months. - Not. There is no such exact information. Different levels of technology for determining antibodies have different sensitivity and hence different dates are called, it is very difficult to determine the exact duration of the existence of antibodies. For example, the most accurate and sensitive methods can find antibodies even after six months, while another, simpler method will not find them in the body at all. - A lot of conflicting publications about the existing Russian vaccine raise a lot of questions. What can you say about her? There is a fact - it is registered. All that can be said about it now is that we hope it will be effective on a population scale. - Three phases of vaccine trial. This is also being discussed a lot now.What do they include? - The main reference point in all phases of research is the safety of use for humans. The first phase is the development of the maximum tolerated effective dose, the second is the dose multiplicity for various methods of administration, the interval and combination, determining when and how much vaccine a person should receive for optimal treatment, the scheme for using the vaccine that will produce the greatest amount of antibodies is being worked out. The third phase is the choice of an option and the development of the immunization scheme, research and observation of vaccinated people. Direct studies of how much antibodies are produced, how these antibodies function for a long time in the body. As a result of all three stages, a "golden mean" is found - to make the most effective and safest immunization process. - How much does seasonality affect the spread of coronavirus? Of course it does. After the spring surge, summer came, everyone stopped wearing masks, establishments opened, albeit limitedly, cultural events began, catering began to work. But there was no splash in the summer, but now it has appeared. - What is "seasonality"? Why do outbreaks of diseases appear in spring and autumn? - A change in ambient temperature in autumn and spring leads to a serious readjustment of the body. This is a complex and energy-consuming process, which the human immune system does not always have time to cope with quickly. And that is why seasonal illnesses occur. In the human body, many processes are associated with heat exchange. In the autumn-spring period, our heat exchange is naturally disrupted, and the body is more susceptible to the risk of diseases. At this point, the likelihood of any infection, including covid one, is higher. And this is a natural process. That is, the waves of the incidence of coronavirus and the usual seasonal diseases will always coincide. - In the last interview you said that everyone will get sick. This is confirmed? - The biological strategy of any virus is such that the more pathogenic a virus is, the faster it is washed out of the environment. The virus tries to stay in its population, and this requires a substrate - that is, a person. Therefore, with each new round (wave) of coronavirus infection, there will be more and more cases, and the disease will be easier to progress. And as a result, it will become a common ordinary infection, like now, for example, the flu. - That's when herd immunity will start working? - Not really. On the one hand, we acquire antibodies, and on the other hand, the pathogen itself loses its properties and "fighting qualities" over time. That is, in order to survive, it develops towards a "carefully flowing" infection without killing the cells in which it lives. Herd immunity will begin to form when more than 60% of the population falls ill. It is estimated that now only 15 to 30% of the population has antibodies. Accordingly, we are still far from the collective. - Again, I would like to ask about personal protective equipment and their effectiveness. Are masks still effective? We must understand that the most important point is the quality of the masks. Masks with a high degree of protection provide real protection against viruses. These are not even masks, these are respirators. We have talked many times about the size of the holes of the cloth masks, which have appeared in abundance on the market and have become a fashion accessory, and the size of the virus. I would compare them to a soccer goal and a ball. Approximately the same size ratio. I will not say anything further and advise nothing. Everyone has to decide for himself: to wear a mask or a fashionable, creative and useless accessory on his face. We must remember all sorts of regional acts and rules that govern this issue. - What can you say about gloves? - The virus does not penetrate the skin. If you wash your hands, you are protecting yourself. But you don't wash your gloves after use. And you probably don't throw them away after every use. Probably removed, often turned inside out, and put in a bag for further use.What do you think will be the effect of such protection? Isn't it easier to just wash and clean your hands? Another point: you can also, by inertia, touch your face with your gloved hand. But even if you just touch your face, it's okay. The virus does not penetrate the skin. You can unknowingly rub the mucous membrane by picking your nose or rubbing your eyes with or without gloves. That is, wearing gloves, you do not protect yourself from the virus in any way, but you minimize the risks of transmission of infection through bodily contact from a patient who sneezed and did not cover his mouth and nose … small particles of suspension with viral particles will be on the surface. So the transmission of these particles from person to person is reduced when using gloves. - And what about the masks and seals in the end? - As a result, masks and gloves for healthy people fully fulfill the protective function for the virus, if others are also wearing masks and gloves. A doctor, when he goes to a patient with a covid infection, does not wear a mask, but a respirator with an increased degree of protection. And the population manages, as in memes, to go through two epidemiological seasons in one disposable non-medical napkin mask. This is not protection. - So the masks are still meaningless? Masks should be worn primarily by those people who are sick. And in general, if you get sick, stay at home, and do not wander around the city, even wearing a mask. Those who come into contact with patients should wear a mask with a normal level of protection. And homemade colored rags on the face are nothing more than an exterior detail that has nothing to do with virus protection. - With masks it is more or less clear. Let's go back to the waves again. Now there is a second wave. How many waves are assumed in total? - There will be a third wave, and a fifth, and tenth. A sufficiently large number of "waves" will pass until the optimal vaccine is found, and only this will change the epidemic process. How the advent of the vaccine led to changes in hepatitis B, smallpox or polio. - If a person has been ill with covid, and he developed antibodies - at this time he can be a carrier of the disease? Not. If a person has immunoglobulin G (antibodies), they can neither get sick nor carry the disease. That is, if new viruses enter his body, antibodies "kill" them. - What advice can you give to everyone who has not yet been ill and is afraid of getting infected? - No need to panic. When the guns speak, the muses are silent. And as a continuation of this thought - when emotions speak, the mind is silent. Any process must be treated calmly and calmly. It is necessary to turn off emotions, hysteria and calmly continue to live, observing the basic rules of hygiene. - But often hysteria is based on ignorance and lack of awareness of the population. - Not certainly in that way. We can provide detailed information, but this will further disperse the wave of panic. After all, it all depends on who we inform, what level of understanding of what is said in a person, what level of education. Any information in one person will cause understanding and reassurance, while another may experience a wave of panic from it. There is not an ounce of snobbery in my words. There is a clear understanding for which target audience what information needs to be conveyed for correct perception. Information is like vitamins - in the right amount, they have a beneficial effect on the body, and in excess, they will lead to poisoning. Information does not exist by itself, it always exists in the intellectual context of the reader. Therefore, the same text can be interpreted in completely different ways by different groups of the population. So you have to stop worrying and just live. Observing all the necessary protective measures, appear less in crowded places and wash your hands more often. And if you are already sick, call a doctor, and do not walk around the city. Recorded by Alexey Glushkov and Evgeny Belyanchikov

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