a worldwide pandemic coronavirus is spreading. And in each country at the forefront of the struggle to be doctors. In Germany to combat the virus was immediately mobilized all of doctors. They are sent to intensive care, and assist with the most difficult patients. How is the situation with the treatment of coronavirus in Germany? What are the side effects of the quarantine? What treatments can save patients or, conversely, to hurt them? The question of “MK” asked the doctor-expert in resuscitation of one of hospitals of Hamburg Ludwig Kehrer (name changed).
What is your medical specialization, experience and great is the experience with coronavirus patients.
-I’m not a virologist or epidemiologist and can’t talk about the nature of this virus and prevention. I’m a pediatrician-neonatologist, I mean, my specialty is intensive care of premature or sick children with congenital malformation of the heart, lungs, or asphyxia. I also have some experience in intensive care of older children up to 18 years, because I also treated them in the past 12 years. So I have, I think, a large (20 + years) experience with mechanical ventilation, blood circulation and cardio-pulmonary resuscitation, and I am familiar with the way in Germany is the situation with the use of intensive therapy.
as for the coronavirus, from the beginning of the epidemic all the doctors of several specialties were “mobilized” and translated into a state of emergency. At least, I, for example, can be used in intensive care adult patients, but still did not personally take part in it.
We wait, when we will receive the patients – children, patients with coronavirus, but so far we haven’t encountered. So far, we have done dozens of tests with our patients-children, but they all gave a negative result.
But in your hospital there are patients with coronavirus? And how do you assess the situation with the treatment of acute forms of the disease in Germany?
-Information about how much is a coronavirus of patients is confidential. I can say that there are not many and they are all older people, usually with severe chronic diseases, which complicates the overall picture. A week ago, we were in the hospital only had four patients who needed ventilation.
-And in General, the level of the country as you estimated?
-In Germany, seven days in intensive care were 2776 patients with a diagnosis of coronavirus. 2045 of them (74%) are connected to mechanical ventilation devices. Before the start of the epidemic in the intensive care units of German hospitals treated 14 thousand 304 people. When the total number of seats – 33 716 thousand. It was a busy 42% of the patients. It turns out that all seriously ill by the coronavirus occupy only 8% of beds in the Departmentdeposits of intensive care throughout the country. And this number is gradually reduced.
German medicine, there is some accepted by all medical course of treatment of coronavirus?
-a Single treatment program (at the time when you talk) does not exist. There are some national guidelines that are mainly based in the us. Because the disease is a brand new treatment guidelines are not based on statistically evaluated scientific data, but on conjecture by some doctors and experience their attempts.
it is not clear whether the used methods of treatment useful or even harmful to patients. Briefly the treatment is as follows: intubation and mechanical ventilation in the early stages of the disease, support with catecholamines blood circulation when it is violated. Perhaps the use of antibiotics if there are some signs of additional bacterial superinfection.
the Drugs used without any evidence of their use is chloroquine/hydroxychloroquine, ramdevi of some HIV medicines and maybe steroids. They are used because they have certified for use in the treatment of other diseases, and guesses on the topic that they can help because they are antiviral drugs.
Ramdevpir used for the treatment of Ebola and HIV, chlorin/hydroxychloroquine – antimalarial. But some laboratory studies have shown that they can help against the virus SARS.
Discussion about the methods of treatment are continuing in two directions. In the first time, talking about medical treatment means that showed successful use in fighting bacterial sepsis, which has some similarities with symptoms COVID-19. Second, there is a debate about the need for non-invasive ventilation. Recently, some doctors report that observed a significant deterioration or death in patients who were intubated and ventilated. This can be explained by poor circulation due to lung damage by artificial ventilation. That is a single of the methods of treatment or therapy is available.
-First we need to organise some reliable and systematic research about this virus and it causes disease to obtain reliable data on how dangerous it is in reality and what treatment gives the best result. Such a study is not existence so far.
the Most important thing is to make a representative sample of the population, perhaps three or four thousand people to determine how many of them were really infected, how many got sick and many died. These data hardly exist d�� date.
the Absence of these data, for example, has led to the fact that in Italy, in the midst of a flu epidemic thousands of patients were placed in one chamber of the sick with coronavirus, which has led to a sharp increase in diseases and mortality. That is, the lack of evidence gives rise to panic, including among doctors.
-what is the attitude in Germany to quarantine measures?
-Virus and quarantine measures already lead to severe side effects. In our hospital, for example, began to do the teenagers who try to commit suicide, two of them had to be resuscitated.
the Reason they’re locked at home and can’t get help. Also it comes to us lot of children who are victims of negligence or aggression on the part of parents who are trapped with them for 6 weeks, although I had not paid so much attention to them.
Elderly people are afraid to call the doctor, which also leads to tragic consequences. The problem largely is that we still don’t know what we actually encountered.
-That is, among the German medical and scientific community there is no single point of view on this?
I would say that there is a real war. There is a group of doctors who claim that the virus is not so terrible as people think. They are now trying to avoid in large media and carefully put up, as supporters of conspiracy theories. Even block sites with their interviews. Who was right – we will understand then. Most likely, the infection is the same in those countries where quarantine was introduced and in those where it was not.
In your estimation, how is the epidemiological situation around the world? All of us or there is hope?
-now we can see that in some countries the epidemic has gone on recession. The result of this quarantine, or simply people have become immune to this question let him answer colleagues virologists.