Today everyone is talking about GSC-52, which has achieved amazing results in the treatment of coronavirus infection. Every day from the hospital, two months ago turned into a hospital, be discharged 40-50 patients. People who have recently panted, coming home on their feet. Many survivors can become donors and save the heavy patients because plasma transfusion is already showing encouraging results.
We contacted the doctor GKB-52 Alena Zagrebneva, chief extraordinary specialist-rheumatologist of the Department of health of the city of Moscow to find out the cause of breakthrough in the fight against COVID-19.
I oversee the issues of appointment of the targeted and biological therapies for patients with coronavirus pneumonia. Patients come to the clinic in a state of varying severity, the tactics of their treatment is discussed daily on the councils. Our task is to determine whether there are indications for targeted or biological therapy. Treat, observe the condition of patients in dynamics, lead analyst.
– Targeted therapy blocks the growth of cancer cells, it has been successfully practiced in Oncology…
Is a therapy that we use in treating their rheumatic patients. It is aimed at reducing the activity of the aggressive immune system, so all these preparations came to us from the University and we are now successfully used in the treatment of patients in whom cytokine storm occurs.
tell us about the plasma you’re using this method?
– Several clinics are now working with plasma of patients who had COVID-19. We only started in the last week, and trying to understand when it is better to use the plasma: in the beginning, middle or end. Now ready solutions yet. We need time – a week and a half or two. But plasma is not a panacea, but one of the means that can be successful. And we must understand that treats not plasma, but rather a set of different methods.
what are the causes of breakthrough in the treatment of patients with COVID-19?
– In our hospital there are four main specialists: allergist, nephrologist, rheumatologist and koagulopatiah Moscow. We are the first who started with any medications
– How the hospital has changed?
the Clinic has undergone great changes: all the buildings of the hospital to take on patients with coronavirus pneumonia — we have deployed nearly 900 beds. Increased the number of intensive care beds, all the beds in the compartments equipped with oxygen, in buildings shaped area of sanitary systems, built two large buildings for observation of patients who are discharged from hospital after primary therapy, but still require around the clock medical supervision. A commonlife for employees.
– You live at home?
Personally I live at home. But many of my colleagues had to change their usual way of life. People whose families have small children or elderly parents who are at risk moved either in a dormitory at a hospital or in a specially designated city hotels.
– Among the medical staff, there are people at the age of 65?
– Yes, of course, a lot of them. They were given a choice, but all the doctors in this age group who do not have diseases that would increase the risks of very severe consequences in case of infection, remained in the ranks. It was a conscious decision of each employee, but typical for the staff of our hospital as a whole.
Some doctors leave the hospitals. About 350 health workers in Kaliningrad, refused to work with the coronavirus. Of your hospital, too, quit?
– we Have, as far as I know, he quit only part-time workers, whose schedules changed significantly at the primary place of work. All health care providers have canceled my vacation and continued to work. Indeed, despite all the precautions, still there are losses of personnel – sick knocked out of action for about a month.
How many people were infected?
26 people. Fortunately, they all survived the infection in the form of light.
– They contracted in the hospital?
– actually, the question is, where can we catch the infection at work or on the way to it — is very relevant. You can become infected in the subway, in the store, because disposable mask and gloves – not the most reliable protection. Partly at work even more reliable and safer than any other place, we provided a fairly reliable means of individual protection. But it is problematic to fully comply with the rules of protection when you’re working around the clock. Meal, water, trips to the bathroom associated with rigorous security measures. Sometimes neglect it. The human factor unfortunately is the place.
Nurses experiencing severe stress…
– actually, we are all very hard it’s true. People forced from their traditional way of life. Matters and the lack of full output, and isolation from relatives.
But patients too have a hard time. Only one diagnosis can strike on the spot.
When the patients enter the hospital, the first thing you see – the number of recovering people. Yesterday the patient was suffocating, and today, his temperature returned to normal, and he almost does not need oxygen. The light at the end of the tunnel they absolutely are! And we do this with no light, because the amount of income is not reduced. There was a period when all offices were filled. Now the number of beds in Moscow increased, and one hundred��on much easier. In fact, all of us with great tension waiting for the end of the may holidays – the call to stay at home working only partially.
– Many people are afraid to get on the ventilator.
– You know, I’m pretty sure this fear — from a complete misunderstanding of causation. Mechanical ventilation is a life-saving technique in the complex treatment of the patient. But is it really in the case of heavy course of the disease.
People are scared, because the mortality rate is high.
– we Must understand that if the patient is admitted on a ventilator, we’re dealing with heavy sometimes uncontrollable disease. Mortality has nothing to do with the very fact of the connection of the patient to the ventilator. Solely with the severity of lesions of organs and systems within the COVID infection.
– First we were told that COVID-19 mainly affects older people, now we often hear about young and healthy. What age are your patients?
– Age with a range from 20 to 100 years. Now the emphasis has really shifted to the young – from 20 to 40 years. From them, some suffer from chronic diseases: obesity, diabetes, chronic obstructive pulmonary disease and other diseases. Of course, to help the patient without comorbidities is much easier.
have you Experienced as a rheumatologist with something new and unexpected?
– I don’t fully understand the laws of the course of the disease. On the one hand, this is a common viral infection, and some patients simply tolerate the conventional “cold” with a standard set of clinical manifestations. But the second part of the event is the reaction of the immune system on the virus: it starts the so-called “cytokine storm”, manifestations of which can kill a person.
Sometimes the patient may have all the signs of a “cytokine storm” on the third day from the onset of clinical signs of disease and sometimes it happens 12-14 days. Unfortunately, not very successful at it to determine the timing of the onset of this reaction of the body. Thank God that the “cytokine storm” has certain characteristics, such as the CT scan of the chest and laboratory analysis, and it kind of suggests which products need to be applied in each patient in a given time.
– Not afraid to get infected?
– No, I’m not. Is absolutely clear to us effective treatment regimens that work, regardless of the severity of the disease. The problem usually arises with those patients who for unclear reasons for us not to comply with recommendations of physicians outpatient stage or do not seek medical helpready and waiting at all, choosing the “ostrich” policy: “I know nothing, it means nothing”. Sick kovida not scary. The only question is the timeliness of access to medical care.
