«The Ministry of Health tells us to only treat COVID-19 patients. This is absurd. Why can’t I help other patients who come for consultations? Every patient should be treated equally. I have never worked in such an intellectual and logistic anarchy in my life »- says prof. dr hab. Krzysztof Simon, MD. What problems is his department facing? Does he think that the restrictions will need to be strengthened in the near future?
- Prof. dr hab. Krzysztof Simon, MD, is the head of the Department of Infectious Diseases and Hepatology of the Medical University in Wrocław and the head of the Department of Infectious Diseases
- Prof. Krzysztof Simon: a quarter of people in Poland (approx. 9,5 million people) are susceptible to severe, lethal infection due to coronavirus. These people must be protected. If we don’t wear masks, keep our distance, wash our hands – these people will become infected. I appeal for common sense
- Krzysztof Simon: the ministry gives us an obligation to only deal with cases of COVID-19 infection, which is an absurd thing
- Why are infectious agents lacking in many hospitals? Prof. Simon: The job is financially unattractive (…) I was president of communicants until 2012. 1,2 thousand people worked in this profession. There are 230 of them at the moment
- Professor Simon: there is a huge risk of another epidemic in the fall-winter period.
Martyna Chmielewska, Medexpress: The coronavirus epidemic continues. At the moment, we have over 35 thousand. infected people and over 1,5 thousand. people died (data from July 3 – Medonet’s note). What is the situation from the professor’s perspective?
Prof. dr hab. medical Krzysztof Simon: Aside from the number of deaths that are fairly true, the latter is unlikely. According to the rules of knowledge, there are at least five times more of these people. Most people (80%) pass the infection asymptomatically. Research in mines has proven this.
If you had screened in other mines or in a large workplace, there would be several thousand of these infections a day. Clinically overt infection occurs in people with a predisposition, generally in people over 60 years of age with burdens and comorbidities. It is dangerous for them.
What is the situation at your ward? How many people are infected and what is their health?
As is known, with the course of these types of airborne diseases, during the holiday season or when it is warm and humid, the number of infections does indeed decrease. We have other infections, maybe not so dangerous, that reach us. There are not many actually infected cases of SARS with COVID-19 disease – several or a dozen people stay in our hospital. The other cases sent are those with a fever, without any other symptoms (…) This applies to massive pressure ulcers, a cancer process, a crushed leg, etc., so as to get rid of the problem in other hospitals. This is the domain.
At the same time, the ministry is imposing an obligation on us to only deal with cases of COVID-19 infection, which is an absurd thing. We cannot consult others. How am I not supposed to consult other people when patients come here? In my life in such an intellectual and logistic anarchy, I did not work!
What are the biggest problems facing the branch? Are your personnel lacking, for example, nurses, anaesthesiologists?
In the beginning, there were organizational problems. We lacked disposable and protective equipment. We arranged everything during the peak of the epidemic. 100-200 were infected a day. People showed up at the emergency room. Of course, only some were infected with COVID-19, the rest had SARS and other diseases. We made it.
After about a month and a half, supplies of equipment from various sources appeared. First, we received them from private persons, the voivode and the marshal. It worked locally. Then central deliveries began. There were no problems in this regard.
Obviously there is a staff problem that puts their lives at risk and is, to put it mildly, poorly paid. Bureaucrats sit behind the desk. They talk about savings all the time and medics put their lives at risk. This was to be compensated, because we suspended our internships, clinics, offices, activities related to extra money or providing free consultations. According to Secretary of State Józefa Szczurek-Żelazko, we cannot do this. This is paranoia!
What action do you intend to take in this matter?
We wrote many times to the Ministry of Health and the voivode to lift this ban. We want to treat every patient the same. You cannot discriminate against anyone in a democratic country on the basis of illness, race or religion. We don’t even dream anymore and we don’t discuss additions etc.
We know that hospitals lack infectious agents …
This is true of many hospitals. The job is financially unattractive. I am an infectious disease, internist and hematologist. I really like my job. This specialization must be treated as a deficit discipline. I was president of infectious agents until 2012. 1,2 thousand people worked in this profession. There are 230 at the moment.
For many years, this specialization was considered as not far-reaching. Currently, it is worth its weight in gold. What actions should be taken so that doctors choose it more willingly?
The specialization is very exciting and interesting, because of course it has sub-specializations. Every job must be adequately paid, regardless of learning, knowledge and passion. They pay meagerly in hospitals. Consequently, very few people are interested in working. And you have to live off something, you have to go on vacation. Specialization becomes scarce. The government is not responding to this.
Ramdesivir is an American drug for the coronavirus. In April, it was tested in the infectious diseases hospital in Wrocław. It is now available to patients. How do you rate him?
We were the first to include this drug in treatment (we also use various other antiviral drugs). I think the drug is effective, albeit overrated. It is not as effective as flu medications in antiviral activity. We do not use it in advanced forms (…) only in transitional forms (…), when there is a large replication of the virus and it may end up with worsening of pneumonia.
According to all the data and our observations, the use of ramdesivir in a patient shortens his hospital stay by 3 – 4 days. The drug is also toxic. There are hepatic and renal side effects.
What is your experience of using other drugs to fight the coronavirus?
We use various drugs, e.g. for HIV (these were our first preparations). The use of more extensive chloroquine and hydroxychloroquine in advanced forms has been withdrawn. We use antiviral drugs for influenza, cytokine shock (main interleukin six blockers), and plasma of convalescents.
The combination of various therapeutic procedures allows us to believe that they are effective. We will not cure all of them. Many people are burdened with various diseases, but we are definitely improving their condition. There are definitely fewer cases of rapidly progressive respiratory failure.
After three months of a very strong lockdown, the public is already tired of the rules and restrictions in force, and therefore avoids them. Do the restrictions need to be strengthened in the near future? If so, which ones and when?
The usual decent solidarity is disappearing in Poland. Society was divided into better, worse and sovereign. A quarter of people (about 9,5 million people) are susceptible to severe, lethal infection due to the coronavirus. These people must be protected. If we don’t wear masks, keep a distance, wash our hands, these people will become infected. From the pool of 9,5 million people, 450 thousand will die. In such a situation, we will have World War II. Some people need this information.
People only think about themselves. They don’t wear masks because they say there’s no virus, for example. Young people are not interested in the fate of older people. Their stupidity is terrifying. Such behavior is not found in Asian or Western European societies. Terrifying stupidity, private life, interest only in the tip of the nose, are unheard of.
- The microbiologist’s experiment showed why it is worth wearing a mask and keeping social distance
I appeal for common sense. Everyone will be older, sick one day. The next generation will say that it “hoots and flutters”. These behaviors are stimulated from the outside. They are better and worse in this country. What does it mean? Better and less educated, hard-working and doing nothing, living off benefits (which others have to earn). This is outrageous from my point of view. I want to help everyone. But I’m not going to give the idlers a single zloty of my hard-earned salary.
A second wave of coronavirus is likely to emerge in the fall along with the flu season. There may be more infections. What changes in the health care system should take place to ensure the safety of citizens?
There is a huge risk of another epidemic in the fall and winter. If it is colder, cooler, dry, disease spreads. An epidemic of normal flu and severe flu may ensue. Our society does not vaccinate. The convergence of the course of influenza in people with multiple diseases and the imposition of a subsequent or previous coronavirus, it will be the holocaust of the people. They will just die. You have to prepare for all of this.
We are no longer adding infectious wards, but at least we can start some construction work. We should create centers in the centers of the country. The point is, in a year, two or 10 years, if an epidemic comes, be prepared for it.
I know there is still no money. If there are funds for giving away, it should also be enough for the health service. There are more and more people. Humanity is penetrating different areas. He settles in worse and worse territories. We eat unhealthy things. These epidemics will happen.
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