Luc Brunet - 17 November 2021
As readers following me on Facebook may know already, I contracted COVID-19 in October and spent 10 days in hospital, now well recovered. This article shall cover two themes, one related to my personal experience, the other one related to the overall situation in Russia and in the world.
First about my personal encounter with COVID.
I was the third family member to get sick, as another member was sick in May 2021 and the second one a few days before myself in October. In all three cases, we used the protocol Raoult based on the name of the well known French professor in Marseilles. In two cases it worked well and my relatives could recover at home without major impact. My case was a bit different, and on my views due to a delay in taking the right decisions. First I started to take the protocol two days after getting the first symptoms (cough and some temperature) as the first antigenic COVID test was doubtful, and the second negative. After two days, a new test was finally positive, and I started the protocol after that only.
Secondly, my oxygen saturation started to go down after a few days, and I was slow to react to it, partly influenced in that by information from Internet sites (medical sites, not Facebook "specialists"!) saying that you need to call a doctor if you reach 93% or 92%. I waited to reach 93% and it was already too late to be cured at home, and we called emergency services.
The rest of the events was quite standard now in Moscow, with first a visit to a chest CT (Computer Tomography) center, were the result was bad enough for the doctor to tell me that the only way was to go to hospital.
Ignoring the state of the Moscow medical ecosystem to help COVID patients, we made an attempt to investigate what could be offered by private clinics, and one of them proposed a personal room, with full treatment, for a price of 500,000 rubles pre-payment and a total cost somewhere between 1 and 2 million rubles (between 14,000 and 28,000 US$). If you read my previous article, you understand my position about health-care, and I decided to follow my written words and trust the state controlled system (to be honest, the price suggested by those COVID "businessmen" helped as well..), and was dispatched immediately to the temporary hospital for COVID, operating in pavilion 75 of the exhibition center VDNKh.
The temporary hospital was created in May 2020, and is now in full operation after a low in activity earlier this year. It was constructed in 2 weeks by a contractor called Homich Group (also doing the refurbishment of many district clinics in Moscow), and a video below shows the construction process, in Russian, but the pictures are self-explaining.
It is a very impressive facility of 36,000 sqm surface, providing around 1,500 usual beds and 200 ICU beds. Of course personal comfort and privacy is limited, and the place looks very much like like an "Open Space" office as we see in many companies. Each patient has a "cubicle", and the picture bellow, taken from my cubicle, shows neighboring empty cubicles, that indeed were quickly filled the next day. Such dedicated resources created from scratch are clearly a contrast with France, where 5,700 hospital beds were closed in 2020 alone, following a plan to save public money. We know what it means.
Personnel in the hospital all have deep experience healing COVID, using a range of different protocols, including new and traditional drugs, like antibiotics and anti-viral tools, mostly using drip-feeds. Blood analysis were frequent and doctors met us every morning. All people were young and very helpful, explaining what was used for the cure and why.
I really thanks all those people for the great work, also considering that they work all shift with a full protection suit, mask and glasses.
The facility was very clean and well maintained, with advanced equipment, especially in the ICU section. Interestingly, the place (usual beds) is populated by individuals of all ages, including men in their 20's. In women groups, I saw however very few young girls, but mainly women in their 40's or more. ICU is mainly populated with elderly people, although some younger men joined us after a time in ICU. There was also a quite large number of vaccinated people, or people getting sick for the second time.
Finally, food was indeed hospital food, but quite well balanced and rather tasty.
The good organization continued to impress me on the day I was released, as a doctor from the local clinic visited me 2 hours after I returned home, to check me and explain the process to follow over the next weeks. Here again, a young and friendly lady, not too afraid of the virus, and was sick twice already. Great people, doing a difficult job. Respect.
The lessons I can share are simple:
- everybody should have an oximeter at home to control oxygen level. Below 96 or 95%, call the doctor and check lungs, do not wait to get lower!
- use early treatments, the one you wish, if possible under medical guidance, in countries where it is possible!
- beware of tests (PCR or antigenic)!. In my case, both proved unreliable (the first PCR arriving at the hospital was negative, while COVID was confirmed next day by blood analysis). I probably had a low virus load in the nose and mouth, but I was surely not the only one in that case.
- if you live in Moscow: the local COVID medical ecosystem is working well, do not fear to enter it!
As I wrote long ago, and in the absence of organized prevention (see lower), we can assume that all of us shall be contaminated once, and may be several times, so better be prepared, vaccinated or not. Mass vaccination during an epidemics is supposed to accelerate the mutation rate, and it seems this is the case. Waves should not be called waves, as they are new epidemics, so everyone can be sick again.
Now what about the situation in Russia?
Looking at the present statistics for Russia, my statements above look like a fantasy I made up when I had high fever. I believe there are several reasons for that.
At first, the organization in Moscow, and I guess the largest cities in Russia is one thing. but what happens in small cities and villages is another story. If someone has death statistics based on regions, we could check that. But I am quite convinced that many COVID deaths come from small cities, where hospitals and the health-care system is in a very bad state. Of course if is great to invest in hospitals like VDNKh 75, but a lot of feed-back I get about regions and about non COVID related medicine is not positive. Investment in equipment and people should be reconsidered and increased (a lot!) - the country can afford it.
The second point I want to make is shared between Russia and many western countries. It is a dangerous neglect of two things: early treatments and prevention.
Early treatments in Russia are at least not forbidden like in many western countries, but they should be explained and made easily available for all, including in remote areas and for people living isolated (like many elderly people in big cities). Messages on TV are too frightening and impressive, the language should be positive and encouraging, explaining to people what are the steps to follow in case of symptoms. Make oximeters free for pensioners would be a good idea. Early treatment kits as used in India could also be distributed. Those early treatment are one tool among others to fight COVID and they should not be neglected. China is now showing the way, investing a lot in treatments for COVID.
Prevention is the next point were Russia and western countries failed. Simple measures taken early in Asia brought good results. For example body temperature controls are more efficient that controls based on QR-codes, as it is proven that vaccinated people and people who got sick once already, can both be infected again. I am talking here about serious controls, not the joke I have seen many times in shopping centers in Moscow, where a guard clicks his thermometer towards your hand and does not even look at the screen! Temperature controls in big malls as well as in public transportation should be automatic, using temperature sensitive cameras. There is a lot of developments to be made in the prevention field. If only a small part of all the money spent into questionable vaccines had been invested in prevention, I am sure we would be much better off.
The picture bellow is an example of well formulated summary of treatment schedules based on age and co-morbidity. I am not endorsing the drugs listed in the picture, its the job of doctors, but I want to show the type of communication we should see from authorities. My own experience as seen from my VDNKh cubicle confirmed what I always thought, that COVID should be cured whenever possible. In 10 days I saw several people leaving ICU and joining us for getting final cure before getting home, but NOBODY from my unit (80 beds) left to be transferred to ICU. If COVID was incurable, I should have seen the opposite trend.
As we see now many countries with 80% or more vaccinated at the start of a new epidemic, the questions of early treatment and effective prevention shall be the key success factors.
But they shall not be addressed properly before the vaccination mirage blows up.