I recently talked to a nurse working in a regular polyclinic. She had a call from her boss, who said: “Tomorrow you have to bring three face masks to work with you.” Her justified objection that they’re difficult to come by was met by the boss’ curt reply: “It’s your problem. The night is long. There’s enough time to sew them.”
This information was the last drop for me, and I have decided to talk. It seems I have been talking non-stop since all of last Friday and Saturday [Oct. 30-31]. My phone book has 850 entries, and it seems that every single person in it called me. I realized that if my friends and patients (who are all well-prepared to fight a simple viral infection) are panicking, the general panic must be catastrophic.
I talked to a TV channel manager from Kharkiv on Oct. 30. It turned out it’s almost impossible to address the residents of our city because the whole air time is taken up by politicians. On the same night Savik Shuster had a show about flu. This show was one of the greatest shocks of my life: I have never felt so embarrassed for my country.
What is actually happening
Most likely, Ukraine has an epidemic of a respiratory viral infection.
Dear mothers and fathers! People! Please remember that your actions should not depend on the name of the virus. Be it seasonal, swine, elephant, pandemic or no flu at all – it makes no difference. What’s important is that it’s a virus, and it’s airborne and it affects your respiratory organs. And your actions should be based on this understanding.
Prevention
If you or your child meet the virus, and you have no antibodies in your blood, you will get sick. You can develop antibodies in two ways: either you have been sick and gotten better, or through a vaccine.
You can only get vaccinated from seasonal flu. There is no vaccine (in Ukraine) for swine flu. Nevertheless, it’s best to have antibodies to the three viruses that make the seasonal vaccine than no antibodies at all.
1. If you have a chance to get vaccinated, do it on two conditions: that you are perfectly healthy and that you won’t have to wait in long lines in infection-ridden hospitals.
2. There are no proven prevention drugs. No amount of onions, garlic, vodka, no amount of pills swallowed by you or your child can protect you from a respiratory virus, or flu in particular. Everything you’re lining up for in drugstores has not been proven effective. It only satisfies the need of Ukrainians “to do something.”
3. The source of the virus is another human. The fewer of them around, the less chance to get sick. So, quarantines are fine! Banning mass gatherings – fine! Walk rather than take public transport, go to the supermarket less – it’s very wise!
4. The face mask is useful, but not a panacea. Whoever gets sick should wear it around those who are healthy: it will not stop the virus completely, but it will stop the droplets of saliva that are full of virus.
5. The sick person’s hands are as bad a source of virus as his mouth or nose. The patient touches his face and hands, the virus is transferred to their hands, and grabs everything around him. You touch it after him, and get sick. So, avoid touching your face, wash your hands a lot, all the time, carry disinfecting wet napkins, don’t be lazy!
Remember to sneeze or cough into your elbow if you have no napkin, and teach your kids to do the same.
Dear bosses! Please ban handshakes in offices.
Use credit cards – paper money is a great source of viruses.
6. Air the room! Virus particles are active in dry, warm and stale air, but are almost instantly destroyed in cold, wet and moving air. From this point of view, a meeting in the center of Kyiv of 200, 000 people is less dangerous than a gathering of 1, 000 people in a club in Uzhgorod.
Walk about as much as you like. It’s almost impossible to get a virus while you’re walking outside. It’s best to not show off wearing a face mask. You’re better off breathing fresh air and putting the mask on before entering a shop, office or public transport.
For best effect, your room temperature should be around 20 degrees, with 50-70 percent humidity. Air the room thoroughly and frequently. Clean the floor with wet cloths, switch on air humidifiers. Don’t switch on additional heating; better to wear an extra layer.
7. Watch your mucous membranes which are responsible for your local immunity. If they get too dry, viruses easily overcome the initial barrier, and your chances to get sick grow dramatically. Dry air is the main enemy of the dry nose, as well as some medications (including antihistamine drugs).
Spray your nasal passages with a salt solution of one teaspoon of salt per one liter of boiled water. Use any sprayer you can find leftover from other drugs. The more people around you, the more often you should do it. You can buy ready-made saline solutions in the drugstore. This is an especially important procedure if you’re leaving a dry room and are going into a crowd.
Treatment
The only medication that is capable of destroying the flu virus is ozeltamivir, its commercial name is Tamiflu. In theory, there is another drug (zanamivir), but its use is limited and there’s little of it in Ukraine.
Tamiflu should not be chomped by anyone who’s just had a sneeze. It’s expensive, and has many side effects, and it makes no sense at all. Tamiflu is used when the illness is very bad or when the patient belongs to a risk group — elderly, asthma sufferers, diabetics. But if someone needs to take Tamiflu, they also need a doctor’s supervision, and – most likely – hospitalization. That’s why all new shipments of Tamiflu to our country should be forwarded to hospitals, not drugstores.
Attention! Most people reading this should have nothing to do with anti-viral treatment. Flu is a light disease for most people. Treating a viral infection and flu, in particular, is not about swallowing pills. It’s about creating conditions for the body to fight the virus easily.
The rules of treatment
1. Dress warm, but leave the room cold and humid. Make sure the temperature is around 20 degrees, and humidity around 50-70 percent. Wash floors, air the room.
2. Never make a sick person eat! If they feel hungry and ask for it – give them light, carbohydrate-rich food, soups.
3. Drink plenty, all the time! Make sure your drinks are roughly the same temperature as your body. Add an apple to the tea, boil raisins and eat dried apricots. If your child doesn’t like something, let them drink whatever they want. Ready-made rehydration solutions are sold in drugstores. They’re ideal.
4. Spray your nose with saline solutions, often.
5. All the “distracting” procedures are fine: mustard patches, feet steaming, etc. This is more psychotherapy.
6. If you want to combat fever, only use paracetamol or ibuprophen. No aspirin!
7. If your upper respiratory organs are affected (nose, throat or larynx), do not use any expectorants as they will only make the cough worse. If lower organs are affected (bronchitis or pneumonia) cannot be treated without a doctor! Please no self-treatment!
8. Antihistamines have nothing to do with treating respiratory viral infections.
9. Viral infections are not treated with antibiotics. Antibiotics do not reduce, they increase the risk of complications.
10. None of the interferons [artificial protein-based drugs] for local use have been proven effective.
11. Homeopathy is not to do with treatment with herbs. It’s safe. It’s psychotherapy (you feel like you’re doing something.)
When you need a doctor
Always! But this is unrealistic. Here are the situations when a doctor’s presence is obligatory:
No improvement on the fourth day;
Fever on the seventh day;
The patient is feeling really bad, but the symptoms are mild;
When you have one or more of the following symptoms: really pale skin, thirst, breathlessness, intensive pain, purulent discharge;
The cough gets worse, when a deep breath causes a coughing fit;
When you use paracetamol or ibuprophen, but the fever either doesn’t get better, or gets better only marginally, or gets better for a very short time.
You need a doctor urgently if there are any of the following symptoms:
Loss of consciousness;
Convulsions;
Any signs of shortage of breath (difficulty breathing, breathlessness, feeling there isn’t enough air);
Intensive pain anywhere;
Moderate pain in the throat with no runny nose;
Moderate headache in combination with vomiting;
A swollen neck;
Rash that does not disappear when pressed;
Temperature over 39 degrees which does not get better 30 minutes after anti-fever drugs are taken;
Any fever combined with shivering and pale skin.
Everything written here is information that any doctor should know and promote among people. But in reality, the opposite happens.
Mistake one: Incompetence
In the first two days of panic and hysteria, the main advisers and teachers of the people were politicians, including deputies, ministers, former ministers, etc. As soon as a doctor appeared on the TV screen, it turned out that politicians are better at talking.
The apotheosis of panic was one presidential candidate’s declaration that Ukrainians are dying from lung plague. I will say it again: It wasn’t an old granny selling sunflower seeds who said it, but a presidential candidate!
Another presidential candidate was loudly complaining that there is no oxoline ointment [a preventative drug produced in Ukraine], that the criminal pharmaceutical companies failed to import it. Of course, none of those present could explain to the candidate that the effectiveness of this ointment is not proven, and it is imported by neither the United States, nor France, nor any other country.
There are no doctors among presidential candidates, and it must be too expensive to keep a medical adviser on staff. But there are doctors among politicians!
One of them kept mixing up Teraflu, an anti-fever drug, and Tamiflu, an anti-flu drug. When a lawmaker-doctor, who is a secretary of the health committee in the Verkhovna Rada, said that Tamiflu is a drug that only supports the immune system and that we “have decided at the National Security Council meeting that we’ll buy ozeltamivir instead,” I started to feel scared and embarrassed. If the country’s fate is decided by people who have no idea that Tamiflu and ozeltamivir are the same thing, what can we expect?
Who else are the decision-makers going to listen to?
Just like somebody else writes speeches for the president and the prime minister, someone else will now decide on the list of drugs sold in drugstores! And tons of useless “medicine” will be shipped to our country, used nowhere else in the civilized world. Here’s my advice to the decision-makers: Ask World Health Organization experts to make a list of compulsory drugs.
Mistake two: See a doctor immediately
The most persistent advice that everyone has been given is to see a doctor as soon as you have any symptoms. The chief sanitary doctor of the country basically said this: We have no idea what caused pneumonia, but you have to turn for help in time, and doctors know what to do.
Such declarations create an impression that doctors know some secret medicines that could help if you contract a virus. But I’m a doctor who has been dealing with respiratory viral infection treatment for nearly 30 years. Imagine a patient coming to me the first day they get sick, and saying “Help me!” What would I tell them? The same as above: air the room, get plenty of fluids, there is no need for drugs.
If everyone turns to doctors en masse, here is what will happen:
Infection-ridden lines in polyclinics;
A huge number of home calls, and the exhausted doctor will either send everyone to the hospital or prescribe useless drugs, plus carry the infection from one patient to another;
Mass prescription of antibiotics and other medications to the great joy of pharmaceutical companies and medical charlatans;
Lines in drugstores because this is the only place you go to after seeing a doctor;
Unjustified hospitalization and hospital pneumonias;
Overwhelmed by the mass of light cases, the doctors will miss serious ones.
Here’s another bit of advice to power brokers: Do not call for people to see a doctor every time they sneeze. Stop your election campaign and let the doctors tell people elementary things about what needs to be done, and when a doctor is truly needed.
Mistake three: Unprotected doctors
Why have the doctors turned out to be unprotected? Knowing about the swine flu pandemic, and that it would hit us in autumn, why did the doctors who are 100 percent exposed to the virus failed to be vaccinated in September?
Ukraine has no vaccine, even for doctors. That’s why now, in the middle of an epidemic, the doctors will be the first ones to have to stay in bed and receive patients with runny noses. Why couldn’t we order the vaccine for doctors at least?
Because after what has been done to the concept of vaccination, after the barbarian, unworthy and uncivilized anti-vaccination campaign, nobody could even imagine that some new vaccine could be imported with a sped-up registration procedure, with no repeat clinical trials. By the way, people have rushed to get vaccinated en masse in the last few days: it turned out everyone suddenly starts to like vaccination as soon as there is a threat of disease.
Conclusions
If you correlate the number of those who got sick (and multiply by two because only a half of people come to the doctor), and the number of those who have died, it becomes a confirmed fact that there is no especially heavy viral disease in Ukraine. According to the data available by the morning of Nov. 2, officially 200, 000 people got sick, 60 died. The mortality rate is lower than from regular flu.
Pneumonia is the main reason for death of many people in many countries in all times. It can develop as a complication of many other diseases and traumas. If all of these deaths are reported by the media massively, nothing good will come out of it.
It’s very unlucky that so many factors have come together: crisis, election, autumn and flu. But we have to remember that a viral respiratory infection is one of the most common and light diseases. It requires calm and concrete, elementary actions, that any person can afford.
I understand perfectly well what stress a mother has and what she is capable of when every day she hears about a deadly disease going around, and then she suddenly discovers that her child has a runny nose. The only thing I don’t understand is why they’re doing it to our people.
Yevhen Komarovsky a Kharkiv-based doctor, is the author of books on children’s and parents’ health. He is also owner of the private hospital Clinicom. This op-ed was originally published on his blog at http://www.komarovskiy.net.
