Head Of Israel Medical Centers Association On Belarusian Method To Combat COVID-19: I Have No Decent Words

The only model that worked was strict quarantine.

You can help those who lost their jobs because of quarantine, but you can’t help a dead person.

A strict quarantine is the only effective way to combat the spread of the coronavirus, said Roman Goldman, head of the Israel Medical Centers Association MEDES, in his article for the Gordon website.

From morning to evening, regardless of the situation, I am in the hospital. But in today's situation, I often communicate with doctors from the very frontline - the chief physician of the infectious diseases department and the virologist, who are responsible for the research on the current pandemic. These are those who take and treat coronavirus patients every day.

I decided to briefly share my observations with you.

The virus.

There is no unequivocal opinion either among physicians or researchers. This is something we are facing now.

Where did the virus come from, how is it transmitted and, most importantly, how will it behave in the future? Initially, it was assumed that the virus is transmitted by drip, settling on surfaces, then by airborne droplets, today there are works that talk about the possibility of transmission of the disease even through sexual contact. It is not clear who is the most vulnerable, and what causes the consequences: some people go through it asymptomatically, in others, even young people, it causes serious damage. And not only the respiratory system, but the whole body. This can be somewhat compared with alcohol tolerance. One will drink a liter of whiskey and go home on their own feet, the other will fall under the table after a couple of glasses. But if the presence or absence of alcohol tolerance is more or less studied, then there is no clear understanding with the virus for a very simple reason. Little time and little data.

In order to draw conclusions, it is necessary to accumulate and process more information. Perhaps it will take years until we finally understand what COVID-19 is, where it came from and how to deal with it. Even the tests do not give a 100 percent result - the doctors tell how they took the test from a patient who is under mechanical ventilation with all the symptoms of the “corona”. One, two, three - only the sixth gave a positive result.

The treatment

There are no protocols that have obtained clinical evidence of efficacy. All for the same reason - too little time has passed. The applied schemes have already changed, and several times. They are suitable for some patients, but not for others. Just recently, for example, they realized that anticoagulants should be used not with preventive doses, but with full therapeutic ones. The remedy for malaria raises many questions, and there is practically no benefit from antibiotics in the treatment of the coronavirus, given the viral nature of the pathogen. Antibiotics are prescribed only for the treatment of bacterial complications.

Israel has one of the lowest coronavirus death toll in the world. Doctors do not explain this with the national and genetic characteristics, or miracles of Israeli medicine. A team of doctors worked on each seriously ill patient in the country, and each seriously ill patient had a place in the intensive care. Not a “bunk”, four legs and a mattress, but a place with oxygen, ventilation and other equipment systems connected. Those who were connected to the ventilator were left on it until the condition was completely stabilized. Patients stayed on mechanical ventilation much longer than in other countries. How is this possible? Yes, it’s very simple - the Israeli healthcare system was not overloaded. There were enough resources for everyone.

Patients with mild symptoms were hospitalized only for medical reasons. This allowed us to always have free places for incoming emergency patients. And to have the most important resource in the fight against the coronavirus - a sufficient number of medical staff. Those whose condition became serious were sent to hospitals, the rest were at home, and their condition was under constant medical supervision. Two emergency rooms were organized in the hospital: “clean”, for “traditional” patients, and “dirty” - where everyone was sent with signs of respiratory infections. As a result, even at the peak, hardly one third of the beds intended for the coronavirus patients in the Ichilov hospital were filled. It was a reserve in case of a strong outbreak. So far, it has been avoided.

The quarantine

Many cursed the authorities. I do not consider myself a fan of the current Israeli administration, this is clearly seen from my posts on Facebook. But for the measures that they introduced, despite the strongest opposition and negativity on the part of citizens, I would like to thank them. Here you need to look at the general plan. You put yourself in the shoes of the prime minister for a second, whom the Minister of Economy is shouting into one ear that there will be a million unemployed, and the whole business will go bankrupt, and the Minister of Health is on the other ear, promising 100 thousand dead people, and the collapse of medicine. And he must make a decision and take responsibility - either a bunch of corpses, or a mass of the unemployed.

But the unemployed can be helped, there are benefits, payments, and the like - but you can’t help a dead person. The economy will recover - slowly, maybe not right away. But you cannot revive the dead. They argue a lot about models. So, there is only one model that actually worked: strict quarantine, masks, distance, a total ban on movement. The Swedish model, alas, did not work - they have more deaths than recoveries. I don’t even want to speak about the Belarusian model - I have no decent words to describe it. Those who were late - Russia, the USA - are just passing the peak now. There is only one fact to remember about “this is ordinary flu” - in Italy for the first time since the Second World War a doctor had a terrible choice: you have five patients, all in serious condition, and there is only one ventilator. So choose whom to intubate - the others are very likely to die.

The conclusion

Nothing is over yet. Maybe there will be a second wave, maybe we’ll be lucky not to have it by chance. Doctors say: danger remains until mass immunity is developed or a vaccine is invented. But mass immunity is at least 60% of those who have been ill. Imagine that if you take 5% of this amount of seriously ill patients, no health system can digest this. This is not counting the death rate from ordinary heart attacks, strokes, etc., which will immediately increase by an order of magnitude due to the lack of help, and the people’s fear to go to hospitals. Such cases happened. In the same Ichilov hospital, they brought a man with a severe heart attack, somehow dragged him from the land of the dead. It turned out that he had been feeling chest pains for a week, but did not want to go to the emergency room. Therefore, quarantine, distance, masks and closed borders are needed. My friends, we are faced with something that has not been encountered for 100 years. On a planetary scale, we are still at the epicenter of a hurricane. As the doctor with whom I spoke rightly remarked: this is the middle of the beginning.

And further. Our hospital is the only medical center in the world that allows relatives to say goodbye to their loved ones, who are in serious condition with a threat to their lives. Of course, in compliance with all biological protection rules approved by the Israeli Ministry of Health.

Samir Agav came to the hospital to visit his beloved grandmother Eugenia, who became ill with the coronavirus. Realizing this is the last time. A few days later she passed away - and the documented meeting became a farewell memory.

His last words were: “Just think about yourself. Everything will be fine, grandmother.”