Oct 15, 2021
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Patients began to get sick differently

Patients began to get sick differently

Third wave. What changed? How does the new strain differ from the already known ones? Why do even the vaccinated get sick? Does this mean that vaccines do not protect against infection?

These questions are answered by Professor Elena VASILIEVA, chief cardiologist of Moscow, head of the laboratory of atherothrombosis, Moscow State Medical University. A.I. Evdokimova, chief physician
GKB them. I.V. Davydovsky.

– Elena Yurievna, have heart attacks and strokes become more severe against the background of covid?

– Yes, heart attacks and strokes in such patients are more severe, because thrombus formation is increased. There are no more such patients, but mortality from heart attacks and strokes has increased all over the world. Fortunately, we seem to have reached out to people who did not call an ambulance at the first symptoms of acute circulatory disorders, were afraid of infection. Now we, as a rule, have time to provide assistance in time.

Here is another problem: we are tired of being afraid of the virus, and what I see on the streets and in public places is a complete disaster. People walk without masks, do not keep their distance, although the danger is real. And the biggest disaster is the fact that they began to issue fake certificates. I am a peaceful person, but in this case, of course, I would have acted to the fullest extent of the law. Another bad thing about this story is that we will never understand the true effectiveness of vaccines if the certificates are fake.

– How do you feel about vaccination of patients with cardiovascular pathology?

– The principle is simple: the higher a person’s risk of dying from covid, the more he needs vaccinations. Any cardiovascular disease significantly increases this risk, especially if they are combined with some other aggravating factors, such as old age or diabetes.

The same principle applies to any other pathology. For example, to patients with cancer, including those receiving chemotherapy. Chemotherapy by itself reduces the likelihood that enough antibodies will form, but it does not in any way deny the possibility of giving the patient a chance. Therefore, vaccination is definitely necessary for such patients.

– How can a higher level of antibodies be achieved?

– The revaccination is starting now. It is very good. It is necessary to be vaccinated after the illness: now there is more and more evidence that the antibodies of people who have had the Wuhan variant may be ineffective against the delta variant. In addition, in the case of vaccination of those who have been ill, antibodies, as a rule, rise sharply and for a long time.

I consider it necessary to emphasize: only one vaccine has passed all the necessary tests with us – “Sputnik V”. For the rest, there are no published clinical studies yet.

– After what period of time after illness it is necessary to be vaccinated?

– Nobody knows this, but in most European countries it is now recommended to be vaccinated regardless of the term. Recovered – get vaccinated. The fact is that current vaccines, including Sputnik V, target the most conservative part of the virus, which mutates less, and therefore antibodies formed after vaccination may be more effective than those formed after the disease in 2020.

– I understand that you do not like to make predictions, but still – what do you think, when will we defeat this damned epidemic?

– There was only one way – a quick vaccination. And we see that in those countries where they successfully coped with this task, the epidemic began to decline. But still, there is now an increase, because the virus is mutating. Although these are incomparable numbers. For example, in Israel there are hundreds of new cases per day – we have thousands. So, if at least 70 percent of the country’s population is vaccinated in a short time, this will dramatically reduce the pool of the multiplying virus. Where there is a lot of this virus, a favorable “swamp” is created for its reproduction, mutations and recycling of new strains. And if you also fake certificates, it is difficult to imagine a more pessimistic picture.

Therefore, I have no answer to your question. If this goes on, we will not be able to defeat this epidemic at all. This is especially offensive against the background of the fact that we were the first in the world to make a good vaccine. We do not know the need for drugs or oxygen beds. The contrast between the well-oiled work of doctors and the reluctance of people to carry out prevention is depressing.

– But there are doctors who discourage vaccination.

– To my great regret, this is true. The very low level of education of some doctors became obvious, many feed on rumors, although one can read the publications of the results of the three phases of the Sputnik V tests. I myself have heard these “versions”: “we are afraid to get vaccinated, because we will infect loved ones”, “after the vaccine you cannot get pregnant” and “potency will decrease.” Strictly speaking, we cannot rule out this, just as we cannot rule out the fact that three years after vaccination everyone will have donkey ears.

Still, the likelihood of this is small: in “Sputnik V” there is no virus at all that causes covid. The production of antibodies to one of the fragments of the S-protein of the coronavirus is stimulated.

We have patients who were vaccinated with Sputnik and got sick. It must be understood that no vaccine guarantees a 100% immune response. For Sputnik, this is about 90 percent according to the Wuhan version. This means that there are people who get sick after being vaccinated.

– Maybe universal vaccination is really needed, as was the case during the outbreak of smallpox in Moscow in 1959?

– What is universal vaccination? Forcibly injecting? Here I am also against. No, there must be consciousness. There is no other way.

– Did I understand correctly that now we have a periodic revaccination against coronavirus infection?

– Yes that’s right. This is the only thing that can defeat the epidemic. In some form, this virus will remain with us, but by that time several types of vaccines or one total vaccine designed for a variety of strains will be made. We coexist with the flu virus and get vaccinated against it regularly. I hope it will be much the same here.

– They say that now people get sick more severely than before. Is it so?

– People get sick differently. So far, one thing is clear: this strain is significantly more infectious. There is European evidence that a larger percentage need hospitalization. It seems that patients sometimes worsen much faster than with the Wuhan variant.

– Is there anything new in the treatment?

– From the new: monoclonal antibodies to SARS-CoV-2 appear in Russia, which makes sense to inject in the first five days to very high-risk patients. First of all, suffering from heart failure in combination with diabetes mellitus and obesity, leukemia. Not all of these drugs in this group work against the new strain, but there are effective ones.

And finally, all unnecessary things have disappeared. In the hospital, the main thing: oxygen in various forms, anticoagulants, dexamethasone in desaturated patients, and at the onset of a cytokine storm – anti-cytokine drugs. All these approaches give good results, however, apart from monoclonal antibodies, we still do not have a specific treatment for covid. Therefore, it is better to take care: get vaccinated and avoid mass events.

Conversation led Natalia Leskova

Photo: Adobe stock

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