Oleh Tarabrin: With the support of partners Odessa Medical University has become an educational hub on COVID-19 and respiratory support

Odessa National Medical University has actively joined the fight against COVID-19. Educational webinars and online workshops on the treatment and respiratory support of patients with COVID-19 are being held. We have talked about it, as well as about the possible development of the situation in Ukraine, with the Acting Vice-Rector, Head of the Department of Anesthesiology, Intensive Care and Emergency Medicine, Honored Worker of Science and Technology of Ukraine, Doctor of Medicine, Professor Oleg Tarabrin.

Are quarantine restrictions in Ukraine adequate to the threat, in your opinion? What is the current situation in Odessa?

I think these are appropriate measures, although at the beginning the process was a bit disorganized. Now we have a daily increase in COVID-19 infections of 400 to 500 or more, with 10 to 19 deaths per day. It is necessary to realize that it can be only 5-10% of that real indicator which we have in our country. I think that in the next 3-5 days we can expect the maximum manifestation of coronavirus disease.

I believe that the measures taken by the government are absolutely correct, but they are clearly not enough. For example, preparation for the possible spread of coronavirus disease in the Odessa region leaves much to be desired. It was sad to see how many chief physicians did not want their clinics to become supportive, even though their hospitals were well equipped. Therefore, at the beginning of the quarantine we lost a lot of time.

From the organizational point of view, I would like to mention the big business that helps the Infectious Diseases Hospital and a number of supporting clinics, including Vodniki Hospital, Black Sea Hospital, hospitals in Podolsk, Ananyiv, Izmail, and not only in Odessa region. Businessmen took responsibility for their equipment. In 2009-2010, during the spread of avian  and swine flu, we gained the necessary experience in the organization of treatment processes. We believed that hospitals such as the regional and other large ones, with central oxygen supply, which is very important, to ventilators, with trained resuscitators and sufficient space, should first of all take full responsibility for the admission of patients with COVID- 19. Now I can say that a lot of work has already been done. I recently visited Vodniki Hospital and I am glad that all organizational issues have been resolved, as well asin the infectious diseases hospital. Medical institutions are prepared for the possible admission of patients.

Can the situation in Ukraine repeat the scenario of Italy or the United States, in your opinion?

I believe that we must be ready for everything. According to my unverified data, the rates of patients are lower by 5-10%. Mortality in Kyiv from undiagnosed pneumonia of any origin has tripled compared to December. Where is the guarantee that this increase is not related to the coronavirus disease? In my opinion, there are many difficulties ahead, and in the near future we may get some sad results. But on our side – seasonality. Viral morbidity usually decreases during the hot season, starting in May, but the virus may reappear in November-December.

But isn’t relying only on the heat, to put it mildly, frivolous?

Certainly. Quarantine and preventive measures must be observed. Look at Germany. They were severely quarantined and had a much lower mortality rate than in other European countries. At the same time, Germany now remains in a rather strict quarantine. After all, when we were preparing for international educational projects two months ago, many of our speakers from Germany, France, Italy, and Austria were strongly in favor of postponing all events to the fall. It was incomprehensible to me then, but then we got data on Europe and realized that it was absolutely appropriate. We then moved on to remote educational projects.

Is Ukraine ready for the peak of morbidity and for a possible second wave, in your opinion?

We are counting on it. We have time to prepare and we have experience, including a sad one, which must be taken into account. I hope that the situation in Ukraine will be easier than in the Western Europe. The onset of summer will give less manifestations, but we will not relax. We will probably be waiting for the possible spread of coronavirus disease in June. Unfortunately, it is not possible to test all potential carriers of the virus, only 5-10%.

The infection was first recorded on November 17. Why was the world not ready for this virus?

It is a difficult question. I think the US and the EU assumed that the pandemic would not go beyond Asia. But the wave spread quickly and covered the whole of Europe. In November-December, the spread took place in crowded places, mainly in ski resorts, then the New Year holidays came with a large flow of tourists.

Why did the situation become catastrophic in Italy, but in Germany, which is in the neighborhood the pandemic was quite successfully coped with?

In particular, because in Italy, as in Spain, there are a lot of elderly people who were not covered by quarantine restrictions at that time. They were among the first patients who, in addition to age, also had concomitant diseases – cardiovascular, respiratory, diabetes, renal failure and others.

In Ukraine, given the short life expectancy, there are significantly fewer elderly people. Can we expect low mortality in this regard?

I think this saves us. Plus – many retirees were the first to respond to quarantine measures. For example, my mother is 78 years old, she still works, but has been staying at home for a month and a half. Another positive point is that many of those over 60 live in villages and are outside the incidence zone. The sad experience of Podolsk, where the doctor died, was surrounded by many medical workers. 32 people are already carriers of the virus, they are isolated, but who will work? A serious problem. This is a sign that many medical institutions are still not properly prepared, and there are no personal protective equipment in sufficient quantity.

The craze for masks and antiseptics has noticeably subsided. How can you explain the fact that such a problem could not be solved for two months?

First, the state was not ready. Secondly, even medical managers were skeptical about everything. Only in the last 2-3 weeks we have seen quite serious conclusions from the ministry. At least the new minister is doing everything to organize this situation and bring it out of the stalemate. Once again, we are grateful to our big businessmen, in particular, Andriy Stavnitser and all the volunteers (Monster Corporation, headed by Kateryna Kozhevnikova) for taking responsibility and continuing to provide hospitals with ventilators and consumables, as well as personal protective equipment.

What precautions do you personally follow?

I think wearing masks and gloves, as well as handwash is a must! Everyone should be responsible for themselves, their family, colleagues and everyone around them. It is important to remember that this virus is specific, that it can be transmitted not only by airborne droplets, but sometimes it is enough to touch untreated keys, door handles, telephones, etc. We need to forget about contact communication, when they shake hands, kiss and hug at a meeting. In addition to gloves, you should always have an antiseptic. Today, fortunately, all this is available in pharmacies and supermarkets.

But life is going on, so let’s move on to educational platforms. What will happen in the near future?

For these two months, we have been developing online distance educational projects, and have completely moved on to topics related to coronavirus disease and respiratory support. We are pleased that Medvoice Medical Education Platform and ONMedU have supported our ideas: we have implemented four major educational projects related to respiratory support in 1.5 months. Just before the quarantine, we held the first two-day course at our clinic in Tinista Street. More than 150 anesthesiologists-resuscitators, therapists, pulmonologists, cardiologists took part in it. We have chosen, I think, the best speaker on respiratory support, doctor of medical sciences Denis Nikolaevich Surkov from Dnipro. We are very grateful to Professor Borys Mykhailovych Todurov for allowing us to hold the second two-day respiratory support course at his clinic on March 14-15, which was attended by approximately 250 people from all over Ukraine. It was decided to continue these projects, and in early April we conducted a 5-day course.The course was also taught by Dr. Surkov, who is an international expert on respiratory support in critical patients. For us and our university – this is a great discovery, his knowledge is very important for all professionals in Ukraine, and beyond.

Has he recently held a course at Odessa University?

Yes, just a few days ago we held a 5-day All-Ukrainian special course on respiratory support, which was attended by up to three thousand people online. On the first day, the video of this conference received 12,000 views. A total of about 50,000 people attended this course, which means that 50,000 people are now carriers and sources of this very important information for themselves and their professionals, for their families and the environment. Today, distance learning is very important. Among the plans is another webinar hosted by your humble servant. About 10,000 listeners have already registered. I am grateful to the leadership of our university, which supported our ideas. We are joined by other universities, foreign colleagues from Moldova, Azerbaijan, Georgia, Russia, Kazakhstan, Turkmenistan, Belarus, Poland, Lithuania. With the support of all our partners, Odessa Medical University has become a powerful educational hub, not only on coronavirus problems, but also on many related issues.