Nurse in the reserve hospital of the department of the City Clinical Hospital No. 24 at VDNKh.

Photo: Ivan MAKEEV

This week, the chief doctors of leading Russian covid hospitals wrote an open letter to opponents of vaccination. Doctors, scientists and government officials continue to convince people of the need to get vaccinated against coronavirus in a variety of ways. But the share of vaccinated people in our country barely exceeded 50%. And to attenuate the epidemic with the Delta strain, more than 80% of the population must be vaccinated.

Some states, such as Austria, have announced the introduction of universal compulsory vaccination. In Russia, compulsory vaccinations are currently provided for in certain regions and concern persons of certain professions who are actively in contact with others. If a person refuses the vaccine, by law he can be suspended from work without pay. At the same time, some regions began to introduce compulsory vaccination for older residents, as well as citizens with serious chronic diseases. For them, vaccinations are especially relevant, but how can you ensure that non-working people are compulsory?

We discussed this and other relevant topics related to the fight against coronavirus in the next issue of the Antikovid program on Komsomolskaya Pravda Radio. The guest of the broadcast was Kirill Masliev, an expert on the treatment and prevention of COVID-19, a candidate of medical sciences, head of preventive medicine at the European Medical Center, founder of the Heroes Foundation for the support of medical workers.

MANDATORY AND FORCED VACCINATION – WHAT IS THE DIFFERENCE

– Kirill Sergeevich, some people call compulsory vaccination compulsory, but these are obviously different things? Could you explain the differences?

– The concept of “compulsory vaccination” is threatening, intimidating. Imagination immediately paints a picture of how a person is forced to come and get vaccinated anyway. Compulsory vaccination does not mean that people can come to your home and get vaccinated against your will. You can refuse the vaccine, but then you are limited to access to public places and to travel, say, to air travel. This is the main difference.

I am deeply convinced that vaccination should not be compulsory. It is necessary to conduct explanatory work. Unfortunately, an open dialogue between representatives of the medical community and authorities did not take place from the very beginning of the epidemic. Various statesmen have become the main voice in the fight against COVID-19. And for me it was quite surprising why certain officials who do not have medical education talk about the incubation period, the formation of immunity, the danger of illness and the need for vaccination. From the very beginning, it was necessary to involve professionals in the dialogue who could convey information to people with authority, having clear knowledge of measures to combat coronavirus infection and prevention. Unfortunately, due to unsuccessful propaganda, we received a wave of indignation and the very talk about compulsory vaccination.

– Readers of kp.ru ask: if a non-working pensioner does not want to be vaccinated, what will he do? They will not come home with a syringe, they also cannot deprive them of their pensions.

– I think we will talk about the same measures that were taken back in 2020. This is a restriction on attending public events (for example, you cannot buy tickets to a theater or a concert without a vaccination certificate) and public places, say, shopping centers.

GOT IN THE HOSPITAL? TELL YOUR DOCTORS EVERYTHING CLEAN

– In Russia now there is an acute problem of buying fake vaccination certificates. In social networks, people are discussing: if a person with a fake goes to the hospital, keeps silent about the scam and the doctors think that he is really vaccinated – what is the risk? Are the treatments for vaccinated and non-vaccinated in covid hospitals different?

– In the overwhelming majority of cases, people who are vaccinated develop immunoglobulins (antibodies. – Ed.) Of class G. This is our defense in the blood, inside the body, which is designed to eliminate the incoming virus. In unvaccinated patients, as a rule, in the first days we can use blood plasma enriched with antibodies (or a drug based on such plasma. – Ed.). That is why at the beginning of the epidemic we waited so much for the plasma of people who would get sick – to get antibodies for administration to those who were not vaccinated. If a person is vaccinated, he has his own class G immunoglobulins, then, of course, a plasma transfusion will not be shown to him. Other drugs are prescribed.

These are nuances, but in general, treatment should be based on the current state of the body, research results, primarily blood tests. If the patient is fully examined, all the necessary data on his condition has been obtained, then it is no longer so important to determine the tactics of treatment whether he is vaccinated or not.

From the editor: Unfortunately, in the field, in conditions of a shortage of beds, medical equipment and medical personnel, patients are far from always being examined according to the full program soon after hospitalization. Therefore, it is in the patient’s best interest to honestly tell whether he was actually vaccinated, so as not to disorient the doctors. And, of course, it is important to realize that the chances of unvaccinated people being admitted to the hospital with the most severe complications of covid are incomparably higher than those who were reasonably vaccinated with a proven and effective vaccine.

NO ANTIBIOTICS, YES – STATINS

– Recently, the Ministry of Health has once again updated the Guidelines for the treatment of coronavirus infection. What’s new and important in the document for doctors and patients?

– First of all, I am glad that antibiotics have been removed from the treatment protocols. They are used only when the attachment of the secondary bacterial flora is established. This can be seen from the blood tests: the leukocyte level is increasing. Only then should the doctor think about prescribing antibiotics. Otherwise, they will not only not be beneficial, but may worsen the course of the coronavirus infection.

It is also very important to change the attitude towards drugs from the group of so-called angiotensin-converting enzyme (ACE) inhibitors. These include a number of medicines to lower blood pressure. At the first time after the outbreak of the epidemic, it was believed that such drugs could worsen the condition with covid, up to a person entering the intensive care unit, since they increase the penetration of the virus into cells. Later, many studies around the world confirmed that ACE inhibitors are not only safe, but, moreover, their use is directly recommended. [в период пандемии] people with essential hypertension.

Also, the new version of the Guidelines reflects the importance of taking drugs that lower cholesterol levels, statins. In everyday life, we approach their prescription very selectively; with a slight increase in cholesterol levels, we are in no hurry to prescribe such medications. However, during a coronavirus infection, everything changes, and even slightly elevated sugar or cholesterol levels are extremely dangerous. Because COVID-19 affects the blood vessels, the body is literally on the front lines of the war. Even with a slight increase in cholesterol, it will attack the walls of blood vessels, trying to patch up the damage, and this will lead to very disastrous consequences.

Therefore, during a pandemic, it is especially important to take medications on medication aimed at lowering cholesterol levels.

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