An interview with Nadejda Volkova, a hepatologist from the Scientific Research Institute of Virology, and Shoirbek Bazarov, an intensivist and anaesthesiologist at the Multidisciplinary Clinic of the Tashkent Medical Academy, who explain how their approach to the coronavirus has changed since the beginning of the pandemic.
First outbreaks in the country
As Volkova explains, “When the first cases of COVID-19 appeared, we were not too worried at first. However, when the number of cases started to increase, with patients in a very critical condition beginning to arrive and the first deaths occurring, we realized how little we really knew about the virus”.
Bazarov echoes these sentiments. “At the very beginning of the pandemic, there were no techniques, treatment protocols or evidence base – and of course, no drugs for treatment, either. We would work day and night, crying every now and then when we lost patients who were someone’s mother, father, relative, or friend. There was tremendous anger at the unknown disease. At first, it was difficult to adjust to such a large influx of patients, but we never gave up and continued to fight the virus”, he recounts.
Learning from experience
For both, the first few months involved trying different methods and treatment protocols, learning from the experience, as well as from new WHO information, updated national guidelines and protocols, and other sources to adapt their approaches.
“Now we know how the coronavirus affects vulnerable areas of the body. At the beginning, however, it was difficult to understand why one patient had one set of symptoms, while another had completely different ones; why one patient died, while another one, with similar symptoms, recovered”, Volkova says.
The coronavirus made doctors study intensively, master new specialisms and change how emergency care was structured and the ways in which patients were treated.
Life in the red zone
Both Volkova and Bazarov talk about the pressures of the work and the distress they witnessed in the COVID-19 patients they treated.
“It was very hot in the personal protective equipment and I always wanted to sleep”, remembers Volkova. “However, all those inconveniences faded away when I saw fear in my patients’ eyes. Moments of panic in patients were common. We tried to explain, support, reason, and comfort as much as we could”.
A sense of tragedy was felt by many doctors, but the influx of patients meant that they had to keep going and be vigilant to the needs of those in their care.
As Volkova explains, “You couldn’t relax, as more than 20 patients who you were responsible for depended on you. Once, I came up to an older patient, took her hand as usual, and noticed that one of her hands was colder and paler than the other. Based on observations, I realized that it was the start of a radial artery thrombosis. If it were not for this habit of regularly approaching patients and taking their hands, it would have been impossible to notice the thrombosis in time”.
Key lessons from the pandemic
The pandemic has certainly been a steep learning curve for both health professionals, but they also agree that there are hidden benefits that will strengthen the resilience of the national health system in the future.
In Bazarov’s opinion, “The pandemic taught us to work effectively as one team in emergency situations”. For Volkova, it identified the best ways to treat both mild and severe COVID-19 cases. “You don’t necessarily need to use the heavy artillery. If the symptoms are minor, the patient simply needs to drink more water, get enough sleep and rest. If there are more serious symptoms, they should not be scared. Instead, they should see a doctor and be prescribed the necessary medication as soon as possible”, she noted.
Putting Volkova and Bazarov’s experience in context
Uzbekistan has seen a steady increase in the number of infections over the last few weeks. Because of this, public health and security measures have been tightened.
WHO has supported the country in developing and implementing its COVID-19 Strategic Preparedness and Response Plan that has applied the capacities built under the International Health Regulations’ National Action Plan for Health Security. These plans have guided the COVID-19 response in Uzbekistan in all technical areas.
WHO has also helped with the development and dissemination of communication materials to support public health and social measures, as well as technical and operational support for the deployment of COVID-19 vaccines in the country. Over one million people have been vaccinated so far and the government aims to have four million people vaccinated by the end of June.
In March 2021, Uzbekistan received 660 000 of the 2 256 000 doses allotted to the country by the COVAX Facility.