Epidemiologist: “Congestions from transport, kindergartens and schools favor the transmission of respiratory infections”

Specialists explain the return to the situation before the Covid-19 pandemic by the fact that people have stopped complying with preventive measures: wearing a mask, washing hands and maintaining social distance.

Europa Liberă spoke with the epidemiologist Angela Paraschiv, head of the Epidemiology discipline at the “Nicolae Testemițanu” University of Medicine and Pharmacy, about the specifics of this cold season and how the population should protect themselves and treat themselves correctly.

Europa Liberă: Madam doctor, how do you explain the fact that in previous years there were fewer cases of respiratory infections and flu and no deaths, and in this cold season the Republic of Moldova is facing a wave of viruses and flu, including with deaths?

Angela Paraschiv: This is true. If we remember the pre-pandemic period, before the cases of Covid-19 appeared, in 2019-2020, we had an excessive number of cases of influenza and acute respiratory viral respiratory infections. With the emergence of a new type of virus, Sars-cov-2, and the danger it posed to the population, it was necessary to implement drastic epidemiological measures. We did not know how this virus manifests itself, who will be affected, we did not know how to treat it and how to protect ourselves, because time was needed.

Quarantine was then imposed, which limited the spread of other types of virus, such as the flu. Other epidemiological measures were also implemented, such as the mandatory wearing of a mask, physical distancing, proper hand hygiene, which were quite restrictive in the first years of the pandemic.

All of this influenced the manifestation of the epidemic process in influenza and other respiratory infections, therefore the number of cases was essentially reduced. In some territories, no case of influenza was registered, but the epidemic process through Covid-19 was very intense. However, the Sars-Cov-2 virus is more resistant in the external environment and is transmitted not only through droplets, but also through different surfaces and, respectively, in addition to the fact that it is transmitted very intensively, the population was receptive to this virus.

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Free Europe: Does this mean that with the onset of the cold season, people should once again wear masks and maintain social distance?

Angela Paraschiv: These prophylactic measures do indeed remain in effect during the cold season. Hand hygiene has always been a recommended measure, as well as the triage of children at kindergarten or school, physical distance, because acute respiratory infections of the respiratory tract are transmitted over short distances, through droplets, that is, through close contact. The agglomerations that form in public transport, in kindergartens, in schools, etc. there are conditions that favor the transmission of respiratory infections.

These measures are recommended, in particular, for crowded places. If there is a person with clinical signs, they should isolate, contact a family doctor and receive treatment. Thus, the spread of the virus will be avoided. They are essential measures in every cold season.

Europa League: Is this season different from similar ones in the past?

Angela Paraschiv: It differs a little, because the manifestation of the epidemic process occurred earlier. If in previous years the high number or peak was reached in January-February, this year it happened earlier. This year, we recorded a maximum number of cases in December. This is explained by the fact that for two years we followed those epidemiological measures and our receptivity to the influenza virus was reduced. If we refer to the clinical manifestations, they are the same. The incubation period is the same, 1-2 days.

Free Europe: One person out of the four deceased had flu and Sars-Cov-2 at the same time. Can you tell us which of the two viruses is more dangerous to the human body and why?

Angela Paraschiv: Both are dangerous and can cause severe clinical manifestations, including death. So, he dies from both viruses. When we talk about the danger to public health, we talk about the impact of the disease in terms of the number of cases, the number of hospitalizations and the number of deaths. Here we can make comparisons. Both in flu and in Covid-19 we have a large number of hospitalizations and deaths. Last week, we had 152 cases, of which 60% were hospitalized. If we refer to deaths, we have cases in both flu and Sars-Cov-2.

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We cannot say that one disease is more dangerous than another. Both lead to some disturbances in the human body, which involve not only the infection caused by the virus, but also bacterial associations, and in this case, the chain leads to the dysfunction of other organs. The cardiovascular system is affected and the person may die.

It is complicated to say which is the cause of death, the influenza virus or Sars-Cov-2, because both act in the same way. But we cannot say that if a person becomes infected with both viruses, the clinical signs will be more severe and the evolution more fulminant. The situations are different. The evolution of the disease does not depend on the association between the two viruses, but, for example, on the dose of infection, on the individual characteristics of the body, if the patient has associated diseases, if he is old or has an immunodeficiency. On the other hand, if he has been vaccinated against the influenza virus or Covid-19 or has passed through Covid-19, he may develop a milder form of the disease, even if he has this association. We must understand that danger is always there, but we can protect ourselves.

Free Europe: What are the first signs that should alert a person and send them to the doctor?

Angela Paraschiv: In upper respiratory tract infections, the clinical manifestations are similar for influenza, for Covid-19, and for non-influenza infections. It can be a fever of 37, 38 and even 39 degrees. Usually, in flu, the temperature is higher. It is important to contact the family doctor when fever, cough and pain in the throat, muscles and joints appear. These signs indicate that we have contracted a respiratory infection. In this case, we cannot say that it is the flu or Covid-19, because without a laboratory diagnosis, it is difficult to determine what type of virus it is.

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It is very important that people do not self-medicate. In no case do we treat the infection at home, because we could make complications, and when we go to the doctor, it will be too late and hospitalization will be necessary. Only the family doctor can prescribe a treatment and it is very important to remember that viral infections cannot be treated with antibiotics.

Unfortunately, the public believes that when they go to the family doctor and have clinical signs of a respiratory infection, the doctor must prescribe antibiotics. No, we do not treat viral infections with antibiotics. If they are associated with a bacterial infection and a complication such as pneumonia is reached, only then can the doctor prescribe antibiotics. Viral infections are treated with antivirals and only the family doctor can examine and indicate the correct treatment.

Free Europe: How does the flu vaccine work and when should it be administered?

Angela Paraschiv: The flu vaccine is an inactivated vaccine, that is, it is a virus killed by chemicals at high temperatures, which cannot multiply. Once administered, the vaccine sensitizes the body, which recognizes this type of foreign antigen and produces antibodies. Accordingly, when we come into contact with the flu virus, our body starts to fight.

It is necessary to know that when we administer the vaccine, antibodies begin to be produced after 14 days. So, the person will be protected only two weeks after the vaccine. This means that, in the post-vaccination period, they must protect themselves anyway, wear a mask and stay away from people who show clinical signs.

The health system must organize the vaccination between October and November. This is the most effective period to form an immune blanket in the population. We need to prevent epidemics by building this immune blanket.

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