"After 286 days of round-the-clock treatment of patients with the coronavirus, nearly 30,000 medical check-ups at our admission and triage ward, and over 4,000 inpatients with medium to severe forms of Covid, the Bežanijska Kosa Medical Centre has entered the non-Covid patient treatment system. In addition to the usual health-related issues and ailments, a new category of patients has appeared – the patients who had the coronavirus infection a few months ago, but are now coming in due to the effects of Covid. We refer them to the necessary diagnostics and evaluation units, and introduce additional therapy as needed," Dr Marija Zdravković, assistant professor and Chief Physician at the Bežanijska Kosa Medical Centre, explained in her interview with Kurir.

What are the most common effects of Covid-19?

"We have people coming in with lung damage and cardiovascular complications, such as the isolated inflammation of the heart muscle, which needs further monitoring and treatment. Sometimes there are cases of severe arrhythmias and frequent chest pains. In addition to these patients, for the two weeks that we have been in the non-Covid system, a great many patients have been hospitalized, examined, and operated on; heart stents and pacemakers have been put in; severe fractures and injuries have been operated on, as well as patients with malignant diseases. Our emergency services are available 24/7. Incidentally, there have been no waits at our medical facility's Oncology Unit because we had over 8,500 hospitalizations through our day treatment oncology unit during the Covid infection period. Other patients were referred to non-Covid healthcare facilities."

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Are we in the fourth wave already?

"We are witnessing a new jump in the number of infections, both in Serbia and around the world. The high number of new infections indicates that the recommended measures are not being observed. The coronavirus is not forgiving of mistakes."

How likely is it that because of this you will go back into the Covid system, from which you were recently released?

"The number of infections is on the rise and with it, naturally, the number of people with a medium to severe forms of the disease, requiring hospital treatment. The main task of all healthcare workers is to provide medical assistance to those whose health is most adversely affected, whether they are positive or negative for Covid. Serbia's health system has proven to be operational and well-organized, as it adapts very quickly to the most urgent needs of the citizens who require hospitalization."

Is there an end to this? Will we live normal lives again?

"The end of the epidemic depends on all of us. The healthcare system, the state institutions, the doctors, nurses, all the staff in the Covid system have done their utmost to ensure life is as normal as possible. However, unless everyone understands how important it is to be responsible and follow the measures to put a stop to the agony that is the coronavirus, I'm afraid that – even though the best efforts have been made to stop the epidemic – it will not stop. The epidemic's greatest allies are precisely those who violate the epidemiological measures. We should all insist on following these measures and even on appropriate penalties. I believe that as citizens we will find the strength to adhere to the measures and ensure maximum vaccination coverage, as that is the only thing that can save us. The vaccines shouldn't be feared – only vaccination can stop the coronavirus once and for all. Whether we will live as before – I'm sure that we will, if we try hard."

Study: 'We know when a patient will take a turn for the worse'

You also conducted a study during Covid.

"The Bežanijska Kosa Medical Centre has a huge experience in treating Covid patients. We started a project of monitoring treatment outcomes, at hospital as well as after release. In the study, we determined the values of laboratory analyses which indicate whether the patient will take a turn for the worse in the next 24 hours, and we know how to respond. We are collaborating with the big hospitals in Berlin, Zürich, and Ljubljana, and I'm happy to see that they have a lot of appreciation for our results. The treatment outcomes were especially good, as what the hospital insists on is teamwork and a multidisciplinary approach. Our colleagues from the Medical Centre of Serbia's Infectious Disease Clinic and Centre for Anaesthesia, as well as colleagues from the Faculty of Medical Science in Belgrade, have been a source of great support. All these results are the results of all of us together. The paper has just been published in a journal with the highest academic ranking – M21."

What surprised you the most during the year with the coronavirus?

"What surprises me the most is that some people are still inconsiderate and think along these lines: 'It won't get me, I'm sick and tired of everything, I have had it with the measures, they don't know anything, the coronavirus doesn't exist.' That still surprises me and makes me angry."

What have we learned in one year with the coronavirus?

"That the outcome of the coronavirus infection isn't known for any of us. Therefore, although we know that the elderly, those with a chronic illness, a heart weakness, asthma, and kidney and malignant diseases as a rule have more severe clinical presentations, often accompanied by complications, there is really no rule regarding who will survive Covid. You never know how it will manifest in any of us: from a slightly more serious cold, through a weakness that lasts for days, to pneumonia in both lungs and what we always fear when it comes to very severe clinical presentations – a complete collapse of the respiratory capacity and lung failure, when the patient is put on a ventilator. Since the outset of the coronavirus, there has always been a group of patients who develop the most severe form of Covid despite receiving maximum therapy, with a fatal outcome in a great number of cases. Modern medicine has not yet triumphed over the most severe forms of Covid, and that worries us all."

(Kurir.rs/Jelena S. Spasić)