Doctor Iryna Krychynska: It Is Better to Introduce a Strict Quarantine and Prevent Catastrophe Than Just Give Recommendations

About the coronavirus pandemic with physician Iryna Krychynska.

TK Media talked with Iryna Viktorivna Krychynska, a general practitioner, pulmonologist, and head of the outpatient department at the Into-Sana clinic.

- How is coronavirus different from the flu?

- COVID-19 is a new RNA-containing virus that mutates rapidly. Already today it is known that there are at least 2 subtypes of this virus, causing diseases of varying severity. However, the main difference between the coronavirus and other respiratory viruses is that it has a direct damaging effect on the lungs and can cause severe viral pneumonia, which may require such complex interventions as mechanical ventilation and extracorporeal membrane oxygenation. In the context of the coronavirus pandemic, the need for such interventions for a large number of patients is a very difficult challenge for healthcare.

- How can one become infected with the coronavirus, and what transmission routes are most common?

- The coronavirus spreads mainly through airborne droplet transmission — droplets released by coughing from a sick person can reach a healthy person at a distance of less than 2 meters. Household prevention of such transmission involves the sick person wearing an ordinary surgical mask — this mechanically interrupts the spread of droplets.

The contact route of transmission is very important. It occurs when a person infected with the coronavirus coughs or sneezes, releasing large droplets that settle on surrounding surfaces. Under such conditions the virus can “survive” for up to 1 week or even longer. Thus, after touching a hard surface and then the face, one can become infected. Therefore, the main efforts to limit the spread of the virus should be aimed at blocking contact transmission.

- How can contact transmission of the virus be prevented?

- It is necessary to regularly clean surrounding surfaces such as door handles, desks, and mobile phones (use antiseptics containing at least 60-70% ethanol). Hand hygiene: wash and treat hands for at least 20 seconds, as often as possible; in the absence of visible dirt, it is sufficient to treat them with a disinfectant with a high concentration of ethanol. Avoid touching the face. This is very difficult, since we constantly touch our faces without realizing it. The main advantage of wearing a surgical mask is that it acts as a physical barrier to prevent hands from touching the mouth or nose. Disposable masks should be changed every 3-4 hours. If you have not been able to find a mask, use a scarf or handkerchief when leaving home. Such recommendations are set out in the guidelines on preventing coronavirus infection used in the USA.

- In what conditions can transmission occur?

- The most common route is contact with a sick person. However, it turns out that one can become infected from a person without symptoms or with minimal symptoms of a respiratory illness. This route of transmission is possible during the incubation period, which lasts up to 14 days and possibly longer.

Therefore, the most obvious prevention methods are social distancing and hygiene measures.

- With what symptoms should one urgently seek medical help?

- The main complaints with coronavirus infection are shortness of breath or difficulty breathing, dry cough, and high fever. Runny nose, sore throat, and diarrhea are almost not characteristic. However, it is already known today that the vast majority of infected patients (80%) have a mild illness and do not require hospitalization.

- Today, 27 cases and 3 deaths have been confirmed in Ukraine. It is believed that there are many more real cases. How do you assess the situation now?

- It is very important now not to give in to panic and not to believe every word you read online. Hiding the real statistics of infections and deaths from the public is not reasonable. Communication between people and the authorities is now one of the key factors helping to prevent panic. If people lose trust in “official sources,” quarantine may become unmanageable, and with it the spread of COVID-19 in Ukraine. I am firmly convinced that information published by the Ukrainian Ministry of Health should be trusted.

- An emergency has already been declared in four regions of Ukraine. The quarantine restrictions are quite strict. Is this an effective mechanism for fighting the epidemic?

- Absolutely. Fortunately, if one can say so about the current situation, we are not the first to face this trouble. Adopting the experience of other countries in fighting the spread of the coronavirus is the right decision. It is better to introduce a strict quarantine in the country in advance and thereby prevent a catastrophe, rather than “showering” the population with recommendations and hoping for the common sense and personal responsibility of each person. As practice shows, this method works questionably.

- What advice can you give ordinary Ukrainians today?

- I just want to emphasize once again that during the quarantine it is necessary to limit travel on public transport and, unless strictly necessary, not leave home. Remember that the most vulnerable category during a pandemic are elderly people, as well as those suffering from coronary heart disease, arterial hypertension, diabetes, and chronic respiratory diseases, for whom limiting time outside the home is extremely important.

And most importantly, in addition to personal hygiene, observe hygiene of thinking and of the information flow. Right now, the information space contains many bad examples, when statements from “leading scientists” about the effectiveness of a particular drug or prevention method appear in the media or from opinion leaders, which are not confirmed by any scientific data or studies. Therefore, be careful! Check sources and information on official resources: the Ukrainian Ministry of Health, the Public Health Center of Ukraine, the US Centers for Disease Control and Prevention, and WHO.