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Assoc. Dr. Petar Atanasov heads the internal medicine clinic of UMHAT “N.I. Pirogov” from 2014 G., and, since March last year, head of the hospital's COVID department. He graduated in medicine from the Medical University, Sofia, there are specialties in internal medicine, Scientific Medical Information, clinical hematology and management, currently specializes in emergency medicine. Doctor of Medicine and Associate Professor of 2016 G. He started working in the internal department of ORB – Kyustendil in 1988 G., from 1992 G. works at “Пирогов”. There are over 50 scientific publications, he has participated in numerous international congresses in his specialties.
Assoc. Atanasov, Your hospital and especially your team are the doctors, treated the most patients with COVID-19 since the beginning of the pandemic. How many people passed, how the disease develops?
Yes, it can be said. We also had the first registered cases in early March. We have launched a campaign to diagnose and treat complicated coronavirus infection. For last year we will exceed 2000 hospitalized and treated patients, which have been shown to be positive for COVID-19 by PCR. Apart from the above 20 thousand. are outpatient examinations.
These are patients in whom it has been proven (as imposed – by PCR only) or not, coronavirus infection, but each of them was prescribed home therapy and they were followed up for at least two weeks after the first examination. These patients had clinical manifestations of viral infection. By no means have we left any of them to chance (whether PCR is positive or not). Everyone went through the emergency department of the hospital, which is led by Dr. Diana Dimitrova, has been triage the most- responsibly and in accordance with the requirements of the relevant medical standard, the standard of the clinical path and the requirements for good medical practice. I can tell you, that Dr. Dimitrova personally monitors a large proportion of these patients, I admire her and sometimes wonder how she manages to do it physically. “Пирогов” has become a machine for diagnosis and preventive treatment, which has effectively counteracted possible complications in the initial stages.
Does the pressure of patients in need of treatment on the hospital decrease according to your observations??
Yes, in late December and early January and hospitalization, and the identification of new infected patients decreased significantly, almost half. It's unpleasant, that the number of severe cases is retained. For unknown reasons, patients stay at home waiting for the knife to rest on the bone. The reason is not only in the holidays. I am very much against it “our type” quarantine, which or not is in its best form, or applied perversely. In many cases, this does not look like quarantine, and under house arrest. This is unacceptable behavior. People stay at home, they dare not go out, do not dare to go to the doctor. We have many patients, who literally come with fear, they were slow enough, and already in an extremely serious condition.
Yes, in late December and early January and hospitalization, and the identification of new infected patients decreased significantly, almost half. It's unpleasant, that the number of severe cases is retained. For unknown reasons, patients stay at home waiting for the knife to rest on the bone. The reason is not only in the holidays. I am very much against it “our type” quarantine, which or not is in its best form, or applied perversely. In many cases, this does not look like quarantine, and under house arrest. This is unacceptable behavior. People stay at home, they dare not go out, do not dare to go to the doctor. We have many patients, who literally come with fear, they were slow enough, and already in an extremely serious condition.
Is the search for help at a very final stage one of the reasons for the high mortality from COVID-19 in Bulgaria??
One of the reasons is, categorically. We created literally out of nowhere a very good organization in hospitals, who undertook to treat these patients. We even came up with the correct protocols ourselves, or rather perfected them – we, on the edge of our strength, treat with commitment, responsibly and effectively these patients. We created an organization, despite the disorganization coming from outside.. or whatever you want to call it. We manage to cope despite the vicious side of the measures. Yes, anti-epidemic measures are generally needed, but the quarantine was somehow perverted – people feel abandoned, scared, that they are even threatened.
How do you deal with self-medication?
Self-medication is a scary thing. But not so much self-medication in this case is the global problem. The global problem, in my opinion, that this type of behavior continues to be instilled in the media. With something strictly specific, requiring a lot of knowledge, competence and experience began to engage people, who have no knowledge of medicine. This continues to be circulated on television and in the press.
Don't mind GPs?
To be alive and healthy fellow GPs, if it weren't for them to take this wave in front of the cabinets as well, surely we would “thunder”. They are active workers – they are useful! But when you see one “specialist” on coronavirus infection more than three times a week in the studios .., I would ask him when he has time to deal with the sick. I mean them, as I say “harmful effects”. They are in the studios every day, and did not smell a patient. But otherwise they competently deny imposed practices and protocols, proven over the years, they do “innovation”, bordering on schizophrenia, promote anti-medical thinking. I react angrily, because the emotions they instill in patients, their attitude to the problem and its aggressive imposition, confronts directly with our work. Patients are coming.. with the mood, that should be treated with “whiteness” for example (it is a sarcastic literary deviation), and they are terrified, when we apply antibiotic treatment, or vice versa – they want an antibiotic given to them immediately “expensive”, and we don't start with an antibiotic “from the door”. All this happens according to the testimony. But to blunt someone on TV.. and to say, that antibiotics have no place in the treatment of coronavirus complications, this is not just illiteracy…
In your protocols, you went through hydroxychloroquine, remdisivir, blood plasma, of ivermectin. Is there a cure for COVID-19?
In general, there is treatment and it is complex. In addition, it is strictly individual. There is no single template, which you can apply to each subsequent patient. Each patient with COVID-19 is a separate universe and if approached as a template, the mistake is inevitable. That is why one must have incredible knowledge, which requires our profession and a lot, a lot of experience. This is the clinical activity. The difference between a clinical and a laboratory doctor, or as we say – among clinicians, the man, which is next to the patient's bed, he is by his side every day, for hours.. and on the other hand the colleague, who does scientific work in laboratories and has never been in clinical reality, and.. the difference between them is huge.
You participated in a clinical study on the effects of ivermectin on the development of COVID-19, what are the results?
We stopped the clinical trial first due to disagreement with the protocol, secondly due to side effects in the first patient and mainly due to the evolution of pneumonia (of the pulmonary inflammatory process) with the patient. The clinical course worsened, that's why I stopped recruiting patients, and not alone, we are a research team, who observed the patients. All colleagues came to the conclusion, that we should not take risks. In addition, we did not accept the second stage of the study, we have not started working on it at all or recruiting patients. On this basis, I cannot express definite opinions on the issue from our experience – we just stopped the study. On five patients, in which we have not conducted the study according to any basic principles, not to mention, that the protocol was not serious, let us not be deceived, that we can draw any conclusions. There is no way to rule. This, however, which we know from the past regarding ivermectin, this, which we have read as scientific information, is categorical. After all, it is a medicine, which in most countries of the world is approved for use only in veterinary medicine. It is right to listen to the opinion of fellow veterinarians. There are also leading scientists in this field in the field of infectious diseases and virology. Let's not forget, that these are specialists, who have very great opportunities for direct experimentation, however, animals participate in experiments, people should not be involved in experiments. Mengele experimented with humans. And, when a veterinary specialist says something, it is good to listen to his opinion. They have extensive experience with ivermectin and follow strict indications even when administered to animals. I am not competent, but from this, which I read in the scientific veterinary literature available to me, there are dog breeds, in which the drug is prohibited due to the peculiarities of the nervous system in these breeds. Can you imagine, given the strict restriction of the use of the drug on some animals, we give it to humans? Still, I was inclined to try these doses, which are offered, especially now, when they changed the protocol a lot, they reduced the dose and it became almost homeopathic – applied in two doses, for example, the first and the seventh, or as a second reception on the thirteenth day. Having said that – we gave it to 20 patient, which are asymptomatic, that is “they should be at the very beginning of the infection” and none of them developed pneumonia! How will you prove to me and can you be sure, that exactly these 20 the patient was going to get pneumonia, if you hadn't given them ivermectin? No way, right? Therefore, one should not draw perverse conclusions based on stepping on quicksand. A study has a strong foundation, it has a concept, so that correct conclusions can then be drawn from the results. so that correct conclusions can then be drawn from the results, so that correct conclusions can then be drawn from the results, so that correct conclusions can then be drawn from the results – so that correct conclusions can then be drawn from the results. so that correct conclusions can then be drawn from the results, so that correct conclusions can then be drawn from the results, as in traditional medical practices and we are so sure.., we will also be able to treat hereditary diseases, and diabetes, and cancer. We are still in the early stages of this field, and I have some fears about RNA-based vaccines, but may my fears prove vain! Anyway, the way out of this situation is vaccination! Vaccinations are a long-standing and proven method, Vaccinations are a long-standing and proven method (Vaccinations are a long-standing and proven method) Vaccinations are a long-standing and proven method – Vaccinations are a long-standing and proven method.
Vaccinations are a long-standing and proven method, Vaccinations are a long-standing and proven method “half-dead patients”, half-dead patients…
half-dead patients…? Yes, half-dead patients, half-dead patients – half-dead patients. half-dead patients, half-dead patients 70-75% of lung volume and this is seen on computed tomography. of lung volume and this is seen on computed tomography, of lung volume and this is seen on computed tomography “of lung volume and this is seen on computed tomography”? of lung volume and this is seen on computed tomography, so far we have very little loss of patients, were treated with ivermectin alone, people feel, that something is wrong in “this magical treatment”, abandon magic and turn to medicine. For some, Unfortunately, it was late. We have helped patients, treated with what not, including two very severe cases, treated with colchicine (a medicine that is taken for a gout attack). Both patients were left with incredible lung lesions, hopefully, that by the sixth month these changes in the lung will be resorbed. And I say again, two patients- we cannot make capital inferences.
Let me say something about the Internet – globally, you need to know who you're reading and where you're reading it – and the scientific edition, and the editorial board, and the author team are the most- and the author team are the most. and the author team are the most, and the author team are the most, however, to give it professional medical weight. When a professional thought is conveyed in an accessible way, in popular language by a good journalist, this is welcome and helpful. But when such a pseudo-scientific thought is multiplied by the press, as has now happened with many of the methods and medications for the treatment of COVID-19, the consequences are very dangerous. For example – there are patients, there are patients. there are patients, we administer antibiotics when the inflammation has made such severe changes, we administer antibiotics when the inflammation has made such severe changes, we administer antibiotics when the inflammation has made such severe changes 90% of the cases is disastrous. of the cases is disastrous, of the cases is disastrous. of the cases is disastrous, of the cases is disastrous, of the cases is disastrous – in antibiotic madness, in antibiotic madness, in antibiotic madness. in antibiotic madness, in antibiotic madness, in antibiotic madness, as on the patient's body, as well as on the course of the disease, and the disease is almost never alone – “..trouble never comes alone..”! And we must take this into account when deciding on antibiotic prophylaxis and making the choice of the appropriate antibiotic and / or combination of antibiotics..
What is the lesson of the COVID crisis for you personally??
What is the lesson of the COVID crisis for you personally?, What is the lesson of the COVID crisis for you personally?, What is the lesson of the COVID crisis for you personally?, What is the lesson of the COVID crisis for you personally?, What is the lesson of the COVID crisis for you personally?, of such beds, of such beds. of such beds, of such beds, of such beds, of such beds, of such beds, how it is necessary from today to tomorrow ophthalmologists to become internists and infectious disease specialists. how it is necessary from today to tomorrow ophthalmologists to become internists and infectious disease specialists, how it is necessary from today to tomorrow ophthalmologists to become internists and infectious disease specialists, The main complication of COVID-19 is related to the inflammatory process in the lungs. The main complication of COVID-19 is related to the inflammatory process in the lungs, The main complication of COVID-19 is related to the inflammatory process in the lungs, specialists in the domain of the great, specialists in the domain of the great “specialists in the domain of the great”, specialists in the domain of the great. specialists in the domain of the great 10-15 years, all decision makers have been trying to throw the mother specialty aside, because there was no need for it. sorry, how to become a cardiologist, without being a specialist in internal medicine? without being a specialist in internal medicine, without being a specialist in internal medicine, without being a specialist in internal medicine? without being a specialist in internal medicine. I think, that the process needs to be reconsidered, that the process needs to be reconsidered, that the process needs to be reconsidered (that the process needs to be reconsidered), they will become cardiologists, hematologists, nephrologists? Without having the necessary knowledge and experience in the domain of the basic specialty and will become a doctor on the little finger of the right hand only…Well done! Now is the time for the ideologues of this madness to realize and abandon this malicious philosophy. Now is the time for the ideologues of this madness to realize and abandon this malicious philosophy (Now is the time for the ideologues of this madness to realize and abandon this malicious philosophy) Now is the time for the ideologues of this madness to realize and abandon this malicious philosophy “specialists in the domain of the great” they planted a terrible time bomb in Bulgarian medical science and practice.
The interview was conducted by Desislava Nikolova