Earlier this week marked two years since the first cases of COVID-19 were detected in the WHO European Region. In this episode we speak with a frontline healthcare worker, the importance of vaccination and find out what it was like to coordinate the emergency response in the Region.
Show notes:
Earlier this week marked two years since the first cases of COVID-19 were detected in the WHO European Region. In this episode we speak with a frontline healthcare worker, the importance of vaccination and find out what it was like to coordinate the emergency response in the Region.
Show notes:
Hello, and welcome to the health and Europe podcast. I'm your host, Greg Bian. We've launched this podcast to bringing the latest on w H's work in the European region. Our region is broaden diverse from the Mid-Atlantic and stretching. As far as the Chinese border work with fascinating and driven individuals and groups. This podcast is about hearing their stories and how they might impact your day to day life. Earlier this week, mark, two years since the first cases of COVID 19 were detected in the w H O European region. As we pass this solar milestone, we'll hear from health worker on the front line, how vaccines are helping us turn the tide and what's, it was like to run the COVID 19 response in Europe, I do seven or 10 hour shifts during which I cannot eat or drink. We can't take off our protective equipment. Once we put it on, on the first day at the COVID 19 hospital, I enter the room where a patient was crying. When I asked, was, had happened. He told me his mother-in-law had died and how he regretted not being able to comfort his wife. All I could do to ease his pain was to place a hand on his chest, but he couldn't even see my face. These are the words of Laura loopy, an graduated nurse who spoke of w O Europe in April, 2020 about the challenges she and colleagues faced as COVID 19 cases, surged her experience is, are traumatic, but all too common health workers have faced an incredibly difficult few years with many battling the pandemic causing a huge strain on their lives, both physically and mentally, nearly two years later, Sarah Tyler, a communications consultant, working with w a Europe spoke of Laura about her experiences during the pandemic and her hopes for the future
Speaker 2:Louder. We last spoke to you in April, 2020 at the very start of the COVID 19 pandemic your message to people, then warning them about the threat of COVID 19 and the need to come together was incredibly powerful. What changes have you seen in the past two years and your colleagues in yourself, in the population at large and in your patients?
Speaker 3:Well, what I can say is the changes have been many. First of all, I remember very well that at the beginning of the pandemic, the first time I spoke with you, the time I did an interview with you, I felt a sense of hopelessness and fear, which were overwhelming. And although two years have passed, I must say that it seems that very little time has passed because with the shutdown, it seems that time has stopped, but at the same time, it has passed extremely quickly. And this period really changes people they've changed in an incredible way. First of all, the main changes were seen in the feelings of the people. Initially among them, you could see, could find a fear uncertainty in the future anxiety, but especially a lot of depression after the initial two months of lockdown in Italy, we moved on to hope because seeing the cases finally start to drop, made us reach this feeling that seemed almost lost. But then unfortunately, we went from hope to indifference. This was perhaps the worst face because people, the population at large, they managed to nullify the immense, psychological and physical efforts we made in staying locked in the house for two months. Unfortunately, selfishness and arrogance took over as a feeling so much so that they made people, deny the evidence denied the existence of COVID 19 and denied danger. Despite the images that passed every day on television, we nurses and healthcare workers have gone from being the heroes of the first wave to being treated and seen as pawns manipulated by the government. We went from being acclaimed to being hated. Sometimes attacked, even threatened. As far as our psychological condition is concerned. It is hard and tough because after two years, we're still in this condition, still working with this disease to see that yes, there have been changes. There has been an evolution or change in the virus, but to see that there are still cases, it's very heavy. There's so much discontent burnout in. So many of us is also evident in so many young people who have just recently started their working careers. Unfortunately in Italy, the figure of the nurse has always been underestimated at the beginning of the pandemic. I hope that this would finally change that nurses would finally be seen for what they really do for what they really go through in their daily work. And at first it almost seemed like it really was. It almost seemed like we had finally changed the way others saw us. Instead, we were back to square one back to how we were before the pandemic. Everyone has forgotten the efforts we were making, the efforts we have made, and the efforts we will continue to make the sacrifices that we will continue to make salaries continues to be low for nurses. There are a few of us and nurses have precarious contracts. So there have been many changes at the psychological level, but not at the work level. Unfortunately, it's astonishing also that people don't seem to be afraid anymore. First, they were really coming to the hospital, scared and terrified. You could really see the terror in the patient's eyes, but now they come and they almost don't care about having COVID. They don't care about infecting those around them. They don't care about anything. This is very unfortunate because COVID continues to exist, continues to take victims and continues to create discomfort. People just don't seem to care anymore louder.
Speaker 2:If you had a message for these patients today, what would it be? Mm.
Speaker 3:That they must continue to pay attention. Must continue pay attention because COVID continues to be a dangerous virus, but above all, we must vaccinate those who have not yet done. So because there was a clear difference between the before and after vaccines, especially now with this new variant, with Omni run, the patients who are coming in now have found out about being positive by accident. Whereas before they arrived with obvious symptoms, such as respiratory failure, cough and fever, now they found out by accident. If, for example, they come into the emergency room because they've fallen. They have a femur fracture. The moment we go do the COVID test for admission, which is a standard practice. Now they found out that they're positive and symptomatic because they're vaccinated. And therefore it is essential to vaccinate that I think is the main message. Vaccination first,
Speaker 2:Nearly two years on, does the pandemic still affect your work and how important were the vaccines in the eyes of frontline health workers?
Speaker 3:Yes, COVID continues to, to be a protagonist in our daily working life. It's a daily battle, especially with this oor variant, which is very contagious. Many of the wards that had been closed months ago had to be reopened. What I can say is that while before vaccines, people were coming to us with COVID and with very serious symptoms, now, the symptoms are much more mild. So workload has fortunately decreased for us as has attention among us healthcare workers. Since we've been vaccinated with three doses, we can work so much more calmly knowing that even if it were to happen and we got infected, at least we are protected by the vaccine before we worked with much more fear and much more anxiety about getting sick. Even at the health hospital level, while there were ICU departments dedicated to COVID 19. Now they are less busy. They mainly work with vaccinated people. And now paradoxically, this virus is circulating so much that so many more people are affected. Also those who come with problems that require a surgical intervention, unrelated to COVID. There are so many who are COVID positive that they open surgical departments dedicated to these people. So we're trying to circumvent the situation COVID 19 has now become our daily life, and we try to live with it. But fortunately, the parts such as intensive care and sub intensive care units are less busy. And we see the effects of the scenes compared to a year ago. And two years ago, the situation has definitely improved.
Speaker 2:Given your call at the start of this pandemic for people to come together, to help defeat COVID 19 and your experiences since then, what are your hopes for the future and what lessons should be learned?
Speaker 3:I honestly wish I knew that too. The feeling of solidarity has been lost after the first lockdown. As I've said before, you can see that we have gone from fighting together against this new enemy to being selfish, to being uncaring. I hope most of all is that people precisely learn to become more selfless. I was really hoping that with this pandemic, we would learn to think more about our neighbors. And initially we did, but then the exact opposite happened. I don't know what you have to do to get back to that feeling of solidarity. And also because now people are no longer afraid of this virus. And so it is no longer a common enemy now to has become just an enemy that everyone wants to fight themselves. Another thing I sincerely hope is that once and for all the nursing profession is recognized, but most importantly respected. And again, it almost seemed like we had succeeded at, but then it all turned out to be in VA. The most important lesson is that you have to learn to trust science. Science is the only thing that can help us get out of this situation from this condition. And if only people had more trust, then maybe we would get out of this much easier also. And this is an appeal I make do it for us health workers who are exhausted. We are really tired and we're also tired of being afraid. Now we're just too tired.
Speaker 4:Uh,
Speaker 1:While many of us continue to do all we can to protect ourselves from COVID 19 one major turning point has been vaccination, but around the world, we, we know that more needs to be done to ensure that everyone everywhere can access the vaccines. Often we hear about people who choose not to get vaccinated, but we hear less about barriers, which make it hard for people to get vaccinated in the first place. Some of these barriers can be remarkably obvious with solutions that are in reality, very, to provide.
Speaker 5:And if we say that we cannot leave anyone behind first, let us find whom did we leave behind. And I think that should be the starting point for us to move forward. And that should be the forward looking vision of this COVID 19 pandemic. Dr.
Speaker 1:CDATA data is w HHA Europe's program manager for vaccine preventable diseases. I asked him about what needs to be done, to understand why people might not be getting vaccinated against COVID 19 and ways that we can solve this drawing on examples from vaccination campaigns against other diseases.
Speaker 5:Yeah, like I said, I think the starting point should be, uh, whom did we leave behind? Uh, did, is, is there any population group in my, uh, community who did not receive a vaccine, if we cannot identify that that should be the first pointer to go out and find out who they are and there, and when we know who they are, it'll be extremely important that we engage with them to understand why a population group is not coming forward, but also in a parallel sphere, we need to understand also that population, which came to us, why did they come? So I think we need to know what, what drove a population to come and get the vaccine and the other group, why are they not coming? As in, in our ward, as you say, drivers and barriers, find out what are the drivers for a population to come and get the vaccine and find out the barriers, why somebody is not coming to get a vaccine each and every population group will be different each and every drivers and barriers that are determining my vaccine, acceptance behavior will be different.
Speaker 1:Could you highlight an example where learning the barriers and drive to vaccination made a difference?
Speaker 5:So, you know, in terms of finding out what are the, um, challenges in a, in a population group should stem from understanding who, who are they, they're not coming in front and getting the vaccine often in the immunization world, we, we tend to, uh, put them under the cover of vaccine hesitant group. And this vaccine hesitancy is a spectrum. It's not a one time to close tight compartment that you can put everybody there within this Prum w two original office has been spearheading this work around understanding what are the factors around demand and acceptance of the vaccine. And if I turn the pages in a few years back when we had this huge measles outbreak in 2017, 2018 in the w European region, we were trying to find out these disadvantaged population groups in a country, and why are they not coming forward in and to get the vaccine while they know that the measles is so lethal, even they can kill children. And they were killing, you know, people in the, in the European region. One of the, uh, you know, community that we have looked into who were termed as being vaccine, hesitant by the system when we went to their community and just trying to understand why that community was not receiving the vaccine. We found that they actually were not vaccine hesitant. They were willing to receive the vaccine. The only issue that that community had was that they services were not open at a time when they would come back from their war work and then get the vaccine services. So meaning that the parents, they were big families, they had to go out every day to look out for work so that, you know, they can put food on the table, which is important, but the, the time they would come back, the health clinic would close. So the health clinic were running between nine five. By the time they would come and get settled, done the family, the clinic is closed. So even with all the good intentions that the family would have want to protect their kids, they were not being able to get that, uh, you know, uh, vaccine. So in engagement with the local health center, the only intervention that, that local health center and w H O was to extend the clinic hour by one more hour in the afternoon. So just from not by closing at five, o'clock, you go by until six o'clock in the evening, the vaccination coverage after one year increased by 20%. So I think it's extremely important that we not just look into when we talk health ancy should not only look into what the population is not doing. And that is extremely important that we understand what are the, what are those barriers, which are preventing a community to come and get, receive the services, which is there at the doorstep. So when we say hard to reach communities, the hard to reach community should be always be seeing. They don't have to live in the mountains to become a hard to reach. They can be services can be just at your doorstep, but could still be hard for me to reach those services. So, and I think these are, these are, uh, by doing, you know, you cannot, you, you need to go to the community. We need to go out and, you know, get our shoes dirty, to understand why that community is behaving in a way we are seeing it from a distance, but just by looking into it, we will, we will be able to unpeel, uh, or peel off those layers, which, which will give us more information. One thing, you know, in the European region and also across the globe, I think everybody wants to keep their community safe. I don't think anybody wants to keep, have an unsafe community. It is just understanding those behavioral and cultural issues or insights will give us much better, you know, managing the health programs, understanding what people want and get a better impact.
Speaker 1:Dr. Do at Nisan has works with w HHA Europe for over 17 years. And most recently was regional emergency director helping coordinate the response to COVID 19 in the European region. But what was it like to run the emergency response in this interview? Dr. Nisan speaks with Nick fre, a communications consult of w HHA Europe, about to work on the COVID 19 pandemic. Dr. Nisen starts by explaining a little bit about how the team managing the response was set up.
Speaker 6:We decided to really anchor us into the countries, into the place, you know, where people are not to stay in cogen. So we established the, what we call the hub hubs and spokes system in place structure. We have hubs in the countries that need us with spokes in the country surrounding them. So we were on the ground before COVID long, before long is a year and a half. So let's not exaggerate. Everything was new. We are a baby, but our first steps were actually taken before doing the prevention and preparedness work. When we were already involved in few emergencies at the, the polio outbreaks measles outbreaks with earth earthquakes in earthquake, in Albania, we had crisis in different countries, but we were really working here and there as needed and practicing. We worked very hard. We continued to work very hard preparedness and, and, uh, phones preparing the laboratories to, to be in place. Preparing the teams in the laboratories in the countries, referral laboratories were established collaborating centers, partnerships with, um, foreign partners with emergency medical teams. So everything was kind of, you know, it's a big, big, big puzzle that pieces were flying into it. And when the COVID came, it found us different at this emergency. And, and how
Speaker 7:Has the, the structure and the work of the I M S T changed over the two years?
Speaker 6:Yes, we were. That's another thing that we learned. We learned that the structure has to be tailored and modified according to the needs, according to what is coming. So if in initially we had to have the laboratory side, the, uh, readiness team in place and, uh, and getting the countries know what the system is. So we focused on different issues later on. We had to understand that risk communication, for example, is not a standalone. It has to come with community engagement. It has to come very strongly with the, all the that was spreading. So another area that we were not at all thinking that is going to come this, this falsified machinery that is beyond our ability to understand why it, it was happening. We had to very quickly focus on that with and establish a team. And, you know, that's one part. Then the part of the clinical management, we had to focus with time more and more on the way that countries, hospitals, primary healthcare, public health services, are able to manage cases, able, able to identify them, follow them and do it in the right way. And,
Speaker 7:Um, what, one thing do you hope might come outta this pandemic? What positive? What would you like
Speaker 6:To see? I think that this pandemic is an eye opener and, um, unfortunately humanity, you know, we tend to forget, we tend to let go. What I would like to see is that we really go back, we learn, we reflect we the way we w H O work, we help countries do the same and get better, not only prepared, but get systems as routine, not for preparedness, get it really, uh, um, uh, engraved into their, uh, lives. So what I mean is universal health coverage for all, no doubt that this is something that needs to be done. Primary healthcare systems should be strongly linked to the communities and the public health services, good elastic and systems that are able to accommodate the needed adjustments should be in place at any time, not only for emergencies, but also for other needs of society. Respect of, to the elderly, to those who are, you know, left behind in many, the countries to the vulnerable, including giving a hand solidarity. I do hope that these things that are so part of our lives as w H O will become the routine for everyone else on earth. And that would be fantastic.
Speaker 1:That's all we have time for special, thanks to all the guests on this week's episode. If you'd like to find out more about any of the topics covered in this episode, you can do so on the w O Europe website, that's Euro, w H O do I NT or in the show notes? The voice O for Laura Lupe was by Veronica Donna, make sure to leave as a rating. And if you like, what you've heard, recommend us to a friend or a colleague, thanks for listening. And until next time, stay safe and stay healthy.