Lessons from the war against covid to improve health

These three doctors see each other on a daily basis. They are in contact to the minute. They share everything and not because it is (only) the teacher and two of his most outstanding students, because there are many more, who pay him devotion. “They just take care of me, like I took care of them & rdquor ;. Miquel Vilardell is everything in medicine. As scientific director of the Department of Medicine at Hospital Universitari Quirón Dexeus, accompanied by Ángel Charte and Jordi Robert, they share reflections on the pandemic that has changed our lives. EL PERIÓDICO has attended several of their conversations which are lessons to be taken note of.

Vilardell’s gaze is that of the scholar, the researcher, the professor, who reads what is happening. The gaze of Charte and Robert is the interpretation of who has suffered the pandemic, rolling up their sleeves to face an unknown virus as happened with AIDS at the end of the last century. A biological chaos that has no end.

“This is neither over, nor do we see the end, & rdquor ;, comments Charte, who, like Robert, has treated more than 4,000 covid cases. “It is not a question of being pessimistic, but of being realistic. Covid is like the volcano on La Palma, volcanologists keep appearing on TV talking about past experiences that are useless, with absurd forecasts, and the volcano continues to spit out lava and destroy everything. Nobody knows the end of the covid. A lot of nonsense has been said & rdquor ;.

We are vulnerable

Vilardell has given many laps to the problem of the covid without going on TV to tell about it. It shows that he has locked himself in with his own to draw conclusions. “First reading: we are vulnerable. We thought that old age began at 85 years old and, suddenly, we realize that, after 55, the virus takes its toll and you can even die when you are 30 years old & rdquor ;.

“Today, a 60-year-old person feels much more vulnerable,” says Robert. “No one thinks that the average life expectancy is 79.5 years for men and 84 for women. The ‘I have a lot of rope left’ is no longer so safe. The virus has made us all doubt & rdquor ;. “Even if you did not have any disease, simply because of age, you are already vulnerable to the & rdquor; virus,” adds Charte.

Sanitary collapse

“When we thought that we were in an advanced world, where we had everything under control, magnificent hospitals, social protection of the best in the world and quality standards of the best on the planet, where we were tired of hearing professionals who were very prepared for whatever arose, the covid proves that it was a lie & rdquor ;, describes Vilardell.

“Our healthcare system lacks resources, many infrastructures have not been renovated, and, furthermore, we have the right professionals. The pandemic also demonstrated deficiencies in our ‘magnificent’ health system. “Charte and Robert recall that resources had to be provided quickly (” in Catalonia, about 5,000 million euros & rdquor;), which shows what health workers have been denouncing for years: you have to care, improve, update and protect health systems, health and social benefits.

Medical failure

“Another great consequence: in medicine, not everything is known, not even those who know best & rdquor ;, points out Vilardell. “This pandemic brought humility associated with science, with doctors. No one knew how to deal with it, cure it. We spent months in the hands of trial and error. We came to supply drugs that a few years ago would have landed us in jail. We worked without scientific evidence, it was tremendous & rdquor ;.

“It has already happened with AIDS,” says Charte, “and it has happened to us again now, and we will see what the next plague will be, we are in the middle of biological chaos. We started with the antivirals; we continue with the corticosteroids and we continue learning how to attack this damn bug based on driving and dealing with the virus. We learned by making mistakes & rdquor ;.

There are no sages

Vilardell as president of the Galatea Foundation (supports health workers with emotional distress, mental illnesses, frustration, addictive behaviors), considers that Covid has brought tons of humility to a profession that was believed to know it all. “Medical students to enter any college need a 14, not a 10, a 14! What happens with this baby at home? He is the king of the house. He has entered Medicine! They say. Hence, many medical students think that only with their intelligence can they reach the top. What happens? That is not the case. Why? Because medicine, practice, day to day, is not the MIR, it is not a question-answer exam that you can brood, prepare & rdquor ;.

“The pandemic has put us to the test and not everyone has overcome it. It is no longer studying, it is facing the unknown. It takes another type of intelligence, empathy, knowing how to be, patience, perseverance, complicity, humility, leaning on others, effort, confidentiality, not criticizing for criticizing, being a single, strong whole & rdquor ;.

The covid has finished with the sages, with the gurus of medicine, with the prophets, with the scholars, the virus has equaled them all, because all have had to work and collaborate in search of solutions for something new, unknown.

Goodbye to the specialists

“Another great lesson: we have to immediately change the training and provide the students with an important, transversal basic training. Why? Because when, suddenly, in all the hospitals in the world, 200 covid patients arrived in one day, we had to use gynecologists, traumatologists, ophthalmologists, surgeons & mldr; and they knew nothing of general medicine. A disaster & rdquor ;, points out Vilardell.

Charte speaks: “The first question was, where do we put so many doctors? “Well, throughout the hospital. The services are over, the specialties are over, the hospital changed its appearance for covid & rdquor; patients. “And, suddenly, the miracle occurred, everyone focused their life and work towards a single goal: to defeat the covid-19 & rdquor ;.

Let others investigate

Vilardell is outraged when he speaks of the lack of leadership and / or competitiveness in Spanish healthcare, which is “one of the best in the world at the healthcare level, but without a plan or monitoring of the large research centers, which are not demands important advances from them & rdquor ;. “There have been people here who have even said that it would take us years to get the vaccine. Why do they say that if they don’t know anything? In other countries, especially the United States, they were already investigating, do not say such nonsense. Those who are ready are always ready. They were looking for her and they found her. And it has been effective, yes, because this has stopped thanks to the vaccine and the mask, which I continue to wear & rdquor ;.

Vilardell, Charte and Robert continue with the mask all day. The explanation is simple: if we know something for sure, it is that covid is transmitted through the air, so if we cover our nose and mouth well, we will be protected. “The rest is pure story & rdquor ;, they point out and insist that the coronavirus also leaves the idea that we must provide research centers with professionals, material and budget. “We are not just any country and less in Health, but, if we support researchers, we must demand results for the benefit of society & rdquor ;.

“Spain has, without a doubt, the best practical and healthcare doctors and, not only that, we also have real artists, surgeons, but we must give ourselves a good financial heart to promote research,” insists Vilardell. “There are professionals who produce a lot of paper, a lot of medical documentation, a lot of reports for specialized magazines, but none of that is used for medicine, for day-to-day life, to improve the health of the patient. Without effective return products to society, research is useless & rdquor ;.

Older people

Vilardell, Charte and Robert have thought about everything that has caused this terrible pandemic, this other volcano of pain and doubts. With a demanding look at how care should change for the elderly. “We have to rethink it completely. The concept is out of date, we must prepare our elders for extreme situations & rdquor ;, points out Vilardell.

“Older people, in a much higher percentage than we think, live alone, absolutely alone. The pandemic has further increased that feeling & rdquor ;, he continues. “The social network, the family network, was broken, and they were left alone at home. Older people must be up-to-date in home technologies in order to make life easier for them & rdquor ;.

“It is evident & rdquor;, intervenes Robert,“ that we must banish the ‘butler syndrome’: I’ll do it for you, dad; nooo, dad, you are older, you will not know how to do it, I will connect you with the bank, I will look at your accounts, I will make the purchase for you & mldr; and the grandfather, or the grandmother, they have no idea of ​​driving at home, alone . We should get our older people to be able to be independent at home & rdquor ;.

“In the same way & rdquor ;, continues Vilardell,“ we must radically change the concept of residence for the elderly, creating smaller units of coexistence, family units, small groups, within the residence itself, little apartments within the residence, an idea that is already underway in Northern Europe & rdquor ;.

A different life

Related news

Vilardell, author of a magnificent and illustrative book entitled ‘Aging well’, is convinced that the covid suggests a life change very different from the one we have carried out so far and, even, when it comes to educating children. “We must teach them to create a social network, family, friends, neighbors, whatever. And, above all, educate them on the idea that they must be faithful, complicit, even succeeding in life, you can never forget or abandon that network. Because you reach old age and everything goes down, everything. And then, if you haven’t taken care of that network, if you forgot about your family, or friends, or neighbors, or colleagues, you may end up very lonely. If you take care of the people around you, whoever they are, they will take care of you later & rdquor ;.