“Bell” from the Medical Association on the “triple epidemic” – What it says about Covid, flu and RSV

An important public health problem is the triple epidemic of Covid-19, influenza, RSV infection, this winter, where alarmingly increased infection rates are observed, experts said at an online conference organized by the Athens Medical Association on the theme: “The triple epidemic, covid- 19, influenza, RSV infection: Hyperbole or reality?’.

The aim of the conference is to inform about respiratory infections, the directions that should be given to citizens, the aggravating factors, the symptoms, the importance of vaccination as well as the methods of treatment and prevention.

“It is not an easy winter, unexpectedly burdened”, said the president of the Medical Association of Athens and regional governor of Attica, Giorgos Patoulis, in his speech, referring to an alarming rise in respiratory infections. The issue, he said, is not Greek, as an outbreak is also observed in other countries. “We find that society is faced with a large amount of health risks and as a medical community we need to ‘notify and protect the public.'” and the dangerousness of the virus outcome that concerns doctors and citizens. It is important for scientific staff to identify the signs for citizens to attend hospitals when it is deemed necessary for all ages, he said. Speaking about the availability of health facilities in view of the new period outbreak of seasonal infections, he emphasized the pivotal role that private doctors play, saying that “they are the real front of the PHY”. Referring to the personal doctor, he said that ISA strongly supports the institution, but in the right way, because its assistance is the A’s and Z’s for the defense of public health He also added that efforts to staff the health system must be intensified, stressing that “new blood must enter” the health structures. “We have to invest in Health”, he said, so that we can create a system, which will be chosen by the global citizen, for doctors to stay in Greece and for those who have left in previous years to return.

The Minister of Health, Thanos Pleuris, spoke about the readiness of the NHS to deal with the new health challenge, stressing that “the pandemic has shown us that we must invest resources in the National Health System and we must not be dogmatic about the concept of public and private because the pandemic also proved that private doctors respectively provided serious services and covered the gaps that existed in the primary health system”. He talked at length about trying to create a framework for a holistic approach to health and, he said, has already started a series of screening tests for cancer and cardiovascular disease. In particular, the minister said “we are investing in the PPH”, by upgrading the structures and the institution of the personal doctor, even mentioning that the ministry is in dialogue with the medical associations for additional incentives to attract more doctors to the institution. The approach taken is that the structures should serve the health needs of the citizens, he said.

National Health System, he added, it is not only the building facilities and equipment, it is also the human staff and we are trying to make the system more attractive and the framework that private doctors have with EOPYY more realistic, so that they are paid for the services they provide in a manner befitting the function of medical science and that the state receives the best possible services. “It was realized during the pandemic that money for Health should not be afraid to give it.” Money given early to Health is sure to better prepare national policies not only for pandemics but also for other diseases, the minister said. Prevention continued to be a central pillar and was exemplified by the Breast Cancer Prevention program. To date, 60,000 mammograms have been performed and 3,380 women have been diagnosed at an early stage and this, he said, is an investment.

Viral infections are on the rise

The topic “Viral infections in children: prevention, prophylaxis, treatment” was developed by Vana Papaevangelou, professor of Pediatric Infectious Diseases of the Greek Academy of Sciences. “Greece is seething with viral infections and not only children,” said Mrs. Papaevangelou, saying that “pediatric clinics have been overwhelmed by small patients” and what worries are the microbial complications that follow viral infections. “Everything has changed in recent years and this is due to the coronavirus, everyone’s exposure to common viral infections has decreased due to restrictive measures,” he said. He talked about immune deficiency especially in infants and children. The other reason for the rise in infections, according to study findings, he said, is based on immunity.

That is, the absence of exposure to viral infections resulted in the children looking like adults. He explained that children have a highly trained immune system, however due to the measures for Covid-19 the activation of this has been reduced resulting in more severe disease and greater dispersion in their environment. As Ms. Papaevangelou said, both the lack of exposure to viral respiratory infections and the reduction in vaccinations have resulted in us now seeing epidemics and possibly even more severe disease than common infections, something that has not yet been recorded and we are certainly seeing and a move to older ages.

He recommended calmness, proper information, vigilance and not the reckless use of antibiotics. “This year will be a difficult winter,” he said, and parents should be educated on how to deal with this phenomenon. He noted that the discussion is open about the possible vaccination of children and for covid and flu. He emphasized vaccination against pneumococcal and meningococcal. He suggested good practices, a balanced diet, good sleeping practices, preference for outdoor activities and good indoor ventilation. “We are seeing a major surge in viral infections and many claim that it won’t be just this winter, it will be next year as well, it remains to be seen,” he concluded.

The epidemiological picture of respiratory infections

The epidemiological picture of respiratory infections was presented by the deputy professor of Epidemiology – Preventive Medicine, EKPA and vice-president of EODY, Dimitris Paraskevis. In the last week, the number of coronavirus cases showed a slight increase of 18%. The BA5 subvariant is the dominant one in the community. A small increase is also observed in hospitalizations, while regarding serious illness he said that there is no change. The trend in deaths is also stabilizing.

Regarding the flu, he said that the rates of people with the flu have increased in recent weeks, especially among young people.

“We have a significant increase in a large proportion of the flu positivity rate, to about 35% of people with symptoms.” The H3N2 subtype predominates.

Information on vaccinations

Information on the course of vaccinations against SARS-CoV2 and the flu was given by the general secretary of the Health Ministry, Marios Themistokleous. As he said, to date there have been 22 million vaccinations against Covid-19, approximately 8 million people have been vaccinated with at least one dose. People over 60 who were vaccinated with a second booster dose are at 25.6%. Regarding the second booster dose, Greece is in the EU average (15th place), while in the third booster dose it is in 4th place and this means that the vaccination programs of the European countries have been relaxed.

Regarding the flu vaccination, he said that so far 2.5 million vaccinations have been done, 24% of the population. Health workers have seen a better response rate compared to previous years, Mr. Themistokleous said.

Charalambos Gogos, o.m., spoke about the benefits of vaccines and future expectations. Professor of Pathology – Infectious Diseases, University of Patras. Georgios Saroglou, om. professor of Pathology – Infectious Diseases, EKPA School of Medicine, stressing that the timely provision of health services saves lives.

Panagiotis Behrakis, Pulmonologist – Intensivist, o.m. professor of Pulmonology – Intensive Care at the EKPA School of Medicine, referred to the symptoms of Long COVID, noting that they are mainly respiratory and neurological.

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