2 years after state of emergency was declared in Bulgaria due to Covid-19 – the experiences of the healthcare professionals

On March 13, exactly 2 years ago, a state of emergency was declared in Bulgaria due to the spread of the coronavirus. Two months later, an epidemic emergency came into force.

Today, the situation looks like this - four regions are now in the covid-19 green zone and fall into stage 1 based on the occupancy of intensive care beds and the incidence of coronavirus, data on the national Information Portal shows. Only the region, which includes the districts of Razgrad, Silistra, Dobrich, Targovishte, Shumen and Varna remains in the yellow zone. In just a week, on March 20, the requirement for a green certificate for staff in public places is expected to be lifted. From 5 March it is no longer required for customers and visitors.

To date, the total number of people who were ill and recovered from Covid-19 is over 1,100,000. In the past 24 hours alone, 960 new cases were registered in the country. The death toll for these two years is just over 36,000. More than 2 million people have been vaccinated and 702,000 people got a booster shot.

And what have the doctors learned in these two years, what experience have they gained?

Uncertainty, fear, limitations. This is what the past two years looked like for us, especially in the first months of the state of emergency. Unknown and gaining experience for the doctors. Dr. Mitev met with Covid for the first time when his father was ill.

"In November 2020, he was ill with Covid. This was the time of the first big wave in Bulgaria. The hospitals were full and we thought it was worth a try, to treat him here," said Dr Dimitar Mitev, head of the COVID ward in “Zdraveto” Hospital.

The surgeon assembled a team of young doctors for the COVID ward.

"Every time we came to work we hoped to see the patients alive and we were very happy when we even saw an improvement in their skin colour, the expression on their faces and their improved condition. It was priceless," said Dr. Iva Petrova, a specialist in pediatrics and a physician at the COVID-unit in “Zdraveto” Hospital.

According to Dr. Mitev, the most common mistake made in treating Covid was prescribing an antibiotic without it being necessary. The biggest problem was patients coming too late, in deteriorated condition. Starting treatment at an early stage is key, he added. The effect of the administration of monoclonal antibodies, which became known as Trump's medicine, is very good, the practice in the ward showed.

"The key thing about them is that they need to be administered early - within 5-6 days of the onset of the infection. But even in older patients with multiple co-morbidities, if the medication is administered right away at the time of the diagnosis of Covid, we see a great result and the infection progressed without any complications," said Dr. Dimitar Mitev, head of the COVID ward in the hospital.

Lung ultrasonography is also applied.

"We see the greatest effect from the application of lung ultrasonography in Covid because with this method we can detect changes in the lungs very early and react immediately, even before they become visible on an X-ray," said Dr. Dimitar Mitev.

Unlike the CT scan, it is quick and gentle.

"The recommendation of the American Radiological Association is that no more than 25 lung scans should occur in a person's lifetime, whereas in Bulgaria, during a Covid infection, some patients have 2-3-4 or more scans to monitor their condition, which is absolutely unnecessary," said Dr. Dimitar Mitev.

And the most valuable lesson that the young doctor learned from the epidemic is that a cohesive team is the foundation of success, which for doctors is measured in lives saved.

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