„...and when we pass the pandemic, the first question would be: why here in Moldova do we have so many associated diseases at a young age of only 50?  And what do we have to do, so we don't have them? ..."
---
I have written several times about the peculiarities of this pandemic and its impact on our current reality. I continue to be optimistic and urge other people to live being  aware of the reality that is now around us.

We have COVID-19, from around the corner we get seasonal flu and on the top of this, we also have our associated chronic diseases.

What do the statistics tell us?

For some time I started to follow the detailed information about those, who died from COVID-19. This information, which includes a summary of the associated diseases, tells us a lot about the status of health of the whole nation. Among the most common comorbidities in people, passed away from COVID-19 and aged 50+, are mentioned the following: hypertension, heart failure, angina pectoralis, diabetes, obesity, cancer. So, if a person suffers from these diseases, it should be automatically included in the list of those with increased risk and deserves special attention during this period of pandemic.

If you go to the National Bureau of Statistics, you will easily find reports on the causes of death in Moldova for the last few years. Last year, 67 out of 100 women died in our country from cardiovascular disease. In men the situation is a little better, but not by much, about 59 men out of 100 died of cardiovascular disease in Moldova in 2019. And these data exist for all age segments. That means, that in fact, about 50% of the population of Moldova, which is 50+, suffers from cardiovascular disease and is in the group of increased risk in this pandemic. If we add here those with diseases of the digestive system and those with cancer, a segment of the population will be shaped quite large.

What would the presence of these diseases now mean in the pandemic of  COVID-19??

Science still can't explain why people with hypertension, heart disease, diabetes,  obesity and cancer are making serious forms of  COVID-19. But  the very fact of the influence of these conditions is already well proven through multiple publications.

At the same time, it is established that people with hypertension, diabetes, obesity and cancer also have serious forms in the case of seasonal flu disease.

Medical publications have appeared about cases of seasonal influenza collide with COVID-19  in patients in risk groups, i.e. patients with hypertension or diabetes. Two out of three patients needed intubation in such situations.

The Moldovan medical system, which has long been working at maximum capacity, will face the following phenomena this autumn:
 

1. Seasonal decompensation or so-called aggravation of chronic diseases and specifically the cardiovascular ones;
2. Continuous increase in the number of patients with COVID-19;
3. Increase in the number of patients with seasonal flu;
4. Increasing the number of serious patients who will need intensive care, due to the overlap of these three phenomena.

How do we cope?

It will be very complicated to deal with such a situation. More and more signals are coming from other countries that total quarantine is again being applied and people are preparing massively for the cold season.

The Moldovan medical system needs urgent and complex resuscitation to cope. Cosmetic measures don't help anymore. And perhaps, the significant resources are required to support this resuscitation.

As mentioned above, we have a large number of people with various comorbidities, with limited access to doctors due to the pandemic and with a high risk of reaching the intensive care units.

The occupancy of intensive care beds is an important indicator that many countries are looking at now. I do not know the occupancy of intensive care beds in Moldova. But I know for sure that such a bed needs a team of at least three people to be functional. And let's admit that we're going to have 1000 or 2000 intensive care beds equipped with everything, but there won't be medical and auxiliary personnel on them? What are we going to do then?

The simplest solution – not to get to those beds

For each member of the community and in particular, for those who are already 50+ and have some comorbidities in their personal medical records, I will simply describe my experience, completing a list of seven tips:
 

1. I will make the vaccine for seasonal flu, which contains four strains of the virus, ie it is tetravalent vaccine. Where am I going to find it? I'm looking for and I intend to ask friends to bring it possibly from Kiev or Bucharest. This year the seasonal flu vaccine needs to be made sooner, already now. And desirable, no later than the end of October. The body needs time to produce antibodies;
2. Another vaccine I want to make is the pneumococcal vaccine. I'm not going to give a trade name here, but there are several vaccines of this kind and they help the body to be fortified against possible pneumonia. For example, in Germany, in February 2020 the mandatory pneumovax vaccination of all people aged 60+ was announced. In Romania, vaccination with these vaccines is now underway;
3. I'm going to take more vitamins, probiotics, prebiotics for prophylactic purposes now to help my body strengthen general immunity. Vitamins are also in seasonal fruits and in seasonal vegetables, so they can be eaten natural, not mandatory procured from the pharmacy;
4. I will exercise daily, at least 1 hour or 5 km, to keep the cardiovascular system in good functional condition;
5. I will maintain the overall emotional state good, through various activities that bring me many joys. For example, there could be painting lessons or singing classes. It can be any creative activity, depending on hobbies and interests;
6. I will respect individual protective measures, including wearing a mask, using disinfectant, sanitizing spaces daily and maintaining social distance;
7. I will communicate immediately with my GP in case of symptoms of the disease.  In case I had chronic diseases, I would talk to the doctor about possible measures to avoid seasonal aggravating them.

If we each take care of ourselves and join our efforts to take care of those around us, we may be able to pass the autumn-winter period without quarantines and isolations.

And when we get past the pandemic, the first question would be: why here in Moldova do we have so many comorbidities at a young age of only 50? And what do we have to do, so we don't have them?