Jiří Votruba has been the head of the 1st Department of Tuberculosis and Respiratory Diseases of the General University Hospital in Prague for ten years. Among other things, he is the author of the book Lung Cancer. Most patients who are positive for Covid-19 complain of shortness of breath and difficulty breathing. We wondered exactly how the coronavirus affects the lungs. In an interview with LP-Life.com, he also spoke openly about the first infected at the hospital and testing the drug Favipiravir. The widescale closure of sports venues is hell for him.
Do you remember the moment when VFN started accepting the first patients with the coronavirus infection?
My thoughts weren't too prognostic, but the fact that there was a pretty nasty viral pneumonia (lung inflammation) was running through my head. Every year we have several types of such pneumonias, which are sometimes more nasty, sometimes less. At that time, however, I had the feeling that this one was really something, because the findings on CT scans and chest images in patients were very colorful.
Could such a rapid and massive development of the disease have been expected from a medical point of view already?
There is a massive increase of the incidence of positive people, which does not necessarily mean a massive increase of the number of patients. Another thing that we see is the increased amount of people who are in the hospital with the coronavirus. But that does not mean that they are ill with the coronavirus. There is definitely an increase in those who die from this one. However, if we look at our statistics, we will find that it is the patients who have had it at the time of death, not that they died from it. So my feeling is that it is a not so perfectly described occurrence of the otherwise common viral pneumonias we see every few years, and that a huge promotional campaign is created around it. The coronavirus probably has a lot of money, so it can secure a promo.
What do you think of those regulations? Do you think that if it hadn't been eased so much in the summer, the second wave wouldn't have had to take place at all?
I think it is necessary to protect weak and sick individuals who are now really at risk. That there is no reason to close schools, pubs and the like. I do not see the reason, nor have I heard any compelling reasons from our epidemiologists to do so. That this is happening all over the world does not mean that it is right. That is the first thing. It's definitely good when people are considerate of each other. When a person goes to visit their grandfather, they take a mask and buy him a respirator, vitamin D and other drugs that will help him overcome the risk period. Because the risk period is now, not only for the coronavirus, but also for flu and other bad diseases.
You mentioned the flu. Can the coronavirus be considered a flu or not?
They are completely different diseases. It behaves differently, it looks different, it has different symptoms and radiological development, just a different disease. It is then interesting to ask if they have the same long-term consequence, because it is similar. As they both lead to ARDS (Acute Lung Injury in Adults), they have similar long-term pulmonary consequences. It is not known whether the coronavirus has more of those long-term consequences. But it has other interesting manifestations - neurological, cardiological consequences. These are things we don't see much with the flu.
Positive patients usually complain of shortness of breath and difficulty breathing. How does covid-19 attack the lungs?
The disease has several stages. The earliest is the vascular phase, this overall inflammatory response. This is very interesting, because it is much stronger than, for example, with the flu. And then it gets caught in the lung tissue, where it makes these deposits of inflammation. In addition, this coronavirus inflammation tends to have secondary infections (bacteria or very often fungi), which is also interesting, it is not typical for all viruses, it is much more common than the flu.
Recently, a novelty has appeared on the market that could allow patients to be examined with wireless probes. How could this device help fight the coronavirus?
Examination of patients with wireless probes would be sonographic, because with the coronavirus we examine blood, mucus, radiology and sonography. You probably mean sonographic examination, wireless, and this is something we already know about that has been on the market for about three years. We are able to work with it if someone gives it to us. Sonographic examination is good in acute cases, when we say that the patient already has a clear case of pneumonia and thus divide the patients into some groups.
The General University Hospital was one of the first to test Favipiravir and Remdesivir. How did these drugs help patients with covid-19?
We cannot evaluate yet because there were too few patients to draw any clinical conclusions. Moreover, because we had and till have the drug available, we do not make any randomization that someone will get it and others will not get it. My subjective feeling is that the Favipiravir we have administered and are administering here probably works.
There have been many articles and theories that those who drink alcohol or smoke cigarettes are far more resistant to infection. What is the truth?
Nobody knows. As for alcohol, it is immunosuppressive. One would have to be constantly drunk to have enough blood alcohol to kill viruses. So the thing with the alcohol is stupid in my opinion.
As for smoking, I know that better. It is certainly the case that long-term smokers who have their lungs destroyed by smoking and become infected have a far greater problem and are much more likely to die. However, it is true that in a small sample of about 300 people in Italy, it has been preliminarily described, not proven, but described that active smokers are slightly less likely to catch the coronavirus. I don't want to draw any conclusions from that. It is just one, and moreover an unblinded study, because no one will blind this study. It is, of course, nonsense to say that everyone should start smoking in order not to get the coronavirus.
What about sports? Can it help us in some way with immunity in this case and reduce the possibility of infection?
Clearly! Sport will do everything. Sport will improve your mood, immunity and defense against viruses. In other words, the fact that we can't play sports right now and the fact that they closed my gym made me angry. I'd love to punish someone.
Are we able to train our breath and affect lung capacity?
You really can train your breath, and we even have special rehabilitation doctors and nurses who are able to train diaphragmatic breathing and chest wall breathing. These are techniques that are well practiced, breathing against resistance, active muscle stimulation. So yes, it is certainly possible and everyone should be able to learn such techniques if they are interested.
What is your opinion on meditation breathing exercises? Do you do any yourself?
I personally do not. I once went to a yoga camp, where I almost died. That was really awful. I went there since it was Fighters Camp. But then it turned out that Fighters camp only takes two hours a day and the rest is yoga and vegan food. Somehow I endured it. Yoga is really hard! There was also a meditation exercise, which doesn't tell me anything because I can't do it. But I'm not against it at all, if someone can do it really well, so they can calm down, they can harmonize, they can feel good about themselves. This is also essential for a person to have good immunity, a positive attitude towards life. If anyone ends up doing it well and for a long time, then congratulations!
You have already studied and experienced a lot. Is there anyone else who can motivate and move you forward?
Seriously, I'm still motivated by patients. It's awesome. Everyone is a little different and each has a different problem.
As a media partner of the real estate agency Y&T Luxury Property, we would like to invite you, together with Mr. Votruba, to support the fundraiser organized by the Our Lungs Fund: Let's donate a pulmonary ultrasound machine to the GUH in Charles Square.
Our Lungs, founded by a real estate agency during the first wave of the COVID-19 pandemic, is dedicated to supporting the treatment of respiratory diseases in adults and children.
"I am the head of the pulmonary department of the hospital in Charles Square. We have been helping patients fight lung diseases for 10 years. We urge you to donate for an ultrasound device for early diagnosis of lung diseases. More information on how to contribute can be found at naseplice.cz."
And why the combination of real estate business and healthy lung care? Elena Jakubovič, the founder of the real estate agency Y&T Luxury Property, and her team believe that a well-chosen house or apartment is the place where you can breathe with ease. And this feeling should be experienced by everyone.