We approach the summer with no restrictions and with the hope that coronavirus is regressing. Unfortunately, there's still sadness in the hospitals, as non-vaccinated elderly fill the spaces. Estonian doctors took time to explain the myths and fears causing the decision not to get vaccinated.
“Sad truth is, a lot of hospitalizations could've been avoided with vaccinations,” said Karin Laas, who has been pointed as the head of the COVID-19 department in East Tallinn Central Hospital for three times now.
Coronavirus turned people's lives upside down, and it's very obvious in the hospitals. Working in the COVID-19 department is very different for Laas from her usual department, as her profession is rheumatology. Usually, her patients are young or middle-aged with arthritis, but in the COVID-19 department, most of her patients are elderly.
“It's emotionally difficult because of the high mortality rate among the patients,” said Laas.
Mostly, her patients are non-vaccinated. Majority of them said they decided not to get vaccinated because they are old, and they have many other diseases. “So the reasons not to get vaccinated for them are the reasons, why they are considered to be in the risk group, and should get vaccinated,” Laas described the most common answer.
Falling severely ill with COVID-19 is more likely with heart diseases (coronary artery disease, arrhythmia, heart valve disease and heart failure, heart aches, high blood pressure, etc), kidney- and liver diseases, being overweight or obese, carotid artery disease, stroke, high cholesterol, diabetes, and cancer.
One of the common myths Laas hears regularly is that a previous deep vein thrombus is a contraindication for vaccinations. “It's not like that! But falling ill with COVID-19 might be the cause for thrombotic complications.”
I don't go anywhere, why should I get vaccinated?
That's the second most common myth that because they don't go to crowded places, they don't need to get vaccinated. “People fall ill with the virus, even at home. Usually, it's brought home by their loved ones, who don't have any symptoms or have them very mild,” said Karin Laas.
It's even sadder, that most non-vaccinated are people with dementia, and unable to help themselves. “So the decision is made by their relatives, and they don't think it's necessary because the elderly person is not going anywhere. Still, the virus is brought home by the cares,” she explains.
Conversations with them include often regrets not to vaccinate the patient, and wondering – how was it possible for that elderly person to catch the virus. Frequently, the final phase of the illness is rapid, and loved ones find it difficult to understand, how the situation escalated so quickly.
I've done the first vaccination course, why should I have the third one?
Last couple of months have proved that besides non-vaccinated people, elderly, whose vaccination course was finished more than 6 months ago, also need hospitalization.
“It's clear, that two doses aren't protecting them well enough, and booster doses are essential. The third dose is necessary for elderly because their immune response is weaker, hence the protection of the vaccine doesn't last that long,” said Laas.
Elderly, who have had three doses of COVID-19 vaccine, rarely need hospitalization, she confirmed.
As Karin Laas sees mainly patients, who are severely ill, then the family physician in the Rapla family medicine centre, Argo Lätt sees other sides of the illness. Nurses and doctors are involved with consultations about vaccinations and treating COVID-19 at home, organizing testing, and treatment related to the complications of COVID-19.
Lätt has about 2000 patients in his list, and about 600 are in the risk group. The majority of them got vaccinated as soon as it became possible, but about 25% of them haven't had a single dose.
“For some, their relatives have prohibited to get vaccinated, others say that they are so severely chronically ill that they are afraid and some are afraid of the side effects,” listed Lätt the reasons not to get vaccinated. Elderly often say that they don't go anywhere anyway, and the only person to bring food for them, is their grandchild. “But the same grandchild brings the virus inside.”
I have chronic diseases, what if the vaccine makes my condition worse?
People, who need the vaccine the most, are the most afraid of it. In Lätt's list, there's a 75-year-old woman with multiple chronic diseases: asthma, diabetes, and a heart disease are only some of them. All of these diseases increases her risks of falling severely ill. “When she caught the virus, at first, she tried to heal herself at home, but eventually was taken to the hospital by the ambulance,” described Lätt with a hope that she will recover.
Lätt encouraged to get vaccinated with chronic diseases. “The only contraindication is a previous anaphylactic reaction or an allergic reaction to any of the ingredients of the vaccine.” The number of this people in Estonia is very small. “I don't have these people in my list,” he said.
Mostly, his patients don't ask advice about vaccinations, but ask help with health complications related to COVID-19.
I had COVID-19 a long time ago, why I still have health problems?
„Almost daily, we have a patient, who complains about a chest pain, arhythmia, tiredness, head ache or cough lasting for months," Lätt lists most common health complications related to COVID-19 recovery.
Long COVID can cause multiple symptoms, and they can last for a long time, even when the tests are negative. Often, lifestyle changes need to be made, and go through recovery treatment.
The best protection against long COVID is to get vaccinated. The latest data, by the Estonian Health Insurance Fund, has shown that 98.5% of people with long COVID were not vaccinated. Non-vaccinated people have more severe cases of long COVID, and their complications last longer.
Besides the long COVID, catching the coronavirus might intensify other chronic diseases. Both, Lätt and Laas admit that COVID-complications are worrisome, and often it feels like it'll be too overwhelming to nurses and doctors.
To overcome this, communication and noticing little signs of progress helps. “Even in the corona-department, we have patients, who are positive and optimistic, although they are old and severely ill. And when the disease eases, the joy is bigger for everyone included,” added Laas.