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This year, the cold could not freeze the country, but instead the viruses almost paralyzed it.

Half-empty classrooms, parents absent from work, whole families sick and a shortage of hospital beds in pediatric wards.

And so virus after virus.

COVID-19 is no longer a topic.

Now the topic is the children, their numerous absences from the educational process and the impossibility of receiving timely medical assistance, due to the crowded waiting rooms and the lack of beds.

But this topic is a topic of social media and conversations between loved ones.

The state is waiting.

And we are waiting for the peak to pass, and if possible, at least to pass us by.

Lachezar Tomov, who is a master's degree, doctor, works at NBU and deals with medical statistics, epidemiology and informatics, has a series of publications together with prominent our epidemiologists, immunologists, pediatricians and cardiologists.

He is a consultant to the Bulgarian Cardiology Society and has been warning for a month about the adverse effects of the lack of adequate centralized measures that can limit the spread of the virus, reduce the burden on the health system and, subsequently, on the educational system.

His opinion is based on more than obvious logic.

It includes science, statistics, shared experience and adequate feedback from specialists in various fields of medicine, writes

What is the objective epidemiological situation in the country and in particular - in Sofia?

There are 5 parallel epidemics in the country and in Sofia - flu, COVID-19, chicken pox, scarlet fever and RSV.

Prof. Alexandrova commented on the flu boom

There is a vaccine for chicken pox that effectively protects against infection, but since it is not on the mandatory list, all young children and unvaccinated adults are susceptible.

It is a serious disease in which brain damage can occur as a complication and is severe after the age of 15.

14 out of 1,000 patients are urgently admitted to hospital.

Also, chicken pox is extremely contagious - 9 out of 10 contacts of the sick become infected.

In 2021, there were 5,400 patients, in 2022 there were already 23,000. We expect the trend to continue in 2023, if urgent measures are not taken regarding vaccination and quarantine of classes or groups of infected children, together with their parents.

We can see over 100,000 cases.

RSV is the respiratory syncytial virus that causes various types and severity of diseases of the lower respiratory tract and is responsible for the death of 1 in 50 healthy children under 5 years of age, without comorbidities, born at normal weight and at full term.

It is one of the main reasons why children's wards in Sofia are overcrowded (latest data from January 6, 2023).

Influenza is the other dangerous virus, which can lead to the death of 1-10 people in 1000 depending on age (increasing with it) and hospital admission in 10-100 people for every 1000 sick people.

Scarlet fever is a bacterial, streptococcal disease that does not provide protection after a relapse and may recur soon after recovery.

It is treated with an antibiotic, but can lead to complications such as kidney damage, central nervous system and internal organ damage.

The appearance of scarlet fever after having passed flu or covid more often leads to complications, as is the situation in Bulgaria now - scarlet fever follows the cases of COVID-19 and the spike appeared before the intensification of the flu wave, which usually begins in December and is strongest in the end of January.

What do you think is responsible for the increased cases of respiratory viruses?

The effects of repeated mass outbreaks of COVID-19 without a vaccine.

COVID-19 has multiple mechanisms to suppress the immune system, including senescence of T-cells and their levels collapsing within a year to levels similar to those of HIV patients.

This happens even after a minor illness.

Also, monocytes are reprogrammed to be pro-thrombotic (blood clotting) instead of doing their job, and the effectiveness of B-cells is reduced.

That's why we have a multifold jump in scarlet fever cases.

What is the incubation period of scarlet fever and how long does it take for children to have no contact with each other in order not to close a vicious circle of constant infection?

The incubation period is between 1 and 10 days.

At least 10 days and a negative test after that are required before the quarantine is lifted.

Why do you think centralized measures are not taken?

To avoid political liability as these are unpopular measures.

The attempt to avoid a bad image, however, leads to damage to the health of children and vulnerable people (pensioners, people with transplanted organs, cancer patients, etc.), to many absences from work of parents and losses of hundreds of millions of BGN for the economy us.

Decentralized management is not very efficient because there is traffic between different regions.

How do high temperatures affect viral spread?

At present, the climate prevents this spread, as temperatures are higher and air humidity is greater.

Inevitably, cold weather and a decrease in humidity will come, and then the epidemics will receive a new impetus.

What is the right thing to do in the current situation and why?

First of all, you need a week of flu vacation and another week of online training to break the cycles of infection.

Getting sick with Covid-19 and flu predisposes to scarlet fever, which helps epidemics.

It is also appropriate to return masks to hospitals, shops and public transport at least while there are many active cases of the five epidemics.

Dr. Gergana Nikolova warns: Antibiotics should not be used for the flu

Could this fifth epidemic have been predicted?

The exact and specific form of petodemia - no, but that there will be a multiple jump in cases of various respiratory diseases, I predicted this already a year ago.

Unfortunately, the world has paved the way for a future where we have to think about how to clean indoor air so as to reduce the spread of infectious diseases, and until that happens, wearing high-end masks will be necessary.

Vaccines are important and useful, but we are always one step behind nature if we try to create them during an epidemic.

With them alone, we cannot fight either covid or the other heads of the thousand-headed llama.

We can't put the "plagues" back in Pandora's box, but we can defeat them if we are smart and think long-term, not just about tomorrow.

Lachezar Tomov

flu epidemic