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We were fortunate enough to have Henk Landa from Clinica San Carlos in Denia back on BayRadio earlier to discuss the current Covid-19 Coronavirus crisis. This is almost certainly the most revealing and dramatic account we've had so far of what it's like on the frontline of the pandemic here in Spain. He discusses the number of health professionals already affected and out of action, shortage of proper equipment and testing, and what is likely to happen over the next few weeks - especially within the Valencia region. Don't forget to call the appropriate number first if you do believe you are showing symptoms. 900 300 555 for Comunidad Valenciana. 900 11 20 61 for the Canaries but you may call the emergency 112 number if all else fails. Stay home and stay safe.
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0:00
this is Bay radio first of April or ATS
0:03
but no April Fool's jokes and all of
0:06
that things a little bit different this
0:08
year and schnitzer catch up with
0:10
somebody else life lucky to have honors
0:11
well because man to be a busy chap and
0:14
dr. Hank Lando it's been a long time you
0:16
used to be in here right nut chair right
0:18
there and it seems a while ago doesn't
0:19
it annoying yeah it just seems like a
0:21
few days ago we'd be abased ear and Enya
0:24
but at the moment you're at the clinic
0:26
in on Dara what's what's the situation
0:28
because it's normally the clinic of san
0:29
carlos right yeah san carlos but in san
0:32
cars at the more we yeah we can only see
0:35
patients over the emergency department
0:36
and we're dedicated full to corona
0:39
corona virus the real emergencies like
0:43
heart attacks fractures etc etc so the
0:48
outpatients clinic has been closed to
0:50
safe personnel so that we can rotate
0:52
better and resources are better used so
0:55
I'm based now outside of the clinic
0:57
seeing my patients that have acute
1:00
problems and anything that I can do over
1:02
the internet to over the Internet to
1:03
avoid them taking to the streets
1:06
obviously and putting themselves at risk
1:08
or myself or other health care workers
1:11
at risk so we're trying to like risk
1:14
management risk control what we're doing
1:16
at the moment so the way things are
1:18
going at the moment we hear of the
1:20
numbers nationally which don't seem to
1:22
be flattening off just yet but we're
1:25
plenty plenty of people within the
1:26
Valencia region wondering just what's
1:28
going on locally I mean I see the
1:30
figures when we do the Spanish news here
1:32
but even around where your base you have
1:34
dealt with some positive cases so far
1:37
that's right but look at the Valencian
1:39
community in Korea Valenciana like the
1:42
provinces of calcium Valencia now
1:43
Mackenzie we're a little bit lagging
1:45
behind what would be Catalonia and
1:48
Madrid each and every community has a
1:51
different outlook in this coronavirus
1:57
pandemic and the models that have been
2:00
made drawn up in the University of
2:02
Valencia are interesting and they
2:05
actually predict that our peak will be
2:07
around the third and fourth week of
2:09
April so we're gonna be a lot later
2:12
than Madrid and Catalunya
2:15
what why would that be is it the amount
2:18
of testing being done no it's the amount
2:20
of cases and how much time it takes to
2:22
spread and also what we have we have a
2:25
big handicap you don't have enough
2:27
testing kits so we really don't know the
2:30
actual the real size of the pandemic or
2:32
the epidemic here in Spain it's a bit
2:36
guessing and there are models out and
2:40
some models even predict that we have
2:41
like six times more real cases than that
2:44
we're finding and we're diagnosing and
2:47
we have another big problem is that a
2:49
lot of health care workers have been
2:51
affected there are either
2:53
oran teen or they are ill of the virus
2:56
of involvement I'm just reading up on
3:00
the on the ABC which is a newspaper
3:03
which did section this morning on the
3:07
canteen
3:07
and as I'm looking here there was like
3:10
forty one point four percent of all the
3:14
the personnel health care workers are
3:16
either in quarantine or they have been
3:20
affected with the virus and in Danya
3:23
we're looking at 53 health care workers
3:25
that are affected to give you an idea
3:27
well it's fourteen point three percent
3:29
of the actual of health care workers
3:33
force so we're looking at very serious
3:36
cases we're looking at over a thousand
3:38
cases just in the province of alicante
3:39
of health care professionals that are
3:42
not able to work so where we're going in
3:45
for a really big problem and in vilify
3:48
OSA the State Hospital is almost at the
3:50
verge of collapse they're asking for
3:53
help and will probably be shipping ICU
3:56
cases to other hospitals so what's going
3:59
on is that the the big peak will still
4:03
have to come in three weeks time our
4:05
ICUs are already getting full and on the
4:08
other hand we're short of health care
4:09
workers when you see these big field
4:11
hospitals being set up you get the sort
4:13
of idea if anyone that's sort of
4:15
doubting how real this is that might
4:18
give you some idea when converting you
4:21
have stadiums and arenas that sort of
4:23
things and putting a hospital beds in
4:25
there
4:26
so you say there's still more to was to
4:28
come around evil AC region yeah we don't
4:31
have enough PPE you know personal
4:33
protection equipment we don't have
4:35
enough and funnily enough we don't even
4:37
have these good masks you know you have
4:40
the PPF two and threes which filter 95
4:43
to 98% of particles there's not a
4:45
hundred percent so they don't protect
4:47
you a hundred percent to Corona but at
4:48
least it's a very high degree for the
4:51
droplets that are in the air which is
4:52
the most infectious part of it was
4:54
people coughing over you know so we see
4:58
people in supermarkets wearing these
5:00
masks and we doctors don't have it right
5:03
this is this stuff coming though I mean
5:06
we hear about you know the equipment
5:07
being manufactured by people that would
5:09
normally make other things and the
5:11
testing kits as well was supposed to be
5:13
arriving then they get distributed out
5:14
to the regions what's happening with
5:16
those we've had a scare or bad luck
5:20
let's put it that way
5:21
last week there was a big supply of
5:23
testing kits that were false or or and
5:25
didn't work very well they didn't really
5:27
predict to to say to level high enough
5:31
to be considered a good test they only
5:34
had like 30% predictability which is
5:36
something like coffee grinds so it
5:38
wasn't really worth it so they've been
5:40
sent back to China now there's new ones
5:43
have arrived about two days ago but the
5:46
ministry is now a bit scared they don't
5:47
want to make another mistake so they're
5:50
testing them first before they're gonna
5:51
hand them out so that's all delaying it
5:54
and there's not enough equipment there's
5:56
just not enough equipment and therefore
5:58
the health care professionals are being
5:59
infected and funnily enough we won't
6:02
have enough healthcare in fact the
6:03
professionals so we're really in a very
6:05
dramatic situation yeah and this is why
6:09
so we have you on because people you
6:11
know well speculated and that's
6:12
something but you want you're on the
6:14
frontline there as it were so we can get
6:15
your first-hand accounts of how things
6:18
are going at that did you see it coming
6:20
how early did you see this really being
6:23
a big thing because people weren't sure
6:25
they thought oh this is going to be
6:26
another you know SARS which didn't kill
6:29
everybody
6:29
but did you get the idea it's quite
6:31
early on and starts to this is a super
6:34
virus yes these are what sorts to the
6:37
the very on
6:38
is actually very identical and they all
6:41
both linked up to the AC AC II receptor
6:46
that we have in the lung so that's where
6:48
they actually their point of entry as it
6:51
were to our body okay
6:52
it's very identical but the transmission
6:55
and the mode of transmission is
6:57
different that that is and also the
7:00
illness is different this this illness
7:03
here we're looking at around a four to
7:06
five percent mortality rate which
7:08
differs widely from country country you
7:11
can see that in China the survival rate
7:13
was a lot higher than what we're seeing
7:15
in Italy were seeing in Spain we're
7:18
beginning to see in UK we're seeing in
7:20
the Netherlands where I'm from we also
7:22
start seeing in the United States so but
7:26
we have our populations are elder we
7:29
have demographic where we're top-heavy
7:31
so we have a lot more elderly people
7:33
with a lot more people with comorbidity
7:35
with other illnesses so our mentality
7:38
rate is a lot higher yeah first see it
7:42
happened I think most of doctors we were
7:46
reading up obviously on the wuhan
7:49
experience and looking into it and
7:51
having seen the gradual spread to Italy
7:54
and then how people didn't take it
7:58
seriously unfortunately we had the 8th
8:01
March demonstration for women's rights
8:04
which I fully agree with but it wasn't
8:07
really a good moment to do so we also
8:09
had the soccer matches obviously in the
8:12
north of Italy knowing that there were
8:13
cases there which wasn't very wise to do
8:16
but we're finding out now we're paying
8:18
for it too late unfortunately so when
8:22
did I see it I think we all saw it too
8:23
late to be very honest yeah and also our
8:27
globalization is making things travel
8:30
far faster than ever
8:32
I remember the SARS one years and years
8:35
ago didn't travel that fast as this is
8:38
doing and I just think it's because our
8:40
mobility is so Halling we have so many
8:42
flights going around we have so many
8:44
people traveling there's so much contact
8:47
that is these viruses can just travel a
8:50
lot faster than they used to I think
8:52
you're right about the when it was that
8:55
Sunday with the Women's Day marches it
8:56
tied in particularly within the Valencia
8:58
region with a lot of the big fiestas
9:00
getting underway with the fires found a
9:03
ton of people gathered in Valencia City
9:04
itself and so two weeks later maybe just
9:08
over that you'll probably starting to
9:10
see these some of these cases coming out
9:12
all right yeah that's right yeah and as
9:15
I say we don't have enough testing kits
9:16
so you have no idea how many people are
9:19
affected with the virus a lot of people
9:22
especially younger people hardly have
9:24
any symptoms they could just maybe even
9:26
be sniffing or not at all and they could
9:30
be carrying the virus no the good thing
9:32
is the less symptoms you have the lower
9:36
your viral load is the viral load is the
9:38
amount of virus you're carrying in your
9:40
body the more symptoms you have so if
9:44
you really have a pneumonia you're
9:45
coughing and spluttering and you know
9:47
then you have a very high viral load and
9:49
then the chance of you transmitting the
9:51
virus is very high so people that don't
9:54
have symptoms or very little symptoms
9:56
actually they're the rate of
9:59
transmission is a lot lower okay so that
10:03
is a good point but on the other hand we
10:05
we have a big reservoir of people that
10:07
are carrying the virus we just don't
10:09
know exactly how big that is that is the
10:11
problem and that's that's the problem
10:12
when it comes to numbers when we think
10:14
we know how many people are infected but
10:16
it could be a lot more so I think you
10:18
mentioned earlier what is it's quite
10:21
early on that we were given the advice
10:23
you know you call this number don't go
10:25
along to your GP don't go along if you
10:27
think you have the symptoms have people
10:28
been following that so what they still
10:30
been turning up to see you without going
10:32
through the proper procedure first most
10:35
people are following it up and I'm very
10:37
glad for that so what you have to do is
10:40
if you have a cold or you're just
10:43
sniffing and it's not right stay indoors
10:45
don't go out don't go to your doctor try
10:49
not to spread it to more people if you
10:52
start to feel very ill you can phone us
10:54
obviously can phone me or all my
10:56
colleagues and we'll be glad to help you
10:58
on the phone
10:59
and if it gets really bad if you're
11:02
getting short of breath or if you're not
11:04
able to eat or drink and you're starting
11:06
to feel very very ill now then we
11:08
contact one one to write this especially
11:12
unit comes and picks you up and takes
11:14
you into the local hospital and we do
11:17
testing now the testing we have at the
11:19
moment still takes at least 24 hours to
11:22
get a result we're still short of kits
11:25
so we do it in the very bad cases so I
11:28
have a lot of people calling me that
11:30
want to do a test and I say well we just
11:32
don't have the test you're not going to
11:33
get it and the tests that they are
11:36
offering in a few laboratories around
11:38
are not worth it because I'll explain we
11:41
have different kinds of tests we have a
11:42
what we call PCR the PCR is it's best
11:46
that we actually detect the virus itself
11:49
and its structure is antigen and we have
11:53
antibody tests now antibody tests take
11:56
longer to develop because first of all
11:59
you need a certain amount of time to
12:01
have a certain load of virus in your
12:02
body before your immune system starts
12:05
producing these antibodies bodies
12:08
against the virus that's why they're
12:10
called antibodies okay
12:11
now that takes at least seven to eight
12:14
days before we start seeing it and so
12:18
you have to be quite ill for about a
12:20
week before we know if you have had
12:24
contact with the corona virus and these
12:26
test tests that's the one we really want
12:29
that they're coming in now these are PCR
12:31
tests that within a number of hours we
12:33
can get a reliable diagnosis if you have
12:37
are carrying the virus or not yeah so
12:40
people I think people were wondering
12:41
bumps if they initially get tested how
12:43
long you have to wait for the results so
12:45
the initial ones 24 hours you were
12:47
saying at least 24 hours yeah and got
12:50
new ones now there are about four hours
12:52
and nerby they're being distributed
12:54
they're being distributed obviously to
12:56
the the place that are worse hit and
12:58
that read Catalonia we read Madrid read
13:03
Valencia capital and it'll slowly come
13:07
to the rest and we hope that we'll just
13:09
get enough to this that we can start
13:11
testing at a larger
13:12
kill and be able to actually get a
13:15
better idea of how big this and epidemic
13:18
is getting okay well looking ahead where
13:22
do you see it ending as far as a vaccine
13:24
goes we see all different lengths of
13:27
time being bounded but banded about but
13:29
as a medical professional how do you see
13:31
that well usually it takes about at
13:34
least a year and a half to develop a new
13:36
vaccine it's also a very dangerous
13:38
process because you can actually make
13:41
people very ill if the vaccine is not
13:43
working very well so you have to be very
13:46
careful and we'll have to try to get a
13:49
vaccine that gives us a reasonable
13:51
amount of cover so usually I wouldn't
13:54
see it developing any faster than about
13:56
18 months and this hopefully that
13:59
becoming available enough for you to
14:01
give you have a quantity of vaccine that
14:03
would really make a difference worldwide
14:06
you're you're talking big big numbers of
14:09
production huge numbers of production so
14:11
it's not that easy to set up know
14:13
presumably plenty of people working on
14:15
that as we speak yeah yeah yeah yeah the
14:18
golden the golden thing you know there's
14:21
a business opportunity that I think many
14:24
many laboratories will not want to let
14:26
go I should say so and also what about
14:28
the I don't hear it as much no but about
14:30
the seasonal thing saying oh once the
14:32
temperatures go up and it gets a lot
14:33
warmer it'll it'll die out that's more
14:36
because most virus and we were looking
14:38
on SARS one had that seasonal I would
14:44
you call it rhythm yeah so as it gets
14:46
warmer the virus will survive less and
14:50
we have studies in laboratories that if
14:52
the temperature goes up like 25 26
14:54
degrees Celsius the virus lives a lot
14:58
less longer on certain surfaces now
15:01
maintain itself that well so then that's
15:05
the prediction we don't know we don't
15:07
know if SARS too is going to behave
15:09
similar to like SARS one the the
15:13
feelings are that it should but we don't
15:16
have proof yet all right well thank you
15:19
as always for your time because it's a
15:21
busy time for you it's obvious I've come
15:23
out with lots of obvious statements this
15:24
morning but great to
15:26
yep and sort of just get the real story
15:28
from that line as it were a little good
15:31
buying advice everybody stay indoors
15:33
stay indoors stay indoors please listen
15:37
to the authorities
15:40
limit your displacements to the
15:42
bare-bones minimum wash your hands and
15:44
wash your hands and wash them again and
15:47
be sure the gloves are not that helpful
15:51
especially if you don't know how to take
15:53
them off taking them off is a very
15:56
serious business I advise you go on
15:58
YouTube go and watch those little
16:02
instruction films how to take off your
16:05
gloves it's not that easy
16:07
and there's even among healthcare
16:10
workers we've been trained how to take
16:11
him off about 30 percent don't do it
16:14
correctly here to give you an idea and
16:16
then what you're doing you're
16:17
spluttering the virus all over yourself
16:18
and actually making it worse so you
16:22
might even be better off not wearing
16:23
gloves fortunately if you can make sure
16:26
it's genuine there's plenty of advice
16:27
online they say on YouTube channels and
16:30
the like and hopefully you'll be able to
16:32
check in with yourself again very soon
16:33
so when we see the people applauding in
16:37
evenings on the balcony serves with good
16:39
reason as you say the number of health
16:41
professionals affected is quite
16:42
staggering some of the numbers at the
16:44
moment so we appreciate everything
16:46
you're doing all right and just want to
16:48
say to everybody take care and stay
16:51
healthy
16:51
and let's hope we all see each other
16:54
after this terrible epidemic
17:03
you
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