Boris Mendelevich: ‘Positive psychotherapy will help stay healthy in 2021’

Why an upsurge of mental and psychosomatic diseases await us after the coronavirus pandemic ends and what we can do with it

Boris Mendelevich: ‘Positive psychotherapy will help stay healthy in 2021’
Photo: Maksim Platonov

The COVID-19 year is over, and not the pandemic but the virus still poses a threat to us. We need herd immunity that can be formed in two ways: when most Russians recover from the disease or will be vaccinated. Of course, immunisation is a safer option, but Russia won’t have enough capacities to produce a necessary amount of vaccines by the middle of the year — as many as 75 million doses, warns State Duma deputy from Tatarstan, member of the Duma’s Committee for Health Care Boris Mendelevich. The parliamentarian offers solutions to the problems in a column written for Realnoe Vremya.

We will get herd immunity...

We stepped into the new year — in such moments, people usually talk about the future. It is very hard to talk about what expects us in 2021. In 2020 that was famous for COVID-19, we daily heard forecasts of the development of the pandemic based on different information — on mathematic models, analogies with the development of other epidemics. Unfortunately, they didn’t become a reality. Nevertheless, something can be forecasted with great likelihood.

In any case, to win the pandemic, we need herd immunity that appears when the majority of the population already had the disease or was vaccinated. The majority is 60-80% of the population according to different data. I think we will get herd immunity to coronavirus when 60-70% of the population of the country has antibodies to the virus.

I think that vaccination is a much safer way for life and health to get immunity than the disease with its possible complications and death at times.

And in 2021, I pin serious hopes on vaccination and that we will finally get herd immunity.

Photo: Rinat Nazmetdinov
In any case, to win the pandemic, we need herd immunity that appears when the majority of the population already had the disease or was vaccinated

... but not till mid-2021

The problem of 2021 is technical — we don’t have enough vaccines against coronavirus. Neither do we have capacities to produce a necessary amount of vaccine doses in a short time.

Around half of the population used to be vaccinated against the flu in our country — 48-49%. It is necessary to vaccinate the same amount against coronavirus, moreover, preferably till the middle of the year — it is around 75 million people. While today the Russian Federation is able to produce much less. For instance, it is planned to make around 2 million doses of the vaccine in January, then 7 million, then 10 million. And in any case, we won’t have the time to vaccinate half of the population.

This is why it is necessary to look for other solutions, for instance, create new plants on our territory. But it is impossible to create factories in a day — it includes the purchase of equipment, licensing, creation of sterile areas. The second solution is to agree with factories outside the Russian Federation on vaccine production on condition that a part of the vaccines will remain in the countries, which is done now.

Masks to stay for another year

In any case, herd immunity won’t mean that coronavirus will be defeated and will go away forever. It will likely turn into a season virus we have already been living with for long — the flu virus, rotavirus, adenovirus, viral respiratory infections...

Some scientists assume that coronavirus can replace the flu and coronavirus itself appeared because mass vaccination against the flu “made” room for it.

This is why we will have to learn how to constantly live with this virus and constantly follow precaution and prevention measures. I think we will be wearing masks and stocking up on sanitisers, following a distance for another year. We will simply get used to it as we got used to brushing our teeth.

Photo: Ilya Repin
I think we will be wearing masks and stocking up on sanitisers, following a distance for another year.

Tourism, restaurants and hotels under threat

Since coronavirus won’t disappear in 2021, while social distancing will remain topical, new loses in the sectors of the economy linked with mass attendance of people are inevitable — it is tourism, restaurants, hotels.

Moreover, even if the pandemic doesn’t stop, people’s new habits and stereotypes will stay. They will fear crowded places, and I am afraid not only in 2021 but also later. This is why I think the government already should take care of support for these sectors of the economy.

Postponed regular screening will turn into postponed death

I think that the state will soon sum up the situation health care was in in 2020. We have already talked about the optimisation of health establishments, reduction of beds and so on. There have been debates, but they have been theoretical, while now they have become practical, and we see where there are problems.

For instance, the death toll in Russia has increased not only because of coronavirus but also because we simply forgot other diseases after repurposing hospitals for COVID-19 and retraining a huge amount of doctors — there was a lack of doctors to help chronic patients.

Photo: Maksim Platonov
The death toll in Russia has increased not only because of coronavirus but also because we simply forgot other diseases after repurposing hospitals for COVID-19 and retraining a huge amount of doctors — there was a lack of doctors to help chronic patients

The regular screening was cancelled, elective check-ups were suspended. While assistance for chronic patients isn’t provided as much as it used to be before the pandemic. And in 2021, we should wait for both an upsurge of aggravation of chronic diseases and a rise in the incidence of patients with primary diseases.

What we used to detect at an initial stage isn’t being detected now and can turn into the so-called delayed mortality rate. So that the problem of assistance to patients with other problems will go to the forefront in 2021, and we should create an algorithm of actions, moreover, coronavirus causes complications, including remote ones.

Tough years await us, we won’t be able to recover something, but health care functionaries should think of how to act to bounce back.

We expect growth of mental and psychosomatic diseases

After the end of the pandemic, we expect a rise in mental diseases. It is well-known that during a crisis, a person’s psyche mobilises, this is why the main growth of the incidence is expected after the pandemic ends. First of all, people who are inclined to have mental disorders are under a threat — the crisis became a kind of trigger for them. It is necessary to prepare for it, including for psychiatrists.

But a lot of people are already facing psychological problems now because the situation we faced is very unusual. It is a provocative factor for the appearance of psychological problems.

Their growth is already seen in various ages, including in children who lost the chance of communicating with their contemporaries as much as they used to. Adults who went through self-isolation don’t understand either how to behave, their long-term habits and stereotypes break down, and the psyche reacts to it.

Photo: Ilya Repin
Adults who went through self-isolation don’t understand either how to behave, their long-term habits and stereotypes break down, and the psyche reacts to it

Moreover, a lot of diseases are psychosomatic. Around 60% of patients in urban polyclinics are patients with psychosomatic disorders. So we expect a growth of not only mental but also psychosomatic diseases in 2021.

We will get out of the crisis stronger

Together with negative things, the pandemic has brought a lot of new and useful things to our lives. Digital technologies have begun to develop by leaps and bounds, they have made a huge breakthrough. While people have started to consider health care not only as a sphere of services from a perspective of laymen — they have started to understand their responsibility for their health and the health of people around them.

It makes me happy as a health worker and health care organiser because we had been talking about for long because the health care system can’t develop and operate within consumer egoism no matter how much money you invest in it. And I think that this consumer egoism will leave the health care sphere from 2021. We will start to get out of this crisis stronger.

The coronavirus crisis has an upside too. It is already clear that we will get out of it stronger than we were, we will learn a lot, we will become better. I am sure of this. There is such a type of psychotherapy — positive psychotherapy. In any problem, one shouldn’t focus on negativism but find something positive, though little, and focus on it. This is what I wish you in 2021.

By Boris Mendelevich
Analytics Tatarstan