Popov: A pandemic was considered unlikely

Your career in emergency medicine will soon mark its 30th year. Do you remember the day you started?

My first day was ambulance training. I was still a student at the healthcare college that was called medical school at the time. It was in 1989 or more than 30 years ago. I remember it well as it was an exciting day for me. I got to drive around with an ambulance crew, with a doctor I later worked with for many years. We became very good friends. It was very instructional and there were also some laughs. I also heard my first medical joke then. I realized it is an interesting profession and one I want to pursue.

What was the joke?

Not one that can be told anywhere. (Laughs)

You have seen different times in Estonian medicine over the last 30 years. Which period do you remember the most vividly?

Times were difficult when I graduated from university in the 1990s. Even though a fresh university graduate should have a clear path and future outlook, the situation felt depressing. It seemed we would never find work as doctors in Estonia. It was quite a difficult and critical time. My financial situation was not good and I decided to go and also study psychology in hopes of finding myself. That was the most critical period, but it quickly passed. When I dove into my work, I took a shine to these processes and that dispelled all doubt of what would come next.

You have moved through the ranks as a medical worker. Has it been a natural journey?

Yes, absolutely. I still believe that if a person wants to work as a doctor, it is key they know what caregivers, assistants, emergency medicine technicians, nurses and assistant nurses do. Once that person becomes a doctor, they will have full respect for their colleagues who actively support them. It isn’t possible any other way.

What captivates you the most about working in emergency medicine?

It is a highly diverse specialty where a single day can bring what an office doctor experiences over half of their career. You could be flying in a helicopter in the morning, resuscitating a person on a ship in the afternoon and working in an ER at night. It is truly interesting work.

Doctors save lives, while it doesn’t always prove possible. How does a medic cope with losing a patient?

While we’re all human, doctors need to have thick skin so to speak. Every patient is a part of life for us and if we lose them, we lose a part of ourselves. It cannot he helped. However, there is always another patient waiting and we must be prepared. We must not allow ourselves to become depressed or concentrate on what already happened. We need to keep moving forward as we would not be able to help anyone otherwise. That is the harsh reality.

Doctors need to have a stable mental state, especially those working in emergency medicine, intensive care units. We need a high level of stress tolerance to be able to work. Of course, failing to resuscitate a child will stay with you for days. A more sensitive person will not be able to keep working in the field, but we need to remain professional. We sometimes receive help from crisis psychologists.

You became the head of the West Tallinn Central Hospital last year. Was it your aim to escape the spotlight when you gave up the post of the Health Board’s emergency medicine department chief?

Absolutely. I wanted to be able to concentrate fully on a different serious assignment – which running a hospital undoubtedly is. Knowing what it is to serve as medical chief – as I had to work in that capacity in spring and fall – one would be hard-pressed to find enough time to serve as an efficient medical chief and also run a hospital.

This is especially relevant if you start from scratch. You need to get to know people and delve deep into hospital processes. It is a completely new post for me and it would be impossible to do both jobs simultaneously.

There has been a lot of talk about Estonia’s vaccination plan in recent days. That it is progressing too slowly or is somehow lacking. What is your opinion?

It is and it isn’t. We can compare ourselves to other countries. For example, Israel serves as an example for the whole world as people are being vaccinated at breakneck speed. It depends on the extent to which a country’s officials could dedicate themselves to securing contracts. We live in the European Union and have joint projects and a plan. We will receive as many vaccines as the EU can procure.

Unfortunately, it seems that is something we must simply accept. As a small country, it is unthinkable for Estonia to be in opposition to its partners or do something radically different. It would likely be impossible both technically and financially. We will pick up the pace and inoculate everyone who needs it, while it will take a little time.

How prepared was Estonia for the second wave of COVID-19? Director of the Health Board Üllar Lanno told Postimees in an interview that he did not receive a plan of any kind from his predecessor. That he had to put together an activity plan himself.

We had a plan. I am talking specifically about the medical aspect. We talked about boosting hospitals’ treatment capacity. We drew up corresponding plans in April and May when we were already considering a second wave and how we needed to be prepared for it. When we started out together with Dr. Ahti Varblane in October, we updated the plan based on the situation then and considered it vital it is taken forward. Yes, you always need to have a plan. I am sure of it – you need plans on every level and people responsible for their sections. It makes things a hundred times easier for everyone in charge of solving crises.

What is the situation of the West Tallinn Central Hospital in terms of combating the coronavirus?

We have the situation under control. We are at 85-100 percent capacity in terms of COVID-19 beds. Other hospitals are actively helping us as patients are distributed where there is room. We are also discharging quite a few people, meaning that patient turnover is rapid. The treatment process is maintained day and night.

We have additional doctors in during weekends. The hospital has capacity to increase the number of COVID-19 beds should it prove necessary. We are eagerly awaiting the second wave to let up to be able to breathe more freely.

You are also a lecturer of disaster medicine. How different is theory from practice? Have you been forced to amend your study materials?

When preparing lectures and seminars on disaster management, we used to prioritize technical disaster scenarios, such as highway pileups or train crashes. While a pandemic was considered, it received less attention as while it is a possibility, it is rather unlikely in Estonia’s geographic location and faith was placed in vaccines.

We need to complement our crisis plans in this respect to be able to effectively withstand viruses, bacteria and pandemics. We have far more skill and experience in this field today. Disasters are never good. They hike stress levels and cost people their jobs. But they are also very educational for people expected to respond. We all learn and take away from such crises the most important thing we need to go on. Stress and hardships from last year have left us with valuable know-how, experience and skills. We are far more proficient when it comes to pandemics today.