Earlier this year, when I was reading what our compatriots living in China were writing about the spread of a new virus, how they were living in an atmosphere of fear, how they had to disinfect themselves and their belongings several times a day, how they had limited all their contacts, put their lives on hold, everything seemed so unreal and far away. It was hard to imagine how all of that would become a part of our lives.
On March 1, the first case of coronavirus was reported in Armenia and by March 14, the number of infected people reached 18. A State of Emergency was declared on March 16 for a month to prevent the spread of the virus, which has now been extended several times. Now, two thirds of the way through June, there are more than 21,000 people infected and more than 370 deaths in Armenia, a population of about 3 million.
Survivors of Extreme Care
The cases of infection were especially widespread in factories. Eliz Badalyan, 72, who works in a large production facility in Yerevan was in a battle for life and death for about 15 days because of coronavirus.
"On Monday, April 20, I had to go to work. In the morning I got up as usual, got ready, but I was very weak. I thought I shouldn’t go,” Eliz recalls. “I called my colleague, I said that I was very weak, that I was not in any condition to come to work. My colleague said that he was the same. Later, my fever went up and I lost all sense of taste and smell.” Thinking that it was the common cold, Eliz decided to simply stay home and treat herself.
When it became clear that her situation was not stabilizing, she went to the Nork Infectious Diseases Hospital on April 26. She tested positive for coronavirus. After spending two days there, she was transferred to St. Astvatsamayr Medical Center.
"I had a light cough at the beginning, I was out of breath and felt like I was suffocating. At first I was taken to a regular room, but they realized that my condition was very serious and placed me in ICU, where I stayed for six days. It is impossible to describe how attentive the doctors and the whole medical staff were. One of the nurses, a 21-year-old girl, would sit by my bed, feeding me with her hand, I was so weak that I had no appetite at all. I was constantly nauseous, I was completely weak, I couldn't even drink water,” Badalyan remembers. Fortunately, she was able to recover from double pneumonia. She had no other chronic diseases. “Thanks to Levon Balayan, and with the help of all the other miraculous doctors, I recovered. I was given 42 rounds of IV, there is no more space on my arms,” she says. “I have no idea how much medication was provided to me, how much all of that cost, it is difficult to imagine. Everything was so clean, everyone was so attentive, three quality meals a day. In a word, I could not have imagined that I would see such a thing.”
In the early days of the pandemic, all those who were infected, regardless of their symptoms, were hospitalized and all those who had come into contact with an infected person were quarantined in special sites across the country, all their needs and expenses were covered by the state.
Eliz Badalyan finally returned home on May 12. Luckily, her family members, all six of them, were not infected.
Although she considers herself recovered, after the difficult days she experienced, her life nevertheless has changed.
“It’s a pity, however, after these fateful days, I need to rest; I have decided to leave my beloved job, opening the way to the young,” Badalyan says. “It was a difficult decision to make because I have worked for 50 years, but coronavirus brought with it certain changes. Now, when I look and see how people are continuing to live their lives normally without complying with a single rule, I understand that they have no idea how evil this is. I, too, never imagined that the day would come when I would not be able to breathe.”
In a short period of time, the virus spread throughout the entire country. Approximately 195 kilometers from Yerevan is the village of Chinchin in the Tavush marz. It is renowned for its virgin forests, a place where one gets a sense that here, nature is a shield against any threat. However, the disease of the century was able to creep in, even here.
A resident of Chinchin, 58-year-old Heghush Gyurjinyan also works at a factory. She says that the safety measures were strictly enforced at her workplace, however, there was no stopping the virus from spreading.
“Up until April, we would hear about the virus only through the television and we thought that it was far away from us,” she recalls. “Then we found out that there was an infected person in our neighboring village. It was May 16, a Saturday, when I came home from work and wasn’t feeling well, my temperature began to rise.”
Gyurjinyan’s 16-year-old granddaughter also started to feel poorly.
“By Sunday, we were really bad. Our family doctor, Gayane Gevorgyan came to check on us. She called Yerevan but they said that we had to have pneumonia before we could get tested,” she recalls. Taking into consideration that Gyurjinyan had chronic illnesses and her granddaughter had cerebral palsy, their doctor was able to get them admitted to the hospital in Berd. This is where their difficulties began.
“It was Sunday, and some of the medical staff were off. We were put in a small room, it was quite cold. Our condition was getting worse, we both had a temperature of 39 degrees. After waiting for two hours, I asked how much longer we had to wait,” Gyurjinyan recalls. “The person on call yelled at me and told me to continue waiting. My granddaughter’s temperature kept rising and no one was offering any help. We waited for another two hours, finally the doctor came. We got lucky with the doctor who kindly took x-rays of our lungs, was tender with the restless girl [Gyurjinyan’s granddaughter], very attentive to us.”
The attending physician determined that Gyurjinyan and her granddaughter must be transported to St. Gregory the Illuminator hospital in Yerevan.
“We arrived at the hospital at 2 in the morning. It’s impossible to describe how they welcomed us, how attentive they were toward us. They helped my granddaughter from her wheelchair, they carried her in their arms. I have been going to hospitals all these years and I have never seen such an attitude. They were so caring, it’s probably because of that kind of care that we were saved. For me having high blood pressure is a normal thing, but they didn’t, not even for a minute, allow my pressure to rise; they hooked me up to an oxygen tank and monitored me throughout the night. They provided us with meals three times a day, we didn’t want for anything,” Gyurjinyan says and remembers how one day she got a call from the Special Commission of the State of Emergency saying that they had “fled” their place of quarantine.
“The state had never once bothered with my sick 16-year-old granddaughter, but when for three days we were in hospital fighting for our lives, they called to say that we had fled. We didn’t know whether to laugh or cry. Later, they figured out what had happened and called to apologize,” Gyurjinyan says.
After being discharged from the hospital, they returned home and continue to remain in self-quarantine. They note with pain that even in their small village, many people, being infected themselves don’t believe in the virus and continue to live their lives normally.
“I don’t know what else has to happen, how many deaths we need to have for people to sober up. I don’t want anyone to go through what we went through,” Gyurjinyan says adding that people should have compassion for the doctors who are on the brink of exhaustion and collapse.
The Achilles Heel of the Health System
The state of emergency has brought to the surface and made even more palpable prevailing problems, the education and healthcare sectors being the most vulnerable. It became evident that although for years on end, the state had allocated funds for the development of distance education in the country, it has remained problematic.
The situation has highlighted that changes made in the primary healthcare system - polyclinics - also remained inadequate. According to experts, the amount allocated to the healthcare sector is quite limited, from which the main problems spring. In 2020, 109 billion AMD (approx. $22 million) was allocated to the healthcare sector, which is about 6% of the state budget. In 2019, that figure was 89.6 billion AMD; in 2018, 84 billion AMD, and in 2017, 85.8 billion AMD.
However, taking into consideration the transmission of the virus in the country, in mid-May it was decided nevertheless that polyclinics would be entrusted with the function of taking care of asymptomatic COVID-19 patients.
On May 19, Armenia’s Health Minister Arsen Torosyan said that hundreds of people who have tested positive for COVID-19, but who had no symptoms or have only a mild fever would be sent home from state-run quarantine sites and that newly diagnosed asymptomatic patients would not be hospitalized. “Their home care will fall on the shoulders of all of you [referring to the medical staff of polyclinics, rural dispensaries and health centers], as well as monitoring those with respiratory infections with mild symptoms,” he said. Many people who had contracted the virus raised concerns about the quality of care they were receiving at these polyclinics.
On May 28, Torosyan announced that taking into consideration that the new role and function of polyclinics had created tensions between patients and primary healthcare professionals, he urged all those who were dissatisfied with the services or had experienced issues to immediately register their complaints through the Ministry’s hotline.
Over the past month, M.M. has felt firsthand the consequences of a flawed polyclinic system. On May 24, her mother started developing a fever, she and her sister also started to feel poorly. Taking into consideration that their mother had come into contact with a coworker who had tested positive for the virus, the next day they immediately went to see a doctor at a polyclinic who recommended that they get x-rayed.
“The next day they told us that my mother and I had acute bronchitis. I noted that I didn’t have a cough, they said well, perhaps your sister has it [bronchitis] but you don’t. We never figured out which one of us had bronchitis. They prescribed medication, however after more than 10 days, there was no difference. We decided to call an ambulance. After testing my mother and finding out that she was positive, she was hospitalized with double pneumonia. But my condition wasn’t good either. For seven days I had pain in my back pain and chest, but the doctor at the polyclinic said it was because of my nerves,” M.M. recalls adding that 14 days later, they did another x-ray at the polyclinic.
“It was a Friday morning when they took the x-ray and said that the results would be ready in the evening or early the following day. We called them the whole day, they didn’t give us any answers, nothing on Saturday, silence on Sunday. It was only on Monday that the doctor told me I had pneumonia, without providing any further details,” M.M. recalls. “That day, I called an ambulance twice, but they didn’t hospitalize me because the doctor did not provide the proper information. I was finally hospitalized the following day in the afternoon. The fact remains that our treatment was delayed and while they were treating us for bronchitis, we in fact, had double pneumonia.”
After being treated at the Artashat Medical Center for ten days, M.M. is back home, however, she doesn’t consider herself fully recovered.
“I have to take medication for another two days. I don’t know whether I am fully recovered and whether it is possible that the infection will reoccur. I undertake every activity with fear so that I am not reinfected or so that I don’t infect someone else. My fears and anxieties continue and I don’t know if they will ever go away,” M.M. says.
P.S. While I was preparing this article and searching for people who had recovered from coronavirus, we found out that my parents were infected. Both of them are in the high risk group. From the very beginning, every precaution was taken to create conditions for them to avoid getting infected. However, the infection did not spare them either. My mother had a fever for two days, then started coughing and like so many other people, thought she had caught a cold and it would pass. My father, who has had three strokes, developed a fever the next day, was tested and found to be infected. He was hospitalized the following day. They tested my mother, however, because she had no other symptoms, except for a cough she was not hospitalized. She was only hospitalized after getting an x-ray at a private clinic that confirmed she had pneumonia.
I am in the third trimester of my pregnancy. Many people have reached out to me to find out whether or not I had come into contact with my parents. Three days before getting tested, my mother called to say she was coming to our house. After putting down the phone, I called her back and asked that she not come, that we continue missing one another and we communicate only through the phone. The whole day, the feeling of guilt was suffocating me; during this very emotional time, I so need my mom. I have seen my parents, who live a few blocks away, only four times since March and always making sure to follow all the safety precautions. This time I decided to refrain from taking a risk and to continue to follow the proposed regulations, although I don’t know if I have any hope of succeeding to avoid this incomprehensible disease, but at least I will know that I did everything possible.
Egor Zaitsev, the World Health Organization Representative in Armenia says that the Armenian government’s decision to implement a lockdown was timely, however, the issue was with enforcement and lifting the lockdown too soon, especially when cases were increasing.