Author: Denis Tahiri
"They say fast buffer in vain, and the state provides a buffer for citizens. In my case, who knows how many others I would have killed if I had followed the rules of the state, which require a doctor's recommendation and then make a tampon", Bledi starts the conversation, a 23-year-old student who, even during the pandemic, has chosen to stay in Tirana in order not to lose his job as a waiter.
He says that he began to suspect that he might have been infected with Covid-19 during the last days of January. A high temperature of 37.7 degrees Celsius was the first sign.
"I immediately went to the health center near the neighborhood. It was about 6 o'clock in the evening and I asked him to do the tampon to see if I was positive or not, as I didn't want to miss the work day the next day. I was told that the tampon could not be done at that time as it started at 10 am and there was no staff at that time, plus I had to have a family doctor's recommendation even though I have a family doctor in my home town and I have not moved the civil status to Tirana. I was forced to go to a private clinic where the swab tested positive and also one of the doctors there gave me the medications I should take. Fortunately, I passed easily", he says, adding that the cost of the cure was about 300 old lek.
When Covid passes faster than the tampon response arrives
Among the many problems encountered during the pandemic, one of the biggest bottlenecks in conducting the Covid-19 test in state structures continues to be the delay in returning the response. Andy, a 27-year-old who passed Covid-19 in February, says that this was the biggest obstacle he encountered. Although he had the tampon done at the end of January at the Health Center, the answer came at the end of the first week of February.
"The tampon response in the state came to me about 8 days after I had the test done at the Health Center. It was PCR buffer and not rapid, as the rapid had run out that day and the testing continued with the old type of testing. After waiting three days, my family members forced me to turn to the private sector and I tested positive", he says, adding that he started treatment immediately due to the fact that one of his family members works in medicine.
"In this respect, I was lucky, as a family member of mine works in medicine and immediately started treating me with vitamins and then with antibiotics as I needed it. Although I had some concerns, I still consider myself lucky since I passed it easily. If I had waited for the response of the tampon from the state, I probably could have been aggravated by the health condition since it was delayed for more than a week", the young man remembers.
But not everyone overcomes the Covid-19 infection easily. Most of the citizens also have other complications, which require a follow-up with medications that in many cases are not allowed to be sold legally in Albania. The situation becomes even more difficult when all family members are infected. No one cares, the psychological condition worsens and a considerable monetary budget is needed to cover the costs.
"I asked to do the tampon, I had the first signs, fever, cough and lightning. I contacted the family doctor, he told me to wait for 3 days so that the temperature does not drop. He advised me over the phone some generic paracetamol type medications, aspirin, two antivirals and a very low dose antibiotic even though I told him I had strong doubts that I was affected by Covid-19. One of my family members was positive and I contacted him", says a citizen of Tirana who does not want to be identified. He also did not find a solution for the tampon, so he went and did it the next day in private and it was positive. Even after another communication with the family doctor, this time with a positive test, the doctor again recommended the same medications as before.
"That's when I lost faith and turned to you privately, because the symptoms were getting worse, while the family doctor recommended me medications that are used for simple flu", he says.
Traffic and medication with "forbidden" drugs
Unlike the state, in private the 30-year-old's recipe changed completely. Part of it were medications that he had previously heard mentioned in the visual media where representatives of the Ministry of Health declare that they were unnecessary.
"The doctor suggested me Favipiravir, Xarelto as a blood thinner, Plaquenil which is for lung protection and both Plaquenil and Favipiravir do not exist in the Albanian market. I had to find it in black. Favipiravir was trafficked from Turkey and was sold for 200 euros per box, where its price abroad is a maximum of 30 dollars and 80 grains were needed for cure, i.e. 2 boxes. Plaquenil was somewhere around 100 euros, a blood thinner with a syringe that was supposed to be 15 lek old doses for my family member who was in a more serious condition." the young man speaks openly. But the deterioration of his family, forced him to address once again
the "black market" of medicines to buy Remdesivir, a medicine that is not allowed to be sold in the Albanian pharmaceutical market.
"Remdesivir was between 150 and 250 euros per dose and 11 doses were needed for a complete treatment. For my family, Dexamethasone and serums, salines, plastic lines of serums and everything for one person cost 3500 euros without taking into account the analyzes done privately before and after, because we did nothing in the state, even when we went they advised us to we used to go to private to do it", he shows detailing the form in which the "healing" medicines were delivered to them.
"They used to bring them to us by motorbike, do you mean these pizzeria bikers?! In the same way, they were handing out sufflakas and when they handed them to us, they told us to put them in your pocket quickly so that no one sees you".
From his experience, the 30-year-old says that in the "black market" of medications, it works like a closed circle, with word of mouth and with the trust that the doctor places in you to give the "guarantee" to the owners of those medications to they sell you. Although something illegal, his gratitude is great when we asked him about the names of the pharmacies where he had bought these medicines. "I will never tell you. Although something illegal, I don't want to know, me and my family members' lives were saved by those medicines", he says.
Most wanted job? Freelance nurse
Cases of medication that require the placement of serum and mixing of various medications must be performed in hospital settings and under the strict monitoring of doctors. But during Covid-19, the "market" of nurses in the home was also born.
In need of a nurse was the main character of the article, the 30-year-old from Tirana, who, after the deterioration of his family's health, started treatment with Remdisivir and Dexamethasone.
"For Remdisivir and for Dexamethasone, someone specialized was needed as they have to mix them specifically and we had to get nurses, who came once a day and were paid 50 thousand old lek a day. These nurses worked both in the state and in the private sector and "freelancer". All the treatment in total cost us somewhere between 9 and 10 thousand euros for the whole family without any fear", he says, also mocking the reimbursement scheme for Covid medicines from the state, since in his family's prescriptions, only paracetamol is reimbursed.
Ministry of Health: We have medicines
We also asked the Ministry of Health about the medications it has purchased to deal with the situation caused in Albanian hospitals by Covid-19, and this institution listed these medications together with their purchase prices.
-Buy antineoplastic immunomodulator drug. Tocilizuma 400 mg/ 20ml, 400 pieces, unit price 62,641 ALL without VAT.
- Ribavirin 200 mg tablet/capsule - 100 pieces; 10,700.00 ALL without VAT, with a unit price of 107 ALL without VAT
- Oseltamivir (tamiflu) tablet" - 6,000 pieces; ALL 885,000.00 without VAT, with a unit price of ALL 147.5 without VAT
-Omperazol 40 mg/cial vial"- 20,350 pieces; 9,666,250.00 ALL without VAT, with a unit price of 475 ALL without VAT
- Propofol 10 mg/ml- 50 ml vial"- 660 pieces; ALL 359,766.00 without VAT, with the unit price of ALL 545.1 without VAT.
-Beclomethasor + Salbutamol 80 mcg + 1600 mcg, bottle- 10,000 pieces, 513,000.00 ALL without VAT, with a unit price of 51.3 ALL without VAT.
However, even though many of these medications should only be for hospital use, they are easily available in the free Albanian pharmaceutical market.
While the fight against Covid-19 is continuing in Albanian hospitals, as well as throughout the world, no one pays attention to the equipment and medications needed for advanced stages of this virus. Similarly, the market of devices, which are offered to citizens seeking rescue at any cost for oxygen equipment, has also exploded on social networks. This market again operates among acquaintances who offer oxygen equipment for monthly rent or to buy. In other cases, dealers sell the device with a warranty of 1 year or more. The issue of oxygen equipment became the object of investigation at the Kavaja prosecutor's office, where after the investigation of Mensur Shtylla, he showed that he had taken the equipment from the hospital to help those affected by Covid-19 who were treated at home and who did not have financial opportunity. During the investigations, the prosecution noted:
"Oxygen cylinders were found in the apartments of four citizens, while in the house of Galip Rena there are patients with covid, although there was a bomb taken from the hospital, it was impossible to enter because there were still patients with covid."
