Author: Denis Tahiri
"They say quick swabs, but the state provides swabs for citizens. In my case, who knows how many others I would have gotten into if I had followed the state's rules, which require a doctor's recommendation and then have them do the swab ," begins the conversation Bledi, a 23-year-old student, who, even during the pandemic, has chosen to stay in Tirana so as 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 around 6 pm and I asked to do a swab to see if I was positive or not, because I didn't want to miss the next day's work. They told me that the swab couldn't be done at that time because it started at 10 am and there was no staff at that time, plus I had to have a recommendation from my family doctor even though I have a family doctor in my hometown and I haven't moved my civil status to Tirana. I was forced to go to a private clinic where my swab came back positive and one of the doctors there also gave me the medications I needed to take. Fortunately, I got through it easily ," he says, adding that the cost of the treatment was around 300 thousand 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 result of the swab test in the state came about 8 days after I had tested at the Health Center. It was a PCR swab and not a rapid one, as the rapid one had ended that day and the testing continued with the old type of testing. After waiting three days, my family forced me to go to a private clinic 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 relative of mine works in medicine and immediately started me on treatment with vitamins and then antibiotics when I needed them. Even though I had some concerns, I still consider myself lucky since I got through it easily. If I had waited for the swab test result from the state, I could have most likely worsened my health condition since it was delayed by more than a week , " the young man recalls.
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 swab, I had the first signs, fever, cough and runny nose. I contacted my family doctor and he told me to wait 3 days for the temperature to drop. He advised me over the phone to take some generic medications such as paracetamol, aspirin, two antivirals and a very low-dose antibiotic, even though I told him that I had strong suspicions that I had been infected with Covid-19. One of my family members tested positive and I had contact with him ," says a citizen of Tirana who does not want to be identified. He also did not find a solution for the swab, so he went and did it in private the next day and it turned out positive. Even after another communication with the family doctor, this time with a positive test, the doctor again recommended the same medications as before.
"There I lost confidence and turned to private medicine, because the symptoms were getting worse, while my family doctor recommended medications used for the common 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 Favipiravir, Xarelto as a blood thinner, Plaquenil which is for lung protection and both Plaquenil and Favipiravir do not exist on the Albanian market. I had to find them on the black market. Favipiravir was trafficked from Turkey and was sold for 200 euros per box, where its price abroad is a maximum of 30 dollars and for treatment you needed 80 grains, so 2 boxes. Plaquenil was somewhere around 100 euros, a blood thinner with a syringe that was supposed to be 15 thousand old lek per dose for my family member who was in a more serious condition", the young man speaks openly. But the deterioration of his family member forced him to turn 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 cost between 150 and 250 euros per dose, and 11 doses were needed for a full treatment. For my family member, Dexamethasone and serums, saline solutions, plastic serum lines, and everything for one person cost 3500 euros, not including the tests done privately before and after, because we didn't do anything in the state, and when we went, they advised us to go privately to get them done," he says, detailing the form in which the "curative" medicines were delivered.
"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 medicines, it functions 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 medicines to sell them to you. Even though it is 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. Even though it is something illegal, I don't want to know, my life and that of my family 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 Dexamethasone, we needed someone specialized because they had to mix them specifically, and we had to hire nurses, who came once a day and were paid 50 thousand old lek per day. These nurses worked both in the state and in the private sector and as freelancers. The entire treatment, without any fear, cost us somewhere between 9 and 10 thousand euros for the whole family , " he says, also making fun of the state's Covid medication reimbursement scheme, which only reimburses paracetamol in his family's prescriptions.
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.
– Purchase of antineoplastic immunomodulatory drug. Tocilizumab 400 mg/ 20ml, 400 pieces, with a unit price of 62,641 lek excluding 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."
