November the 24th, 2020 - Professor Markotic has become a household face and name ever since the novel coronavirus, SARS-CoV-2 penetrated Croatia's first lines of defence back in spring. The director of Zagreb's ''Dr. Fran Mihaljevic'' Clinic for Infectious Diseases has always had a calming presence, but even she is growing alarmed by the situation in Croatia.

As Poslovni Dnevnik writes, the director of the Croatian Institute for Public Health, Krunoslav Capak, said that we have an incidence of 886 cases per 100,000 inhabitants and thus we are in 24th place in terms of EU countries.

"We're in 13th place in terms of mortality. Mortality is growing all over the world, including in Europe,'' said Krunoslav Capak, adding that Croatia's share of positives in those tested currently stands at 29 percent.

"The situation at Dubrava Hospital is stable. There are respirators available, if necessary, new ones will be obtained,'' assured Vera Katalinic-Jankovic, Minister Beros' assistant.

When it comes to the now rather tiresome topic of wearing protective masks and the ones which were recently found to be faulty, the microbiologist says that “there has always been a discussion about masks - how much they protect us, how much they don’t. We're now exposed to various products and declarations. Those masks proved inappropriate and the inspection responded. When those shortcomings are removed, they will return to the market", said Katalinic-Jankovic.

''We have 26 patients on respirators. Across Europe and around the world, the number of coronavirus patients is extremely high, their clinical picture is more severe than it was back in the spring, and many more people have pneumonia. The situation is under control, but everyone is following the situation with concern. Two or three winter months are now ahead of us, it will be difficult to keep everything under control. The responsibility is on all of us,'' said Professor Markotic when discussing the situation at the Dr. Fran Mihaljevic clinic.

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As Poslovni Dnevnik writes on the 21st of November, 2020, the director of Zagreb's ''Dr. Fran Mihaljevic'' Clinic for Infectious Diseases, Prof Alemka Markotic, was a guest on Dnevnik Nova TV where she commented on Croatia's new measures to fight the spread of the new coronavirus.

She says the first results of the new measures are expected in two to three weeks

"The first results of these new measures should become visible by then. If the numbers don't fall, then all options are to be considered. If we manage to all pull together we believe that with these newly introduced measures we'll see an improvement. The measures can't do anything on their own if people don't adhere to them,'' Prof Alemka Markotic said.

Prof Alemka Markotic: We're worried about the increase in the number of dead and sick people

In addition, she added that the National Civil Protection Headquarters is concerned about the increase in the number of sick and dead people.

"We're worried about the increase in the number of sick and dead people. Especially since spring is far away. The winter period is on its way and we expect to have to fight this virus for the next two to three months. Everything is being done with different measures and with the exchange of knowledge on how best to treat and take care of patients,'' added Prof Alemka Markotic.

She stated that this is a continuous process. "We're trying to do everything in our power to reduce these trends [of the virus]," she added.

She noted that about 4,000 healthcare workers have now successfully recovered from coronavirus and that there are thoughts about reducing the number of days people need to spend in isolation

Prof Alemka Markotic also revealed how, when the isolation period was shortened to 10 days, a dose of risk was also taken, but also how now they are thinking about shortening this period even more.

"What Croatia did back in September to reduce the isolation period down to ten days has also been done by many countries over the last month," Markotic said, adding that a dose of risk was taken into account in regard to this move.

"One study and review analysis of more than 5,000 people showed that, regardless of the amount of virus particles, after 9 days from the onset of the disease, the virus can no longer cause infection, it ceases to be infectious," Markotic explained, adding that this is very good news indeed.

"Further studies are needed, so we're thinking and discussing reducing it to even less days, but with additional testing implied. This is being discussed at several levels across Europe. We assume that some common recommendations for all European countries could be made,'' concluded Prof Alemka Markotic.

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ZAGREB, November 20, 2020 - Regional Development and EU Funds Minister Natasa Tramisak on Friday presented contracts on EU funds worth HRK 73 million for new healthcare projects to Zagreb's Dr Fran Mihaljevic Hospital for Infectious Diseases and the Health Ministry.

"The coronavirus pandemic has raised awareness of the need to invest more in the health system, in Croatia and the EU alike. We are therefore using all available money from European structural and investment funds," Tramisak said at the contract-awarding ceremony.

She said the contracts would help the hospital continue boosting its capacity and procuring new equipment as well as the Health Ministry buy the necessary equipment, such as a linear accelerator for the KBC Rebro hospital.

Tramisak said projects worth more than 3 billion kuna had been agreed for the health system, with 2.7 billion being grants.

The latest contracts are valued at more than HRK 73 million, and almost 100% of the contract value are grants.

The minister said that apart from a HRK 369 million contract signed last week for the procurement of protective equipment, her ministry had asked the EU Solidarity Fund for an additional €39 million if the procurement of additional equipment should prove to be necessary.

The contract for the Health Ministry is worth HRK 23.7 million and will be entirely financed with EU funds.

The contract for the Dr Fran Mihaljevic hospital is worth HRK 50 million, and EU grants amount to HRK 49.6 million. The funding will help adapt part of the hospital infrastructure and almost half of the funds will be used to buy valuable diagnostic equipment, the hospital's director, Alemka Markotic, said.

ZAGREB, November 15, 2020 - Head of Zagreb's Fran Mihaljevic hospital for infectious diseases, Alemka Markotic, has reported on the first meeting of the EU scientific advice platform, which was held on Friday.

It was aggred that EU member states would exchange information on the pandemic and that the main focus would be on testing and reaching a consensus on the duration of quarantine and isolation, as well as on preparations for vaccination.

It was also agreed that they would exchange their experience with validating rapid antigen tests so that different EU countries would not validate the same tests.

"So far, there have been different experiences with those tests," Markotic said.

Next Friday, on November 20, another meeting of the EU platform will take place, and in the next two to three weeks a common position on testing should be established.

ZAGREB, November 12, 2020 - The Croatian government on Thursday nominated Dr Alemka Markotic as a member of the European Union's future scientific advisory platform on COVID-19.

Markotic is the head of Zagreb's Fran Mihaljevic hospital for infectious diseases, a professor at the School of Medicine in Rijeka and a member of the national COVID-19 crisis management team.

The platform will soon be set up at the proposal of European Commission President Ursula von der Leyen.

The platform will include a group of respectable doctors and researchers from all EU member states whose task will be to ensure a better, faster and coordinated exchange of scientific data and expert opinions as well as practical experience at the EU level.

As Poslovni Dnevnik writes on the 9th of October, 2020, Croatia recently recorded 542 newly infected people, and as such there was an extraordinary meeting in the Government, and what moves the national crisis headquarters plans to make was discussed by Professor Alemka Markotic.

Most likely from next week on, masks will be mandatory in all indoor spaces across Croatia, and most likely in some outdoor areas where a lot of people gather together. Krunoslav Capak and Davor Bozinovic said that they would do everything to prevent a new lockdown, but that possibility wasn't entirely ruled out either.

"Nobody is in favour of a new lockdown, we know how difficult this measure is. In the first wave, it was justified, it saved us, now we all have to work to prevent that from happening again,'' said Professor Alemka Markotic.

For those who don't wear masks, Professor Alemka Markotic has one very clear message: "Everyone who doesn't want to understand that this isn't just some stupid virus, those who don't realise that they can endanger others, harm all of us, our health, and ultimately themselves."

Asked whether they should be punished, Professor Alemka Markotic said that they and the entire staff are more for ''endless conversations and persuasions. We think that any person who has any sense can understand what this is all about, especially when they look at recent figures, and that with a normal approach we can get those who don't yet understand what it is about to do so,'' she explained

If that doesn't work, there are other measures, the professor says, but she pointed out that she is convinced that a large number of people are responsible, but they have just relaxed a little too much. The increase in the number of patients could be a big burden on the Croatian health system, which is currently still under control, but if it continues like this, the Zagreb Arena hospital could soon be reactivated.

"The system is still under control, however, a few days of such large numbers in about 10 days will certainly result in a large number of patients. If we take the City of Zagreb, which has had the largest number of patients for a few days now, the capacities we currently have in the Clinic for Infectious Diseases and in the Dubrava Clinical Hospital, which is more than half full, won't be enough. The scenes we had when we set up the Zagreb Arena hospital... well, you remember what effect it had on all of us,'' said Markotic.

We will also need to wear masks outdoors in places where a large number of people gather.

Professor Alemka Markotic also noted that she is talking intensively with the representatives of the Church because we will soon have holidays like All Saints' Day. The professor says that they are aware of the seriousness of the situation and that the proposed measures will be accepted and implemented.

"We can definitely expect big numbers in the coming days. In the coming days, we still have a chance to decide whether we're going to be responsible, whether we'll decide on health, on life, for the economy, for a more or less normal life and work and jobs, or we'll decide to be irresponsible and decide on disease and chaos,'' warned the professor, adding that she believes that Croatia's residents will decide for the former and "that we will reverse the game currently led by the virus with 1: 0", reports Dnevnik.hr

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Sometimes the big solutions are in the little things. Dr Alemka Markotic, the director of Zagreb's Fran Mihaljevic Clinic for Infectious Diseases is also trying to check whether this is the case with the new virus that saw the world grind to a halt through a new study.

As Poslovni Dnevnik writes on the 20th of September, 2020, while the world's pharmaceutical companies and the most prestigious scientists are busy working on the production of vaccines against the new coronavirus, Dr Alemka Markotic has stated that even some simple procedures such as maintaining good nasal hygiene can help fight respiratory infections in general.

The observations she cites are still in their initial controlled study phases, but this finding cannot certainly be harmful to anyone. The idea for the study, she explained, was born out of trying to help asymptomatic infected people who had been in isolation for weeks because of a positive swab test that was no longer in line with their state of health because they were feeling well. The key is in saline solutions that the new coronavirus, much like other viruses, finds hostile.

''From the very beginning of the pandemic caused by SARS-CoV-2, scientists and doctors have noticed that in a number of patients, but also in people who have been diagnosed with the infection but haven't developed symptoms, we can detect the virus in the nasal mucosa for a long time. Cases of over two months of positive swabs have been reported in some individuals. In the first few months of the pandemic, while we didn't know how long the virus could be infectious for, it was associated with the long-term stay of positive people in isolation, which led to certain psychological problems, but also existential ones due to long-term isolation and the inability to return to work,'' said Dr Alemka Markotic in conversation with 24sata. She is exploring the possibility that in a number of people, slowing down or preventing the spread of the virus from the nose to the lungs could be done with the simple use of saline.

''During the spring and early summer, some people with long-term positive swabs turned to me for help. Since there's no specific cure for now, I was thinking how best I might help them. The assumption was that the results of the swabs were probably made up of defective virus particles or viruses that had lost their power to infect, but there wasn't enough information in the relevant scientific and professional literature to attest to it for sure and they had to be isolated until negative results were obtained from them. I thought that maybe a good nasal clean, that is, rinsing and moisturising the nose with sea salt-based preparations, could help remove the dead epithelium in the nose, and thus the viral particles from that epithelium.

I advised people to refresh and clean their noses 3-4 times a day by injecting seawater-based preparations for 2-3 days and then do another control swab. In most cases, after that procedure, the test returned negative and they could finally leave isolation and return to their "new normal" lives,'' explained Dr Alemka Markotic. The next step was to scientifically prove this interesting observation.

''As these were individual observations and experiences, which definitely need confirmation in a controlled study in order to be considered scientifically and professionally relevant and applicable, we launched a pilot study at the Clinic for Infectious Diseases in Zagreb. In the study, we'll try to examine patients with COVID-19 and see how much regular nasal bathing with seawater-based solutions can reduce the presence of the virus in the nose, and if the results are encouraging, we plan to continue the study in asymptomatic cases to reduce the possible spread of the virus to the lower parts of the respiratory system, ie towards the lungs,'' she noted.

She stressed that maintaining a healthy nasal mucosa is extremely important in general.

"Doctors regularly give such advice to their patients, and it's good that now, before the season of respiratory infections comes around, where the flu will play a big role, we remind everyone of this type of protection. The nasal mucosa is the site of entry of numerous microorganisms that cause respiratory tract infections. Cells that line a healthy and undamaged mucosa represent a physical barrier to the entry of microorganisms and the contraction of disease. The nasal mucosa provides heating, moisturising and purification of the inhaled air.

In addition, IgA antibodies are secreted on the surface of the mucosa that can offer local protection against various microorganisms. Cold weather, but also overheated areas with dry air damage the mucous membrane, cause inflammation and swelling of the mucous membrane and increase the possibility of microorganisms settling on it. Therefore, keeping the mucosa moist and undamaged, including regular nasal cleaning, is important in defense against microorganisms,'' said Dr Alemka Markotic.

To ensure nasal patency and normal breathing, Markotic added, various drops are used to reduce mucosal swelling, but most such drops should only be applied for a short time, as their long-term use can also lead to damage to the nasal mucosa.

"For the daily moistening of the nasal mucosa and the prevention of damage to the mucosa, seawater-based solutions are recommended. Salt reduces swelling by binding water from the mucosa, dilutes the mucus and facilitates its expulsion, and can also have an anti-allergic effect. It can also physically remove dead and damaged nasal epithelial cells.

In the current era of COVID-19, in addition to measures of distance, hand hygiene and wearing masks, it's important to maintain proper nasal hygiene, which includes regular cleaning and moisturising, especially since the prolonged wearing of masks can further reduce the normal wetting of the nasal mucosa,'' concluded Dr Alemka Markotic for 24sata.

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As Poslovni Dnevnik writes on the 20th of August, 2020, just a couple of days ago, with 219 new cases of infection with the new coronavirus, Croatia recorded a record number of new cases, and the number of citizens being tested for coronavirus is increasing. The director of the ''Dr. Fran Mihaljevic'' Clinic for Infectious Diseases, Alemka Markotic, explained for Dnevnik Nova TV that the increased number of new cases is mostly not the result of an increased number of tests.

''We test as needed. People recognise when they need to test more and they accordingly. The situation is definitely different now. In the first phase, we had few patients and few asymptomatics, so we went in part to test those with clinical indications and those who had close contacts. Now there are many more asymptomatic and with mild symptoms, but people are aware that they are returning to their families, so they themselves go more for testing,'' explained Alemka Markotic.

She pointed out that the prices of tests have dropped compared to the amount they once costed in the spring, so now people can be tested on their own initiative. "We can provide the lowest price of 501 kuna. If people suspect that they have been in risky situations or if they have extremely mild symptoms, for which their doctor believes that they don't have to get a referral, they can come for testing, and they can also come for an assessment,'' explained Alemka Markotic.

"There is a lot of pressure on both the city and the state public health institute. The clinic currently tests 250 to 300 people a day, mostly people from hospitals. It definitely has enough capacity, we have the largest device that can test up to 1400 samples, we can cover some tourists and some citizens,'' she assured.

When it comes to Slovenia, which has announced that it will put Croatia on the red list, Alemka Markotic says that there are still many tourists staying in Croatia from Slovenia. "Their general impression is that they are safe in Croatia. Look at the amount of these people, if you realise that there were 300,000 people, about 50 of them got sick, that's nothing compared to that number,'' she said.

When asked what kind of winter awaits us, Alemka Markotic said that today there are currently more patients with milder symptoms. "In the winter, we'll have to deal with the situation much more seriously," she said, adding that the health system is preparing for that.

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As Poslovni Dnevnik writes on the 19th of August, 2020, a recent guest of Dnevnik N1 television was Alemka Markotic, the director of the ''Dr. Fran Mihaljevic'' Clinic for Infectious Diseases in Zagreb. The current situation, measures for the beginning of the school year and the race for the vaccine are some of the topics she discussed.

"Slightly higher numbers are the result of more activity over the summer in this part of the Earth's hemisphere where everyone relaxed and are travelling, it was obviously easier for the virus to penetrate. It all happens in the open, more or less among the younger population, so for now, at least in Croatia, there are no serious consequences, almost 90 percent of those infected didn't need to be hospitalised, but that doesn't mean we should relax and think that everything is solved,'' she stated.

''The virus accelerates when we reduce precautions. There has been talk for months about mutations, and research by Professor Cicin-Sain, in which this same clinic for infectious diseases also participated, shows that the virus has point mutations that allow it to be transmitted more easily from person to person,'' said Alemka Markotic.

"We're not in closed spaces, so the dose of the virus people receive is lower, which can also affect their clinical picture, but we should be careful and the disease shouldn't be transmitted to the elderly, into facilities used by the health system and into nursing homes, that's what we're trying to stop from happening all the time," she explained.

On the question of schools and some of the confusing information that has been circulating, she said: ''We may be late with information to the public, but sometimes it is better to refine everything to make sure it's all clearer than to run around giving out unfinished information, it's best that we can do everything two months before, but we saw that cooronavirus is also preparing surprises and that the situation is changing, so when it comes to the instructions, we will have to change and adapt to the situation as it comes. ”

At the moment, the US, China, the UK and Germany are working intensively to find a vaccine. Alemka Markotic analysed how far they had come.

“The advantages for now are that all four vaccines are quite close to coming to the results of the third clinical study, some are at the very beginning, some have a significant number of subjects, all four vaccines haven't had serious side effects and there is good information on the vaccine's efficacy, and which can offer efficacy with lower doses,'' she explained

As for the Russian vaccine, she says the rules must be followed, but that she cannot say that the vaccine won't be any good, but all stages of testing, whether for vaccines or for medicine, must absolutely be followed.

Alemka Markotic also pointed out that the policies of these countries will try to take advantage of the invention of vaccines, but as for the scientists and pharmaceutical companies, she said that the competition is great because over 200 companies and scientific institutions want to create a vaccine and it is then "maybe a matter of scientific prestige the first to be able to help people. ”

She doesn't anticipate higher profits from such moves, except in the case of the mass vaccination of people.

What about anti-vaxxers?

Alemka Markotic also commented on people who doubt the effectiveness of the vaccine. She doesn’t think that a large percentage of people are in question. "There is a percentage of people who think differently, they need to be talked to and I have often talked to them and when arguments are approached and in good faith, people accept it," she said.

She added that she can see from the data that more and more people are being vaccinated, for example against the flu. She also recalled that after the outbreak of measles, people rushed to get vaccinated against the disease. In addition, she also believes that experts should make an effort to make people understand and contribute further to this, for example, by issuing more clear information on how vaccines are produced to remove conspiracy theories.

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ZAGREB, Aug 17, 2020 - The head of Zagreb's Hospital for Infectious Diseases, Alemka Mrkotic, said on Sunday that getting children back to school at the start of the new school year this September would pose no heightened health risk.

Markotic told the national broadcaster HRT that the examples of the countries that kept schools open also during the peak of the epidemic of coronavirus proved that.

She said that pupils with respiratory infections should be kept at home.

As for the current COVID-19 infection numbers, the epidemiologist admitted that those figures would be considered a serious issue if they had appeared in winter. 

Furthermore, 90% of those who have now caught the virus do not need hospital treatment and a mere 1% of these cases are on ventilators, Markotic said calling for taking the whole situation into consideration rather than focusing only on the new cases' statistics.