What is happening now in Permian medicine? And what can we expect next when the flu comes? The most pressing questions were answered by the Chief Sanitary Doctor for the Perm Territory Vitaly Kostarev, the Regional Minister of Health Oksana Melekhova and the chief freelance doctor – infectious disease specialist of the Perm Territory Valery Masalev.
A photo: Vasily Vakhrin
The number of cases of SARS and coronavirus is growing every day in the Perm Territory. Perm residents complain that they cannot get through to the clinic and call a doctor, they publish videos on social networks of dozens of ambulances waiting in line for a CT scan (lung diagnostics through computed tomography).
What is happening now in Permian medicine? And what can we expect next when the flu comes? The most pressing questions were answered by the head of the Rospotrebnadzor department in the Perm region, the chief sanitary doctor Vitaly Kostarev, Regional Minister of Health Oksana Melekhova and the chief freelance specialist in infectious diseases of the Perm region Valery Masalev.
Why are there so many cases?
– Over the past two weeks, the numbers on the incidence of coronavirus have increased by a third, – said Vitaly Kostarev. – In this we see three main reasons: seasonality, the formation of teams (children went to school, workers returned from vacations) and neglect of the use of personal protective equipment.
When interviewing the sick, it turns out that 87% of them did not use masks, 60% did not observe social distance, participated in public events, visited shops and traveled on buses.
Will self-isolation measures return?
– If we all together observe anti-epidemic measures: wear masks, wash hands and carry out regular disinfection, additional restrictive measures will not be required. If we are careless, then this is possible. But this is not specifically planned for now.
How to keep your distance if buses are crowded?
– There is a share of responsibility of municipal authorities, carriers, and passengers. As for the municipality, we are meeting, discussing this problem and looking for a solution. At the first stage, we will encourage passengers to put on masks. Penalizing them is not a good option.
Are there enough beds to treat patients with covid infection?
– Now 2615 beds are deployed, 2303 are occupied, – explained Oksana Melekhova. – Of these, there are just over 300 intensive care units. 66 patients are now on ventilators in serious condition. Then we are ready to deploy up to 3,300 additional beds. In addition to “covid” ones, we will be able to use infectious beds for the treatment of these patients, of which we have more than 500.
Now it all depends on how the epidemic process will proceed, and how much we can all stretch it out in time to get away from peak loads and avoid a sharp surge in morbidity. In order to survive any infectious upsurge with minimal losses, we need help. The system is ready, but it has been operating in this mode for a long time, and we do not know what will happen when the flu starts.
The longer we stretch the peak incidence over time, the less the load on the system will be. This can be done only by including now all anti-epidemic measures.
Are the ambulance lines no longer talking about a critical situation?
– Indeed, there is unrest among the population, and in recent days we have indeed seen an increase in the number of calls, but if we compare the workload on doctors now with the time when the epidemic is on, then we are still far from the peak. Yes, in recent days the system began to malfunction, there was an overload of ambulances and ambulances. They began to understand, it turned out that the calls that used to go to the house, due to the difficulty of dialing, went to an ambulance. In this regard, we have increased the number of dispatchers and administrators who will now receive calls. And in order to relieve the queues in polyclinics, narrow specialists will now work at acute receptions.
Is it possible to free ambulances from waiting for patients to undergo CT scans?
– We are working on this topic, we looked at the practice of colleagues from other regions. This could be done if ambulances were used to transport outpatients only for CT. Those patients who are now being transported for CT have indications for hospitalization.
What if a person has symptoms of COVID-19?
– All viral diseases – ARVI, influenza and COVID-19 have similar symptoms. If there is no condition called “life threatening”, and there is no loss of consciousness, then the most correct thing is to call a doctor at home. Telephone numbers for home calls and the telephone of a single dispatcher are available in each clinic and on their websites. Then you need to wait for your doctor or emergency help.
A doctor or paramedic will determine your condition. If it requires hospitalization, then an ambulance will be called to such a patient and sent to the hospital. If there are indications for treatment at home, then a certificate of incapacity for work is issued, the attendance is determined and the treatment is signed.
One of the main signs by which it is determined whether there is an indication for hospitalization is saturation (determination of the level of oxygen in the blood).
“It is the duty of a medical worker to check saturation, all of them are now equipped with pulse oximeters,” says Oksana Melekhova. – This must be required, and in case of refusal to report to the clinic. At a high temperature and pronounced symptoms of ARVI, the doctor should call a team to you to take a smear. I agree, there are situations when the doctor does not say when this team will arrive, and I do not deny him.
After taking a smear, the result gets to the doctor and the diagnosis begins. If COVID-19 is confirmed, additional treatment is prescribed. If the infection is not complicated and there is no transition to pneumonia, antiviral therapy and antibiotics are prescribed, but all individually and according to the doctor’s prescription.
What are the symptoms of a coronavirus test?
– With ARVI symptoms: temperature above 38, catarrhal phenomena (sore throat, runny nose, lacrimation), dry cough, shortness of breath, impaired sense of smell, possibly diarrhea, explains Valery Masalev.
Do confirmed cases from private clinics go into general statistics?
– All people who received the test result call a doctor, and he already makes a diagnosis. All positive cases are referred to Rospotrebnadzor by private clinics, regardless of whether the patient himself reports it. Upon receiving a positive result, the patient must call the doctor at home, tell and present the positive test result to the doctor, – said Vitaly Kostarev.
Trying to play it safe, the person himself goes to the CT scan, is that correct?
– There is a clearly defined time frame for when and under what conditions a computed tomography should be done. Now we have up to a 30% increase in the number of CT scans that do not result in pneumonia. Why? Undergoing computed tomography at an early date can lead to a false delusion that everything is in order, everything is clean, and with time it can only prolong the infection, ”notes Oksana Melekhova. – If the patient has a high temperature, bright signs of acute respiratory viral infections, a positive test, then computed tomography, which will show the development of pneumonia, is recommended to be done no earlier than the fifth day. In Perm, there are now four computed tomographs that work around the clock for coronavirus infection, each conducts at least 100 examinations per day, and that’s enough. There are CT scanners in the region.
Can Perm residents get vaccinated against coronavirus?
So far, Perm residents cannot even be vaccinated against COVID-19 for a fee. Vaccinations are expected to start in early 2021. Not so long ago, a trial technical batch of vaccine arrived in the Perm Territory. That’s 42 doses for 42 people. It is placed twice with an interval of three weeks. While the vaccine is stored at a temperature of -18 degrees and is waiting for the first willing doctors who work in the “red zones”, they have not yet been ill and are ready to be vaccinated against COVID-19.
– I will say more, my spouse and I are on this list, in my family all supporters of vaccination against coronavirus, says Oksana Melekhova. – Knowing the structure of the vaccine and assuming how it should work, I don’t see any fears.