The Russian healthcare system is hastily honed to fight against coronavirus. At a meeting of the State Council’s working group on combating Covid-19, the regions were recommended to adapt the new buildings of medical facilities of other profiles to infectious wards. As the BBC Russian Service found out, Moscow medical institutions are already working according to the new rules: preventive medical examinations and planned hospitalizations are being canceled.
The user of the site for communication between mothers Baby blog Alexandra was going to give birth at the Moscow maternity hospital No. 8. “They called in the morning,“ pleased ”! The maternity hospital with which I have a contract is quarantined, new [рожениц – Би-би-си] they don’t take, the old ones were taken to different hospitals, ”she wrote on the Baby blog forum. – The contract was with a certain doctor who agreed to conduct EP [естественные роды – Би-би-си]. And now, in general, it’s not clear what maternity hospital to go with such a bouquet, and how the delivery will take place. And give birth to me even today. “
On the website of the maternity hospital №8 (part of the State Clinical Hospital named after Demikhov) it is written that it is closed. In fact, it will work, but not as a maternity hospital: on March 14, it became known that the building was redesigned to receive patients with coronavirus. According to TASS, doctors suggested this, and they were supported by the Moscow Department of Health.
How coronavirus impacted healthcare
On March 20, a meeting of the working group of the State Council on the fight against coronavirus was held – it is headed by Sergey Sobyanin. At a meeting, the Ministry of Health ordered to fully mobilize all health systems in 10 days. The regions were advised to take into account the experience of Moscow in re-profiling beds in hospitals, including adapting new buildings of medical facilities of other profiles to infectious wards.
According to the order of the Ministry of Health of March 19, which the BBC Russian Service got acquainted with, federal centers are being created in the country to combat the new virus. New rules for the work of ambulances and regulations for doctors who treat patients with acute respiratory viral infections at home are introduced. In polyclinics of patients with acute respiratory viral infections plan to examine through the “reception and examination boxes.”
But preventive examinations and medical examinations are suspended, the document says: doctors should “consider the possibility” of transferring planned medical care.
Patients will be able to remotely receive a prescription for the medicine and the drug itself with home delivery.
Moscow hospitals are already working under the new rules. The website of the Veresaev hospital says that preventive medical examinations in the clinic are canceled. The admission of visitors to the hospital and maternity hospital is limited: transfers for them are received in the halls.
The 81st hospital has confirmed to the BBC the cancellation of planned hospitalizations. In State Clinical Hospital No. 29, one of the doctors spoke about the same on condition of anonymity. If you call the 13th hospital, the answering machine reports the transfer of planned hospitalizations. In the 67th hospital, the BBC said that they first received a citywide order to cancel planned hospitalizations, but then they recalled it, and now each medical institution makes its own decisions.
Why measures are needed
These measures are needed to protect healthy people by separating them from patients, on condition of anonymity, a source in the Moscow Ministry of Health explained to the BBC. He added that only those operations that can be postponed are canceled, while urgent ones will continue to be done. So it will be possible to get chemotherapy and get vaccinated.
But other patients, such as Alexandra, who were not accepted by the reassigned hospital, may suffer from the focus of medical institutions on the coronavirus. Or Natalya, who complained to Facebook about the closure in Zvenigorod of a special hospital No. 45 for people with asthma and lung diseases. “Yesterday there were some commissions, and today they announced that the hospital is closing and by 12 o’clock all patients (no matter what stage of treatment they are at) should leave the territory,” she worries. “They explained that the hospital would be re-profiled for infection due to coronavirus epidemic, but all who are there on treatment, I repeat, are at risk. ”
As early as March 23, a message appeared on the Facebook page of the hospital No. 45 that quarantine was introduced there: it was forbidden to visit patients, and the patients themselves to leave the territory. At the same time, “planned hospitalizations are carried out in a timely manner, in a planned manner and in full,” the announcement said.
“This is a useful reinsurance,” said BBC virologist Anatoly Alstein of the Gamalei Research Institute of Epidemiology and Microbiology. “Of course, busting happens sometimes, but it’s such a thing, where it’s better to bust than not.”
He agrees that this could harm patients who are not suffering from coronavirus, who are now not a priority: “The epidemic has its own laws. This is a disaster that does not harm anyone, it’s worth a single blow to the economy.”
In St. Petersburg, the professional community even had to protest against tough measures. On March 23, the city’s chief sanitary officer canceled until April 30 all planned hospitalizations and planned visits to clinics, as well as vaccination, despite the fact that the order of the Ministry of Health only advises the governors and chief doctors to decide what can be postponed and what cannot.
The Association of Clinical Research Organizations did not agree with such tough measures. This NGO wrote a letter to a health doctor, emphasizing that failure to provide planned care can pose a life threat to patients as much as coronavirus infection: for example, for cancer patients or hemodialysis patients. They also reminded about participants in clinical trials: if they miss visits for experimental treatment, they will lose innovative therapy that is vital for them, which can save their life.
After that, the measures were softened. On March 26, just three days after the decision of the Sanitary Doctor, the document was amended. Now, if a delay in treatment can lead to a deterioration in the condition and a threat to life and health, the patient will nevertheless be placed in a hospital as planned and will be admitted to the clinic. And those who are undergoing treatment in a day hospital will be allowed to bring it to the end.