it affects not only the lungs, but the whole body

The first 10 days after the onset of symptoms of the disease, the 38-year-old American was feeling quite well. He was not at risk; he had no chronic diseases.

– The man was examined, the disease was mild. The patient had a slight cough. Therefore, he was sent home for treatment, ”says the head of the Department of Vascular Surgery at Westchester Medical Center Sean Wengerter.

And then the incredible happened.

One morning, a man woke up with icy and numb legs. The body was constrained by terrible weakness; there was not even the strength to get out of bed.

The examination showed that the patient had aortic occlusion – a large blood clot formed in the main artery at the place where the artery diverged in two directions – to the right and left leg. Because of this clot, blood enriched with oxygen did not enter the iliac arteries.

“This is extremely dangerous.” From this can die from 20% to 50% of patients, – notes Vangerter. – But such things are not typical for 38-year-olds.

An emergency operation to remove a blood clot could save the patient’s life. But doctors working with patients with COVID-19 are everywhere faced with rather strange and frightening phenomena in infected patients. For example, the formation of blood clots (actually blood clots) of various sizes throughout the body, renal failure, inflammation of the heart muscle and malfunctions of the immune system.

“Coronavirus occurs in each patient in its own way,” notes Scott Brackenridge, associate professor of emergency surgery at the College of Medicine at the University of Florida. – In some cases, the patient has a problem with breathing, in others, the internal organs begin to fail. In children, the immune system as a whole begins to rebel.

Coronavirus is not just a respiratory diseasePhoto: Ivan MAKEEV

MYSTERIOUS STROKES

A new type of coronavirus is considered to be a respiratory virus, although it is already becoming obvious – the infection affects the entire human body. The most common symptoms are fever, pneumonia, and acute respiratory distress syndrome.

In this case, the virus attacks some organs directly. First of all, the mucous membrane of blood vessels, which entails unnatural coagulation of blood.

– COVID-19 provokes a local inflammatory reaction that leads to the formation of blood clots, – explains Wengerter. – This is due to the direct effect of the virus on the arteries.

A number of doctors recorded strokes in young patients with coronavirus, as well as the formation of blood clots in the lungs. Blood clots were found even in the smallest vessels.

“Since each organ feeds on blood vessels, and the virus attacks them first and foremost, we end up with damage to internal organs,” adds Dr. Scott Brackenridge.

Another serious symptom that is observed in some patients who become ill with the new coronavirus is the “co-fingers.” The infected toes swell, becoming red or purple. It is possible that the reason for this is blockage of blood vessels. But doctors say that usually this does not have serious consequences.

Kawasaki Syndrome

One of the most alarming reactions to COVID-19 is observed in children. It has already been named as a children’s multisystem inflammatory syndrome. In newYork Doctors have identified more than 100 cases.

This syndrome is characterized by a rather long fever, inflammatory process, malfunction of one or more internal organs, as well as the general condition, which is usually observed with shock. Pediatricians also compare these symptoms with the syndrome. Kawasaki.

Kawasaki syndrome is a rare disease that affects children aged 3 to 10 years. It is characterized by damage to the medium and small arteries, thrombosis, the formation of aneurysms and rupture of the vascular wall. Cases of infection are rare. However, recently, doctors have noted an increase in the number of patients with this syndrome.

Both childhood multisystem inflammatory syndrome and Kawasaki syndrome lead to an overly aggressive immune system response to coronavirus. This may be accompanied by inflammation of the blood vessels and heart muscle.

KILLER CELLS

However, scientists note that coronavirus is not able to cause a strong immune response, but, on the contrary, suppress the entire immune system. And this can allow the infection to freely attack the internal organs.

Partly this theory was confirmed by Chinese experts, led by Dr. Zhang Zhang. Scientists analyzed samples of immune cells taken from the lungs of 9 patients infected with coronavirus. The results of the study showed an abnormally high level of leukocytes – macrophages and neutrophils responsible for the destruction of harmful pathogen – in severe patients. At the same time, these patients had a rather low level of CD8 T cells, which are called killer cells. They are responsible for killing virus-infected cells.

But doctors are reassuring, noting that they have drugs that can thin the blood, and also help the work of white blood cells that resist infection.

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Actor and comedian Jerry Stiller died in the USA :: Society :: RBC

Ben Stiller and Jerry Stiller

(Photo: Michael Loccisano / Getty Images)

American actor and comedian Jerry Stiller died at the 93rd year of his life. About it reported his son is actor Ben Stiller. According to Stiller, his father died for natural reasons.

“He was a wonderful father and grandfather, as well as Ann’s most devoted husband [Энн Мира] for about 62 years. He will be sorely missed. I love you, dad, ”he wrote.

Jerry Stiller was born on June 8, 1927 in New York. He gained the greatest popularity thanks to the roles of Frank Constance in the series Seinfeld and Arthur in the sitcom of the CBS television channel King of Queens. In addition, he also starred in the films “Airport 1975”, “Hairspray” and others.

The actor also won the American Comedy Award and was nominated for an Emmy for his role in the Seinfeld series.

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US Air Force reports about the explosion in space of the tank of the Frigate-SB upper stage – RBC

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Coronavirus. Loose containment could jeopardize May 11 date

Fearing a loosening of compliance with containment measures, the government warns: the date of May 11 may be postponed.

Warning against loosening compliance with containment measures, the French government stressed Sunday that the date of May 11 chosen to initiate the deconfinement of France could be questioned if the number of new patients were to be too high.

If the confinement is respected until the end, the lid will have been put on the pan of the epidemic, and we will be able to gradually deconfinate in the best conditions, explains the Minister of Health, Olivier Véran in an interview with Parisian.

“Objective to conquer”

Otherwise, and if the number of new patients should be too high, the date of lifting of confinement could be questioned and will be assessed according to the departments., he adds.

Our goal is deconfinement for the entire national territory from May 11, said the Minister of the Interior, Christophe Castaner. But, he reminded the Grand Jury Le Figaro-RTL-LCI, it’s a goal to conquer.

This is our goal and we will reach it, I am convinced, he continued, noting that there was actually more people on the streets but that the French controlled were in good standing and that the police did not issue more verbalizations.

Increase in outflows

This recall comes when the rate of transmission of the virus, the famous R0, which had dropped to 0.5 thanks to the containment measures implemented since March 17, is now going up between 0.6 and 0.7. This virus reproduction rate represents the number of people an infected individual infects. When it is less than 1, the epidemic recedes.

Another signal, the latest data from the Datacovid association’s barometer with the Ipsos institute show a slight decline in respect by the French for barrier gestures to the coronavirus and an overall increase in the average time spent each day outside.

Over the period from April 15 to 21, the survey conducted week after week with a sample of 5,001 people indicates that compliance with barrier gestures remains at a high level but slightly down, writes The world.

Verdict Thursday

As of his presentation of the strategy of progressive and differentiated exit from containment, last Tuesday before the National Assembly, Prime Minister Édouard Philippe had stressed that the plan would depend on the evolution of the epidemic and mentioned a threshold of 3,000 additional cases per day.

I have indicated that we base our testing strategy on an assumption of 3,000 new cases per day around May 11, said the head of government.

If the containment is released by then; if, approaching May 11, say Thursday, May 7, it appeared that the number of new daily cases was not within the expected range; that we cannot break the too many chains of contamination, then we will have to draw the consequences, he added: I say to the French, if the indicators are not there, we will not define May 11, or we will do it more strictly.

New cases on the rise

On April 27, the day before his speech, the general directorate of health had reported 3,764 additional cases in 24 hours. This number has since fallen to an average of 1,132 additional cases in 24-hour increments (+794 in the latest daily report, Saturday evening), within limits set by the executive.

On Saturday evening, the number of deaths increased by 166 more in the space of 24 hours, the smallest increase since March 22, reaching 24,760 since the start of the epidemic.

Emmanuel Macron has already warned that Monday May 11 will not be possible that if we continue to be civic, responsible, to obey the rules and that the spread of the virus has actually continued to slow.

Perverse effect of cards

The publication, since Thursday, of maps presenting the departments in green, orange and red according to the circulation of the virus and the tension on the capacities in hospital resuscitation services could give the feeling of a controlled situation in certain parts of the territory.

Aware of the risk, the executive multiplies the precautions, indicating, like Olivier Véran, that they do not change absolutely nothing to containment which remains necessary until May 11 : The French who see themselves living in a department which appears in green this evening should not consider that they could go out or take risks.

Opinion shared by Pascal Crépey, epidemic specialist at the School of Advanced Studies in Public Health, who believes, this Sunday, on France Info that these cards represent a risk, in particular for the green departments, that the deconfinement is relaxed.

However, he adds, the success of deconfinement and the device that is put in place, it rests on the success of confinement. If the containment is released too early, the deconfinement will become very complicated and less effective and there will be a risk of rebound of the epidemic.

Same observation for the mayor of Montpellier, Philippe Saurel, who also stressed on France Info than the end of an epidemic cannot be decreed politically. Just because the department is green doesn’t mean there are no more viruses.

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Doctors compared mortality of COVID and other infections

On the page of the doctor and TV presenter Alexander Myasnikov interesting information about the situation with infectious diseases in the world was published on the social network. And in particular that rotavirus infection causes hundreds of thousands of deaths per year in the world. Is the familiar and familiar rotavirus more dangerous than the coronavirus? “KP»Understands together with the immunologist, expert in public health and international health care, candidate of medical sciences Nikolay Kryuchkov.

– Of course, in addition to COVID-19, there are many other dangerous diseases in the world and these are not necessarily infectious diseases. Let me remind you that mortality from cardiovascular diseases is in the first place, also high mortality is associated with oncological diseases, in particular, lung cancer, and, of course, infectious diseases are also often the cause of death. However, the threat of rotavirus infection today is greatly exaggerated, said Nikolai Kryuchkov.

How many people die from rotavirus?

According to pessimistic estimates provided by the World Health Organization, around the world in 2013, 215 thousand children under the age of five died from rotavirus infection. According to other data obtained in international studies, this is 122 thousand deaths in 2013.

– The situation since 2013 in terms of mortality from rotavirus infection has not changed much. I think here we can talk about 200 thousand deaths per year among children under five years of age. Half of the world’s deaths occur in five countries: India, Pakistan, Nigeria, Angola and Congo– emphasizes the immunologist Nikolai Kryuchkov. – In the media you can often find information that up to a third of deaths of children under five are caused by rotavirus. This is not true! The fact is that among all deaths of children under five years of age in the world, mortality from diarrhea accounts for about 8%, but among these 8% of deaths from diarrhea – from 25% to 30% are attributable to rotavirus. That is, it turns out about 200 thousand deaths of children under five years of age per year in the world, while more than 6 million children under five die in the world per year.

On the page of the doctor and TV presenter Alexander Myasnikov on the social network, interesting information was published on the situation with infectious diseasesPhoto: Ivan PROKHOROV

Is rotavirus disease relevant for Russia?

If you consider Europeyy region to which Russia, then the figures for mortality from diarrhea are lower than in developing countries. Mortality from diarrhea among children under five in Europe is 4% – 5% of all childhood deaths. About a quarter of them are rotavirus.

In Russia, according to WHO estimates, in 2013, 52 children under the age of five died from rotavirus infection, which is 0.3% of all other deaths of children under five years of age. Rotavirus infection is not the most common cause of death among children, and even more so among adults (the latter rarely die from rotavirus, so all statistics are data on the death of children – approx. Ed.).

– Rotavirus is a problem primarily in poor countries with a warm climate. For Russia, this is also a problem, but to a much lesser extent, ”said Nikolai Kryuchkov, a doctor. – It is important to emphasize that effective and safe rotavirus vaccines exist.

The incidence of rotavirus infection after the introduction of vaccination has decreased many times. In Russia, universal vaccination against rotavirus is not carried out, but, despite this, mortality is low, given that it is clear how to help such patients. The main thing here is replenishment of lost fluid and symptomatic therapy. Given these two factors — the availability of a vaccine and the development of affordable treatment — mortality from rotavirus is very low even among children from zero to five years old, not to mention adults. Among adults, these are isolated cases.

Who is worse: rotavirus or coronavirus?

According to epidemiologists, mortality (taking into account the number of deaths from the number of episodes of the disease) of rotavirus infection in the world is from 0.05% to 0.09%. This is comparable to mortality from seasonal flu. Yes, in the poorest countries it can reach up to 2%. However, in this case, only moderate to severe episodes are taken into account, and not all cases of rotavirus infection.

“With coronavirus infection, according to my most optimistic forecasts, the mortality rate in the world will be 2%,” says Nikolay Kryuchkov. – Let me remind you that now the mortality rate from COVID-19 in Russia is about 4%. AT Germany – 3.5%, and this is one of the best examples in Europe. Of course, a lot depends on how the data are kept and analyzed, but even though there are probably unaccounted cases, the mortality from coronavirus infection is much higher than the mortality from rotavirus. And the epidemic of coronavirus infection is still far from over.

“It is also important to understand that we are having a coronavirus pandemic, and the situation with rotavirus is under control.” The number of deaths from coronavirus is now growing, due to the fact that there is an increase in cases of infection. The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8%. Therefore, it is obvious that the situation with rotavirus is stable, and the coronavirus pandemic for us is not known how it will end. The coronavirus infection pandemic continues to grow, it is important to understand this, ”Nikolay Kryuchkov emphasized in a conversation with“ KP ”. – When we talk about the number of deaths from rotavirus, 200 thousand people a year around the world among children under five years of age are deaths that happened in a year! As we know, the coronavirus epidemic lasts about four months. This is significantly less than a year.


The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8% Photo: Ivan MAKEEV

The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8%Photo: Ivan MAKEEV

How many deaths from coronavirus infection will be in a year (given that, according to the data of May 3, 243,922 people died in the world – approx. Ed.)? Yes, there are other dangerous infections in the world, but many of them can be protected. This is Hepatitis B, and pneumococcal infection, tetanus, and so on. And Dr. Myasnikov rightly points out the need for widespread vaccination against the most dangerous and common infections. Unfortunately, there are no vaccines from COVID-19 yet, they will be ready by the spring of next year at best.

Also, an important difference between the course of rotavirus infection and coronavirus infection: hospitalization with rotavirus disease in developed countries is very rare. All necessary treatment conditions can be provided at home. With coronavirus, the patient often needs active therapy, which can only be provided in a specialized medical institution.

SPECIFICALLY

Dr. Myasnikov gives such statistics on mortality from infections (in the world for a year)

Measles (there is a vaccine) – 140 thousand deaths per year

Pneumococcus (there is a vaccine) – 2 -2.5 million deaths per year

Hepatitis B (there is a vaccine) – 650 thousand deaths per year

Tetanus (there is a vaccine) – 89 thousand deaths per year

Cervical cancer (there is a vaccine) – 250 thousand deaths per year

Tuberculosis (there is a vaccine) – 1.5 million deaths per year

Influenza (there is a vaccine) – 650 thousand-1 million deaths per year

Coronavirus (no vaccine) – 244 thousand deaths from the beginning of the spread

Coronavirus: myths and reality.The farther the coronavirus, the more truth and speculation around it. We tried to deal with the main myths about the Covid-19 pandemic

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The Cabinet of Ministers of Ukraine withdrew Saakashvili’s representation at the Deputy Prime Minister :: Politics :: RBC

Pre-election poster with the image of Mikheil Saakashvili

(Photo: Julia Zozulia / UKrinform / ZUMA / TASS)

The Ukrainian government withdrew from the Verkhovna Rada the idea of ​​the appointment of the former head of the Odessa region, Mikhail Saakashvili, as deputy prime minister, according to the Ukrainian publication Censor.net. An interlocutor close to Saakashvili confirmed to RBC that the Ukrainian government had withdrawn the submission.

According to the Censor, the reason for the government’s decision was that the Cabinet failed to recruit a sufficient number of deputies who were ready to support such an appointment.

Georgia threatened to recall ambassador to Ukraine over Saakashvili’s appointment

Mikheil Saakashvili

The material is complemented.

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Echo of the Prague Demolition – Spark No. 16 (5611) of 04/27/2020

The dismantling of the monument to Marshal Ivan Konev in the Czech capital threatens to provoke a response flurry of historical emotions in the space from Moscow to Vladivostok.

Konstantin Mikhailov, editor-in-chief of the site “Keepers of Heritage”

The recent demolition in Prague of the monument to Marshal Konev, whose troops prevented the Nazis from destroying the city in 1945, provoked understandable indignation both by the Russian authorities and the Russian public. Meanwhile, discussions about this, of course, unfortunate event in the Czech capital may have an unpredictable continuation stretched in time and space – up to Vladivostok.

Few people know that modern Russia is still implementing a large-scale program for the installation of monuments and memorials dedicated to the so-called Czechoslovak Legion – an armed unit that had an important influence on the course of the Civil War in Russia in 1918-1919. In the context of ostentatious and mocking (no one in Russia will forget the joke of the Czech elder of the Prague 6 region about the absence of a mask on the face of the bronze Marshal Konev) the dismantling of our military monument in the Czech Republic, the further implementation of such a program, and even with the participation of officials of the Russian state, looks more what is strange.

Trailer agreement

The Czech Foreign Ministry officially reminded us of the monuments to Czech legionnaires in April 2020, publishing, in particular, such a “Statement”: “I would like to remind the Russian side that while the Czech Republic properly contains 4224 military graves and memorials on its territory and monuments, on which, unlike the monument to Marshal I.S. Konev, the provisions of the Agreement between the Government of the Czech Republic and the Government of the Russian Federation on the mutual maintenance of military graves of 1999 are being circulated, in the territory of the Russian Federation still has not been able, despite years of negotiations at the local government level, to resolve the issue of updating military monuments to fallen Czechoslovak legionaries in Samara, Novokuybyshevsk – Lipyagah and other places. “

The agreement, cited by the Czech Foreign Ministry, entered into force on August 11, 1999. In accordance with it, Russia and the Czech Republic committed themselves to ensure “the safety of military graves in the territories of their states and their proper maintenance.” Among other things, the 1999 Agreement also referred to the “arrangement” of military burial sites, which was interpreted as including the installation of “monuments or other memorial structures” (we are talking about memorials and monuments directly related to the burial sites, and the monument to the Marshal in Prague formally emphasizes Ministry of Foreign Affairs, this is not). Such “arrangement” could, according to the text of the document, occur, “as a rule, in the locations of the remains or, if this proves impossible, in other places worthy of the memory of the dead.”

In these “other places” it became possible to implement the whole Czechoslovak memorial program in Russia, which, I must say, modern residents of Russian cities and villages who found themselves in the zone of military operations and following the Czechoslovak legion in 1918-1920, could not and did not want to understand and appreciate it. More precisely, they could not understand why monuments to people who walked on it with fire and sword should stand on Russian soil.

Yes, in fact, no one asked the inhabitants about this, according to the old Russian tradition.

Remember or recall?

Two years ago, in the publication Red and White Route, Ogonyok (No. 20 for 2018) spoke in detail about the sad role played by the Czechoslovak corps in the history of Russia, so I will only recall in brief.

During the First World War, the Russian authorities in August 1914 began to form a national military unit – the Czech squad of Czech and Slovak colonists and immigrants living in Russia. The calculation was simple – to win over the soldiers who fought against Russia under the banner of the Austro-Hungarian monarchy, showing the prospect: from a separate Czechoslovak army to the Czechoslovak state. There were about a thousand soldiers in the squad, commanded by Russian officers. Since 1915, they began to replenish it at the expense of prisoners of war: by February 1916, it became a regiment, by April – a brigade.

The combat debut of the Czechoslovak Brigade took place in June 1917 at the town of Zborov (modern Ukraine), against the Austro-Hungarian troops. The February Revolution had already taken place in Russia, but the Provisional Government did not prevent the creation of new Czech units, and by the fall of 1917 the brigade had grown into a Czechoslovak corps of three divisions. At the beginning of 1918, it numbered more than 38 thousand people – 37 451 infantrymen and 638 cavalrymen.

While the war was on, the Czechoslovak Corps was a natural ally of Russia. But after the separate Brest peace concluded by the Bolsheviks, the Czechoslovakians ended up in a foreign country in the form of an armed formation with an incomprehensible status.

At the same time, the path through the border to Austria-Hungary was closed to them: for the Habsburg empire that continued to fight, they were traitors. A project arose of transferring the corps to the Western Front through Arkhangelsk or Murmansk, but they were afraid of German submarines; in the end, it was decided to send Czechoslovakians on a world trip – through Vladivostok. In the spring of 1918, the Czechoslovak trains reached the Trans-Siberian Railway. And stretched for thousands of kilometers: in May the vanguard of the Czechoslovak Corps reached Vladivostok, and the “tail of the squad” was in the Volga region.

Perhaps, over time, Czechoslovakians would have left Russia quietly and peacefully, but on May 25, 1918, the drug commander Lev Trotsky issued an order for their disarmament (there are historians who believe that this was done under pressure from the allied Austria-Hungary Germany). The result of the attempts of the local Soviets to disarm the corps was its uprising, which in Soviet historiography was called the “White Bohemian rebellion”. Since mid-1918, the entire Transsiberian, from Samara to Vladivostok, has been in the hands of Czechoslovakians.

The Czechoslovakians were not “white,” as the course of events showed, – just as they had no reason to get involved in a war in Russia. But the Civil War was little interested in their desires. Everyone tried to use organized armed forces for their own purposes: the whites, who saw a natural ally in the Czechoslovak rebels; and the Entente countries, which faced the prospect of restoring the Eastern Front against the central powers; and the Bolsheviks – it was not for nothing that Czechoslovakians extradited Admiral Kolchak to the Soviet authorities … In short, the upheavals of the Czechoslovak combat adventures in Russia in 1918-1919 were bizarre. But it is worth noting: it was precisely as a result of their capture of Samara in June 1918 that it became possible to create there ComUcha (Committee of Members of the Constituent Assembly) – the first all-Russian anti-Bolshevik government. Therefore, a number of historians call the Czechoslovak rebellion the detonator of the Civil War in Russia.

The evacuation of the Czechoslovak Corps from Russia dragged on until 1921. On the way to Vladivostok, Czechoslovakians had a lot of military clashes with the red garrisons, partisans and other armed forces. Establishing their power in different cities and territories or overthrowing someone else’s, the Czechs did not stop at violence, executions, and repressions against the population. There is plenty of evidence about their appropriation of property, food and values. Researchers and publicists attribute to Czechoslovakians the disappearance of part of the “gold reserve of the Russian Empire” that ended up in Siberia in 1918.

Be that as it may, in the perception of Russian public opinion the “military path” of the Czechoslovak Corps in 1918-1919 in our country is not something to be proud of and noted by monuments.

Legion 100

On the occasion of the 100th anniversary of the corps in the Czech Republic (it is now called the Legion), the Legion 100 program was launched, within the framework of which the Czechoslovak Society of Legionnaires, together with the Czech Ministry of Defense, organizes “pilgrimage trips” to the battlefields of the “Legionnaires” in the Central and Southern Urals . This was announced only in 2019 by the Czech Embassy in Russia.

“Pilgrimage” is not limited to. As the Russian media have repeatedly reported, in the framework of the 1999 Agreement mentioned above, at the expense of the Czech side, it was planned to establish monuments and memorials dedicated to the Czechoslovak Legion in more than 50 settlements of Russia.

By order of the Government of the Russian Federation No. 1615-r dated September 24, 2010, the “sole memorial” was defined as the “sole performer” to ensure the safety and maintenance of foreign military (including newly built) memorials on the territory of the Russian Federation. On the official website of this association, photographs of nine already erected monuments to Czech legionaries are presented (Krasnoyarsk, Kungur, Vladivostok, Chelyabinsk, Buzuluk (two), Yekaterinburg, Nizhny Tagil and Mikhailovka, Irkutsk Region). But from open sources you can find out that in fact there are at least a dozen monuments to legionnaires in modern Russia.

So, in 2005, a commemorative stele was installed at the cemetery of Czechoslovak legionnaires in Vladivostok. In 2006, the Czechoslovak memorial was opened at the Trinity Cemetery in Krasnoyarsk. In 2007 – a monument in Buzuluk, Orenburg region. In 2008 – at the Mikhailovsky Cemetery in Yekaterinburg (here the largest Czechoslovak military necropolis in Russia). In the same year, a memorial sign appeared at the Embassy Monastery on the shore of Lake Baikal (Buryatia). In 2009 – in Nizhny Tagil. In the 2010s, a monument appeared to the “legionnaires” in the village of Kultuk, Irkutsk Region. In 2011, in Chelyabinsk. In 2012 – in Kungur and Pugachev (Saratov region). In 2013 – in the Upper Uslon (Irkutsk region). In 2015 – in Penza, Ulyanovsk and Syzran …

The press also discussed the construction projects of Czechoslovak monuments in Miass, Kurgan, Nizhneudinsk, Samara, Tyumen, Novokuybyshevsk, Ufa, Kansk, Zlatoust and other cities. In some places it came to the installation of pedestals. But in no paragraph there was public agreement on the installation of such monuments, but open protests, statements and pickets are, on the contrary, not uncommon. Why the authorities most often did not dare to force the process.

Alien memory and own

For many representatives of the regional authorities in the Russian Federation, it was probably a surprise that the local population does not care what monuments stand on their land. But the story of the perpetuation of the “legionnaires” showed that this is precisely so.

Particularly loud were the protests in Samara, where for seven years now, next to the railway station, there has been an empty pedestal for the monument to “legionnaires”. In 2013, 2016 and 2017, local communists, together with residents of nearby houses, went to protest pickets, collected signatures under an appeal to the president. The local press conducted a survey “Do Samara need a monument to Czechoslovakia?” – 72 percent answered negatively. Residents wrote to newspapers and local deputies: “My grandfather died from them (” white-hatches “.— “ABOUT”) hands ”; “At the Obsharovka station, 11 railway workers were shot by white whales, 4 were buried alive, tortured underground worker Tatyana Lepilina. She was only 22 years old. The grave-monument of Lepilina is still standing in Obsharovka … Will there be a monument to her murderers in Samara? ” etc.

Even the descendants of Vasily Chapaev opposed the erection of the monument in Samara – in 2020, his grand-niece Marina recorded a video message to the Minister of Defense of the Russian Federation Sergey Shoigu, asking: “How does the Czech Defense Ministry completely, and often with the support of your subordinates, implement your ideological project “Legion-100”? Just think: the NATO country participating in the new Cold War against us, through the hands of our association War Memorials, requires the local authorities to establish monuments to the legionnaires of the Czechoslovak corps. ”

However, Samara is not the only “center of resistance.” In Chelyabinsk, the regional branch of the Liberal Democratic Party declared that “the installation of a monument to Czechoslovak legionnaires, who came to Chelyabinsk as invaders and occupiers and left behind notoriety, contradicts common sense and desecrates the memory of Russian soldiers whose bones still lie in the ground throughout Europe in nameless graves. “

In Penza, in 2015, social activists sought an answer from the authorities: why there was no monument to its founders in the city, but a monument was erected to the Czechoslovak Corps: “After all, it is, in fact, established by people who staged an open rebellion in our city against legitimate authorities, and also carried out robberies, artillery shelling of peaceful neighborhoods, torture and murder. What did Czechoslovak legionnaires do so good and worthy for Penza to erect a monument in their honor? ” At the same time, the Penza communists held a picket under the slogans “Monument to white whales – there is no place on Penza land,” etc.

And in the village of Mikhailovka in the Irkutsk region in 2014, a Czechoslovak legionnaire was doused with red paint. It was especially outraged that he was placed near the mass grave of the red partisans, who were shot by the White Guards and Czech punishers. “What did the Czechs become famous for since they erected a monument to them?” – the locals sought an answer.

There are many more examples – from Kansk (Krasnoyarsk Territory), Zlatoust, where veterans of the Great Patriotic War, Ufa, Tolyatti spoke out against the installation of the Czechoslovak monument, where in 2017 the city hall refused to agree on a picket to collect signatures against the installation of the monument to the legionaries, from other places . No matter how you relate to the protest slogans and their initiators, one cannot but admit: the installation of monuments to Czechoslovak legionnaires in the vastness of Russia does not add public consent. The fact that for the Czech side is the perpetuation of the memory of compatriots in Russia is perceived as an exaltation of this memory. This is the national tradition of the perception of monuments, nothing can be done.

How to answer for Konev

After the dismantling of the monument to Marshal Konev in Prague, the situation around Czech monuments in Russia could not but worsen. The context, as they say, is heated: the public council under the Ministry of Defense of the Russian Federation, for example, even called for renaming the Prague metro station in honor of Konev. And hotheads among publicists began to claim that the very fact of the Prague dismantling of the Czech side had withdrawn from the 1999 Agreement, and therefore, they say, the hands of the Russian side were untied – Czechoslovak monuments could be demolished. The deputy chairman of the Legislative Assembly of the Ulyanovsk Region, concurrently – the leader of the Communists of Russia party Maxim Suraykin, said he would seek the demolition of the Czechoslovak monument in Ulyanovsk in response to the dismantling of the Konevu monument in Prague.

Is it permissible to get involved in the proposed “war of monuments”? In my opinion, by no means. And not only because in the Czech Republic there are about three thousand military burials of Russian and Soviet soldiers, which the Czech side is obliged to take care of under the 1999 Agreement. The main thing is that you cannot become like vandals and stand on the same board with them.

But, of course, Russia’s implementation of the 1999 Agreement should, especially after the Prague dismantling, be limited to preserving Czechoslovak burial sites and standing monuments, without adding new ones to them. You can not be likened to vandals, but you should not even turn their other cheeks to them.

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Is it true that nicotine users contract Covid-19 less?

Hello,

Numerous case studies demonstrate this unequivocal : smokers who get Covid-19 have a risk greatly increased to develop severe forms of the disease. In this work, we find that the proportion of smokers is two to four times higher in severely ill patients than in those with a moderate form of the disease.

On the other hand, several publications relayed since the beginning of April report a counterintuitive phenomenon: in several countries, the proportion of smokers infected with SARS-CoV-2 would be lower than the proportion of smokers at regional or national level. The Minister of Health, Olivier Véran, recently mentioned this data.

In France, works being published conducted on a limited number of patients at the Pitié-Salpétrière, as well as a study in a school environment in Crépy-en-Valois (prepublished this April 23), also reported this statistical trend.

Many potential limits

Note now that the link between smoking status and propensity to be infected does not appear in all research. So in a recent study published in the Jama, involving 5,700 New York patients hospitalized for Covid-19, the proportion of smokers was analogous to that observed in the regional population.

The first studies were met with skepticism, not without reason. Indeed, many of these works have sometimes significant biases.

First limitation present in all studies (with the exception of French studies): the age parameter of hospitalized patients. Indeed, a significant proportion of patients with severe forms of Covid-19 are over the age of 65. The prevalence of smokers decreases very strongly with age (for example, in France, 65-75 year olds smoke 2.5 times less than the general population).

In the study conducted at Pitié-Salpêtrière, taking into account the age and sex of the patients, smokers nevertheless appeared to be four times less likely than non-smokers to be Covid +. A rate observed both in hospitalized patients and in patients treated on an outpatient basis. However, in order to draw more solid conclusions, these results should have been put into perspective with the smoking profile of patients who usually attend this hospital, at the same periods in previous years.

Another parameter that seems to be excluded from most analyzes: the socio-economic profile of the groups studied, which can strongly influence the expected proportion of smokers. A limitation mentioned by the authors of the French study, who established their calculations “Assuming that the population studied who lives in a limited area around a Parisian hospital has the same smoking habits as the French population in general”, and who note that “Healthcare workers were overrepresented in the outpatient group due to routine workplace testing when they became symptomatic”. The study conducted at Crépy-en-Valois seems to take this parameter into account. And its results are consistent with the Pitié Salpêtrière study.

Third important pitfall: the quality of the information collected is not always there … far from it. In some studies used by epidemiologists to conduct their analyzes, the smoking status of the sickest Covid + patients was simply not informed. Commentators have also noted that one of these studies considered individuals to be “non-smokers” less than 30 packages per year – preventing any comparison with national statistics which relate to all cigarette consumers.

For its part, the study conducted at Pitié-Salpêtrière seems to consider as “former smoker” any person who had quit smoking at the time of his hospitalization … without mentioning the hypothesis that patients may have stopped smoking because of the first Covid-19 symptoms! A point which would considerably influence the results. Requested by CheckNews, Zahir Amoura, author of this work, has not yet commented on this point.

Is the phenomenon biologically plausible?

The interpretation of these statistics, as well as the extent of the associated phenomenon, are still questionable.

Researchers, however, have begun to explore the hypothesis of a direct causal link between smoking status and primary SARS-CoV-2 infection. The question arises indeed: from a physiological point of view, is it plausible that lungs exposed to tobacco are less permeable to this coronavirus? Could nicotine be involved in the phenomenon?

A possible link with the ACE2 receiver?

SARS-CoV-2 infects cells by binding to the ACE2 receptor, abundant on the surface, in particular, the cells of the mucous membranes and the alveolar pulmonary tissue. The expression of the gene corresponding to ACE2 is not identical in smokers and in non-smokers. Based on animal models, smokers have long been considered to express less ACE2 – which suggests a simple explanation for the phenomenon: less ACE2 induces a lower propensity for infection.

But recent data, which seem to be corroborated by new researchsuggest that in humans, smoking is associated with a higher expression of ACE2. A higher propensity for coronavirus infection would therefore be expected. The epidemiological observations mentioned above, suggesting a protective effect of tobacco, would therefore raise a paradox.

Several explanatory hypotheses have been formulated. Some authors have advanced that in all patients, infection with SARS-CoV-2 would decrease the availability of ACE2 receptors in the lungs. The biological processes that usually mobilize these receptors would be hindered, leading to various symptoms of the disease. People with more ACE2, even if they were infected, would develop fewer symptoms. However, this interpretation is challenged by the Crépy-en-Valois study, where the diagnosis of infection was made on a blood test, and not on a simple clinical assessment of symptoms.

According to other works, the nAChR nicotinic receptor could modulate the activity of ACE2. Could stimulating nAChR make infection through ACE2 more difficult? This fact is not yet proven. “The possibility of a reciprocal modulation between ACE2 and the nicotinic receptor is an interesting scientific question for which we have no answer”, insists Professor Jean-Pierre Changeux, co-author of a scientific article inviting this hypothesis to be explored.

La Pitié-Salpêtrière has announced the launch of several clinical trials in this direction. The first, conducted on caregivers, aims to compare the infection rate between a group carrying nicotine patches and a group carrying placebos patches. More trials need to be done on Covid + patients in hospital to assess whether nicotine affects the course of the disease – especially in smokers who are forced to quit as a result of hospitalization.

Nicotine and vaping: preliminary data not very encouraging

The return of associations of electronic cigarette users does not seem to go in this direction, however. According to the analysis of a questionnaire sent in early April to several thousand members of the AIDUCE and SOVAPE associations, the rate of patients suspected of being Covid + was similar whether or not there was nicotine consumption – around 2.5 %. “Although it concerns nearly 10,000 people, this citizen survey is inconclusive on a major protective effect of nicotine, note the associations in a press release. The first data show no major positive or negative effect of vaping when faced with the risk of contracting Covid-19 for vapers and their entourage. ”

Tobaccoologist Bertrand Dautzenberg, who had encouraged these associations to explore this hypothesis, notes on Twitter that the data was not collected under conditions “Respecting all the obligations of scientific studies”. He nevertheless considers that they are not showing strong signs of a beneficial effect of nicotine in reducing Covid-19 levels. ” He invites an analysis of the Health Database to further explore this hypothesis.

No reason to start smoking

The tobacco specialist recalls “That tobacco certainly brings a negative effect greater than that of a small benefit which is not confirmed at all”. “This leads to encouraging all doctors to advise and support smoking cessation for all smokers.” The authors of the Crépy-en-Valois study abound in this sense, recalling that tobacco is responsible for 75,000 deaths per year in France. “Smoking cannot therefore be offered as a way of protecting oneself against the new coronavirus”, they insist.

Unsurprisingly, this finding is similar to that of the authors of a review on the complications of Covid-19 related to smoking. “Risk factors for severe forms of Covid-19 (pulmonary and cardiovascular disorders, diabetes, etc.) are more common in smokers. Smokers with comorbidities should quit smoking by all means. ” They also observe that confinement can lead to social isolation and psychological distress that increase the need for smoking. [En outre], smoking is more prevalent among the economically less advantaged groups, and they are potentially more at risk for Covid-19. ”

For its part, the association Alliance contre le tabac urged the greatest caution with regard to speculative information in circulation. In the absence of more evidence, nicotine users, “Should not expect to be more protected than the population from the current epidemic”, she recalls. In addition, she advises non-smokers to use nicotine substitutes. A warning also formulated by the promoters of the Pitié-Salpétrière study or by the Minister of Health.

In summary

Although well publicized, epidemiological observations associating smoking and the risk of developing the symptoms of Covid-19 are difficult to interpret at this time. Under the hypothesis of a real cause and effect link, the biological mechanisms mentioned in the press are still hypothetical. None have yet been formally tested.

Listen to the weekly behind the scenes podcast of CheckNews. This week: Covid-19: what are the real figures for deaths in intensive care?

Jérôme Salomon, the Director General of Health, mentioned a mortality of 10% in intensive care of patients hospitalized for Covid-19. In this episode, Luc Peillon explains why this figure is largely underestimated.


Florian Gouthière

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the doctor said why there are few coronavirus cases in Samara

The number of patients with coronavirus in the Samara region since the beginning of April has grown by three people. It’s really a bit, but the situation around is more like preparing for combat action. New infectious beds are constantly being prepared in the region, doctors are being trained, hospitals are being re-equipped. Residents perplexed: “More patients? They don’t tell any information? ” In fact, there is no need to look for a dirty trick: citizens are honestly told about how the situation is developing. But what comes next is difficult to predict. Associate Professor of the Department of Infectious Diseases of Samara State Medical University, Chief Specialist of the Ministry of Health of the Samara Region on the Problems of Diagnosis and Treatment of HIV Infection, Infectious Disease Doctor with 30 Years of Experience Elena Strebkova now helps to organize an infectious diseases hospital at the hospital named after Midpoint “There are no patients here, but who knows if they will appear tomorrow.” She told in an exclusive interview to a journalist “KPSamara”, Why the whole branch of medicine is working so hard today, although the numbers of cases and the inhabitants seem low, are Samara residents at risk of picking up a coronavirus and why is COVID-19 more dangerous than“ ordinary flu ”.

– Elena Alekseevna, why is such mass training, reprofiling of hospitals necessary?

– The measures taken by the government of the country and the region, and now allow us to prevent a surge in incidence. If not for them, we would be faced with a situation that is now happening around the world. Thanks to the measures taken for isolation and sanitation, a large number of cases of infection do not appear. This is done so that all our medical organizations have time to prepare. We see that new cases of infection and new cases appear daily, and we must be prepared to provide highly qualified medical assistance to the residents of the region. Like all my colleagues, we will be happy if we do not have to. But we must be prepared.

– How are hospitals preparing to receive coronavirus patients, what is the peculiarity of interacting with such patients?

– Infectious diseases that we usually deal with in the Samara Region are caused by microorganisms that do not require special preparation from a doctor. And COVID-19 is a particularly dangerous infection. Therefore, all protective measures in hospitals converted to infectious hospitals, for example, in SOKB named after V.D. Seredavina, taken for this class of pathogenicity. For this, doctors put on protective suits, masks, goggles – a person must be fully protected, because even small aerosol drops that remain in the air after coughing or sneezing can get on it and then lead to infection.

– How are doctors trained to resist the coronavirus?

– Doctors at hospitals that are converting to infectious hospitals are currently undergoing training. First of all, they are taught to wear and take off protective clothing correctly. Because the physician must first protect himself from infection, otherwise there will be no one to help people.

In addition, doctors are told how the virus is transmitted and how to protect themselves; they explain all the rules for disinfection. Of course, we study the clinical forms of the disease, how it manifests itself, what supporting signs of coronavirus infection, what indicators you need to pay attention to in order to make a diagnosis and assess the severity of the patient.

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– And as for lung ventilation, for example? Is she taught to do it?

– Naturally, such a huge number of resuscitators, infectious disease specialists, pulmonologists, which may be needed in case of a surge in incidence, is not in the healthcare system. Therefore, if necessary, infectious disease specialists and pulmonologists will work as consultants. One infectious disease specialist and pulmonologist per 100 patients – this will be quite hard work.

Under their guidance, doctors of all other specialties, after training, will be able to work with such patients. But the main burden will fall on resuscitators. Here, one resuscitator with two nurses will work for six people. Although basic training in mechanical ventilation and resuscitation will still pass all the doctors. For example, the staff of Seredavin Hospital is almost completing such training.

– How large, in your opinion, is an infectious disease specialist with 30 years of experience in the likelihood of a scenario when 100 coronavirus patients fall on one pulmonologist?

– We all want to hope that this probability is low, but we should always be prepared for this. It’s impossible to deploy an infectious diseases hospital in a hospital that was not intended for this; deploying such a huge number of resuscitation beds is impossible. The preparations that are currently underway will allow us to avoid the so-called “Italian scenario” – the very help that is needed will be immediately provided to the patients. IN Italy such a difficult situation was due to the large number of patients at the same time. Quarantine was announced late in the country; the healthcare system was not ready for such an arrival of patients who need ventilation support. In our country, the health system managed to prepare.

– Explain why we have so few patients and how relevant is self-isolation in this situation?

– These are the rules for the development of the epidemic. Why in Moscow so many sick? Not only because there are more people. But also because people from different countries flocked there and only then were distributed among the regions. Therefore, a huge number of sources of infection fell precisely in the capital. Naturally, there is the largest percentage of cases. But people from Moscow came here, and now the virus is spreading here. And now it doesn’t have to be contact with a person who came from abroad. This may be contact with a person who has not left the territory of the Samara region, who himself does not suspect that he is a source of infection.

The virus already exists in the urban environment, and it was for this reason that self-isolation measures were taken to protect people from each other. The closer we are to each other, the greater the likelihood of becoming infected, and the biggest danger is that this will happen at the same time, giving a greater burden on the health system.

“How can the virus spread if we all sit at home?”

– Let’s really look at things. You are not sitting at home. Anyway, you go to the store, to the pharmacy, where to whatever. The main distribution path is through door handles, through the buttons of elevators, in contact with trolleys in stores. These are transmission routes that no one has canceled. And with close contact at a distance of less than two meters, infection from person to person is also possible.

– They say that coronavirus is less dangerous than ordinary flu, it has less mortality, there is no reason for panic?

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– Mortality from influenza was also quite high until the moment of mass vaccination. Now vaccination saves us from a large number of deaths with the flu. And we expect the appearance of a coronavirus vaccine only by the end of the year. Therefore, people are not protected. And since the virus is new, it first appeared this year, we have no immunity. And since no one has immunity, there is no layer that would restrain the explosive nature of the epidemic. Explosive is when several thousand cases appear at one moment. According to some experts, the main surge in the incidence may occur next week. The medical system must be prepared for this.

– In social networks, KP-Samara asked readers why, in their opinion, in the Samara region such a low incidence of coronavirus. It turned out that most are sure: we just have little testing for coronavirus. How do you rate coronavirus testing in the region? Are they enough?

– We test as much as necessary, except Rospotrebnadzor A laboratory has been deployed at the AIDS Center. They test those who came from abroad and are in quarantine, all patients with pneumonia, with severe forms of acute respiratory infections, pregnant women – volumes are large.

“And the main question that worries everyone is when will it all end?”

– So far, the measures taken are designed for the next three months. But we will all be happy if everything ends earlier.

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