Notebook

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 “KP–Samara”, 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.

– 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?

– 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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