The new order of the Lombardy Region will be released shortly, which extends the obligation to wear the mask outdoors until July 14th. “Despite the annoyance of the mask, especially in the heat of July, I am of the opinion that it is necessary to continue with its maintenance until July 14,” said the president of the Lombardy Region Attilio Fontana on Facebook. “It’s hot, very hot, but the opinion of virologists is still to maintain the anti-contagion precautions, first of all, the use of the mask” wrote Fontana.
“Despite the discomfort of the mask, especially in the heat of July – added the president of Lombardy -, I am of the idea that it is necessary to continue with its maintenance until July 14.” “As you can see, I also wear it, not without sacrifice” he concluded by posting a photo of him with protection on his nose and mouth.
Cloving hospital on the basis of the Medical Scientific and Educational Center (ISSC) Moscow State University named after M.V.Lomonosov took the first patients on April 21 and completed his work on June 13. It turned out that it was possible to achieve the best treatment results for COVID-19 in Moscow. Over the entire period, 4 patients died, and among severe patients who got mechanical ventilation, the mortality rate was less than 14% (for comparison, the average for the city and the world was up to 70 – 80%). Eighteen doctors out of 220 employees of the hospital were infected with coronavirus, there were no deaths among the medical staff.
What approaches were used at the University Hospital of Moscow State University to achieve such results? We continue the conversation with the head. Department of Therapy, Faculty of Fundamental Medicine, Moscow State University, Head of the Department of Age-Associated Diseases, Medical Scientific and Educational Center, Doctor of Medical Sciences, Cardiologist Yana Orlova.
MEDICINE FOR COUGH FOR 80 RUBLES
– Most of those who are ill or are afraid to get sick are worried about fibrotic changes in their lungs. They say that you have developed special therapy that can reduce the risk of developing fibrosis. Is it possible?!
– Yes, we launched an appropriate clinical study. There are no final results yet, but we have developed clinical practice.
“What did you do to save the lungs?”
– We used a combination of bromhexine and spironolactone (both are long-known very cheap drugs. – Ed.). Bromhexine is an expectorant that has been prescribed to patients with pneumonia and cough for many years. At the same time, experimental data showed that this drug can block a specific enzyme and impede the penetration of coronavirus into cells. True, it was on this effect that we counted to a lesser extent in inpatients, since such an effect is important mainly in the early stages of the disease. But the expectorant effect of bromhexine really helps patients with COVID. I heard that our colleagues in Peter launched a study of bromhexine for prophylactic purposes. We will wait for the results.
Coronavirus infected 18 doctors from 220 employees of the hospital, there were no deaths among the medical staffPhoto: Ivan MAKEEV
FIBROSIS OBSTACLE
– The second drug – spironolactone – is traditionally widely used in cardiology for the treatment of heart failure, severe hypertension. It has a small diuretic, magnesium and potassium-preserving effect, continues Yana. Orlova. – It has several mechanisms through which it can be useful in coronavirus infection.
Firstly, a mechanism that prevents the development of fibrosis in general in the body. There are works that, in particular, show that spironolactone reduces fibrosis in the heart. At the same time, it is known that the tendency to fibrosis is not local, but systemic – where there is more inflammation, there will certainly be fibrosis. And we see, of course, fibrotic changes in the “covide” in our patients. Therefore, we prescribed spironolactone as a drug for the prevention of this process.
Secondly, this drug blocks sex hormone receptors, in particular testosterone. Some published studies suggest that “high-testosterone” men suffer from “covid” more often and develop more severe fibrotic changes. Therefore, blocking these receptors for several weeks during COVID treatment may be useful in reducing the severity of complications. We are not talking about a longer intake, since male patients are unlikely to agree with a decrease in testosterone levels in the long term.
And perhaps the most important point. In almost all of our patients, we observed hypokalemia (a decrease in potassium levels. – Ed.). With coronavirus infection, potassium is intensely excreted from the body, and scientific articles even suggest that hypokalemia serves as the trigger for a cytokine storm. So spironolactone has a real chance to reduce the risk of this dangerous complication. But the main thing, in my opinion, is that lowering the level of potassium in the body is extremely harmful to the heart and triggers life-threatening rhythm disturbances, increasing the risk of sudden death. We, like all others, replenished potassium with droppers, but it was more effective to retain it in the body with the help of spironolactone.
Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patientsPhoto: Ivan MAKEEV
WHEN PRESCRIBED PATIENTS
– Yana Arturovna, how many patients did you have on average?
– About 10 – 14 days. But someone and 50 days.
– Have you noticed signs by which it can be assumed that the disease in the person brought is likely to go the hard way?
– Such studies were carried out in the world, our clinical practice confirmed them. Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patients. Men with a classic male type of baldness, a lot of facial hair, we can say brutal men get sick harder.
– Under what conditions did you discharge patients?
– We acted as close as possible to the recommendations Ministry of Health: so that the temperature for three days was not higher than 37.5 degrees; so that C-reactive protein (an indicator of inflammation) is lower than 10 mg / l, and saturation, that is, the level of oxygen in the blood, is higher than 96%.
“HEAD OF EPIDEMIOLOGY DEPARTMENT OF ITSELF WORKED AT SANPROPUSNIK”
– How often do you get sick doctors and nurses?
– In the first month no one got sick at all. We have a very powerful epidemiological service. The head of the sanitary-epidemiological department, a senior researcher, correctly organized the whole process, and for the first two weeks she personally worked in the sanitary inspection room at the exit from the “red zone” and helped doctors and nurses who were exhausted after the shift safely remove protective clothing.
Then both people’s fatigue and viral load accumulated. By the middle of the second month, sick people began to appear. There were no seriously ill patients. We treated part of the staff in our observation, part of it was treated at home. In total, 18 people were infected from the medical staff (less than 10%).
– Doctors take something for prevention? Vitamins C, D, Zinc?
– I saw the recommendations of American nutritionists, they speak out positively about taking zinc, melatonin and vitamin C. There were somewhat conflicting data on vitamin D. But we did not give any such recommendations to our employees. We have all the prevention was associated with minimizing contacts and other measures of epidemiological safety.
Physicians are the heroes of our time.“If you think that you are special and that a pandemic will not affect you, you are deeply mistaken,” listen to what the doctors who are fighting with coronavirus say
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Half recovered from the coronavirus in the future may experience physical, cognitive and psychological impairments. And every third recover from threatened pulmonary fibrosis, warned British doctors
Photo: Valery sharifulin / TASS
Every third patient who had recovered from coronavirus, may the rest of your life to suffer lung damage, chronic fatigue and psychological disorders. To such conclusion experts of the National health service in the UK, reports The Daily Telegraph.
According to the study, 30% recover from coronavirus infection can later develop pulmonary fibrosis. This is a disease in which the light forms scar tissue that leads to disruption of respiratory function and diminished blood oxygen saturation.
Half of the survivors may experience physical, cognitive and psychological impairments, and about 70% may suffer from delusional disorder. Every tenth patient revealed an acute lesion of the heart.
Pandemic coronavirus. The most current at 24 June
According to scientists, there is also evidence that coronavirus can cause brain damage that can later lead to Alzheimer’s disease.
That COVID-19 threatens the human body serious consequences, in April, said Russian scientists. They found that infected can cause serious brain damage, said scientist-a virologist at the Russian Academy of Sciences Felix Ershov. As influenza viruses and herpes, coronavirus can lead to the death of whole sections of the body and weakens the immune system, he said.
According to the Johns Hopkins University, in the world of coronavirus infection was diagnosed in more than 9.2 million people. Of them died 476,9 thousand
In Russia since the beginning of the epidemic revealed more than 599 thousand cases of infection with coronavirus. Died 8359 people, recovered more 356,4 thousand
The spread of the coronavirus Covid-19 in the world
How to change labor relations in the conditions of a pandemic, how much of Ephraim will spend under house arrest, which the US will start to buy icebreakers that virologists think the abolition of isolation in Moscow; main news — a review of RBC
The authorities refused the special rules of the layoffs and idle during a pandemic
The Ministry of labor has radically rewritten the draft government resolution on regulation of labor relations during a pandemic.
Disappeared from the document, the prohibition of employers to dismiss employees or send them in a simple and new procedure for relocation of employees to shifts and changes of their duties without consent. Many of these initiatives had previously criticized both the trade unions and employers.
The Ministry of changes was explained by the fact that the previous version of the draft is no longer current, since “a significant part of the restrictive measures have been removed”. In the document left “rules, which require rapid adoption.”
Among them vacation benefits for residents of the far North, as well as the norm regulating the procedure of transition to digital service book.
The court sent Mikhail Efremov under house arrest
Tagansky court of Moscow satisfied the petition of the investigation and sent the actor Mikhail Efremov, who became the participant of road accident in the center of Moscow, under house arrest until August 9.
The head of the public relations department of the administration of the President of Turkey, Fakhrettin Altun, wished the speedy recovery of the coronavirus infected by the press secretary of the President of Russia Dmitry Peskov. Post in Russian Altun published on Twitter.
“I wish my friend Kremlin spokesman Peskov a speedy recovery. We will succeed together! ” He wrote.
On May 12, Peskov announced that he had become infected with a coronavirus, and therefore he was admitted for treatment to one of the hospitals. He also assured that he personally spoke with Vladimir Putin more than a month ago.
Spouse Peskova, skater Tatyana Navka, also fell ill with coronavirus. She reported that her husband was under medical supervision. At the same time, Navka added that her condition had improved.
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
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
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In the United States, 14 coronavirus vaccines were selected for testing. This was reported by NBC, citing a source in the presidential administration.
According to the channel, as part of the Trump administration’s project to accelerate work on the drug, which was called “Warp Speed,” 14 of the 93 most promising developments were selected.
Scientific and manufacturing efforts to accelerate vaccine development, according to NBC, cost “several billion dollars.”
Bloomberg learns about U.S. plans to accelerate coronavirus vaccine development
Earlier on April 29, Bloomberg announced that the presidential administration was developing a project that should accelerate the production and appearance of the COVID-19 vaccine on the market. It will reduce the time to develop a medicine to eight months and submit it before the end of 2020, and not after 12-18 months, as planned before.
The project should combine the achievements of private pharmaceutical companies, state and military institutions. In particular, animal vaccine testing will be accelerated. Separate clinical trials of each research center will be combined into one large test. The main objective of the project is the production of 300 million doses of vaccine by January 2021.
The distribution of coronavirus Covid-19 in the world
Number of confirmed cases of infection
Source: JHU
World Data i
On April 21, all member countries of the UN General Assembly signed a resolution that provides “fair, transparent, equitable, efficient and timely access to future COVID-19 vaccines.”
Virologist Anatoly Altstein and MD, Nikolai Malyshev, said in April that the coronavirus vaccine would be ready by the end of 2020 – early 2021. However, they will not begin to use it in public earlier than in a year and a half.
Coronavirus
RussiaMoscowPeace
0(per day)
Recovered
0
0(per day)
Infected
0
0(per day)
Died
0(per day)
Recovered
0
0(per day)
Infected
0
0(per day)
Died
0(per day)
Recovered
0
0(per day)
Infected
0
0(per day)
Died
Source: JHU,
federal and regional
anti-virus operations
Source: JHU, federal and regional anti-virus operations
In Spain, on May 2, quarantine measures against the coronavirus were relaxed, residents were allowed to go for walks and play sports in the fresh air. This was reported on the website of the government.
The Ministry of Health of Spain has set the exact time for different age groups, during which from May 2 you can walk and engage in “unprofessional physical activity” in the open air. The allowed period for citizens from 14 to 70 years is hours from 06:00 to 10:00 and from 20:00 to 23:00. People older than 70 years or with special needs can only walk from 10:00 to 12:00 and from 19:00 to 20:00. Minors are allowed to go for a walk from 12:00 to 19:00.
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Separate time is specially introduced so that older people do not overlap with younger ones. The Ministry of Health clarified that such restrictions are intended only for municipalities with a population of more than 5 thousand people. In other settlements, street walks and sports are allowed from 6:00 to 11:00.
In exceptional cases, Spaniards may violate the time frame if there are medical reasons for this.
“Last appeal” of Renzi to Conte in the Senate. “Let’s face it: we are at a crossroads. He was good at reassuring the Italians, he was very good. The point, however, is that in phase 2 of politics it is not enough to play on fear and concern. There is a reconstruction to do which is devastating and will require vision and courageous choices. Give an extra eye to Istat’s data or we will not be by your side. If you choose the path of populism you will not have Italy alive by your side. Our country – continues Renzi – has had moments when politics abdicated its responsibilities, in 92-93 abdicated the judiciary, in the first decade of 2000 when it abdicated technicians, now we cannot abdicate virologists, we cannot ask them how to fight unemployment, touch to politics. There is a new deeper division between guaranteed and unsecured. We call you to have a broader look at the economic future. We will vote on the liquidity decree prepared by Gualtieri but the world v forward and in front of this now is the time to act: to prevent, not to chase. Be more cautious when speaking to Italians: you said 11 times ‘we allow’. A prime minister doesn’t allow it, because constitutional freedoms come before you. She doesn’t allow them, she recognizes them. I denied Salvini full powers: I didn’t do it to give it to others. Coronavirus is a terrible beast that has made 30 thousand deaths in the most cowardly way but we are not on the Coronavirus side when we say to reopen, we honor those dead. The people of Bergamo and Brescia who are no longer there, if they could speak, would tell us to reopen. “
“Which ultimatum? Conte replies – Renzi asked to do politics? It is what we are doing, so there is no ultimatum”. So does the majority still exist? He is asked. “Yes,” replies the Prime Minister.
The situation with the spread of coronavirus in Russia is stabilizing, and in a few weeks the number of people infected with the infection may begin to decline per day. About this “RIA Novosti” said the doctor of medical sciences and professor Anatoly Altstein.
According to him, in the last week the number of confirmed cases of infection has been falling slightly and is increasing slightly day by day. The most unfavorable data were 5.8 thousand and 6.1 thousand cases detected per day, however, 6 thousand new infections were also on April 19. The professor expressed the opinion that in connection with this, the situation with coronavirus is stabilizing in Russia.
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“We are not breaking into a cloudless height with these diseases, with the frequency of diseases, and somewhere around we are close to a plateau. I think that in a couple of weeks, probably, we will observe a decrease, ”said the virologist.
Earlier in April, Altstein did not rule out the possibility that Moscow had already reached the peak of the epidemic. Galina Kozhevnikova, head of the department of infectious diseases at RUDN University, suggested that the capital will peak at the beginning of the May holidays, and other regions of the country a week later.
