“Masks do not even have enough emergency physicians, equipment for critically ill patients is almost there” — the Russian doctors about preparedness for epidemic
The experience of China, Italy and Spain in the fight against coronavirus showed that if time does not protect doctors, it affects not only physicians, but also patients who may be left without assistance. In the Russian provinces this lesson is not learned. The seriousness of the situation do not understand neither the local authorities nor the management of medical institutions, nor, sometimes, the doctors themselves. In the hospitals significantly not enough doctors of all levels, no individual protection equipment and modern medical equipment. Doctors and paramedics who came to talk to The Insider, are recognized directly: masks are not enough even to the paramedics, instead of special disposable protective suits are used conventional medical gowns, artificial lung ventilation in the regions is extremely small, and safety standards and quarantine openly ignored.
Nurse ambulance Krasnodar Krai
I fear an outbreak in Sochi, because many decided that quarantine is best to wait at the resort and went EN masse to the South. So, the burden on medical institutions is already too high. Motels trying to follow all the steps — each pen wipe every two hours. Of course, they don’t want to lose tickets and money. But how many is enough?
In the same Sochi lacks 60 physicians, 10 physician assistants, 10 nurses, not enough cars. What happens when not enough medical staff — no team? Came the driver sits in the car and sitting in it the entire shift, 12 hours. Sometimes, several machines are without teams. People are forced — out of the threats from the persuasion — to work day after day. But this is a violation of the law. Medic max can operate day and next day night. Then needs to be output. That is, half rate max. Of course, nothing in full is not paid — not recycled shift or night shift. Instead of the law of 12 calls per day of the team perform up to 22 — that is, almost do not call in to the station even fill up a medication.
The medical staff is not enough, so that the driver arrives, gets in the car and sitting in it the entire shift — 12 hours
75-80% of those who work on the ambulance in Sochi, not even local. Some live right at the station, organized on the fourth floor of the Dorm, and the other practical. For the room where they are paid five thousand rubles, which is very advantageous, because the rent in the city will cost at least 30 thousand. And then consider: the salary of 20 thousand minus five thousand to the hostel. Life remains 15 thousand. So they plow like crazy. They are ready on everything if only to stay in Sochi. Some work days on the state of emergency, and then the next day, after resting, go on shift in the ambulance. Like this and survive. Many physicians happen strokes, heart attacks. Mortality, especially on the ambulance, very high, but it is in the statistics does not get.
At the ambulance in Sochi acute shortage of doctors and nurses
Now many people, even doctors, simply do not comply with the quarantine, there is no understanding of personal responsibility. All the well-known Stavropol case: infectious disease physician went to rest, came and infected a bunch of people, despite the fact that she was supposed to be the guarantor of protection of the population. My friend is visiting from Belarus and called the hotline. He was told what to do, and he still walks everywhere. Says masks nowhere to be found, and he believes that “the virus is all a fairy tale”. Only when Italy began to die EN masse and in Russia there were the first dead, became a little more serious.
People don’t believe. Most medical professionals, even at the level of the authorities, have an indirect idea about epidemiology. And therefore to the protection of the doctors attitude is extremely serious. Only a show. Sometimes this manifests itself in seemingly small things. For example, publish photos of the action “Stay home, we work for you”. The picture shows that the doctor bahila tight on the Shoe so that the laces stick out. He’s kind of like from the coronavirus was protected?! Or the team responds, and the driver of a robe fluttering, like a Cape for Batman.
But most importantly — protective suits have virtually none, which means we are all at risk of getting infected. There are some reusable anti-plague suit QUARTZ <universal remedy against viruses, germs of especially dangerous infections — The Insider>, each of which is worth several thousand. But we mostly use the cheap surgical. But they do not protect, because it is not sealed. For sanepidemiology viral rules the person should be from all sides closed, and a double layer. If breaks the upper layer, against penetration of infection and protects the second. Otherwise it makes no sense. Ideally, we should all be working in the hearth of infection in costumes, which put the President in Kommunarka, coveralls, long boot covers, mask.
Ideally, we should work in suits as Putin, but they have almost no
And what is done in the Krasnodar region? Our regional Ministry of health order № 198 <the order of the MoH from 19.03.2020 “On temporary order of organization of healthcare organizations in the implementation of measures on prevention and reducing the risk of spread of the new coronavirus infection COVID-19” — The Insider> added your item, you can use surgical gowns. But as such an order at the local level may be contrary to Federal, where no mention of a surgical suit?
I call the doctor on duty: “According to the order of Krasnodar Krai so-and-so, you go to the person to take samples. He was in contact with the infected, the terms of pathogenicity class 2”. Type, do not worry! Well that’s okay? If we conditionally must treat all people as infected, the arrival of any such person for the test — in fact, the game of Russian roulette. For example, I arrived, took it, and destroyed the costume. But my suit does not close completely, those parts of clothes that should be closed according to Regulations. It turns out that the virus could get to some part of my clothing. And then I, dressed like this come to an ambulance, dress up, take her hand, take her home, then go for the other patients.
And then, if really someone after me will be infected, will blame not the doctors our ambulance, specifically, I arrived on a call. I was accused that I didn’t have rules and epidemiological regime that I broke the rules, and then infecting the patient. And even if I survive this coronavirus, then I’ll sit the rest of my life in jail and answer to all claims filed by the relatives of these patients.
Ambulance paramedic, Ryazan
In Ryazan there were patients with symptoms similar to coronavirus, four confirmed cases in the region. Another woman came from Spain and turned with signs of pneumonia and hemoptysis. But her analysis is not ready yet. The brigade, which it was carrying, took swabs and said that the result will be ready in three days. Both teams, who was hospitalized those two, went to the quarantine. Yet patients with SARS, it seems, goes the same as every year we observe this time of year. Flash until we see. If people report that they have been abroad or in contact with sick people, we are also perceived as potentially infected.
While the numbers are small, people in Ryazan are concerned that there is no means of protection. Even the medics in the ambulance for some time had no masks, then there were. At the Central station there is a specialized reusable costumes. Used — it is necessary to give to the disinfection, which takes three days. But they are in limited quantity. Therefore, there are several teams that send only on calls where the symptoms are similar to a coronavirus. These teams provided a reusable costumes for the other teams at the Central station is just a standard disposable bathrobes and other personal protective equipment.
And at the substations, these disposable bathrobes generally be reusable. They are disinfected after use. Respirators do not give us, only three disposable masks for the shift, and standard shift lasts for hours. Now we do not send calls if there is suspicion of a coronavirus. But we are prepared for all that we have, and will remain reusable. We posted at the substation manual — what to do if a patient suspected of coronavirus: what tests, how then to handle how to soak the suits in disinfectant solution. Gloves, gown, goggles. And be sure to call and warn that we’re bringing such a patient to the doctors in the hospital also could properly prepare. But still the basic information about pandemic coronavirus I mostly get from the Internet. Our trade Union Action there are online sites where doctors share information and experience.
We are told, we have a hospital named after Semashko reorganize the unit, additional space is prepared. Promise that with the influx of patients, if anything, should handle. While everything is, there are separate boxes. But how it will be implemented, hard to say. The Ministry of health, too, now broadcasting, we provided with masks, respirators and protective equipment. And in fact, we have meetings, say in plain text “You wear the crown on his head wearing? Sew at home ten gauze bandages and change them. You gauze better protection.”
In the meetings we just say: “You wear the crown on his head wearing? Sew at home 10 gauze bandages and change them”
We also know that a direct recommendation of the who that the mask should be disposable, and the coronavirus can protect only a respirator. But not even enough disposable masks. So today we are themselves elementary from SARS can’t protect.
Anna, the doctor, city of Kimry, Tver oblast
Today we finally gave out hats, masks, gowns, now in the hospital they have only very little: the day the doctor is supposed one hat and three masks. Until today, we were working without PPE. We also distributed a memo on how to dress. In this case we have at hand, in Kimry, a plant that produces remedies. But in urban drugstores and the hospital is still there! It all goes to other regions, are the primary orders. In short, the authorities are making money.
Today we have entered quarantine, blocked entrances and exits to the hospital. To us almost no one put all suspected coronavirus and heavy trying to send to Tver. According to official data, in Kimry yet sick, and unofficial — is already there. They become known from relatives of patients is word of mouth. All perfectly understand that if officially we will be sick with coronavirus, the hospital just closed. We have a lot of visitors from Moscow and the region. It is resting and those who work in Moscow. Even now, they continue to travel back and forth.
The hospital has only one intensive care unit. So if they do severely affected patients, we place them we can’t. All of them must send to Tver, maybe even a helicopter. If the CLB will flash and the flow is great, we just won’t be able to organize the shipping! And our hospital is not ready to receive patients with coronavirus, even a small part of them. Authorities and the management of the hospital, the head physician Alexey Prokopenko, I promise we are fine and we are ready. The equipment for heavy patients almost no ventilation — just 5-6 pieces. Not sure they’re working properly. Not to mention the fact that not enough doctors and medical staff — one nurse for a shift. If she gets sick, I don’t know what will become of us.
Our hospital is not ready to receive patients with coronavirus: equipment for critically ill patients is almost there
Irina, oncologist, 42, Rostov-on-don
As a nurse I have a daughter-in-law of our chief, previously, she was a “computer operator”. To the “medicine” I’m not attracted to everything. But a nurse with no education is quite common in the city. Nurses are sorely lacking, and its quality — even tragedy. Load — the most common, in processing I’m not complaining. But the salary is, of course, is another story. In January, for example, I received 7000 roubles. We have a salary consists of base salary and multiple benefits, but to understand what determines their size, it is impossible. One month it could be 12 thousand, the other with zero. At planning meetings I have repeatedly raised the issue, but others did not support me — it turns out that publicly is not accepted to ask such questions.
To daughter-in-law of the physician had a nurse with a diploma. So she didn’t know what “diagnosing”. Just trouble was! So, in early March, my nurse flew to rest in Czech Republic. Back on March 10 and 11 went to work. By this time in Russia already acted certain requirements for people who came back from Europe. She had to notify about the trip and the CPS to go into quarantine. However, the next day back she was already at work. I was outraged, of course, said it might be that you voluntarily sit at home? But she didn’t want: I say, feel good — why? No I did not listen. And I work with cancer patients, they have reduced immunity, you can’t risk!
The nurse returned from the Czech Republic and calmly went to work for cancer patients
March 16 I started feeling sick. At first glance — SARS. I turned to my local therapist, went to the same clinic where I work. She examined me, listened to. No fever — the hospital did not put. I explained to her that sitting in the same office with a man who recently arrived, that I am at risk, and offered to take the test for the coronavirus. She stated that such decisions will not accept, and sent me to the hot line of the Ministry of health.
I called. Talk to me someone Shevchenko V. V. and confirmed that I have no rights to require testing for the coronavirus and the hospital I also do not put. All this time I felt bad, but worked. Mask? Yes, I gave them before I and they enjoyed, and PPE was not given. In the 20 days of March I got worse in this state I continued to work, all this time, I wrote a complaint to the Ministry of health, Roszdravnadzor, the regional Prosecutor’s office.
And on 26 March began a very bad cough and fever. I went to the doctor-infectionist. She was surprised that the hospital did not immediately issued, prescribed medication and sent home sick. Here at me the patience burst, and I wrote to Putin. And in the evening of the 29th of March got raided. I began to call from the chief medical officer, from head of the clinic. Came from my same clinic and took my brush strokes on the coronavirus, now waiting for results. I think I will get fired because of this scandal and my perseverance. But to endure all this, I’m not going!
The material is prepared with the participation of Natalia Frolova and Elena Romanova
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