How Moscow removes the restrictions imposed because of the coronavirus, and conducts mass screening of the citizens and helps the regions? This is not only in interview to TV channel “Russia 24” said Deputy mayor for social development Anastasia Rakova.
– Hello, Anastasia Vladimirovna! Please tell us about the new decree of the mayor of Moscow on test mode, remove the restrictions from 1 June. Why these steps resolved to do now? And the results of these two weeks what the outcome will be considered positive?
– Good day. We have three weeks taking various actions for the opening of those or other spheres of urban economy. And each time very carefully calculated risks. People are returning to their jobs at enterprises, in organizations, but we hope that, although the workers of the place to which they return, the old, but the rules of social behavior they have a new. That is, people wear masks to protect each other, keep social distance, employers are very careful about the observance of sanitary regime. And, despite the fact that we are taking measures for the opening of the city, we see that we have the sanitary-epidemiological situation does not deteriorate. The number of patients is not just getting bigger, and they become less. And it allows us to do already-designed, responsible steps forward.
By decree of the mayor from 1 June resolved a long-awaited walking and exercise, however, with great restraint. The worst thing now is to prevent the simultaneous accumulation of a large number of people in a public area, so we were forced to impose a certain schedule. So, exercise in the fresh air every day, but so far, alas, only until 9 am. As for just walking, you can walk from 9 am to 9 PM, but, alas, still only three times a week.
Opened and all of the city’s natural territory is parks and public gardens, and yards, and any other areas free access for residents. There is only one limitation: while you can’t use city infrastructure. What are you talking about? We are talking about benches, rotundas, pavilions, playgrounds, wordeater, various simulators, and so on. Why? Here there is quite logical explanation: any contact with the surface of such infrastructure unlimited circle of people – this is the risk of infection.
Also for walking it’s not possible to use public and private transport. It is best to use bikes (bike rental is open), skateboards, scooters, and other similar appliances. It is desirable, of course, also not to go so far from home and walking in nearby natural areas. Thank God, in all urban areas now such site is.
of Course, such a regime of walking, at first glance, it may seem difficult and strange. I understand that the posting of the schedule of trips each individual home may seem tricky. And, I think, well, what could be simpler? We are all people competent, are allowed to walk – we will walk normally. But you know perfectly well, how does Moscow, Moscow streets, parks in the usual nice summer day – they just fill up with people. And what will happen if longing for the festivities at the same time all Muscovites will be released?! Of course, we are very apprehensive of this situation.
all of Us together in any case can not prevent the deterioration of the epidemiological situation. So all we ask is a little patience to see how this mode will operate for two weeks, and if we do not see increase in new patients, if the situation is to improve, to be followed by the weakening of the regime. In this case it is better to proceed slowly, gradually but surely towards the open city, rather than fall back, as, in principle, we see examples in other countries.
– Free testing for antibodies to coronavirus is now available at Samostoatley record. Please tell us how active Muscovites, whether they are interested in this study? And is it possible to speak about any results data on the results?
– first, I would like to say that to date no one test system is not perfect, no test shows a perfect result. So in order to provide Muscovites a full set of testing, we are probably one of the few cities in the world, which applies in full all currently existing forms of testing.
the First method is PCR-based diagnostics that we used from the beginning of the epidemic, it allows to determine the presence in the human body of the virus. And today we have reached an approximate volume of patients testing PCR diagnosis is 50 thousand tests per day.
the Second test method is the so – called ELISA, which determined the presence of antibodies in the blood. This is a quick test that is also now well known, and Moscow as they apply, providing all health care workers and in hospitals and clinics these tests that allow rapid diagnosis.
And the most serious tests are CLIA-diagnosis (immunochemiluminescent analysis – ed.) which shows not only the presence in the blood of immunoglobulin M and G, but also shows their quantitative importance. Accordingly, based on the values of these antibodies and their relationship to clearly understand that man today is sick, even if he doesn’t know that hurts, because the disease is asymptomatic he. The man has been ill, he was faced with an infection, and he begins to form immunity. And people never come in contact with this infection, so it has the risk of becoming infected. That’s exactly the test we’ve made public and free for all residents.
of Course, it has been said that our ultimate dream from the very beginning the epidemic was, to every Muscovite could pass this free test. But well is the desire to have, and how difficult it is to organize it! Of course, I want to have the maximum number of Muscovites had the opportunity to quickly pass such a test. But at the same time we cannot allow institutional collapse, we cannot allow the accumulation of queues, discontent of citizens, high risks. So we spent just a great job, before I discovered such testing.
first, we created a special electronic control system which allows the public to sign up for a specific time. Further – clearly organized workflow in clinics, has allocated a special zone, divided the flows of patients were timing how long it takes to work with one patient and formed a necessary electronic part.
Next: we clearly worked with our health workers to teach them to organize this process. This number of tests to handle day – too easy! We did this so our technicians can promptly work efficiently for such a large amount of tests.
And, most importantly, information for the Muscovites were promptly available, we brought it to the electronic medical records of each Muscovite. Within three days the results of the analysis are available in the electronic map of each citizen. Moreover, we have tried to provide as simple a human review, which would give a clear understanding of person – he is sick or healthy or already ill. And if, God forbid, he is sick, what action he should take or how and in what time frame will be contacted from the clinic and determine further tactics of treatment.
To date, we have opened 30 outlets in urban clinics. Their capacity is 5 thousand tests per day. And Wednesday earned the electronic part, we see a great demand of Muscovites – two weeks almost painted all the slots. In the matter how do we increase productivity, we will try to open another new additional slots.
– the President of Russia Vladimir Putin in conversation with Sergey Sobyanin, mayor of Moscow, spoke of the need to send doctors from the capital to help in the regions of Russia. What areas is now a priority? How many specialists will travel to Russian regions? And can you share Moscow with their reserves of medicines and equipment?
– Yes, on behalf of the President and the Moscow mayor, we have already sent such multidisciplinary teams in 6 regions. They have already got started to work.
We are specially formed that is multidisciplinary teams, which allow you to close all the issues related to the coronavirus: this infectious disease specialists and pulmonologists, and radiologists, and physicians of intensive care units, and intensive care sisters. Headed by a team of experienced Deputy chief physician for surgery, who already had experience translating simple multiprofile hospital in cavigny, and who has worked for three months on the front lines. This is the most our experienced professionals who can quickly provide real help. Of course, the professionals are going with everything you need for the treatment of patients, primarily personal protective equipment – a respirator and suits for physicians. We help regions, their doctors, to ensure their protection, which is very important.
Second, we send the necessary medicines that were used in Moscow for the treatment of coronavirus infection. We provide medicine and medical technology equipment, which is necessary for oxygen support and mechanical ventilation, it fluometry is a special equipment which provides the ability to provide patient oxygen support.
I Want to say that from the very beginning of the epidemic were in close touch with all regions, exchange of experience, knowledge, and videoselector conducted, and various webinars. At first, many doctors from the regions went to to help us, now gained experience, you can go back home. We are very grateful to them for that! We are pleased that today the Moscow health system can help other regions.
in Addition to what we sent professionals in these regions, we are ready to take serious cases directly in Moscow clinics, providing them with the tech support for this profile.
– You have just touched upon the resources available in the capital. In General, you are now able to assess system state of health in Moscow?
– of Course, to assess how managed and mismanaged health care system, and any sector of the urban economy, yet, perhaps, before. But I can say for sure that we managed the main thing – we managed not to slide into collapse, to ensure that all the necessary medical care. Most importantly, none of the doctor in Moscow had to make a choice – whom to give to live, and to whom – not to give. All patients who needed medical care in the medical bed, we had a medical bed.
moreover, intensive care bedspace was even at the peak is used by only two thirds, allowing us to fight for the lives of every person and to provide the maximum assistance. The doctors tried very hard.
– When we had just joined the fight against the epidemic, then it made various predictions. How do these compare with the current situation? Are you happy with the results of the work done? What was the most difficult?
– Many of the projections was really very pessimistic. I hope that in time the measures taken – and sanitary-and-epidemiologic, and exclusion, which were adopted at the level of the whole country, and at the city level did not allow us to go into a situation that was in Europe that we see in America. We won the time. Logically we probably should have been one of the first countries, I’ve talked about this, which would come uhpideme. But we got the first cases in early March, the peak of the epidemic was in April. By and large, we had the opportunity to prepare for January, February and March. We have formed the necessary amount of beds, we have worked proactively stocked with the necessary medicines, medical equipment. So, of course, worthy worked!
I want to say a huge thank you to the doctors. In this long period, all medical workers of Moscow, worked as a huge big team. And it’s not just about doctors, about nurses – it speaks about all the employees of medical institutions. No matter, Manager, accountant, personnel officer – all had at this moment very hard. And they all coped well.
no One worked on your own record, all worked for one common goal – the result. Of course, the hardest was the hospitals and their employees every day had to fight for the lives and health of hundreds of patients. It is very time to lean on our clinic. They took with them a heavy load at the peak of the pandemic, taking upon himself the treatment of patients with mild pneumonia, taking on themselves many questions related to quality diagnosis, proper diagnosis. And also that they subsequently carry out aftercare of patients who return from the hospital – I define it as the continuity of treatment.
Indeed, we have created a unique mechanism for outpatient treatment of patients with coronavirus pneumonia is CT centers. They work 24 hours a day. They provide a full operational diagnostics and aftercare for those patients who remain at home.
I Want to say that we have initially, the percentage of those who were left to be treated at home, and then, because of the deterioration of the situation, was hospitalized, was small – about 10 percent. But we see that in the process of using technology every week he declined, declined and removedpity that says about the quality of our outpatient clinics.
of Course, the link was imminent. It ensured a balance between the work of the hospital and clinic. First aid for those who became ill with mers was of course imminent. They had to make very tough, very important decision whether to leave the patient on treatment at home, either, for health reasons, he should be hospitalized. They were crisp, hard, clear algorithms that we worked with representatives of the entire healthcare system, and emergency clearly it worked. It is really nice when the whole system works on a common goal, hears, sees each other and tries to help – this is probably our main achievement during this difficult period.