Point in the fight against COVID too early, but the turning point came

Author: Dmitry Kiselev

Russia has been steadily moving out of the pandemic coronavirus. Now this process has a visual confirmation. On the website Stopmanager.Russia map where you can see at what stage of the removal of restrictions is a particular region of the country. At the zero point of slightly more than 10 subjects. Where the situation with the incidence of difficult restrictions almost full.

the Majority of regions now in the first phase of lifting of restrictions when allowed to walk and exercise in the fresh air, and small objects-food trade and services. A dozen regions went to the second stage. It has opened stores area of 800 square meters and some educational institutions. The third stage came only on Sakhalin island — there are cafes, restaurants, shopping malls, libraries, and museums. At the same time mask mode will continue throughout the country, even after removing all restrictions, as “the virus hasn’t gone anywhere”. About this informed the head of Rospotrebnadzor Anna Popova.

More good news – drawn 53% of all confirmed infected more than 280 thousand people. While doctors continue to fight for the lives of everyone. Now is one of those times when a number of heavy patients accumulated over the entire period of the epidemic, because the treatment of difficult cases, and then another, and rehabilitation — a matter of weeks and even months.

Author: Elena Erofeeva

he was recognized by the mask — not medical — diver. In such runs only Dr. Sergeyev. Every day he sinks to dangerous depths, where patients can’t breathe the virus-infected lungs, and, passing through death, coming back to life.

Dmitry fought for nearly two months. 9 days in a coma, 6 weeks on a ventilator. And here he gets on his feet. First steps by the bed, as if for the first time. Then disconnect from the ventilator. And Dmitry will take the first breath without the machine. The first few meters it will pass based on brother.

They — the twins — Dimitri and Yuri Kluchnikov. Healthy men 42 years of age, without severe pathologies and chronic diseases. Coronavirus picked up most likely at work in the subway. Yuri easily undergo the disease. A few days have a fever, and then released. But he remained in Yakhroma the hospital to take care of his brother. Steady breathing, steady step — discharge day with them, said goodbye to all the office.

Roommate Oleg Erohin with the twins learned to walk. He also spent on a ventilator for 40 days. “I do not believe. I even thought it somehow exaggerate in the media heated. But now that I already believe. Thanks to doctors, God is gradually coming back,” — says Oleg.

His personal meeting with COVID-19 occurred in April. He thought the seasonal flu. Confusing the temperature with paracetamol, and it was viral pneumonia with severe complications.

“His lung tissue was so impressed that, despite the need for ventilation, this as a complication, lung tissue did not survive. There was a rupture of the lung tissue,” explained Victor Sergeev, anesthesiologist-resuscitator of the Dmitrov city hospital.

They do massage, help to get out of bed, trying to persuade to take a pill and be a bit more patient when very hard in an unusual prone position. Lying on the stomach uncomfortable, but it helps to breathe without the ventilator.

“Patients like children. When arrive here, they experience shortness of breath, fear that “we’re all gonna die, we’re not tenants, we caught this virus.” Somewhere we have them, and mocked, of course. Without this in any way. Are you a man or what? Let’s recover faster! Trying to raise them to their feet. Where is mocked, where polskem. The hardest part when people start to nurse, and he was worse than worse. You can’t do anything, it’s hard,” said Yevgeny Berdnikov, nurse-anaesthetist Dmitrov city hospital.

In iesthe Romani Department Dmitrovskaya hospital resuscitation has never been. Local surgeons cut open the boils and ulcers. Today there is 90 davidnyc beds. New patients arrive every day.

“Everything is so new and unusual, hard. Want to have faster end of all this, to defeat this plague, really want to relax,” said Tatiana Alandarenko, surgeon Yakhroma Dmitrovsky branch of city hospital.

fifty kilometers from Yakhroma — Moscow. And already there are slowly returning to normal work. In cavigny hospital hospital name Demikhova has evolved over three days, from comignago out a week. Here today everything is back to the old life, from the opening of the cardiovascular center, neurosurgery, urology, therapy, if there was three months of hard work. The gateways that separated the hospital corridor on the “red” and “green” areas were demolished. Doctors, as before, in white coats. For the time that it was used to treat coronavirus, on the CT scan done a few thousand studies of the lungs.

a CT scan of the lungs will now be done for each patient, in order not to miss COVID. With suspected coronavirus in the hospital Demikhova is no longer accepted. Again strokes, heart attacks. All that was postponed due to urgent care to infected patients.

“Very complex virus that no one knows how it will behave. We don’t know the duration of the presence of antibodies in the body, how long we could fight it yourself his immune system if he will come back. The amount identified in Moscow is becoming less and less. Hospitals, so they are not idle, must work according to his profile,” said Dmitry Merkulov, head of neiroreanimation GKB them. VP Demikhova.

In interoperational back surgeons. Two weeks ago there were beds for patients with coronavirus. It was the reserve — in the most extreme case, when no one knew how to develop pandemic.

“COVID-19 can be taken for diseases. There are so-called intestinal form digestive disorders, flu-like symptoms, when muscle pain, intoxication. Masks very much. And acted on such a principle: the presumption of comenote, if I may say so. It was necessary to prove that this is not a coronavirus, and until then it was thought that this is it,” — said Artem Snisar, Deputy chief physician of the medical unit of the clinical hospital named. VP Demikhova.

“This is not simply a viral pneumonia, it is not just one organ — the lungs. But in addition to lung lesions at COVID -19 is the defeat of the coagulation system — the same thrombosis. There are lose heart, kidneys, liver. It’s actually a difficult problem,” — said Sergey Avdeev, head, Department of pulmonology sechenovskiy University, chief freelance pulmonologist of Ministry of health, corresponding member of the Russian Academy of Sciences.

History COVID -19 early to write off in archive. From the beginning of June — almost 9000 new cases every day. Coronavirus have not yet gone. People continue to get sick, doctors continue to treat. In the irradiators 15 GB of Moscow today 12 operation. The patient with viral pneumonia will clean the vessels where the blood clot was formed.

Coronavirus causes the formation of blood clots. Blood clots formed in leg veins, causing thrombophlebitis, the blood vessels of the brain, leading to strokes, heart, as a consequence — heart attacks. Such patients prescribed drugs to thin the blood — anticoagulants.

During the pandemic not only changed the understanding of the disease itself COVID-19, but the relation to treatment.

“If you remember, in the first months of the disease was widely discussed drug “Hydroxychloroquine”, “Chloroquine”, then they were cursed, now they are trying to whitewash. The main question to them: is not enough that their effectiveness is in question, yet they have not assessed the safety, in terms of side effects. Theys under certain circumstances, cause arrhythmias, including fatal, especially in combination with “Azithromycin”. And it was one of the most popular combinations at the end of March — beginning of April. Being unnoticed, this side effect can result in some patients in cardiac arrest,” — said Oleg Averkov, Deputy chief physician of the city clinical hospital №15 named. O. M. Filatov.

Today there is no convincing evidence that “Hydroxychloroquine” wins coronavirus. The attention of clinicians drawn to anti-inflammatory drugs: with their help, doctors try at an early stage to prevent the cytokine storm when the body injures itself.

“Everything we do is still called “compassionate therapy”, mostly because people are sick seriously, doctors really want to help them, and almost anything that has an evidence base, characteristic of the drugs we introduce into your life in time of peace, does not exist”, — said Oleg Averkov.

the 15th hospital stays coveny hospital, the largest in Moscow. Here today 1200 patients. Here transferred patients from hospitals that completed the work with the coronavirus.

“patients also occur, myocardial infarction, cardiac arrhythmias, pulmonary edema, aortic dissection, pulmonary embolism. Became more patients of a cardiological profile. We are gradually returning to the category of patients that we lay before the pandemic,” said Mikhail Arefyev, head of the 9th Department of anesthesiology and intensive care clinical hospital №15 named. O. M. Filatov.

cardiac Surgeons 15-th city hospital of Moscow even now continue to do complex heart surgery. In difficult conditions, with greater risks when a patient connected to a heart-lung machine which replaces the heart and lungs with a viral infection.

“in order to have access to the heart and lungs have to completely blow fTue off from work. Lungs are recovering after such an intense surgery much harder. Due to the fact that the impaired ventilation in a damaged lung regions, patients recover harder to breath” — said Natalia Neznamova, anesthesiologist-resuscitator of the 4th branch of resuscitation of city clinical hospital №15 named. O. M. Filatov.

In the nursing home, redeveloped for COVID-19, moms with newborns can only talk on the phone. Video sessions — morning and evening.

Konstantin Alekseevich was born on the 8th of June. Ales haven’t even held him in my arms. She will give the baby, when will come the third negative result at COVID-19. Come to the baby only a doctor and a nurse. Put on another robe, and a third pair of gloves. Fed baby food. To take on hands of the child only in extreme cases — still “red” zone. Dangerous.

In Moscow, the curve of infections since the end of may is winding down: the day the virus became ill less than 2000 people. Coronavirus is gradually disappearing from the capital.

“We see positive trends in reducing hospitalizations. However, speaking about the severity of the disease, we still have severe patients still in intensive care units and intensive care there are patients who are on a ventilator, there are patients that receive substitution therapy,” — said Sergey Avdeev.

“circulation of the virus in Moscow among the population has decreased in 10 times. Layer grows immune to what, in fact, we strive. And we know that when the immune layer of the population exceeds 30%, has stabilized the situation. The number of persons having antibodies to the coronavirus, equal to 14.5%. And after immune stratum or herd immunity reaches figures of 60-70%, the virus goes into the category of seasonal,” said Alexander Gorelov, the Deputy Director on scientific work of Institute of epidemiology of Rospotrebnadzor.

the Capital’s doctors now in the regions to help treat the coronavirus. The chief physician of the 52nd hospital of Moscow Maryana Lysenko flying to Chita. Her 8 doctors. The peak of the epidemic in the TRANS-Baikal territory has not yet passed. Here are more immersed in medical reports and numbers. Over the past day — plus 89 ill. Recovered six times less. Transbaikalia in quarantine.

“We will implement a transfusion of plasma from patients with coronavirus, the number recoagulation disease at the moment is enough to start organizing donor movement. And I hope it will be of great help in the treatment of patients,” — said Lysenko.

Denis Protsenko, the head 40-1 of the hospital in Kommunarka — with his team working in Dagestan. The region where happened one of the major outbreaks COVID-19. Today more than six thousand patients.

In the city hospital of Makhachkala, he conducts bypass: with colleagues speaks in medical language with patients in simple, understandable. Convinced that we should be treated.

“is Everything perfect? Probably there is no perfect. However, we discussed the aspects of the development. In particular, I don’t have enough here of the ecmo machine, which I hope will appear soon,” — said Protsenko.

Dagestan gradually recovers. The increase in cases today is not as explosive as it was in the beginning. The defence Ministry building in Dagestan medical center. In Buynaksk, Botlikh and patients take mobile hospitals.

In regions where the peak of the epidemic has already experienced, gradually remove the quarantine restrictions. Revives Russian tourism — the cable car in Krasnaya Polyana in Sochi flock to the mountains. Prepare for the opening of hotels.

studded with amber On the Baltic coast in Kaliningrad under the warm June sun is already among locals — miss the sea.

In the cities to open stores and barbershops. In the Moscow beauty painted before your booking tontsa months. In the capital there are no more digital passes and walks on schedule. Work parks. Soon the summer terrace the cafe will be accepting visitors. In the restaurant kitchens make blanks.

But this is only the first stage. The third and final one only came in Sakhalin oblast. On the island removed all quarantine restrictions.

“in Summer, the situation will have a distinct tendency to reduction of incidence, but to exclude the second wave in the autumn is not possible. Most likely, she will,” said Alexander Gorelov.

Point in the fight against coronavirus have not yet put before. In Russian regions there are still pockets of the epidemic. Hospitalized but has become much less, and it’s a sure sign that a fracture has already occurred.

Text: “Conduct. The duty of”