“It’s important not to blame sick people for spreading the disease”
— The situation with coronavirus in
— I must say that this is a new virus for us.He lived in animals and at some point moved to people. So I think the biggest thing about coronavirus is fear. And there are two objective reasons for this. Firstly, it began to transfer quite quickly. Secondly, because people who have not yet encountered this microorganism do not yet have immunity.
Coronaviruses are a large family. A few common, seasonal respiratory infections, such as a runny nose, are also a coronavirus, but of a different type. SARS-CoV-2 was alerted because it caused very serious diseases in a vulnerable group of people. These are primarily patients with impaired immunity, the presence of a history of chronic diseases, elderly people. In these risk groups, high mortality. But today there is still no way to calculate the exact mortality from complications after COVID-19.
Coronavirus- a family of viruses that includes, as of January2020 39 species, grouped into two subfamilies. They affect humans, cats, birds, dogs, cattle, pigs and hares. In almost all cases, they are transmitted from animals to humans, as most likely happened in the case of SARS-CoV-2.
As a rule, coronaviruses provoke damage to the respiratory system, gastrointestinal tract and nervous system. Moreover, it is believed that coronaviruses are responsible for 15% of all colds,
stopcoronavirus.rf
Of course, if you look at tuberculosis, the annualmortality from it is much higher. But now we see something that we still don’t understand, and don’t know how it will behave. The worst thing is that a lot of people get sick right away, and the course of the disease is often very difficult. And the beds needed for such serious patients are not enough, because they are designed for the pathology that the entire population always has. And now the situation in hospitals is comparable to a traffic jam on the street: everyone is on Tverskaya Street, it is standing, and the Garden Ring is empty.
- What are the main difficulties in fighting the pandemic?
- Firstly, it is a difficult logistic task. Almost military. Because this is a real war with the virus. A large number of hospital areas, doctors, staff, equipment and materials should be allocated to it. China, I think, has already invested more than $ 50 billion in this and was able to react quite quickly.
Secondly, many infected people do not immediately understand this. They may feel tired, weak, have a cough and runny nose, but take these symptoms for a common cold.
It is important not to blame sick people for spreading the disease. This is a very wrong approach, which many media now sin. Not people are dangerous, but the virus is dangerous.
Melita Vujnovich, WHO
I know they’re not doing it on purpose, but it’sbehavior is very harmful. People need to be convinced that they do not try to hide their illness from themselves and others, so that they fully follow all the instructions and recommendations of the health services, even if they think: “This cannot happen to me.”
Third, the main strategy is to slow down the virus,not let him immediately hit a lot of people, especially from a vulnerable group. These are primarily people with impaired immunity. And not only the elderly, but everyone who is being treated or treated for something that reduces the protective functions of the body. For example, children diagnosed with leukemia. Therefore, it is very important to slow down the virus and protect those people who are vulnerable, who may develop a severe form of the disease.
"Russia got ahead of the infection"
- What is the reason for the scenario that we are now seeing in Italy: when many people at risk are ill, and the healthcare system simply can not cope with this?
- Not only in Italy there was such a situation,there are several more countries where the disease has spread so widely. There is still no precise understanding of why this happened. Both Italian epidemiologists and international experts are examining this case - how it happened that in one city and region so many people fell ill at the same time. At the same time, the demographic structure of the population must be taken into account. Undoubtedly, foreign medicine is very good. But there are still a lot of people with chronic diseases. So the risk group was very numerous, and these people went to the hospital right away, crowded medical facilities, which, of course, were not ready for such a scenario. Unfortunately, preparedness is one of the main steps that are needed by the time you have no cases of the disease. We must still prepare for such a scenario.
Top 10 countries by the number of cases on April 10:
USA - 466,299
Spain - 153,222
Italy - 143,626
France - 118 785
Germany - 118,235
China - 82 924
Iran - 66,220
Great Britain - 65,872
Turkey - 42,282
Belgium - 24,993
— According to current onesgiven, in Russia there are already almost 12 thousand.sick, more than 800 people recovered and almost a hundred cases were fatal. Taking into account the size of the country, the number of borders and other factors, how does WHO evaluate measures thatapplyin Russia?
— The measures that Russia has been applying since day one,when the WHO received notification of a new virus from China, they were remarkable. Because this is not one measure, but a whole complex, and it expands if you look at the recommendations that WHO gives to all countries of the world. Russia's strategy does not match them exactly, since this strategy was developed more than 20 years ago. And it is constantly updated, so that Russia is practically ahead of the infection in its preparedness: surveillance, isolation, self-isolation and quarantine.
Globally, the number of cases is expected to beonly grow because there are infected people, but the virus is not noticeable until it is detected. Some will carry it very easily. Perhaps someone did not go into self-isolation, did not go into quarantine, and did not even realize that they were infected somewhere. Taking this into account, the most important thing is to comply with all the measures that are being taken: increase and maintain the distance between people, do not overload public transport, do not be in crowded places, at public events, even do without a birthday party, wedding feast or something else. . Yes, it is unpleasant to miss something in your life that you would be very happy about. But at the same time, we need to save those people who are vulnerable, whom we cannot protect now because there is no vaccine. Consequently, the measures that Russia is taking are very correct.
At a meeting of the Ministry of Health, it was noted that Russiais ahead of the epidemic. And we hope that we will stay at this level of the slow growth of those who are infected and even sick, so that the number of those who need highly specialized care does not go into a difficult situation. In this case, it is very important to separate vulnerable people, but at the same time not to create prisons. We now need to help these people so that they spend this time in isolation and at a distance good for their health. And WHO is going to make several videos to help the media get people informed about how to spend this time well and how they and their family can deal with this difficult situation. Because it is heavy, psychologically difficult.
“The first step is to separate patients”
— How to protect health workers who work with sick people? Why in ItalyIt wasseveral tens of thousands of infected medical personnel, and the head physician of Kommunarka fell ill in Moscow?
— First of all, I must say that not only inIn Italy, many medical staff became infected, but also in China and other countries. I just won't list them now. We saw this with the Ebola outbreak. Why? Because doctors and nurses meet patients first.
Essentially, this is a two-fold situation - first contact.A person comes in who needs any help, but does not have symptoms of COVID-19. It turns out that it is necessary to follow the rules of infection safety at every contact. If a person comes to the clinic for something else, there should be good hand hygiene, masks for medical staff, glasses and cleaning of all surfaces. Yes, now there are many ARVIs that are not coronavirus. But patients who cough and those with a fever must be immediately separated from other patients. This is the first WHO recommendation. The second step is absolute hygiene.
I read some portals and, frankly,being a doctor, I was very upset. Patients in the hospital should understand that this is not a hotel. Even in hotels, people do not have to chat with guests from other rooms. "What? I am not allowed to go into the corridor? ” - but you are in the hospital not to communicate with friends, but to be in your bed and to be treated. That is why it is very important to observe a regimen in which you will not tolerate any disease to other patients. It can be a coronavirus, or something else.
Sure, I understand people's fear: doctors and medical staff are temporarily not enough to explain to everyone in detail what will happen to him. Here we have work to do. One of the recommendations of WHO is to help patients understand this. But this is possible when there are few patients. The number of cases is growing, and doctors just need to trust the healthcare system and provide assistance at the highest level. The rules must be followed by every doctor, nurse and nurse.
We think we know everything, but actuallywe forget and begin to touch, for example, our eyes - and that’s it, we got infected. Gloves are very necessary, but they also need to be treated with alcohol gel. And at home, all this must be removed in order. We need a very complex eduction (education, upbringing - “High Tech”), I saw it on the websites of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare and Health. I know that there is an order even of the mayor of Moscow to resume the eduction of infection control for all doctors, all medical staff from primary health care up. Hope this can help.
- That is, this is happening not only in Moscow, but also in all regions?
- Absolutely.
Top 10 regions of Russia byconfirmedcases of infection as of April 10:
Moscow - 7 822
Moscow region - 930
St. Petersburg - 408
Komi Republic - 208
Leningrad Region - 129
Krasnodar Territory - 125
Nizhny Novgorod Region - 119
Bryansk region - 57
Sverdlovsk region - 56
Tula region - 54
- How to distribute the burden on doctors in this case?
- It depends on the organization of the service.health care. Of course, if there are not enough experienced doctors, then the load goes to the inexperienced. All the more, eduction should be done so that everyone shares practical skills, knowledge that they need for good patient care. And it depends on each hospital, city and region. We are all doctors, and you know, when the order comes, there is no "I can not, I can not." You just have to go to the forefront, and there is no doubt about it.
“In Russia, a nurse sometimes does not smile, but I do not smile either”
— Does WHO have recommendations on how routine medical care should be carried out during a pandemic?
— It is very difficult and depends on the capabilitieseach country and health system. First of all, it is necessary to ensure complete infection safety inside hospitals. Today, in several countries around the world, the acceleration of the epidemic occurred precisely because a patient came to the hospital who did not know that he was infected with coronavirus. Both medical staff and patients were injured. This is scary. Because of this, infection control should be the first step.
Of course, no one cancels emergency care.And it should be noted that, for example, the surgery is well equipped with protective equipment and everything necessary. And the provision of planned care should either be postponed or the load on hospitals should be redistributed, if this is permissible. But decisions should be made by the doctors who deal with this, it all depends on potential. Unfortunately, an emergency never leaves a choice. Sometimes it's very hard, and it's not one person's choice. This is a selective strategy, a doctrine that has existed in medicine for more than 200 years. In most cases, it allows the most optimal way to help a person with the disease that he has.
There are enough opportunities in Russia, and Iit seems that soon we will see that the local healthcare system will begin to consider each case separately. But now you need to show a little patience. And for such cases, WHO will provide recommendations, but they will be of a general nature. We cannot connect in specific cases, because we do not know about the situation. It should be decided by those doctors who know all circumstances very well.
- You have been in Moscow for several years. Seeking medical help in private or public centers? How can you evaluate the Russian level of medicine?
- No private medicine. I just went to federal and city institutions. Yes, of course, sometimes the nurse does not smile, but I also do not smile, that's okay. But progress is noticeable. We hope that the image of Russia as a country that cares about the health of not only its population, but the whole world, will continue to advance through WHO.
Of course, there are problems, and there are a lot of them:refusal to vaccinate, distrust of vaccines and the need to be vaccinated. We need to work on this with the population, listen to people, find out why this is not profitable for them.
And then we talk about individualresponsibility, but this is the most important thing - to create conditions under which we can take care of our health, so that we have the following priorities: a healthy choice is an easy choice. And then we can say that healthcare and the population will have good interaction, one on one.
There should be no premature mortality. But there are diseases about which we do not know quite a lot. So far they are only being opened, and patients need to be treated here and now, even if with the help of expensive and highly specialized technologies. Because of this, we need the hospitals that are being built today - safe hospitals with a digitalization system. But if the system is built in such a way that it is almost impossible to make a mistake, as in aviation (airplanes, helicopters), then there will be fewer errors.
“Completely blocking the world is a terrible thing”
- How do tourists follow after returning to Russia?
- This is an unprecedented measure, because inEverything is done at the airports at once: people arriving from abroad undergo inspection, have testing, have self-isolation or isolation for 14 days. As the situation in the world changes, the measures of Rospotrebnadzor intensify. This is done not only at airports, but also at other border crossing points. So we expect that such control will be effective. But now is not the time for tourism, to be honest.
- Is it possible to leave the city during quarantine?
- I don’t know, I need to ask the city authorities. If you can observe the quarantine there, I see no obstacles, but at the same time do not violate the city regime.
- Why not isolate the cities from each other? And do not leave only a freight message?
- You know, completely blocking the world is scarybusiness. And we see now that this has great consequences, which we still cannot calculate. If Russia can abide by the rules of discipline, as well as every person who can return from travel infected, it will be much easier to maintain a normal life and economy.
“What will all this lead to if we survive?”
- We will survive everything! But, sorry, I know one diagnosis that is 100% fatal, and that is life. We will all die. But not now and not from the coronavirus. So, please, do not panic, there are much more serious diseases, but you need to keep this virus within some limits.
- When will the distribution of coronavirus end?
“Nobody knows that.” Unfortunately, I am not Nostradamus. I hope that the sooner we comply with all the rules, the faster the virus will leave the community of people.