Posted 18 мая 2020, 10:49
Published 18 мая 2020, 10:49
Modified 24 декабря 2022, 22:37
Updated 24 декабря 2022, 22:37
The cost of work and the maintenance of hospitals is the secret of the city hall.
These are the Crocus City Hall concert hall, Expocenter on Krasnaya Presnya, exhibition pavilions in Sokolniki park, pavilion No. 75 at the Exhibition of Economic Achievements, Krylatskoye Ice Palace, Patriot Park. Thus, coronavirus patients will receive for aftercare 10,000 beds equipped in haste in unsuitable hangars. The epidemiological effect of the event remains to be assessed. But in the Moscow City Hall, under the pretext of combating a pandemic, it seems that a "two-handed saw festival" has already taken place.
How much will it cost Moscow taxpayers? The Department of Capital Repair of Moscow, under whose leadership temporary hospitals are deployed, does not disclose budgets, preferring to amaze the imagination with the scope of other figures. In the 75th pavilion of VDNH there are 1779 beds, the Ice Palace in Krylatskoye - 1305, the Expocenter on Krasnaya Presnya -3130, the Sokolniki Exhibition and Convention Center - 1230 beds ...
The budget of temporary hospitals is kept secret, partly because the financing of some of them will be assigned to the owners (for example, ATC “Moscow” and the Multimedia Historical Park “Russia - My History” at VDNKh), and they do not want to admit how they got their hands out. But someone like Araz Agalarov, the owner of Crocus Expo in the Moscow Region, considers his participation in a charity event as an honor and willingly shared upcoming expenses with Komsomolskaya Pravda. According to him, a hospital with 1,100 beds will cost him 900 million rubles, the cost of one bed is about 818 thousand. This includes the costs of equipping the entire infrastructure of the hospital and auxiliary facilities (including the catering unit), plus 4400 sets of linen, a double set of mattresses, blankets, pillows, and bathrobes. In the future, the cost of “medicine” to the philanthropist is offset by the budget.
A medical procurement source shared other calculations with NI. Resuscitation bed costs 3-5 million rubles. (and without related equipment, without which it is basically dead). The price of only one ventilator is an average of about 1.5 million rubles. But besides this, an ECG apparatus, defibrillator, monitor, syringe pumps, pulse oximeter, breathing apparatus, etc. are needed. If you have a complete set, the price of a resuscitation bed will be 10-12 million. A simple bed with oxygen supply, a perfuser, a pulse oximeter, bedding and clothing for the patient costs about 100-300 thousand rubles. But for state-owned hospitals, the price usually rises by 30–40%, the source says, so it’s more profitable to order “bare” non-resuscitation beds, and nobody cares how the doctor runs with one ventilator for 100 patients. According to him, 90% of beds in temporary hospitals will be equipped to a minimum, and paid to the maximum. It is not possible to confirm or refute the source’s words - the public procurement website does not contain any information about the costs of hospitals. Apparently, the idea was in a hurry to implement, until the pandemic ended.
The facilities selected for conversion to temporary hospitals are very similar in many respects: large space, convenient location and the ability to not spend a lot of time dismantling internal structures. It was easy to solve the issue of temporary re-profiling, said Petr Biryukov, Deputy Mayor of Moscow on Housing and Public Utilities and Beautification. “All the premises, except for the Moscow shopping center, are city property, here the mayor of the capital, Sergei Sobyanin, made a decision, and they freed the area during the day,” he explained. They didn’t specify how ATC “Moscow” was persuaded, but as early as May 10, when they asked the “NI” whether the coronavirus hospital began to operate on their territory, the management gritted their teeth saying that they had no data on the construction of the hospital and they were not conducting any construction work. Peter Biryukov argued the opposite. He knows better. The sites for prefabricated infectious hospitals are prepared within two to three days - “they will be made of panels, quite comfortable, with ventilation. There is electricity, water, heat, all the possibilities to create a normal medical institution,” - we quote Peter Pavlovich, delighted with the role of the main When there is no need, they can be dismantled, used for other purposes: to have hostels or sports complexes in them for practicing various sports - Mr. Biryukov switches to his favorite skate without losing sight of new epidemiological tasks. To ensure the operation of temporary hospitals, he said, a serious increase in energy capacity, as well as additional disinfection and wastewater treatment systems will be required, while all 10 thousand beds will be equipped with the necessary medical gas supply systems, including oxygen devices. They are planned to be installed and connected as soon as possible, for which about 30 gas generating units will be installed and 200 cubic meters of gas will be supplied.
Each hospital has a sanitary checkpoint, designed to wash people with the simultaneous disinfection of their clothes, linen and shoes. For example, in Krylatskoye it will be equipped with 760 lockers. The reception department of this facility will consist of 6 examination boxes, a treatment room, and a zone for doctors to work. They will also build here 12 street modular primary care centers, a separate discharge area for patients with showers and an internship for 20 doctors.
In the Expocenter on Krasnaya Presnya, the scope of work is larger, which is explained by the area of the re-profiled space. Under the temporary hospital will give 19 rooms in 6 pavilions. One of them will be adapted to accommodate social protection and psychological assistance services. Another will turn into a completely clean area for personnel to work with the sanitary inspection device. There will be installed 800 lockers, 48 bathrooms with washbasins and 73 showers with hermetic door blocks and partitions. The territory of the complex allows you to equip 14 reception departments with 33 viewing boxes and 8 treatment rooms. There will be five areas for discharge of patients, an internship for 210 doctors, a laboratory, 38 posts of nurses. Three points will be created for cleaning and disinfection of ambulances.
There will be two reception departments at VDNKh, they include 12 examination boxes, four treatment rooms and three areas of doctors' work, each of which up to six specialists can work at a time. The sanitary inspection room will be supplemented by 1,189 lockers and 53 showers. Two more rooms are intended for compressor and vacuum stations. Two patient discharge zones are provided; they will be equipped with showers and toilets. For doctors, they will make two internships for 20 doctors, as well as 50 nursing posts. There will also be points for cleaning and disinfection of ambulances.
The complex in Sokolniki will receive two sanitary checkpoints with showers and changing rooms for staff. There will also be built three reception departments with 10 observation boxes and three registries, as well as a separate recreation area for doctors, an area of 1000 square meters. In addition, three laboratories and 38 nursing posts are being equipped. An ambulance cleaning and disinfection center will also appear here.
- The most interesting thing in the huts is the layout of the chambers. In each area fenced off for patients, there will be four wards, for a total of 30-40 beds, ”said Milton Erickson, an expert at the Institute (Moscow) Mikhail Roshchin. - Maybe the Overhaul Department knows something that clinicians don’t know, but to “heal” coronavirus patients in a field situation with one toilet per floor is like scooping water. There will be knee-deep infections ... The most basic question for such temporary hospitals is where will they get the doctors in normal numbers? In ordinary hospitals, staff are worth its weight in gold .. I won’t be surprised if the city hall announces an appeal among the Housing and other offices reporting to it. Personally, I do not wish the enemy to be in such a "medical" center.
AK, an anesthetist who had already been recruited to the Expocenter, on condition of anonymity told NI why he refused:. “In my understanding, such a hospital is an overexposure point, not a full-fledged hospital. You cannot organize resuscitation there, because there is no laboratory, no CT scan, no MRI, no operating rooms. Plus - the problem of a lack of equipment and protective equipment for physicians and patients. They told me: everything will be - the money is already charged. But I believe with my own eyes my experience more than the promises of another company. ”
By the way, a shortage of equipment and protective equipment is inevitable for all hospitals, no matter how much the mayor’s office assures otherwise. The head of the Ministry of Industry and Trade of the Russian Federation Denis Manturov estimated the need for protective suits at 800 thousand units per day, and in April they were produced 500 thousand, May came with the same deficit of 300 thousand pieces. With the addition of “hospitals,” the shortage of personal protective equipment will double. However, for the production of even 500 thousand suits, it is necessary to use about 45 thousand seamstresses daily, and this is about 3 thousand sewing factories. “There are no such number of sewing factories in Russia,” says Vladimir Kotov, president of the Association of PPE. - We faced the production problem already in masks and left it not in the best way - the population sewed them for ourselves from improvised materials, but for the doctors this homemade was unacceptable. Almost two months passed before the Minister allowed the import of masks. The situation with costumes in Moscow City Health is not commented on, as well as the problem with ventilation devices. It seems that the main thing these days is the delivery of mattresses and sheets. ”
Vague doubts torment: why is there such a fuss in Moscow with additional hospitals if, according to the official version, the epidemic is on the decline, and the headquarters for the fight against coronavirus has been reporting for the third day in a row about reducing the number of cases in Russia? What went wrong in the capital if, after the most severe mask-and-glove measures and voluntary self-isolation of citizens, it needed 10,000 new beds, on which at least half a million people could be put on a conveyor in the next month, and half-Moscow before the fall? In the end, why are unsuitable rooms hastily converted to hospitals if Moscow is full of empty hospitals, even now ready to receive coronavirus patients?
“The opposition has been asking the mayor this question from the very beginning of the epidemic,” says Nikolai Zubrilin, head of the Communist Party faction in the Moscow City Duma. - The fact that the recently renovated, fully equipped hospitals stood closed at the peak of the disease and are not open until now, and the executive branch began to build recreation huts for the future, does not lend itself to any logic. Sergei Sobyanin explained to the Russia 24 channel that they do this in all countries. I would look in which country the mayor sat in his chair, if I closed people access to normal medical care.
By early May, Moscow had 30,000 infectious beds. This is 2.5 times less than required for the treatment of 77 515 people with a diagnosed diagnosis. Re-equipment for hospitals of unsuitable premises would look logical if there were not many empty hospitals in the capital, including recently renovated ones. According to the estimates of the Alliance of Doctors trade union, if you open them, you can place at least 4100 beds. This was repeatedly demanded by the medical workers' unions, both municipal and city deputies, literally throwing pictures and lists of hospitals in the health department that can be used as hospitals for patients with coronavirus. That's just offhand: maternity hospital No. 10 (150 beds), No. 14 (169 beds), No. 18 (215 beds), No. 32 (120 beds), MBUZ Gynecological Hospital No. 1 (110 beds), MBUZ Gynecological Hospital No. 5 ”(210 beds), Gynecological Hospital No. 11 (250 beds), Infectious Clinical Hospital No. 3 (570 beds), City Hospital No. 40 (Rostokino, 785 beds), City Hospital No. 54 (Preobrazhensky District, 520 hospital beds), City Hospital No. 56 (440 beds), City Clinical Hospital No. 59 (560 beds).
According to the municipal deputy Zyuzino Konstantin Jankauskas, the 10th and 14th maternity hospitals were repaired and closed at the end of last year, both buildings are empty. In the 10th maternity hospital, it seems, a cancer center is planned - as in any case it follows from the information board on the facade, but not the fact that it will generally be preserved as a medical facility. In place of the 54th City Clinical Hospital, for example, Moscow State Law University named after O. E. Kutafina, and the All-Russian State University of Justice moved into the maternity hospital No. 2.
The fate of the 14th hospital is unknown. So far, as the head of the Tagansky municipal district, Ilya Sviridov, says, he is keeping his plans under lock and key and secret. Maternity hospital No. 32 was closed only in January this year, but it is also not being given to coronavirus patients. Presnya municipal deputy Anatoly Yushin wrote an appeal to the Moscow City Health Department demanding that he be opened, to which he was told that there would be a rehabilitation center at the Botkin Hospital. Gynecological Hospital No. 11 was closed in December 2019. Now the building is empty, it is in good condition, there are high ceilings, there are chambers equipped with a shower and toilet, former employees consider the building ideally suited for infectious patients, but ... we’ll rather see a commercial center there than a covert hospital. After all, the city hall on the site of the Infectious Clinical Hospital No. 3 on 1st Kuryanovskaya St., ow. 34, closed in 2015, open the Mosmedpark warehouse complex. Hospital No. 54 has been repaired and it is unclear why it was given to the Law Academy, but it is empty. Moscow City Duma deputy Mikhail Timonov proposed using it under a temporary hospital. City Hall did not consider it necessary even to answer.
“Closed hospitals, even dilapidated ones, are more suitable for a hospital for coronavirus patients than VDNH, Krylatskoye, Avtotsentr Moskva, etc., because there are isolated rooms, separate bathrooms, and engineering networks are designed for high loads,” the leader of the independent said Union of Doctors Anastasia Vasilieva. - It would be reasonable to restart empty hospitals. You understand: it’s just scary for people who have to be treated in the trading floor.
This may not be the worst option. In one African Lanceupia, coronavirus stacks are stacked on the street and not even given a sheet. But there, they say, budgets are very tiny - there’s still enough to put in one’s pocket, no longer for sick people. In Moscow, all the same, it’s not so ... If we are fighting the virus, then not sparing the budget, if they begin to treat it, then they will completely lose their pulse and wherever they catch it, at least on skates in the Ice Palace, at least at a concert in Crocus -City. A mattress and a sheet - as preventive measures - at the expense of the establishment. Well, you remember: in Africa this is not...