Covid in the Russian province: don't cry, don't be afraid, don't ask...

Novye Izvestia chronicles the struggle between patients and doctors in Russian regions, and the help that is still awaited from Moscow.

Lyudmila Butuzova

The total number of people infected with coronavirus infection in the country is approaching 2 million. Covid captured not only million-plus cities. The main blow in Russia is now directed at small and medium-sized settlements, where more than 120 million people live. According to Rosepidnadzor, 60% of cases are in the hinterland, that is, those who obviously have a weaker economy and are much worse with money and medicine. How do they stand this test? There is no general - official - picture of how acute the situation is. But people are not silent.

Chronicles of lawlessness

Residents of Russian regions talk on social networks about the terrible situation with the covid. On the forums, there is a flurry of desperate posts about how people all over the country outside of Moscow have to fight for their lives and powerlessly watch the departure of their relatives who did not receive the medical assistance promised by the authorities.

Sverdlovsk region . “Kovid breaks the system in places that are the weakest”, - says Irina Tatarchuk , a resident of Yekaterinburg, having made sure of how things are in small towns using her family as an example. - You can't get through to the clinics, the ambulance arrives with delays, and this is in a town where there is not even 100 thousand people. Mom has pneumonia, this was shown by fluorography, to which mom reached with her legs, desperate to wait for a doctor. The grandmother has obvious signs of covid - a high fever, a cough that tears the lungs. All adults in the brother's family are ill. So what? Never mind! - “There are no medicines. Look for antibiotics yourself, at least some. " Mom called me in Yekaterinburg. I scoured the city until nine in the evening, left for Ozersk at night, finally finding the necessary antibiotic. Ask me where did I find it? In the pocket of a doctor at a private clinic. They just sympathized with me: I myself am a pediatrician, and it was clear that not today or tomorrow I would fall over. A package of "Azithromycin" was given free of charge, one for all my relatives".

The day before, a team of not particularly narrow specialists came to Ozersk - the townspeople did not get it. Such preventive races happen once a year - and they are akin to a sale of Belarusian knitwear in a local recreation center: there are a lot of people - there is nothing to see.

Perm Territory. For the second month in the Perm Territory, there are daily records in the number of cases. Now there are 200 people, a month ago there were about 100. The increase is 1.3% per day, the total number of confirmed diagnoses in the region is more than 15,500. The official position is that it’s okay, there are enough free beds, diagnostics and treatment are carried out promptly. Residents of the region - tests are not done to everyone, even from risk groups, the results may not come at all, patients wait for an ambulance and an ambulance for days and may not wait. Nurse of the Perm ambulance, Artнщm Boriskin, at the risk of losing his job, sided with the sick. “It is unclear where these hundreds of free beds, which the Ministry of Health is talking about,” he wrote in a local public. - We are now leaving very difficult patients with a saturation of 77% at home. We give the person oxygen to breathe, and that's it. We do not even take them to CT, on the verbal order of the senior doctor, because there are still no places in hospitals - there is nowhere to be hospitalized. "

Tver region. “We need to invite the press and go to the rally. There are no doctors. There are no medications. In the ambulance, paramedics talk through the window. There is no pain reliever. The chief doctor did not get in touch. People with fever sit for hours waiting to see who will receive them. The mess is complete. Only coronavirus is treated. And what should the rest of us do? ”, - Svetlana Yurova from Torzhok shared her impressions.

Irkutsk region. There is a terrible shortage of antiviral drugs and antibiotics in pharmacies. Prescription drugs "Levofloxacin" and "Azithromycin", which are prescribed for covid pneumonia, manage to buy units. There are no injections for blood thinning "Kleksan". “But this is a crime !!! - writes on his page in the FB member of the local ONF Oleg Sobyansky. - After the destruction of local hospitals (optimization, your mother), after the collapse of regional medicine, we are told about the dangers of self-medication. Many of my acquaintances who are sick with covid would like to be treated under the supervision of doctors in hospitals, but now you can't get there! "

Oryol region. In the Kroma hospital, converted to covid patients, five days after the launch, there were no more places. This was reported to "NI" by the paramedic, coordinator of the trade union of independent doctors "Action" Dmitry Seregin. As proof, he cited an extract from the documents about the "impossibility of hospitalization in the Kromska Central Regional Hospital as of 11.11.2020." According to the activist, the region needs the help of the federal center to increase the number of beds, otherwise the situation with the coronavirus will become critical: “If now we do not start asking for help from the center, we will have nowhere to bury the dead, nowhere to treat the sick and nowhere to work for healthy people. 140 places (in the Kromskoy Central Regional Hospital) were filled in less than a week ”. The paramedic also criticized the inaction of the head of the Department of Health of the Oryol Region Ivan Zalogin: “When asked whether the region needs military assistance, for example, for the construction of a“ covid ”hospital, the official called the situation uncritical. This statement was made only because of the fear of getting a hit from Moscow. Because the situation in the Oryol region is worse than in the same Kurgan region, where doctors from the Ministry of Health and the Ministry of Defense were sent".

The prevention and treatment of covid in the Oryol region is "helped" by the daily online lines of the Governor Klychkov and the head of the Department of Health Zalogin. The correspondent of "NI" took part in one of the recreational activities, the report is attached. “What to do, since there is no one to take at the appointments, referrals to the Oryol hospital are not given, what to do: buy coffins?”, A rural resident Yevgenia Malkova asks her superiors. "How were you treated?" - asks the Department of Health. - “This is his own director! They even called friends in Kommunarka to find out what to do! The son-in-law still has a temperature. Where can I get a CT scan at my own expense? His lungs are affected! " - the woman does not appease. “Not every mother-in-law cares about her son-in-law so much,” the official relieved the tension. By the way, there are only three computed tomography scanners in medical institutions of the region, all of them are old, they are on their way. If they are also raped with paid services, the devices will not survive the pandemic.

Saratov region . There are problems with diagnostics here. Two months ago, the Minister of Health of the region, Oleg Kostin, said that nine computed tomographs would be installed in Saratov by November. Since spring, according to the minister, he blushed and felt ashamed at various meetings, because in the field of "there were practically no outpatient CT scanners." But by November, CT machines had not appeared in Saratov polyclinics. They are in warehouses because there is not enough money for installation.

Mow down, the scythe

The most difficult and scary stories on covid forums are about the loss of loved ones.

Tyumen region. Ksenia Payusova told 72.ru how she lost her mother. “On October 16, my mother called me and said that she was very bad. I called an ambulance. She described the symptoms, neatly hinted at the need to get tested for covid: after all, 64 years old, a risk group. I was told that everyone understands, there are many challenges, we need to wait. By evening, my mother felt even worse. I called the ambulance and asked how to speed up the process, offered money, asked if there is a paid brigade in the city? There was only one answer: "Wait, we remember you." I asked if it was possible to immediately go to the institution where covid was treated, to which they answered: “Yes, but this requires a referral from a therapist.” It is logical. We have no right to diagnose ourselves ...

An ambulance never came to Ksenia's mother. The woman was rapidly getting worse, they called a taxi and took her to the Neftyanik polyclinic, where she was not admitted: “There is no evidence, no tests, and in general, maybe you have no covid”. In a mono hospital on Novaya Street, the situation is the same. Doctors suggested that it is possible to break through to hospitalization through the admission department of OKB No. 1. After hospitalization, CT scan was done and immediately sent to intensive care unit under mechanical ventilation. During the night, Xenia's mother died. The state provided a place in the cemetery for free.

Far East: “A colleague's husband died, the ambulance did not go until the last moment. When we arrived, there was already a saturation of 70, and these are irreversible consequences for the body. We drove for a long time, processed it for a long time, and as a result, immediately to the intensive care unit under mechanical ventilation, where the husband of a colleague safely passed away. The man was only 35 years old. Only the most difficult ones are taken away by ambulance, who, alas, cannot be helped, and who else can be helped, are left at home to bend over. But this is if there is no money. For money, and, moreover, rather big, health care still works. Even in our hole there is an experienced doctor who will quickly diagnose, and a place in a decent clinic, and there will be medicines. And what do we have if we have no money? The test for the same covid is done for so long that the patient either has time to die or recover. Medicines must be sought somewhere closer to the capitals. And then you still run. There are no places in hospitals. And if there is, then the chance of getting infected there is very high. Therefore, without money in our country, it's better right away ... Well, you get the idea. "

Volgograd region. “Words cannot convey what is in my heart. A bitter realization of the boundless lies pouring from the TV screen and absolute helplessness in reality, ”writes a resident of the Volgograd region, who buried her mother, who was 60 years old.“ This is how everything was brought to a tragic end: the first 3-4 days it was like a cold: cough and temperature 37-38. Then the temperature rose to 39.5 and shortness of breath appeared. They called an ambulance. They said - be treated at home. For the next two days, the temperature was almost constantly kept at 40. Mom could hardly speak, there was severe shortness of breath. They called an ambulance again and asked for hospitalization. Doctors gave an injection of triplets and ordered to see a local doctor. The next day, they tried to call a doctor for two hours. Hopelessly, the phone was dropped on the second ring. With a temperature of 39 I took my mother to the clinic. There were 5 in line !!!! Hours. The examination revealed a suspicion of pneumonia, but confirmation is needed in order to be sent for hospitalization - the result of fluorography. Fluorography only the next day, the results - another day. Bilateral polysegmental pneumonia. Then - two days of waiting, which hospital would agree to accept... As a result, my mother spent another week in the hospital - first in the corridor, on a bed made up of four chairs, the last days in intensive care, but she was not saved - “too much lung damage. You have no idea how many elderly people die every day. They are taken to hospitals one way, because it's late... ”- the woman laments.

State Duma Deputy Sergei Shargunov added fresh pictures of hell in his column on the pages of the Svobodnaya Pressa newspaper: “In Kemerovo, a disabled person of the first group in a serious condition slept in the corridor, waiting for the help of doctors, and died. The woman died at a doctor's appointment at the regional hospital in the city of Leninsk-Kuznetsky, where she arrived herself, without waiting for an ambulance. She waited for an ambulance for two days to no avail. A pensioner with pneumonia lay for four hours on the floor of the Central Regional Hospital in Sokolsky in the Nizhny Novgorod region, and died. ”On all the facts, Shargunov turned to the prosecutor’s office. Verifications began.

Deep moat, holy cross

That's how. “We held out all spring”, - writes Galina Paramonova from the Chufarovsky district of the Ulyanovsk region to NI. “They said on TV, and we ourselves were sure that villages and villages were better protected from covid than townspeople, and we ourselves were sure of this - until April there was not a single sick person in the village. In general, we have little illnesses, the places are healing. All because of the spring in Grigorovka. Back in the eighteenth century, a cross appeared in this spring. A chapel was erected nearby, where this cross was kept, and people flocked to it to pray for health. Then the cross was sent to Jerusalem, and from there it miraculously returned to the source. We just get better - got sick, drank some water, washed and everything goes away. And then they came to us - summer residents from Chufarov, townspeople from everywhere began to buy abandoned buildings in secluded places. And away we go! One family of newcomers fell ill, the second ... They applied to the spring, but either he had no strength for the covid, or they themselves did not believe. They took them away. The infection spread to the locals. The spring stopped helping us too. We needed pills, but where will you get them? The nearest pharmacy is 15 km away, there is nothing in it at all. The last time I went, there is only naphthyzine for a cold, you don't need to - I took 20 bottles for all. The regional hospital - one name, there are no doctors in it, the ambulance does not travel to our wilderness. That is, there is nothing to treat and there is no one to ask - people are lying in bed, and it is not known whether it is covid or not covid. The worst thing is the lagging behind, the constant lagging behind of aid, control - from the course of the disease".

“Theoretically, covid spreads in the village more slowly than in the city”, - Natalya Samokhvalova, an epidemiologist at the Altai Infectious Disease Center, told Novy Izvestia . - The second wave of the epidemic, when outbreaks of the disease began to be recorded in many villages and transmitted along a chain, refuted the theory. Now we see that it was possible to prevent the disease by blocking the path of its transmission only at the very beginning of the epidemic, when it was brought to Russia by travelers, taken away by summer residents and fans of rural tourism. Now this is more difficult, as each Russian region has its own hotbeds.

A terrifying example from the Altai Republic. Rural residents make up about 70% of the total population. People are busy, they don’t show their noses farther than the courtyard, and guests are infrequent - far, dear. Therefore, until the end of April, they did not even hear about covid here and were not afraid of him. Everything was disrupted when a woman came from another region to visit relatives. Seemingly healthy - the village head personally measured the temperature. A week later, hospitable relatives and neighbors began to get sick. They did not immediately guess to quarantine the village. More than 5,000 cases of COVID-19 have now been recorded in the republic. Over the month from September 18 to October 18, the total number of cases has almost doubled. New cases are recorded there at once in many areas, and the index of the number of infections per 100 thousand population is one of the highest in the country.

The authorities in Buryatia turned out to be more agile and as soon as they dug a triple ditch around the village of Shulut to stop the covid. Shuluta is located on the border of Buryatia and the Irkutsk region, 30 kilometers from Lake Baikal. This ulus is a village with a predominantly indigenous Buryat population. Most of the locals live off agriculture: they raise livestock and sell cow and sheep milk, cottage cheese and meat in neighboring villages and Irkutsk. There is no hospital or first-aid post in the ulus, there is only one store. According to an investigation by Rospotrebnadzor, the cause of the infection of the residents was a "mass religious event." On June 10, about 30 relatives from Shuluta, two neighboring villages and Ulan-Ude held an annual ceremony in one of the courtyards of the village, during which they asked the local spirits of nature for abundant rain, a rich harvest and an increase in livestock. Only the disease began to grow.

- I think that an increase in the number of deaths from COVID-19 in the country should be expected simply due to the steady increase in the number of cases per day, which does not depend on certain recommendations of the Ministry of Health, but on the introduction or non-introduction of effective measures by the authorities to limit the spread of the pandemic, - following the example of the same Buryatia and other regions, where quarantine was declared not out of an addiction to volitional methods, but out of a sober understanding that one cannot rely only on medicine, - Professor Sergey Borisov, vice president of the Federation of Intensive Care Medicine of Russia, shared with Novye Izvestia. - Perhaps it is possible in Russia to interrupt inter-territorial ties for at least 3 weeks? It's not just about the number of hospital beds. A temporary hospital can be deployed in a week, even at the North Pole. But where do you get the medics? Among the bears? We don't even have enough college students to fill all the vacancies.

About the conditions under which doctors in the provinces are fighting covid - in the next article of Novye Izvestia.