Died of ...the disease: why no one knows the true coronavirus death rate

Victoria Pavlova

Doctors, of course, earned this money in full with their work. But, as Novye Izvestia found out in the first part of the material on medicine of the covid period, the mere injection of hundreds of billions of rubles into the health care system did not prevent excess mortality from reaching the mark of 1 million people. As a result, Russia became one of the countries with the highest mortality rate with moderate morbidity dynamics. It's time to figure out why money doesn't help doctors, and what has gone wrong in the healthcare system once again.

The editorial office of "NI" received an appeal from Sergey Mamonov, who was personally confronted with how people are now being treated in our country. We publish it in full.

- 10/13/2021 called an ambulance for my mother. Symptoms: fever, shortness of breath, weakness, joint aches, cough. The ambulance arrived very quickly. Examined. They diagnosed ARVI and transferred the asset to the clinic. According to the Order of the DZM dated 01.10.2021 No. 953, when detecting ARVI for risk groups, as well as living together, it was required to do PCR tests as soon as possible. Until now, this has not been done. Then I called the ambulance several times. Each time the asset was transferred to the clinic. As a result, on November 8, 2021, the mother was hospitalized at the City Clinical Hospital on 29.11. The test rates are high, which indicates that the disease was transferred in the period from 3 to 8 weeks. Since no one treated the corona and did not even identify it, she was hospitalized with completely other diseases, in particular - a complete blockade of both branches of the left bundle branch, pneumonia, bilateral hydrothorax. On 11/30/2021, my mother died - my heart could not cope with the hemodialysis procedure. Formally, the cause of death was 2 tbsp hypertension. 3 tbsp. very high risk of cardiovascular complications (CVC). She went to hemodialysis due to growing acute renal failure (ARF). In fact, a blow to the heart, hydrothorax, bilateral pneumonia, and acute renal failure are nothing more than the consequences of the postponed coronavirus.

Crooked mirror of diagnoses

There are no complaints about the lack of expensive equipment, the ambulance arrived on time without delay, and a place was found in the hospital. But the man died anyway. In general, a typical case: a misdiagnosed, missed the moment of treatment for the coronavirus, which caused complications. And the billions allocated to health care have not helped. The patient was treated for anything but covid. So the independent demographer Alexey Raksha argues that the published structure of excess mortality, in which coronavirus accounts for 63% of added deaths, is far from reality.

- In the structure of excess mortality, no less than 90% of people who died after being infected with covid and would not have died if they had not become infected. These are precisely Kovidniki, that is, the lion's share, the predominant share, or in general they are all such people. If we take the case when a person, for example, died of a heart attack, but had a positive test for covid and was recorded as dead from covid, then for 1 such case there are hundreds of those who contracted covid, went to the hospital and died, and they put him on heart attack and did not write him covid. Believe me, the ratio of the first and second categories is one to one hundred.

In Russia, the system of accounting for causes of death is very lame - adds Sergey Shishkin, Director of the Center for Health Policy at the Higher School of Economics (HSE):

- As for mortality from covid and other diseases - we have such a leapfrog with fixing the causes of death! By the way, not only here, but also abroad in many countries. A person died from covid, this is recorded, then it is recorded that the person died of cardiovascular disease, but he was infected with covid, and in some countries this is recorded, in others it is not, at first this was not recorded as a cause of death from covid , then they began to fix it as related to covid, because covid provoked it - a heart attack or stroke, and here during these two years there is no consistency and clarity, and the data on the number of infected, the number of deaths from covid do not inspire any confidence.

As "NI" found out in a previous publication, officials associate all problems with a reduction in routine medical care - a result of the inevitable re-profiling of hospitals into covid hospitals and the necessary increase in safety measures for patients without coronavirus. But Alexey Raksha does not consider this a reason for attributing all the problems of domestic medicine to covid realities:

- What is the impact of the reduction in planned medical care on mortality? Insignificant. It practically did not work. Because this contraction did not last long, it was not constant - this contraction goes on for a certain period, when there is a large wave of covid, it then recovers when this wave subsides. It is a very flexible system.

The President of the "League of Patients" Alexander Saversky explains that there are big problems with understanding what a person is sick with, with the diagnosis:

- There is a statement by Protsenko that 70% of him in Kommunarka died from nosocomial infections. What is really happening: they (doctors), in fear of a cytokine storm, erase the immune system of patients with immunosuppressants, suppress the immune system, bring them to the hospital, and that's it. Therefore, in terms of mortality from covid, the real proportion is generally unclear .

The doctor himself in an ordinary hospital, perhaps, understands the true cause of a person's death. But it is not he who makes global decisions about which methods of treatment to apply, on a national scale. Officials in the Ministry of Health see a distorted picture and may give incorrect recommendations for treating people. And this process of distorting reality did not begin last year. Alexey Raksha explains that the system for recording the causes of death began to malfunction after the May decrees were issued:

- After the May decrees, it broke down very badly, special goals were put in them, to what indicators it was necessary to reduce the mortality rate, and all this turned out to be just a corruption of statistics. They began to adjust the data to the indicators of the causes of death. This was long before the covid began. Therefore, unfortunately, in most regions of Russia this system is inadequate and does not allow understanding the real dynamics and trends.

Equation with medicines: solid unknowns

The lack of understanding of the real situation even extends to the procurement of medicines. Alexander Saversky notes that in Russia and in this direction there is simply no necessary statistics:

- Two years ago, at a group in the State Duma on drug supply (this happened in my presence), the then head of the Ministry of Health department for drug supply Maksimkina said, answering the question, whether the situation with drug supply was worse than last year: but we do not know, because that we do not have statistic forms for reporting the subjects of the Russian Federation on the state of drug supply. That is, we do not know anything about what is happening in the subjects. The Ministry of Health stands at the crossroads, like a gendarme with a baton, and thinks that it regulates traffic, but no one comes to this crossroads, maybe, thank God. That is, today we do not know the needs of the population, not only in medical care, but also in medicines.

The pandemic came to Russia in full force in March 2020, and a lockdown was announced in April. But throughout 2020, the structure of purchased drugs, according to the head of the DSM Group marketing agency, engaged in pharmaceutical market research, Sergey Shulyak , has not changed:

- If we take 2020, then the increase in the procurement of medicines fell on precisely those programs that were originally planned - this is oncology, these are cardiovascular diseases and other programs that were prescribed back in 2019, therefore, in government procurement, as part of the provision of hospitals, covid did not affect very strongly, that is, it practically did not affect the procurement structure. If we take those drugs that were used for covid, then they did not play a significant role in the circulation of hospitals. This is not to say that there was any lack in terms of financial support for non-covid health programs.

At the same time, the Deputy Mayor of Moscow for Social Development Anastasia Rakova says that there are still no uniform standards for data exchange between various medical institutions.

Confused yourself - confused people

Over the past two years, Russians have received a colossal amount of information, often ambiguous. The federal authorities speak and make some decisions, the regional authorities others. Either they stop routine care altogether, they simply require PCR tests from patients, or they restore it in full. People simply do not understand what is happening now. In the modern world of information, every word is worth its weight in gold, but civil servants and officials sometimes treat them too irresponsibly. At the same time, a whole section of the report of the Ministry of Health on work in 2020 is devoted to communications with the population. But such campaigns are carried out only on the key topics of the national projects "Health" and "Demography": oncological diseases, healthy lifestyle, HIV prevention. From September to October 2020, when no one doubted the danger of coronavirus, the Ministry of Health launched a special project in the media aimed at popularizing the early diagnosis of cancer. Not a word was said about covid in the report! The Ministry of Health, in conditions when every minute counts, conducts only those campaigns that were laid down in the national projects of 2018. Such sluggishness gives an unpleasant effect - people lose confidence in state medicine. And few can afford private clinics. As a result, according to Alexander Saversky, people themselves refuse to seek help:

- If you look at the official data of Rosstat, 34% of the population from among those who consider themselves chronically ill do not seek medical help, because either it is not available, or it is paid (that is, it is also unavailable), or do not trust doctors.

Here is what a neurosurgeon, candidate of medical sciences Alexei Kashcheyev says:

- It seems to me that there was a moment when it was said too categorically that non-vaccinated patients would not be accepted for treatment. So much so that some people actually stopped trying to get routine care, believing that they would be denied treatment. And in the end, the idea was not really conveyed to people that, in fact, if a person is not vaccinated, then he simply takes PCR and an antibody test upon admission. Then he enters a conditional observation - an isolated ward. And then, if the test is negative, it goes to the general ward, if it is positive, then depending on the condition: we either transfer it to a specialized covid clinic, or we send it home. The challenge is to minimize risks to staff and patients.

It turns out that the unskillful handling of information by civil servants led to the rapid increase in mortality. The data is distorted sometimes due to the desire to achieve the tasks set by the president in the simplest way, and sometimes due to incomplete statistics. In such conditions, it is possible to allocate as much money as you like to co-payments for doctors, to support the regions, but on the basis of mortality rates, the generosity of the government will not change without understanding what people get sick from, what they die from, and how they are being treated. The exhausted population will finally become disillusioned with doctors and will stop turning to them en masse, switching to self-diagnosis and self-medication according to the behests of the main “medical communicator of All Russia” Elena Malysheva. And migrant workers will give birth to new citizens in exchange for the dead.