COVID-19 crisis – Heroes wear white. Part 1

In the fall, an increase in the detected cases of coronavirus infection per day began again in Russia. According to the latest data, the total number of cases in the country has exceeded 2 million people. Now I would not want to discuss why thinking people many times became convinced that the statistics of mortality and morbidity in Russia is not true. Let’s discuss how ordinary people, not their state, are struggling with the problem.
Here I will give a few stories from different healthcare professionals who talk about what is really happening now. They were interviewed by the Russian opposition media “Meduza”. I decided to try to translate their stories, because I think that those people are heroes.

Medical names have been changed for security reasons.
resuscitator, Kotlas, Arkhangelsk region
“I have been working in intensive care since November. Came from Arkhangelsk, I was invited [to work in the hospital]. If there are still a lot of serious patients – and now the intensive care unit is completely clogged – then I will stay here further. There is a shortage of personnel in Kotlas, but the covid intensive care unit was completed – three doctors arrived from other cities.
There are a lot of patients. Several shifts ago, there were 500 of them throughout the hospital, today it is 430. It seems that it has become smaller, but every day 40 people are admitted, and sometimes more.
The situation is stalemate, very difficult. Spring and summer patients responded better to therapy. Pneumonia was better treated, less complicated. Now patients mostly come by ambulance, many come after outpatient treatment. People get fever, respiratory distress. They are placed in the infectious diseases ward, and if their condition becomes heavier, then in intensive care.
There are not enough beds [in the hospital] – patients lie in the corridor, in the halls. There are only 16 beds in the intensive care unit, and sometimes you think: who should be transferred to the usual infectious diseases department in order to put an even heavier patient in his place?
It seems the chief physician has made a kind of emergency in the hospital. For example, routine surgical care is not provided – only emergency. Almost all anesthesiologists are thrown into a covid intensive care unit. All forces are thrown here [to fight the covid].
Doctors also get sick, but the symptoms are blurred, and not everyone understands that they are sick. While they donate a smear or blood, time passes. While there is no exact answer, they go to work – and sit on sick leave only when the results come. Someone is ill at home, and someone remains at work already in the role of a patient.
In intensive care, we lead the most severe patients – those who cannot breathe on their own. We put them on a ventilator, adjust the treatment, control a number of indicators, prescribe tests, control therapy and go to the infectious diseases department for consultations. Any worsening patient in the infectious diseases ward is a challenge for the resuscitator. We reanimate patients from there, we do our best. But every shift we write posthumous epicrisis: many die.
Usually, either people over 60 years old or large, obese people who weigh under 120-160 kilograms get into intensive care. It’s hard for such people to breathe in ordinary life, and the coronavirus finishes them off. But today a young patient was admitted – 44 years old. She lay down for an hour with circulatory arrest, we reanimated her, but after 30 minutes our actions did not lead to anything, and we, unfortunately, could only state death.”

ambulance paramedic, Moscow
“Previously, ambulances had specialized infectious disease teams that dealt only with COVID-19, and there were teams for other tasks. Now there is no such division – everyone is busy.
The journey takes a long time. I work in the south [of Moscow], and they can refer a patient to the opposite side of the city. Then you stand in a long line [of ambulance cars in front of the hospital] to see a patient, hand him over and disinfect the car. At the same time, other challenges don’t go anywhere. Because of this workload, it has increased, and our team has breaks only twice for 20 minutes to eat, and that’s all [per day].
Since summer, the number of trips for coronavirus infection has increased by about 40%. It happens that the therapist came to the patient a few hours before us and identified him for CT scan. Then we arrive, but he became so bad after two hours waiting, that we urgently take him to the hospital.
In my practice, there were no problems to send [to the hospital]. There are places in Moscow, albeit at the other end of the city. But colleagues from the region have to transport patients from one city to another. There were cases when they brought a patient to the hospital and closed the doors in front of them with the words “Guys, there are no places here.”
[Now] everyone is sick. Among the patients, there is even a baby with a coronavirus – he and his mother became infected in the hospital. Many old people are surprised when they become infected – after all, they don’t go anywhere. But they are infected by relatives who come to them. At the end of the summer, there were many patients among the patients who came from Turkey and became infected there.
I have to advise friends from the regions – many, unfortunately, are sick with coronavirus. I tell them what to do: [in their cities] they cannot get medical help, doctors do not come to them, they do not have antibiotics in pharmacies. This is all true. Recently I gave my friend an antibiotic that costs a penny. I didn’t think that it might be in need. This is a disaster, and this is all [happening] in the regions. In Moscow, in this regard, everything is organized, although I cannot judge the quality of treatment and I don’t know how many people I took [to hospitals] came out alive. “
doctor in the infectious diseases team, Moscow
“At the end of September there was a meat grinder – it was necessary to visit 30 people. For ordinary people, this is a normal amount, but here not, because on average you spend 30 minutes with one patient. The first week and a half I returned home at half past one in the night. After you have bypassed everyone, you need to return to headquarters and fill in all the information.”

To be continued…

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