Nowhere to lie down – Newspaper Kommersant No. 152 (7353) of 08/22/2022

In Russia, against the backdrop of an explosive increase in the incidence of coronavirus, the number of patients in need of inpatient treatment is also increasing: on Friday, the operational headquarters reported 3.3 thousand hospitalizations. At the same time, in early July, the Ministry of Health of the Russian Federation recommended abandoning specialized departments and treating patients with COVID-19 in non-infectious medical facilities – and today the regions are forced to deploy additional covid beds again. However, the scale of the problem is still incomparable with the previous peaks. So, in Buryatia, there are 265 such beds, while in the third wave their number reached 3.6 thousand. Experts interviewed by Kommersant believe that there are few medical indications for hospitalization with COVID-19, but the workload of hospitals may increase from – for the so-called social indications, for example, the anxiety of patients.

On August 21, the federal operational headquarters for combating COVID-19 reported more than 39.6 thousand new infections per day. This is the highest since March 2022. At the same time, the number of hospitalizations is still half as much as in the spring. So, at the end of the working week, 3.3 thousand Russians with coronavirus were hospitalized. For comparison: on March 15, when 36 thousand cases were detected in the country, 7.2 thousand people were hospitalized. At the same time, the number of COVID-19 cases requiring hospital treatment is increasing daily.

Back in early July, the topic of specialized covid beds seemed closed. The Ministry of Health issued an order in which it recommended that the regional authorities restore the provision of planned medical care in full, including resuming the main activities of hospitals previously converted into covid hospitals. To do this, it was necessary to transfer patients with coronavirus to ordinary infectious diseases hospitals by July 10 and provide further assistance in non-infectious medical institutions (subject to sanitary and epidemiological measures). However, the sixth wave of morbidity is forcing the regions to start allocating special hospital beds again.

In Udmurtia, according to the local Ministry of Health, from July 15 to August 17, the “covid” fund increased from 41 beds to 119. Of these, about 20% are now free. “If necessary,” medical organizations of the republic are ready to deploy more than 3.5 thousand beds within 48 hours, the department assured. According to the Ministry of Health of Tatarstan, 611 beds for those infected with coronavirus have been deployed in the republic, of which 7% are free. Back in late July, it was reported that 460 beds were used for patients with COVID-19.

In Vladivostok, 516 beds have been allocated for these purposes in 17 medical institutions. Moreover, all these are infectious diseases departments of central and district hospitals. Less than 11% of seats remain free.

In the Leningrad region, due to a twofold increase in hospitalizations, the number of beds was increased on August 8 from 90 to 150, and on August 9 – to 170 more. 27% of them are not occupied. The situation is similar in St. Petersburg: on July 15, there were 1109 “covid” places in the city, a month later their number increased to 2712, more than 25% of the beds are free.

In the Saratov region, 100 beds have been allocated for the treatment of patients with coronavirus. However, the number of inpatients in the region, on the contrary, decreased from 125 to 80 people compared to mid-July. But the number of outpatients is growing: 545 on July 18, 594 on August 1, 1681 on August 18.

In Buryatia, where the authorities were among the first to return the mandatory wearing of masks in public places, by mid-August, 265 beds were repurposed for the treatment of coronavirus infection. This is 3.3 times more than at the beginning of the month. The occupancy of the bed fund is 84.6%. However, in comparison with past outbreaks, the situation does not seem so serious: during the second wave, 2938 beds were deployed to the maximum, and in the third – 3613 beds.

About 900 beds have been deployed in the Irkutsk Region, while at the peak of the pandemic there were about 6,000 beds. The region now has only one mono-hospital focused on coronavirus patients.

The Ministry of Health of the Krasnodar Territory reported that there were five infectious diseases hospitals with 620 beds in the region (at the height of the pandemic, there were 28 hospitals with 7.7 thousand beds). At the same time, the number of beds more than doubled in a month: from 175 to 445 beds.

And in the Perm Territory, there are currently no beds specifically designed for the treatment of patients with COVID-19. The regional Ministry of Health explained that, as recommended by the Ministry of Health of the Russian Federation, all places previously converted for these purposes are now used to provide planned medical care. Since July 25, patients with coronavirus in the region have been treated in the departments of infectious disease. It is clarified that they lie in separate wards and do not intersect with other patients of the infectious diseases department.

Maxim Novikov, head of the Center for the Treatment of Patients with COVID-19 at Medicina JSC (Academician Roitberg Clinic), a member of the European Respiratory Society and the Russian Respiratory Society, claims that now there are few purely medical indications for hospitalization of a patient. He recalls that the current circulating strain (it’s a subline of “omicron”) is not as aggressive, so the vast majority of patients can be treated on an outpatient basis. Moreover, he argues, modern methods allow to make hospitalization brief. Thus, the introduction of synthetic antibodies to a person with a potentially severe course at the onset of the disease can take two hours. Round-the-clock supervision of specialists, according to Mr. Novikov, is really necessary only for patients with low oxygen levels in the blood. “However, among our population and even among some doctors, there is a strong belief that the patient should be hospitalized, I would even say “hospitalized,” says Maxim Novikov. “Because of this pressure from anxious patients and some doctors, the number of hospitalized without medical, but, let’s say, for social reasons.

The scientific director of the network of clinics for immunorehabilitation and preventive medicine Grand Clinic Olga Shuppo believes that no one can give a reliable forecast for the number of diseases, and hence hospitalizations in the new wave: the virus mutates, new strains appear: “Most likely, in the fall we will see general statistics viral diseases with an admixture of coronavirus infection. She notes that the situation with the treatment of COVID-19 is generally under control, and the method is not much different from the treatment of any other viral infection. But to prevent complications after suffering a coronavirus is a “primary task of public health.” “The rehabilitation system is not built. Coronavirus actively replicates in the body for up to five to seven days, like any other virus. Further, each patient should be monitored for complications after the underlying disease. Most often, this is paralyzing fatigue, heart complications, the risk of heart attack and stroke and various thrombosis, as well as the risk of the onset of autoimmune diseases,” concluded Olga Shuppo.

Natalia Kostarnova; regional corset “Kommersant”