Denis Protsenko held a live broadcast on KP.RU accounts on social networks and answered the main questions about a new strain of coronavirus that infects more than 140,000 people a day.
– How has the number of hospitalizations and the condition of patients changed?
– Hospitalization rates in Kommunarka have grown in the last two weeks. On average, we see about 175 patients per day. But if we take big data, then with Omicron , 6.8 – 7% of the total number of patients get to the hospital. For comparison, “Delta” sent to the hospital one in five.
– Is it true that mostly young people are hospitalized?
– The proportion of patients older than 65 is still high. It should be clarified here that the City Clinical Hospital No. 40 in Kommunarka, just like Sklif and the City Clinical Hospital No. 15 named after Filatov, are covid hospitals that provide assistance in many areas. And if a patient with a mild course of covid has appendicitis, a heart attack, a stroke, they also come to us. And due to the severity of the underlying, non-covid disease, they may end up in the intensive care unit. In addition, in elderly patients with chronic diseases, prolonged fever can lead to worsening of the condition – and this can also lead to hospitalization.
– Does Omicron have symptoms that are different from those of previous strains?
– According to Rospotrebnadzor, in fact, the incubation period has been reduced by half – up to 7 days. In general, the symptoms of the “Omicron” strain are in many ways similar to the classic symptoms of acute respiratory viral infections: fever, runny nose, weakness. Loss of smell and taste is much less common than before. Severe forms of respiratory failure, too, fortunately, have decreased.
– The Omicron strain is more contagious than its predecessors. And during what period does the sick person pose the greatest danger to others?
– The entire incubation period . The infection has already occurred, but the person does not yet feel sick, continues to actively communicate – and isolate the virus. That is why proper mask wearing remains probably the most effective way to protect yourself and those around you.
Is this the correct mode?
– When the mask covers both the mouth and the nose, like you and I have right now. Even if you sneeze right now, masks and social distancing will minimize all the risks for me and everyone in this room. Let me remind you that a medical mask should be changed every three hours, and a respirator with a higher level of protection – every six.
– Is it true that children are now hospitalized significantly more often than in previous waves?
– But it really is. And this is probably the most striking – and unpleasant – distinctive feature of the Omicron.
– How do you know which strain you are infected with? Are there any tests for Omicron in pharmacies?
– Such tests exist, but only in hospitals. Because the strain is determined on special highly sensitive equipment. Test strips sold in a pharmacy can only determine the presence of a virus or antibodies to it. On the other hand, monitoring shows that, in studies to determine the strain, it is Omicron that is detected in 85% of cases. Therefore, if covid is confirmed, it is most likely this new strain.
– So, the person did the test and realized that he had contracted the coronavirus. His actions?
– If social and living conditions allow, he must isolate himself in a separate room, wear a mask, use separate dishes, regularly ventilate the room and observe the drinking regimen. This is very important because we lose more fluid in conditions of elevated temperature, and it must be replenished. Compliance with the drinking regimen will prevent a number of unpleasant consequences that dehydration can lead to. In most cases, Omicron proceeds transiently, the temperature persists on average for a day and a half. If it lasts more than three days, this is an occasion to consult a doctor. If fever is accompanied by difficulty breathing, call an ambulance. Mild cases, in my opinion, do not require medical intervention. Moscow has done a lot for the convenience of residents: you can now open and close the electronic sick leave remotely. The digital solutions adopted in Moscow healthcare, I believe, can be an example for other regions.
– How are severe cases of Omicron being treated now? Have approaches changed?
– The basic protocol has not changed. We still have the ability to block the hyper-inflammation caused by the virus with special drugs. In case of respiratory insufficiency, we provide the same complex of respiratory support – from putting the patient into the “prone” position to non-invasive mechanical ventilation. A slight extension of the protocol was due to the introduction of new drugs – virus-neutralizing antibodies. They have proven to be effective. In a number of Moscow city hospitals, including ours, so-called day hospitals have been opened, where we administer this medicine to patients, and after two hours we send them home in an isolated transport.
Who is this treatment for?
– Patients at risk. Age over 65, morbid obesity, diabetes mellitus, heart failure.
– How do they get into day hospitals?
– Moscow has a database of patients with a positive test for coronavirus. If any of them have risk factors (these data are also in the databases), doctors can refer the patient for treatment to a day hospital. In our hospital, 60 people are currently receiving such treatment.
– What about antibiotics? Are they assigned to Omicron?
– Antibiotics do not affect the virus, so no one treats a viral infection with them. Moreover, the use of these drugs not according to indications is fraught with the development of serious complications. Antibiotics – a categorical “no”. The only indication for them is a confirmed bacterial infection.
– Are there any medicines today that can be taken at the very beginning of the disease, in order to be proven to alleviate its further course?
– Infected, drank – and forgot about the disease?
– Something like that…
– It’s called the magic pill. No, this has not yet been invented (smiles, but it is not visible under the mask – author).
– And how do doctors protect themselves from infection?
– All the same personal protective equipment, social distance and hand washing. Doctors are no different from ordinary people. Another thing is that, working in the “red” zone, you understand how important it is to follow these simple rules. And so nothing supernatural.
– The Internet has again begun to write about the supernatural effectiveness of an alcohol-soaked wipe as a means of post-exposure prophylaxis.
– We then laughed at it – let’s laugh again. There is no evidence of the effectiveness of this, so to speak, method, and there was not. I believe that “vapours” are praised by those who actively use this “remedy” in liquid form.
– In 2021, the United Russia party adopted a people’s program, with which it subsequently went to the polls. The program provides, in particular, an increase in the funding of FAPs, additional incentives for doctors working in the countryside. How does the party plan to carry out this order?
– Indeed, the most important section of the program is the improvement of primary health care. The executive branch has been implementing these programs for more than a year. These are the well-known projects “Rural Doctor” and “Rural Paramedic”. If we talk about the role of the party, then it is rather to control how these programs are implemented. Personally, I think that it is not enough to attract specialists to the primary link in the countryside. You need to keep them there. And this requires not only financial stimulation, but also powerful social tools. For example, assistance in purchasing housing.
– The Commission of the General Council of “United Russia” on health discussed the program of early rehabilitation of patients, including after the coronavirus. Which party sees the stage of rehabilitation?
– The key feature of this program is that it starts when the patient is still in the hospital. No matter how paradoxical it may sound 20 years ago. All studies show that we get the maximum rehabilitation potential if we start this work even in the acute period of the disease. Our commission controls the progress of this project in the pilot regions. The United Russia party has a fairly large network of regional branches, which includes not only politicians, but also doctors who will participate in the control work. It was one of the decisions of the last meeting of our commission.
– From the very beginning of the pandemic, volunteers from the United Russia party, including medical volunteers, have been working in hospitals. How is this work set up now in Moscow and across the country as a whole?
– The first thing I want to say: guys, thank you very much for what you are doing! You are cool, you are handsome! You are not working chaotically – a clear centralized structure has been created that quickly responds to changes in the situation – and help comes to where it is needed right now. At one stage, they were useful in hospitals, then medical volunteers took on elderly patients who were isolated at home … It seems to me that volunteering is that service to people, the desire for which is inherent in each of us, in any decent person . That is why this is done not for money, not for prestige, not for the fact that they will appear on the air of Komsomolskaya Pravda social networks, but because it comes from here (points to the heart – author).