CORONAVIRUS TESTING RUSSIAN HEALTHCARE

                 As the new Coronavirus that has killed more than 24,000 people continues to spread around the world, Russia has stepped up its measures to tackle the pandemic and prevent its spread within the country, there have been 1,036 cases of COVID-19 infections reported in Russia so far and 4 deaths.
The authorities confirmed 196 new cases on Friday, bringing the country's official number of cases up to more than thousand and making the largest one-day increase in cases so far, it also said one person had died in the past 24 hours, taking the total number of deaths to 4, Russia will suspend all regular and charter flights to other countries starting today, President Vladimir Putin has declared that the week from March 28 to April 5 will be a nationwide paid holiday to encourage Russians to stay home and slow the spread of the virus. All restaurants and cafes have been ordered to close during this time with the exception of delivery services. Russia is urging its citizens to refrain from traveling, with the exception of essential trips, Prime Minister Mikhail Mishustin said, tough measures were needed, the more stringent changes in Moscow should be extended to other regions, the country will close all resorts, sanatoriums and children's camps until June, the kremlin confirmed that a member of presidential administration has tested positive for Coronavirus, according to spokesman Dmitry Peskov, the infected person had no contact with Putin, the Russian Direct Investment Fund (RDIF) and its partners have produced 500,000 Coronavirus test kits so far but they are planing to soon ramp up production to 2.5 million kits a week.
Russia plans to build new isolation units for patients with infectious diseases in several regions in response to the spread of Coronavirus, Deputy Prime Minister Marat Khusnullin was quoted by the state run TASS new agency as saying on Sunday, he said the units would be based on close study of such units built in China and that the Russian government was discussing its plans with Chinese partners in the construction sector. It's one several measures being introduced as Russia, which has reported few confirmed cases of the disease compared to European countries, readies its healthcare system for a possible spike in patient numbers, Khusnullin said a state television program, according to TASS, "In order to be prepared for all the ways in which the situation could develop, the decision has been taken to begin construction of additional isolation units in several regions, we have studied China's experience very carefully and how they built isolation units" In Moscow, which has seen the majority of confirmed Coronavirus cases, hospital wards are being re-purposed to treat patients diagnosed with the disease, as well as suspected cases are currently being admitted to one specially designated hospital in the Kommunarka area and two backup wards in other city hospitals. The capital's deputy mayor Anastasia Rakova said in a statement published on her office website, "Despite the fact that all of our facilities, including the Kommunarka hospital, are fully able to cope with current inflow of patients, we are starting to prepare additional capacity in advance"
The city is also working to increase the number of medical staff available to handle an influx of new patients, including attracting medical volunteers, graduate doctors and other personnel, Moscow has also taken steps to reduce social contact in the city to prevent the spread of the virus, including ordering the closure of schools and sports facilities and prohibiting all public events involving 50 or more people, church attendance, normally higher during the Lenten weeks in the lead-up to Easter on April 12, has not been restricted, though the leadership of Russia's Orthodox Church earlier this week urged worshipers to refrain from the common practice of kissing the cross and told staff to regularly disinfect religious icons.

Like all the other health systems around the world, Russian doctors are worried that Coronavirus pandemic will expose equipment shortages and old facilities. For the past five years, nurse Svetlana Shchedrina has been stowing away protective masks and latex gloves, right now she has two large boxes of each, she was forced to start stockpiling after the tuberculosis hospital in the Urals city of Kurgan where she works stopped providing its staff with more than two or three sets of masks and gloves to use over a 24 hour, "we wash our masks, dry them, wipe them down with towels and then use them again" she said, now as Russia braces for the Coronavirus epidemic which has already swept across a host of other countries, Svetlana is taking stock of what she has in preparation for receiving infected patients, should Kurgan be hit at the moment the city has not reported any cases, but medical experts are raising questions over the efficacy of Russia's testing procedures, which may have resulted in much lower official infection numbers than the reality, as preparations step up, attention is turning to how the country's struggling healthcare system would cope with a surge in patients.
Russia looks well prepared to deal with a widespread Coronavirus outbreak, only five countries in the world have more hospital beds per person according to World Health Organization data, Russia has a higher proportion of doctors than most richer countries, but Judy Twigg, a professor at Virginia Commonwealth University who has been studying Russia's health system since 1990 said, if you dig beneath that surface just a little bit and start to ask questions about what those hospitals actually look like, how well those personnel are trained, what the logistical setups are and overall quality control, then we have some serious doubts about the robustness of the system, Twigg and others also questioned the reliability and relevance of the top line statistics on Russia's health system, as information and data can be closely guarded. In a shocking report published just weeks ago, a state watchdog found that a third of medical facilities in Russia had no running water and 40% lacked central heating, experts also pointed to weaknesses in the set up of individual facilities which could be exposed as infections grow. Vasily Shtabnitsky, a Moscow based pulmonologist said "We don't have enough beds in intensive care units, in general 10% of all hospital beds should be in intensive care units, but in Russia it's only around 5%, that means hospitals are not ready for large increase in seriously ill patients" He explained that Russian hospitals typically only have wards for either basic or intensive care, that means patients with moderate conditions often end up in intensive care units, potentially taking up beds, ventilators and care giving, moreover those wards are already largely occupied with little spare capacity.
Russia's weaker record on infection controls withing hospitals could put vulnerable patients at heightened risk, in context of a pandemic, lot of people for whom there isn't space in high level intensive care units are going to be put on wards with other patients, and you worry that people who might just be sick with influenza might have patients next to them with the Coronavirus, Twigg said. A curiously timed spike in pneumonia cases is already exerting extra pressure on intensive care units in Russia, last week Moscow saw a 37% increase in pneumonia cases, a phenomenon doctors are noting around the country, even Russian lawmakers have begun raising fears that misdiagnosis could already be rife, like in many countries, authorities have already started scrambling to address some of the potential pressure points, construction started this week on a new Coronavirus treatment facility outside Moscow that the city wants to have completed within weeks and there are reports of local authorities starting to order more respiratory ventilators, the capital has launched a tender for more than 150 new ventilators, while several other regions have also issued public procurement notice in recent days. Historically the health system of the USSR and Russia was built on the basis of mobilization it is militaristic because governments were preparing for an emergency, said Yury Krestinsky, who previously worked in Russia's Health Ministry and now leads Sberbank's healthcare business, he hopes this feature of the system could allay concerns about a lack of capacity in intensive care units, for instance he said 800,000 regular hospital beds, 15% could be quickly transformed into intensive facilities, meaning 120,000 patients with more serious conditions could be treated at one time, of course we don't have enough money for everything in our medical care system, but is we talk about emergency mobilization this still works and it works well. This capacity to marshal extra resources is already being called upon in Russia's response to Coronavirus, with Russian prisoners, students and military personnel being asked to produce medical masks and other equipment to avoid a shortfall, but Russia's wider defensive policies have also undermined its health system, experts and professionals, Moscow has stepped up its import substitution drive in the medical sphere in recent years, tightening the screws on what equipment and medicines hospitals and pharmacies can buy from abroad as recently as Summer 2019. Twigg said, there's a real question mark about Russian production of kind of antivirals that we hope will turn out to be effective against Coronavirus, that if advances are made on treatment or vaccinations in the current set up, it's not clear that kind of avenue is going to be available to Russian patients.
Doctors' concerns about the quality of Russian produced equipment being used in hospitals have also grown in recent years, last summer a dozen Russian healthcare NGOs wrote to President Vladimir Putin calling for the government to rethink a proposed ban on importing some kinds of ventilators from abroad, the letter went unanswered.
Ivan Konovalov from Doctors' Alliance, an independent trade union linked Kremlin, said that in Moscow, there is more money, there is equipment and there are doctors, lots of doctors are forced to move to Moscow because of low salaries in the other regions, Moscow is not bad but still quite bad, but in the regions it's catastrophic, they don't have enough doctors, hospitals are in a really bad condition and they don't have sufficient and modern equipment, the medical system is not all ready for Coronavirus or any other epidemic. While some governments have taken drastic steps to address shortfalls in equipment, British Prime Minister Boris Johnson publicly called on the country's manufacturers to switch their assembly lines to start churning out more medical ventilators, Putin has insisted Russia has the situation under control, saying it effectively contained the virus be sealing off Russia to travelers from China in the early days of the outbreak, while not everybody buys that argument and as Russians digest stories of a health system at breaking point in northern Italy, few want to find out just how well Russia's system would hold up if tested to the extreme.