The Head of Regional Health Care Told About Centralization of Ambulances and the Risk of Overdue Vaccines

The head of the Department of Health spoke at a meeting of the Public Chamber of the Vladimir region

On October 25 the new head of the Healthcare Department of the Vladimir region addressed a meeting of the regional Public Chamber. Recall that Konstantin Baranov was appointed head of the regional healthcare department less than a month ago, but from the beginning of summer he was an adviser to the governor on health issues and was probably getting acquainted with the situation in order to take up his position.

Baranov’s report, together with answers to questions from the public, took more than an hour – the official was even late for a later scheduled meeting with the chief physicians of medical institutions. ProVladimir cites some of the official’s quotes about the situation in regional health care.

About vaccinated and unvaccinated covid patients

“The vast majority of those who fall ill are unvaccinated people. There are among them those who have been vaccinated, but mostly they are unvaccinated. And right away, not to repeat myself – these are not my words, this has been proven by scientists, this has been proven by practitioners in our country. Those people who have been vaccinated have a much easier reaction to the disease than those who have not been vaccinated.We analyze virtually every day – who goes to intensive care units, those who were not vaccinated. There are elements with alleged vaccinations. But in any case, I would have a question for those organizations, where these vaccinations were given. And for those patients [there will be questions] who are now in the intensive care unit, who have a very severe course of the disease and, unfortunately, sometimes end fatally”.

About Vladimir physicians and the council of chief physicians

“I have been in medicine for probably more than 40 years and worked in several areas. I want to responsibly say that the doctors and all medics in the Vladimir region are very decent, good, qualified and responsible people. The most important thing is to shape the work in such a way that they understand that they are not the only warriors in the field. Because the most difficult thing is to work in the primary level, “in the trenches”… So that they understand that there is support. If we build a vertical, and we will, I think things will be as we plan.There’s a very strong cohort of chief physicians, very experienced people. Now we plan to create a council of chief physicians, which will be a public organization that will not be subordinated to the department, but with which we will be in contact. Because all the smartest suggestions – they don’t come from above, they come from below”.

About local acquaintances

I’ve been on the job for two weeks, and I guess the rhythm of my work is not built correctly, because I should have started with a tour of the territories, of all the health care facilities. As a professional chief physician, I can tell by the smell what kind of institution it is. From getting to know the head doctors, the paramedics of the FAPs, and so on. But the pandemic made adjustments. Now, by and large, we are working in manual mode. And I think that when we reach the plateau, the first thing we’ll do is travel”.

About the risks of overdue vaccines

“We’re going to have a “flashing” geo-information slide where all the vaccination sites are marked. Starting tonight, maybe tomorrow morning, all these sites will show in real time – how many they vaccinate, what their capacity is… You know, like a control car. And we’ll be able to transfer actively people and vaccines. Because there are points where 8 to 10 vaccinations are done in a day. This is unacceptable, because there is a team there – a doctor, a nurse, and so on. And there are places where 100 to 200 [people are vaccinated]. This geolocation, which we want to implement, will help us coordinate the work of vaccination sites in a timely manner… You remember, during the summer months, there was a surge in vaccinations where restrictions were imposed. But, as luck would have it, at that time we had no vaccine in the region. Quite serious measures were taken. The federal center allocated vaccine to us, I participated in this, in requests and with letters. And a sufficiently large number of different vaccines came. But here again we have a paradox: when the vaccine came to the region, the restrictions were lifted and people were no longer willing to be vaccinated.We have a rather paradoxical situation, in some units the risk is up to 12 days – there will be overdue vaccine. Can you imagine what we’re getting? It would be a very big paradox if we have overdue vaccine. So we will now scatter it [to different vaccination sites in order to have time to use it before the expiration date].” 

About the medical school in Vladimir

“We submitted a request to the federal Ministry of Health to open a [medical] faculty in our city. Well, the institute, it sounds loud. It is very surprising to me why such a large central region, an outpost, one might say, – with four [medical] colleges and no medical school. It’s very surprising. But we can’t have a medical school right away, but if we open a faculty, then our children will study here, and we will feel it immediately. The governor supports it”.

About the ambulance

“Almost every district has its own ambulance. They live by their own rules, they work according to their own methods and standards. It is necessary to centralize – with a single information system, with a single GLONASS map, to see where the car went and why it spent two hours at the gas station or why it passed by the calls. With the paramedics’ reports electronically on a tablet – what have they done. You don’t have to write them, you can’t figure out under a microscope what it says. Electronically, when a person is typing, you can see everything, you can’t change the numbers and so on. This work, I think, is not so huge, especially as there is experience. If we centralize an ambulance, we won’t have these problems when people are waiting for a long time.There are cars, but there is only a small problem with the drivers. The paramedics are good – I talked to them, they are so toothed, they answer properly. But we need to centralize – now he’s out on the track and understands that he’s alone. And they need to feel supported, to have that tablet glowing in their hands, so they know they’re going to get, if necessary, counseling, if necessary, routing at any time.”

About the perinatal center

“I have a surprise, of course, that we have some things that, unfortunately, only exist on paper. We need a perinatal center if we want our population to increase. Women with difficult pregnancies should give birth in a perinatal center. We need to have perinatal diagnostics at the perinatal center. When I looked – 99% coverage – it is in general, well, at least put it on the world’s radar. Only when I looked at undetected malformations – it turns out that the coverage is high, but nothing is detected. Why such coverage, then?There should be a gynaecological department, which is focused on correcting the reproductive function of women, if there are any problems. There should be a family counseling department that, if necessary, corrects the reproductive health of the man. If we do not have all this, of course we will have a problem with procreation. We need a perinatal center. And it’s not about the building, it’s about filling it. Translated with (free version)

“This is where it gets really sad. You all know that we are 81st out of all the regions [in terms of vaccination rates], with several Caucasian republics ahead of us. The first feeling was that maybe not everyone was being entered [data on vaccinated people]… It was not confirmed that they were not being entered. Yes, due to a lack of staff, sometimes there are a lot of vaccinations, but they are not entered in the register, and we are behind. Then it gets entered, something gets lost, and it’s very unfortunate, because work has been done.But we asked for it and the region met us halfway – they gave us volunteers and students of higher educational institutions, the “system” started and vaccination began. So now every shot is under our control. But, nevertheless, the rate of vaccination, although it is increasing, is still insufficient, and, most importantly, the coverage of the population.We made a sampling, we took the districts by vaccination rate, we took the districts by morbidity and mortality. I am familiar with the situation, because I worked in the Federal Ministry of Health, and my colleagues share the data with me. The five regions of the Central Federal District, which I took for comparison, have an almost direct correlation. Where there is low vaccination coverage, there is more morbidity. Where there is more morbidity and low vaccination coverage, there is more mortality. We have a paradoxical situation in several areas. That is, it seems that the vaccination is not the worst, but the death rate is the highest. We started to look into it. Again – all because of the statistics. She’s a windy girl, we have to work with her”.

About covid beds

“It seems that there are a lot of infectious disease beds, even more than the standard. But where are they? An infectious disease bed has clear [standards] – how many square meters, oxygen supply, and so on and so forth. What I see – yes, nominally there are beds, but it’s summed up. So – necessarily in such an area, a large, large, like Vladimir, there should be an infectious disease hospital.

You see, a hospital that provides routine care, including for pregnant women, and an infectious disease building in the middle… Look, we’re all adults, right? You can make a separate building with separate plumbing and ventilation, but still – a person can get infected. There should be a separate good infectious diseases hospital, a children’s ward with children’s intensive care for infectious [patients]. The intestinal department should be separate, the viral department should be separate. For adults, there should be a place where, if a person with covitis or some infectious disease has a heart attack, stenting could be done. So that there would be its own laboratory, its own cleaning system, its own air-conditioning system. This is all realistic and it will happen. But why there has not been one so far is unclear.

Statistically, we have more than 200 intensive care beds. The intensive care bed is the most expensive. By a resuscitation bed we mean the equipment and the possibility of invasive and noninvasive ventilation, the connection of artificial respiration, AIC, ICMO, and so on and so forth. This is an infectious disease bed. It should not just be a bed, it should be filled. What 200? Right now we are opening it because we have to”.

About the Regional Health Department employees

“About the department I want to say, and this is not a “cry of the peasant woman”. There are three doctors left in the department, one of them is me. Alexander Zhestkov [deputy director of the regional health department] is just a remarkable person who should be commemorated – as a lawyer he headed the department for half a year. He was just a wonderful and decent man. There are four deputies in the management team – an economist and a lawyer. One is Svetlana Grigoryan [head of the organization of medical care], who has a medical degree.

I honestly tell you, I am even glad that after this trauma, when I was recovering and rehabilitating for six months, at least I felt alive [Baranov, being the Minister of Health of Kaluga region, was involved in a traffic accident]. I was on the phone for the fourth night. Now I just do not have the right to say who will come to us. But people will come, we found them. One girl is definitely coming – woah! The guy’s doing the paperwork, he’s very promising. I would call him a “ready-made minister”, just a little bit more work. A couple more people…”

Konstantin Baranov added that in about a month he would be ready to tell the public about the situation in health care in the Vladimir region with “dry numbers. But in advance he will coordinate the data with the federal specialized departments, because “there are a lot of questions to the statistics, which were submitted by the region.

Original publication

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