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Meeting on construction and repurposing of medical institutions in the regions

April 17, 2020, Novo-Ogaryovo, Moscow Region

Vladimir Putin held a meeting, via videoconference, on the construction and repurposing of medical institutions to treat patients with the coronavirus infection in the Russian regions.

President of Russia Vladimir Putin: Colleagues, good afternoon,

Today two new specialised medical centres to treat people infected with the coronavirus opened in Russia.

One of them is a hospital with 500 beds in Voronovskoye, Moscow, which will begin admitting patients on April 20, and the other is a multifunctional medical centre of the Defence Ministry, with 60 beds, in Nizhny Novgorod. It is ready to start working today.

Both centres were created from scratch over a very short time, just several weeks, which is unprecedented. I want to thank the civilian builders and the military personnel of the Defence Ministry.

The centres have been fully staffed. Doctors, nurses and medical personnel are facing a period of hard and intense work. Friends, I wish you success with all my heart.

But today, of course, is not the time for solemn speeches on the opening of new facilities, although we need them very much and we need to mark such events. We still have a lot to do all across Russia, in every region.

In this connection, I believe it is important to take note of the following before we listen to the reports.

We all know that Moscow was the first city to face the impact of the epidemic, and now it is quickly building up healthcare capacities based on its financial potential and large capabilities of the construction sector. The Defence Ministry also has great human and organisational resources, and I am confident that its programme to establish 16 medical centres will be completed in full and on schedule.

But let me repeat: it is important for us that the entire country – not just large cities and agglomerations but every region – are one hundred percent ready to fight for every person’s life and help those who have been affected by the disease.

The risks associated with the spread of the epidemic are still very high. We have not yet reached its peak. The number of infected people is growing, and not only in Moscow but also in many other regions of Russia.

Even if all the reserves that are being created today are not needed on a full scale, we still must have them to be able to respond to any challenge and deal with any scenario that may develop in any region. God helps those who help themselves.

The task was to prepare an additional 95,000 specialised beds for treating people with the coronavirus infection. Thirty percent of such beds were ready on April 3, and 72 percent by yesterday, according to the latest information. This work must be fully completed by April 28.

Less than two weeks are left before the deadline. Therefore, I ask you to speed up this work as much as possible and report today on the problems that still exist in preparing specialised beds, purchasing equipment and reorienting the work of hospitals and infectious disease wards, on the regions where these problems exist and on the exact steps being taken to promptly resolve them.

The number of beds is not the only concern. They must be fitted out with everything that is required. There must be a staff of specialists that should undergo special training, while doctors and other medical workers must be provided with personal protective equipment. It is necessary to continuously monitor the implementation of all these measures.

Today, we will listen to a report by the Vladimir Region Governor, Mr Vladimir Sipyagin. A complicated epidemiological situation is developing in the region, and it faces problems with organising medical assistance.

There is also a dangerous hotspot of the epidemic in the Komi Republic . I ask you to analyse whether enough is being done to localise the hotspots, all the more so since the new head of the region – Vladimir Uyba – is well versed in all these issues. He headed the Federal Medical-Biological Agency for many years. We will also listen to reports by a number of other regional governors who will tell us what is being done in their regions.

But first I will give the floor to Healthcare Minister Mikhail Murashko. Please report on the situation in general and the most important issues that the federal authorities and all regions are facing.

I would like to emphasise once again: as I said in the beginning, Moscow was the first to be hit by this problem, but now we see it spreading into the regions and people in every region must be ready to overcome all difficulties that may emerge. This is a must for every region.

Mr Minister, go ahead please.

Healthcare Minister Mikhail Murashko:Good afternoon.

Mr President,

Measures to stop the coronavirus infection from getting into the country and spreading around helped avoid the peak load on medical organisations and create an additional reserve of time. So far, 32,000 cases have been reported. The largest number, as you noted, is in Moscow, the Moscow Region, St Petersburg, the Komi Republic, and the Nizhny Novgorod Region.

Over 2,500 people have already recovered and have been discharged from medical institutions. Medical workers fight for every human life.

Medical measures to combat the coronavirus are being used in three main areas.

The first is creating the necessary bed capacity, which, in accordance with the course of this disease, requires an oxygen supply, resuscitation and, as per the requirements established by regulatory legal acts specially developed to fight this infection, should be provided with a full range of services.

As you mentioned, 95,000 beds are expected to be created by April 28. Today, more than 72 percent have been set up. There are 26,000 patients in hospitals now, including patients not only with a confirmed diagnosis, but also those who are being diagnosed and treated for community-acquired pneumonia of another etiology. Today we have a good reserve, but nevertheless, following your instruction, we are working on plans for additional beds, if necessary, including in federal medical institutions located in the regions. In addition to Moscow, we plan to reequip 44 medical institutions, that is more than 5,000 beds.

Today the Government has allocated over 78 billion rubles to finance this process of repurposing regional and federal healthcare facility beds – that’s jointly with all support measures. Although we believe coverage with ventilators is not bad, 69 percent, this is an issue for special control, and today, the Ministry of Industry and Trade is working actively, giving the regions with the most complicated epidemiological situation first priority.

Human resources are the second essential issue. Over the last two months we have carried out re-training in every way possible, remotely or face-to-face where possible, for 1.2 million medical workers. As of today, over 150,000 medical personnel in total are providing medical aid to patients with the coronavirus in hospitals and outpatient facilities. I am sincerely grateful to my colleagues for working responsibly and fulfilling their duty. Under your instructions, today additional compensation has been set and funding allocated for special working conditions and additional load on medical personnel.

For the first time, we have created three remote intensive care consulting centres at the federal level. Almost every serious patient in Russia today is receiving consultations from federal experts, and each of them agrees to a strategy with the leading Russian experts. Today there are over 640 patients that are being observed remotely and consulted, that’s over 10 children and 16 pregnant women. Every patient on ventilator receives several consultations; and their situation is being monitored in real time.

Of course, we are focusing on the personnel and the provision of personal protective equipment. This is a very important issue that the Ministry of Industry and Trade is addressing today, and not only through imports, which we are pleased to note, but also through production launched in several regions of the Russian Federation.

It is important to note that our colleagues from Rospotrebnadzor have begun testing personnel working with the coronavirus infection for specific immunity to it.

The third important component of the treatment process is the provision and development of medicines and medical equipment. And of course, we are looking forward to the eventual development of a vaccine.

The early initiation of treatment prescribed when the patient was diagnosed – based on their clinical data, x-rays, computer scans – can help avoid the development of severe cases. I would like to take this opportunity to repeat that everyone should remember this and should begin treatment promptly under the supervision of a doctor. Failure to begin treatment on time often leads to serious complications and requires much more effort, and we all know that greater medical intervention also means a greater load on the patient during treatment and subsequent rehabilitation.

The scientific community has incorporated international experience and developed several treatment regimens. We have already released the fifth version of protocols; they are updated regularly. These regimens are described in detail, including the diagnosis, treatment and safety precautions for the personnel.

Five new drugs are now at the clinical trial stage. Four more drugs planned to be included in the treatment protocol are undergoing state registration according to the new procedure established by the Government. Vaccine research is underway at seven research sites; the projects are at varying stages of progress.

Russia has 12 domestic test systems for lab diagnosis and verification of the coronavirus infection, and in the near future, seven more diagnostic kits should be registered by Roszdravnadzor.

We are introducing organisational models for the provision of medical care to patients with infectious diseases. Information resources have been created for managing and predicting the situation. We are supervising the treatment of every patient in the country today.

The new routing arrangements required certain changes as the healthcare system is adapting to the new challenges. We can see that today all regions are already involved in this, including the outpatient and inpatient services, and new approaches to diagnosing and treatment are being formed.

Scientific research institutions of Russia’s Healthcare Ministry have confirmed their participation in testing international treatment protocols under the auspices of the World Health Organisation.

We are not relaxing, by any means, because this work involves the regions. And here I would like to thank those governors who got the most involved in the process, especially, perhaps, Mr Sergei Sobyanin, because he is also sharing his experience with the governors of other regions, and there is also general support and efforts to deploy networks and mobilise medical resources.

This concludes my brief report. Thank you.

Vladimir Putin: Mr Murashko, you said – and I know that too – that seven research sites are working on coronavirus vaccines. I know, in general terms, that the projects are making good progress, at least some of them. What can you say about this?

Mikhail Murashko: They have already begun preclinical testing, and protocols for subsequent clinical trials are in the works for this type of drug product. There are encouraging results, and, in particular, we are actually starting to work with production facilities that can start manufacturing this product on their production lines. We are working in several areas in parallel.

Vladimir Putin: This is what I wanted to hear – that, first, your colleagues are moving, and confidently progressing towards creating these vaccines. What do you think about the timeframe – can they finish earlier than they said before, maybe earlier than the third quarter of this year?

Mikhail Murashko: Today, we are using every regulatory mechanism available, including the possibility of using some of them in parallel. However, we understand that in addition to simply producing the vaccine we need to confirm its safety and effectiveness. This is why we are testing and working out different versions in cooperation with the scientific and expert community, including those versions of the vaccine that already have a background in application against other diseases, which might be accepted for use quicker. At this point, several versions are being considered and developed.

Vladimir Putin: Ok.

I do understand that you must be cautious in these evaluations and forecasts. But I want to express my hope to everybody who is working in this area. We all understand how important the results are for us, for our country and really, for the entire world. So we hope this research will be completed with favourable results, and as soon as possible.

And one aspect of a practical nature – which you just mentioned – is production. In addition to finding the right vaccine, it also has to be produced in the necessary volumes. This is why we should take care of this now. We need to work on the production process now, as you said. Hopefully, it will be organised like this.

Now, for the regions. You mentioned some good examples, but I know that not everything is going so well in the regions. What can you tell us in this respect?

Mikhail Murashko: We would like to note that a number of regions really require further mobilisation of efforts. I want to stress that the Irkutsk Region, Udmurtia and, as you mentioned, the Komi Republic, the Vladimir Region and, probably the Trans-Baikal Territory should work to step up their efforts. We can see that this work is being performed and at a pretty good pace, but the situation requires not only keeping to the schedule, but also preventing possible risks and, God forbid, failures.

Thank you very much, Mr President.


Vladimir Putin: The Defence Ministry has been devoting a lot of resources to building medical centres in Russia’s regions. Mr Shoigu, please go ahead.

Defence Minister Sergei Shoigu: Comrade Supreme Commander-in-Chief,

Following your instructions, the Defence Ministry, with a tight schedule, is engaged in building 16 multipurpose medical centres in 15 regions of the Russian Federation from Kamchatka to Kaliningrad. The centres are based on the Defence Ministry’s military hospitals and will add up to 1,600 hospital beds for patients with infectious pathologies.

Modern technologies significantly reduce the time needed for construction and ensure high quality operational characteristics. The total area of the facilities is almost 115,000 square metres; each facility is between 5,000 to 12,000 square metres. Construction has been proceeding around the clock for 29 days in every military district – the Western, Southern, Central and Eastern.

Almost 11,000 workers and 540 pieces of equipment are at the construction sites. The projects are being performed in two stages: by April 30 we will have completed eight centres (in Odintsovo, Podolsk, Nizhny Novgorod, Smolensk, Volgograd, Novosibirsk, Rostov-on-Don and Omsk), and the remaining eight centres will be finished by May 15.

Cutting-edge medical equipment is being installed in all the centres including ventilators, CT scanners, and intensive care equipment. Telemedicine equipment will be installed to hold real-time consultations with leading experts at central military hospitals and the Kirov Military Medical Academy.

The medical staff will include 2,224 people, and the specialists have been trained to diagnose and treat the novel coronavirus infection at the Military Medical Academy of the Defence Ministry. The necessary reserve of personal protective equipment and medications has been created for the centre. Today, the first of the 16 medical centres will be commissioned in Nizhny Novgorod.

Comrade Supreme Commander-in-Chief,

Under your instructions, the Armed Forces have established staff to provide help to the constituent entities of the Russian Federation. Sixty-five resuscitation medical teams have been formed, 20 of them have already started work in Moscow clinics. Seven mobile hospitals were prepared, each with a capacity of 100 patients, and three medical special task units. The Irtysh hospital ship in Vladivostok has 450 beds ready. Sixteen additional laboratory centres were commissioned for PCR-diagnostics for the coronavirus infection, 17 rapid response units have been trained, and four field laboratories were opened, which can identify the presence of the coronavirus.

If necessary, we will deploy six infectious disease hospitals – two in the Nizhny Novgorod Region, two in the Ryazan Region, one hospital in the Chelyabinsk Region and one in the Primorye Territory, for a total of 900 beds. As of today, 4,900 beds have been prepared in case the constituent entities of the Russian Federation need help, and by May 15, we will be ready to offer our citizens 7,500 properly equipped hospital beds and 5,200 personnel for servicing them.

We are ready to step up the availability of the CBRN defence troops to disinfect buildings, equipment and localities by deploying an additional group. To pursue the task, the army has over 3,500 pieces of special equipment and 10,120 personnel. The Armed Forces are ready to fulfil the tasks you ordered.

Thank you.

Vladimir Putin: Thank you.

Today, the Defence Ministry is opening a multipurpose medical centre at the 422nd military hospital in the Western Military District. Deputy Defence Minister Timur Ivanov is now in Nizhny Novgorod.

Please go ahead, Mr Ivanov.

Deputy Defence Minister Timur Ivanov: Comrade Supreme Commander-in-Chief of the Armed Forces of the Russian Federation,

This is a report by Deputy Defence Minister of the Russian Federation Timur Ivanov.

The construction of a multipurpose medical centre with 60 beds and a total area of 5,500 square metres has been completed in 28 days on the grounds of the 422nd military hospital of the Western Military District in Nizhny Novgorod. The medical centre is designed for the diagnosis and treatment of patients with various infectious diseases. The centre has 10 intensive care wards.

The centre meets all the requirements for treating the new coronavirus infection. The medical centre units can receive and treat patients and are functionally and territorially separated. The centre has all the necessary gear for protecting the medical staff and civilians against the infection.

This multipurpose medical centre is fully fitted with the necessary medical equipment, including ventilators, CT scanners, X-ray machines, ultrasound scanners, ECMOs and other modern equipment which makes it possible to provide medical aid on the required scale and at the highest technical level. The centre also has a sufficient inventory of medications.

The centre’s staff consists of 35 doctors, 50 nurses and 40 ward attendants. Military doctors have undergone additional training on the diagnosis and treatment of the new coronavirus infection at the Kirov Military Medical Academy. All medical workers have received full personal protective equipment and have already started performing their duties.

This concludes my report.

Vladimir Putin: Thank you.


Vladimir Putin: Colleagues,

What would I like to say about the results of our discussion here at the end of the meeting?

First, I would like to ask the Government, the Healthcare Ministry and other federal agencies to work more closely with the regions. What the Healthcare Minister just said about the Irkutsk Region, Udmurtia and the Trans-Baikal Territory is a source of concern for me.

What’s happening, colleagues? We all know, and I said at the beginning, that Moscow was the first place to be hit by this problem. But we are seeing that it is now spreading into Russia’s regions that are not as affluent, to be honest, as Moscow. They do not have as many beds; they have no federal medical centres, and do not have many departmental medical institutions. Therefore, our efforts in the regions, on these territories, must be particularly intensive.

I know that the regions are sending more requests for the purchase of equipment and to refit bed capacity, as our colleagues have just said.

I would like to tell you that the Government has allocated over 36 billion rubles for these additional requests. Let me emphasise that these funds must be used efficiently, carefully and as sparingly as possible.

I would like to recall that considerable funds – over 50 billion rubles – have already been earmarked to support regional healthcare, including over 33 billion rubles for reequipping in-patient facilities and fitting out beds for coronavirus patients and another 17.7 billion rubles for purchasing modern medical equipment, including, as a matter of fact, ling ventilators that we discussed today, and ambulances.

An additional federal reserve of medications and equipment, including personal protective equipment for medical workers will be created soon. I ask you to quickly work out a mechanism for sending these reserves to the regions and those medical institutions where the situation is particularly complicated.

Next, starting in April, special federal payments were introduced for doctors, nurses and other specialists working directly with coronavirus patients all across Russia. I am once again telling the regional heads that all regional premiums and extras for medical personnel must be fully preserved.

Every regional head is personally responsible for organising the effort to increase the preparedness and the capacity of the healthcare system onsite. I am asking you to go into every detail. We are talking about people’s health and lives.

I would also like to stress that all the goals we have set must be resolved not only in a timely manner, regardless of any difficulties, but also efficiently and professionally. The money we are now allocating to counter the epidemic – to purchase equipment, to reequip and build hospitals, retrain personnel – represent additional considerable investment into our healthcare system in general. Everything we are doing now as emergency measures must be used efficiently in the future.

I am asking the Government and the regions to do all the planning and analysis already now, in particular, how to use the purchased diagnostics and treatment equipment in the future to strengthen the primary and other elements of healthcare in the regions, or in what areas the centres being constructed or upgraded now will be used in the future.

Let me repeat that everything we are doing now must help protect people’s health in the future too.

We know and we can be sure that Russia will overcome this epidemic. We will pass through this difficult period, and this victory will be more important if, during this difficult time, we make the healthcare system in Russia, in every region, stronger, more up-to-date, effective and accessible so that Russian citizens more than anyone can feel these real, qualitative changes.

I would like to encourage you to work effectively together, and I hope that our meeting today will only be a step towards achieving a common result.

Thank you.

April 17, 2020, Novo-Ogaryovo, Moscow Region