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Meeting on sanitary and epidemiological situation

May 22, 2020, Novo-Ogaryovo, Moscow Region

The President held a videoconference meeting on the sanitary and epidemiological situation in the Russian Federation.

The meeting was attended by Prime Minister Mikhail Mishustin, Chief of Staff of the Presidential Executive Office Anton Vaino, First Deputy Chief of Staff of the Presidential Executive Office Sergei Kiriyenko, Deputy Prime Minister Tatyana Golikova, Presidential Aide Maxim Oreshkin, Minister of Sport Oleg Matytsin, Healthcare Minister Mikhail Murashko, Defence Minister Sergei Shoigu, Chairperson of the Central Election Commission Ella Pamfilova, Moscow Mayor and Head of the State Council working group on countering the spread of the novel coronavirus Sergei Sobyanin, Head of the Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor) and Chief State Sanitary Physician of the Russian Federation Anna Popova, Deputy Director of the Rospotrebnadzor Epidemiology Institute Alexander Gorelov, General Director of the Pirogov National Medical and Surgical Centre of the Healthcare Ministry Oleg Karpov, Director of the Rospotrebnadzor Mikrob Russian Anti-Plague Research Institute (Saratov) Vladimir Kutyryov, and Chief Physician of Moscow City Hospital No. 52 Maryana Lysenko.

* * *

President of Russia Vladimir Putin: Good afternoon, colleagues.

Let us get down to work. You, our experts and scientists provide me with estimates and assessments of the development of the coronavirus pandemic both in Russia in general and in every region on a daily basis.

This allows us to react promptly to the dynamically changing situation and the arising problems and to provide the necessary assistance to the regions in their plans to gradually abandon the restrictive measures; if the situation is still difficult, it allows us to make decisions regarding emergency support and additional federal assistance and curbing the risks of the spread of the virus.

As you remember, this week we had an in-depth discussion on the situation concerning the coronavirus in the Republic of Daghestan. A number of practical measures were approved, including the construction by the Defence Ministry of an infectious disease hospital, which will be later turned over to the republic – later we also decided that two temporary hospitals should be built there to provide emergency aid; also disinfection efforts to be made by Emergencies Ministry personnel, including at social, healthcare and other public facilities. The Healthcare Ministry has sent teams of doctors and other medical personnel, and provided other assistance related to the delivery of equipment and medicine to the republic. Ms Golikova has reported that the Deputy Healthcare Minister was supposed to go there. She will tell us today if this has been done or not.

I would like to hear reports today on the implementation of these instructions and on the developments in Daghestan and other Russian regions where the situation remains complicated and calls for special and continued attention.

I believe that the following should be given special attention today before we hear the reports. According to objective information and expert assessments – I hope we will hear them today – the situation is stabilising throughout the country. The number of new coronavirus cases registered daily in Moscow, which was the first to be hit by the epidemic, as well as in many other regions of Russia is decreasing. This positive dynamics is not yet developing as rapidly as we would like it to, and although it has been unstable so far, it does exist.

Only a week ago, the number of new coronavirus cases was growing by 5.9 percent across Russia, whereas it is 3.5 percent today. It is important that the decrease has been registered against the background of the ever increasing number of tests, which helps medics to identify the disease at an early stage, as I have already said, and to prevent serious complications and raise a barrier to the spread of the virus. Over the past two weeks, the volume of testing has increased by nearly 3 million. We take an average 240,000 tests every day.

As we agreed, it is necessary to continue ramping up this work all over the country. Once again, the hidden danger lies in the fact that the disease may not be detected promptly and an asymptomatic person will not be warned about the threat to their own health and to that of their loved ones.

I would like to stress once again: right now, as we are gradually lifting the restrictions and key industrial sectors and agricultural companies are resuming operation, it is vital to carry out large-scale testing and to strictly and scrupulously adhere to all sanitary requirements in order to reduce and localise risks, consolidate the success that we have achieved in fighting the epidemic, make sure we do not slide back, and protect the lives, health and safety of our people. These are extremely important things, and they fully comply with the WHO recommendations.

I would like to point out another significant fact in the same context. It is the precautions and extensive testing that allow our healthcare system to operate with a good reserve margin right now. Some 110,000 out of 165,000 hospital beds specifically allocated for treating patients with severe coronavirus complications are currently in use, which is around 66 percent. But, again, this entire bed supply must remain readily available.

I would like to point out once again that it is necessary to fully resume regular scheduled medical care for patients with cardiovascular diseases, cancer, endocrine disorders and other conditions, as soon as possible. In fact, we have already discussed this many times. This concerns ambulances, outpatient clinics, hospitals and specialised medical centres.

Colleagues, now I would like to hear your opinion on where we stand right now, so to say, and your views on the measures taken and their results so far. And, of course, I would really like to hear the opinion of experts – representatives of the medical community – about the outlook regarding this situation.

<…>

Vladimir Putin: I would like to ask Healthcare Minister Mikhail Murashko to review our discussion.

Please, Mr Murashko.

Healthcare Minister Mikhail Murashko: Mr President,

First, I would like to add a few words on Daghestan. It is true that a third group of specialists is working in the republic; these are specialists from federal institutions at the highest level headed by a deputy healthcare minister now. There is an emergency response group in Derbent, among other critical locations.

It is very important that over the last week the situation both with the number of hospitalisations and intensive care patients has begun to stabilise. We have enough unoccupied beds in intensive care, and the number of patients there has not increased, which is a good sign and a reason for hope.

We have 8,828 beds, which is enough today. Still, together with the Defence Ministry, we are opening two infectious disease hospitals in Botlikh and Buinaksk, and three infectious disease departments with 60 beds each are under construction. We have trained over 2,400 doctors in Daghestan and can see that webinars have improved the quality of treatment and that the specialists feel more freedom when dealing with this infection.

Now we are training specialists for the new infectious disease departments under construction, because they must have local personnel; the medical academy in Daghestan has already begun this training. We have also added specialists and patients to advanced and clinical research. New medicines that have proven their effectiveness in the first stage are already being used in the region.

The action plan has been drafted; today it will be completed and signed, and we will present it to you. The question is that it looks like additional money will be needed for several measures: this is clear, because today the group is to present its budgeting estimates. We have included the mandatory supply of medicines for outpatient care in the republic. Today we will complete the concept plan, and it will start tomorrow. Next week 30 C-class ambulances will arrive there, which will also strengthen the ambulance service in the region.

Summing up the results, we see that the situation with medical assistance has in fact stabilised. The country has created over 160,000 beds; ICU beds allow us to feel more confident, and there is no overload on them. The number of patients has stabilised over the past week; we have about 108,000–109,000 people in general units and about 2,500 people in intensive care units. I repeat once again, federal specialists consult each patient in an ICU bed or on a ventilator.

And a very important element that I would like to note. Despite the fact that the spread index is decreasing, patients with chronic ailments, especially cardiovascular diseases and lung diseases, have a higher risk of their chronic diseases getting worse even if they have mild symptoms of the coronavirus.

I would like to take this opportunity to ask our people and patients with such chronic diseases, as I have already mentioned, to follow their regular treatment. First of all, this concerns people with arterial hypertension and coronary heart disease – taking your regular medication helps prevent the infection from developing.

Mr Karpov [General Director of the Pirogov National Medical and Surgical Centre] spoke about how well mobilised his staff was. This is unique unity and a unique experience for specialists. We can see this in all the “hot red zones.” Medical workers learn new skills and fight against the new infection, and the team spirit grows stronger. This is very important for the healthcare system. And of course, all medical workers today feel public support.

Thank you very much.

Vladimir Putin: Thank you.

You just mentioned the beds that were created throughout the country. Actually, based on the epidemic situation, the regions increased the number, created new beds – there is a total of 165,291 beds now. Currently we are using 66 percent of the beds, that is, thank God, we have not exhausted our capacity.

Mikhail Murashko: Yes, that is right. Several regions, where the epidemic is stable and no growth is seen, are proposing re-designating some hospital beds back to normal healthcare use because the treatment of patients who need surgery or other procedures has been postponed. This is why we have a sufficient reserve today.

Vladimir Putin: This is exactly what Mr Karpov was saying. I would like to go back to this.

Look, there are 165,291 beds and only 66 percent are being used. As for special purpose beds, I mean beds equipped with lung ventilators, the plan for equipping them with these systems has not been completely fulfilled. But 91.8 percent of the beds with lung ventilators are not being used; in other words, thankfully, only a small number are needed. As for beds with oxygen, the target has been exceeded, but not all of them are being used either, 34 percent of the available beds are free. 

In this connection, I would like to say the following. First, we have not resolved all the problems yet. Secondly, once again, you told me yourself that subsequent waves are possible, including a second wave – this is what the World Health Organisation says as well – in the autumn, at the end of October or November and the beginning of December. You must certainly analyse in detail what we need and in what quantities. You know better how many beds with lung ventilators and oxygen and so on we need. But we definitely need a reserve. I ask you to take this seriously.

Second. I am asking the Government to consider today's discussion and prepare further recommendations for overcoming the coronavirus epidemic, further activities to fight COVID-19. We certainly need expert opinion in deciding on how to return to a normal life in the country, how to proceed in opening the economy, what approach we should take and how fast. I expect your reports soon.

May 22, 2020, Novo-Ogaryovo, Moscow Region