In Primorye, the daily incidence of coronavirus has tripled over the week — from 501 last Monday to 1,517 people on Wednesday. By the arrival of the “fifth wave”, the doctors were preparing ahead of time, but they are sewn up anyway. Every day, more than 5,000 patients with symptoms of SARS and suspected covid contact polyclinics, infectious disease centers, and ambulances personally and by phone. Outpatient infection centers in Vladivostok, Artem and Nakhodka have been operating 24/7 since last Friday. From Monday, however, it is possible, with a mild course of the disease, to open a sick leave remotely, without even taking a PCR test, sit at home for a week and also go out, without going to medical institutions. But people still, for various reasons, prefer proven methods, even if they have to wait in line for three or four hours.
How the «first line of defense» works, Novaya understood.
At the AIC registry at the third polyclinic. Photo: Valeria Fedorenko/Novaya
Starikov — go ahead
Center of Vladivostok. Svetlanskaya Street, 131. Before covid, therapists, psychologists, nutritionists, allergists, ophthalmologists and other specialists of the clinical diagnostic center worked in these old two-story buildings. Now there is a «red zone» in the CDC. The streams of patients are thoroughly separated — different iron doors and even entrances from the street.
Last week, when the number of patients increased dramatically, and the hospital without PCR was not opened remotely, people even waited on the street. Now everyone is placed inside and in the order of a lively (and in some places a little lively) queues go first to the registry, and then to the doctors. Someone keeps cheerfully, someone barely stands on his feet. Most are young. Some people prepare thoroughly for waiting in line, stocking up on snacks and water.
Some daredevils from among the patients even here wear masks on their chins, although they are in the real “red zone”.
The doctors are wearing creepy laminated overalls, in which it instantly becomes hot. Entrance — across the street, exit — through the gateway with processing.
— I was let through quickly the first time. I came to the clinic, they say to me: “Why are you stuck here? Suddenly you have covid! They brought me here, I did not know what to do. And now again, — says the grandmother at the entrance, folding and folding her coat into a bag. — I've already recovered. They call every day: how is the condition? What is this call center? You won't talk there. Answer the question: yes, no. Everything! But I need to see the doctors … Close this case so that they do not bother me. I got sick already. Not covid, no! Why would I climb with covid?!
People come here with the “good old” SARS and coronavirus. The first entrance is for those who feel unwell and do not know if they are sick with the “crown”. In the second — with a confirmed diagnosis. Although, in general, with a light course of the “crown”, now you can sit quietly at home. And the sick leave should be opened for 7 days without PCR and closed remotely without passing the test; you can go to work in three days, but then you will have to do a smear. Now doctors believe that with a mild course of the disease, a person just has time to recover in a week.
There has been confusion in recent days. Previously, if you were feeling unwell, you had to call the clinic and “hang” for an excruciatingly long time on an overloaded line. But recently, the number 122 was introduced in the region — this is not the Ministry of Health and not a hospital, but an MFC. The call center specialists, thrown to the aid of doctors, really answer calls many times faster, ask all the necessary questions according to the questionnaire, which greatly simplifies the life of doctors.
Ambulance not soon
Those who call the call center at number 122 are immediately divided into groups. The doctor contacts those who can be issued a sick leave remotely: conducts the so-called primary audio monitoring of the patient, prescribes an examination and treatment, if necessary. And sends the data back to the MFC. On the seventh day, they must call back again to everyone who has such a sick leave open, and either they close it or extend it through a doctor’s examination. And, for example, people of age and with chronic diseases (who are predisposed to a more severe course of covid) are recorded and immediately transferred to doctors house calls. An infectious disease team should leave the clinic for them. If it becomes clear from the answers to the checklist questions that a person needs an ambulance, they will be transferred to the ambulance line.
But since there are almost 2.5 times more sick people, and fewer doctors (they also get sick), they even call back from polyclinics, let's say, not immediately. Not all employers understand this and are willing to wait even a day. Therefore, people in any condition go to the center.
Yes, I called 122 first. I was told that the doctor would call back and issue an electronic sick leave — as a result, nothing happened. Nobody calls back, no treatment was prescribed. Got off work from work. The boss asks: are you on sick leave or not? And I have nothing to answer, says Oksana. She does not cough, but complains of disgusting health. I brought down the temperature and went to Svetlanskaya. The infection in the family knocked down not only her.
— On Saturday, I called the doctor's father, called polyclinic No. 3 — the temperature is 37.8. So far, no one has called back or come…
They also complain about the ambulance.
“Dad lives on Russian Island in the small village of Minka. I called an ambulance: “Will you come to Russian?” — «Certainly. Surname. The address. Wait. Your challenge has been accepted,” says journalist Natalia Ostrovskaya. Her father (89 years old) fell ill: temperature 38.5, cough. The call was made at 4 pm, but the ambulance did not arrive in the morning. She didn't show up for the second call. For the third time, the registrars at the branch of polyclinic No. 1 on the island, already in person, said that they had not even received the call, they could issue it, but it would take a long time. So they said: sew up.
In the AIC, already on the mainland, Natalya brought her father herself — and then everything worked out clearly. They got to the reception quickly, to the doctor — a queue of coughing and sneezing for two or three hours. “But how brightened my soul was when people decided to let my dad go ahead — out of respect for his venerable age. Then they passed a blood test, a covid test, a CT scan of the lungs (all under the policy). Received a referral to hospital. The polyclinic agreed with the hospital, and we, without waiting for the ambulance, rushed there, — Natalya writes. “The Veterans Hospital accepted my dad and placed him in a good room.”
Everyone gets sick
Patients complain about queues. Sometimes you have to sit until you get a sick leave for two, three, or even five hours. On the other hand, many could get by with a phone call. Doctors agree: in a few days everything will settle down. It was the same when outpatient infection centers began to work around the clock.
Valery Savina. Photo: Valeria Fedorenko/Novaya
Valeria Savina, chief medical officer of polyclinic No. 3, at which the AIC on Svetlanskaya was opened, says that over the previous day, about 100 people with confirmed covid, and more than 150 people with signs of SARS, turned to the infectious center.
“In order to minimize waiting times for patients at Entrance #1, our staff has recently been triaging. We distribute checklists, according to which we then evaluate the patient's condition. One primary patient just needs to open a sick leave. Another is very bad, he did not get through to the service and came here already for a covid test and help. Many people are not from our territory. When my colleagues and I came in today, there were a little more than 90 patients, we handed out questionnaires to them, talked to everyone.
Doctors «fail» by becoming infected, like all other people. Hope, says the chief medical officer, for the students of the Pacific State Medical University.
In these two years, the guys help their adult colleagues in the «red zones» of outpatient clinics and hospitals. A pandemic really looks like a war, where battalions in white coats are deployed to the desired section of the “front”. These days, for example, outpatient clinics have to be strengthened; more than 11,000 of the 15,500 people who are sick right now are being treated in them. For a week, it was outpatients in the region that increased by 80%.
“I worked at Dalzavodskaya for the first two months of the pandemic,” the medical worker shares, giving me overalls. “Then we were sent for a breakthrough. Now here … Yes, what to talk about, come on. You need to tuck your hair so that nothing sticks out, then put on a hood, there is already a shield on top …