Lifting restrictions stage by stage
Excerpts from the transcript:
Briefing with Tatyana Golikova and Rospotrebnadzor Head Anna Popova
Anna Popova: The current national sanitary-epidemiological situation remains rather tense. More and more people are contracting the coronavirus infection every day. At the same time, there are 158.3 coronavirus cases per 100,000 of the Russian Federation’s population. This puts Russia among the 50 countries currently providing public coronavirus infection updates.
Since 3 May and over the past ten days, approximately the same number of new coronavirus cases is being recorded in the Russian Federation. Therefore we don’t see any marked growth in these ten days.
All essential measures being conducted since the very first day remain topical and continue to be implemented in all the regions of the Russian Federation.
Men and women account for approximately the same number of patients. There have been some changes in the age categories, and the share of children under 17 has increased. Three weeks ago, this share totaled five percent, and it has now reached almost seven percent.
The number of patients in hospital accounts for 28.4 percent of all the registered coronavirus cases in the Russian Federation. All other patients are treated at home, and 41 percent have no symptoms at all.
Almost 40 percent contracted the novel coronavirus infection after closely contacting other patients. This confirms the theory that the infection is transmitted during close contact. And 37 percent became infected after contacting members of their families or friends in the initial stage of the disease.
The number of tests has increased considerably to expose as many coronavirus cases as possible. Polymerase chain reaction (PCR) tests are instrumental in diagnosing the disease. The number of these tests has risen quite a bit. Their manufacture has expanded, in the first place. Today, the Russian Federation manufactures tests for diagnosing three million people per week. Almost six million people have been tested in the Russian Federation to date, and their number will go up because the number of people being tested in every Russian region per day is among the main parameters. Today, this limit totals 70 tests per 100,000 of a region’s population daily. This would allow such regions to scale down restrictions and to lift some of them.
Today, we have received additional evidence that the virus remains sufficiently stable in the environment, and that it survives for up to 72 hours on a surface. Therefore the new methodological recommendations stipulate intensive disinfection measures. These must be unfailingly observed because the virus’ absence in the environment is among the conditions for preventing it from penetrating the human body and reducing the risk of infection.
The novel coronavirus infection is now perceived as an infection that will stay with us for quite a while. We need new rules linked with the restrictions for reducing risks and the number of patients. Two Presidential executive orders, issued just over a month ago, already formulate and stipulate them for the Russian Federation’s citizens and the country. Today, we have reached a stage when some regions can attain different levels of these restrictions that can become more lax. Special methodological recommendations, mentioned in yesterday’s Presidential Executive Order, were formulated to make this procedure clear and understandable. These rules include some provisions that determine essential daily measures. First of all, this implies the wearing of face masks. Today, virtually all Russian regions have ruled that their residents must wear face masks on a mandatory basis.
Anna Popova at the briefing
Next, disinfection is a must, and all working and other surfaces around people must be clean at all times. It goes without saying that hands must always remain clean.
It is also necessary to keep social distancing. Today, it has been irrefutably proved that the virus is transmitted as a spray of droplets, and that 1.5-2-metre distance between two people wearing face masks considerably reduces and virtually minimises mutual infection risks.
Mandatory requirements regarding a special regime to preserve the health and life of people aged over 65 and those with chronic pathologies remain in force.
It is important that special conditions be created at work places. Rospotrebnadzor’s special methodological recommendations stipulate them for almost every kind of activity, including industrial companies, the agro-industrial sector, construction companies, the service sector and many other areas.
Considering the current epidemiological situation, these recommendations stipulate sufficiently tough requirements. We hope very much that it will be possible to change these requirements in a changing epidemiological situation and in conditions of reduced risks.
The methodological recommendations contain extremely concise tools making it possible to assess this situation. And there are very many examples when regions implementing the entire range of measures attain indicators making it possible to lift certain restrictions fairly quickly.
Tatyana Golikova at the briefing
Tatyana Golikova: As the President said yesterday, the non-working days mandated by his executive order end in Russia on May 12, 2020. In effect, we have gone over to a new stage when regional authorities, regional governors will decide on the opening of different businesses in accordance with the new presidential executive order, in cooperation with regional chief public health doctors, and proceeding from the methodological recommendations adopted by the Chief State Sanitary Physician of the Russian Federation.
In adopting plans and lifting restrictions, it is very important for regional governors to be guided by the indicators that have been chosen the main ones for decision-making on easing restrictions. In all, there are three stages.
The so-called infection rate is the most important indicator. For a regional governor to lift restrictions, this rate must be one or below one.
Two other indicators – 50 percent free bed capacity and number of tests per 100,000 people are additional indicators to the key one. The infection rate shows how many people may contract the сoronavirus from one infected person before he or she is isolated. It may increase in some regions, so the decisions made in them must be carefully balanced. It is necessary to pay the salaries of employees at companies that will not be opened for public health reasons.
Anna Popova: All suggested measures on adopting or lifting restrictions should be very clearly justified on public health grounds. A decision may be drafted and adopted only after all current and projected indicators are analysed.
Methodological recommendations make it clear that restrictions may be reintroduced if there is a meaningful change in the epidemiological situation. The period in which a region may pass form one stage to the next, or cover all three stages in one go and get to virtually unrestricted movement and lifting of self-isolation orders depends on how strictly the already established requirements are fulfilled and how methodically the adopted restrictions are removed.
Tatyana Golikova: The virus we are dealing with is unknown. It is impossible to predict with 100 percent accuracy the course that the epidemiological situation will take. But if there is full compliance, we are hoping that life will go back to normal in summer.
Today, there are two well-known tests: PCR- and EIA- based diagnostics. The latter make it possible to determine the presence or absence of antibodies in people who recovered from the new coronavirus. Now a number of Russian regions and Rospotrebnadzor have launched a study of the population to establish how many people many have had the virus and developed immunity to it.
Naturally, medical workers are the first group in the study. They are working on the frontlines and it is important to establish whether they had the disease or not and whether they are susceptible to it.
The first tests by Rospotrebnadzor revealed that the number of medical workers who contracted the virus amounted to 21 percent of the total in the study group. They had stable titres that showed that they had been sick. Most important, they got sick not only in an infection hotbed but even before that, when they were simply living in society, in their usual environment.
We continue to conduct these studies. We should stress that Moscow was the first to launch a major study of its population to establish whether people had been infected by the new coronavirus or not.
Anna Popova: Next week we will start a planned and well thought-out population survey in several of the Russian regions to determine which part of the society has gained immunity to the new coronavirus.
It is a proven fact that the virus is producing an immune response and immunity. As for how long this immunity can last and how effective it can be, we need more time to answer this particular question. It is only four months that we have been working with this virus.
All positive PCR-based Covid-19 tests are immediately entered into special databases. This information is collected by the territorial departments of Rospotrebnadzor at all medical facilities, regardless of the forms of ownership and organisation, in all the Russian regions. The diagnostic laboratories submit their data, including complete information about the tested persons, to the Rospotrebnadzor database on a daily basis.
This data is compared to the information collected by the healthcare facilities in a given region. The information is complemented with the data about the treatment of every established Covid-19 patient.
Our diagnostic methods are based on the tenth revision of the International Classification of Diseases, ICD-10, which the World Health Organisation adjusted more than a month ago now. We are registering all the cases in accordance with the sanitary requirements that have been effective for years. Every case of infectious disease is registered in Russia and the information about this is provided via telephone within two hours, while written conformation or an email is to be forwarded within 12 hours. In other words, absolutely all the cases registered in Russia are entered into the database and brought together for subsequent reporting to the emergency response centre.
Tatyana Golikova: In accordance with WHO recommendations, we register all cases of laboratory confirmed cases. The diagnosis is only made after laboratory confirmation.
We have also benefited from the experience of other countries, because we had about two months when the new coronavirus infection was not spreading across the country due to the restrictions we had introduced, and we used these two months to analyse the developments in other countries.
We started monitoring all those who had respiratory disease and pneumonia symptoms at an early stage. They received treatment at home or were taken to hospital. We acted on the assumption that they could be carrying the new coronavirus infection and hence had them tested for Covid-19.
The number of tests we have taken has increased from 2,500 to nearly six million. It is a breakthrough achievement, which allows us to diagnose the disease and to take the necessary measures at an early stage. Russia will continue to build up these efforts.
Question: Could I ask you to comment on the report by The Financial Times alleging that Russia has been underreporting COVID-19 deaths?
Tatyana Golikova: We have never manipulated official statistics. Fatality statistics are published in the Russian Federation every month stating the leading causes of death. The April statistics will be published at the end of May. We do have updates for our daily effort to monitor fatality rates from COVID-19 in the Russian regions. The average fatality rate in the Russian Federation is 7.6 times lower compared to the world average. In Moscow, this indicator is 6.8 times below the world average. There are many identified cases in Moscow, since many people are getting tested here. Being a major industrial and transport hub, Moscow was the first to come into contact with this infection and face all the resulting challenges.
Question: Is there sufficient money in the budget to pay for the new support measures announced by the President, or will other reserves have to be used?
Tatyana Golikova: There is enough. We are very scrupulous when it comes to spending financial resources from the federal budget. Of course, we had to adjust our priorities. This is largely due to the restrictions that were introduced, making it impossible for us to carry out the events that had been planned. Accordingly, we have saved some money and can now repurpose some federal budget funds in order to support people and the economy. Today, we have absolutely no doubt that the budget will fully cover all the social commitments that were planned before the crisis, as well as those that the President announced in three packages. Our citizens will receive everything as intended by these initiatives.
More to be soon...
