From the transcript:
Today we are holding a regular meeting of the Presidium of the Government Coordination Council to control the incidence of novel coronavirus infection. Even though the situation continues to gradually improve, we are constantly monitoring it to be able to quickly identify infected people and provide assistance, and most importantly, we continue to conduct massive testing of citizens for this infection. This is one of the key measures to contain the coronavirus.
Before moving on to the reports on the current situation, I would like to say a few words about an important decision that we have made on behalf of the President. We have established a special procedure for medical workers now helping patients with the coronavirus or suspected coronavirus for calculating their length of service and retirement age. One day of working with such patients will be counted as two working days. This rule will be applied from January 1 to the end of September 2020. A corresponding government resolution has been signed.
Thanks to this decision, about 4,000 doctors and other medical workers will be able to retire early every year. According to preliminary estimates paying them all their retirement benefits will require an additional 325 million roubles annually. We will earmark the required funds in the federal budget.
Let’s begin discussing today's agenda.
Mr Sobyanin, I know you continue to keep in touch with the governors as part of the State Council coronavirus working group. Please update us on the situation in Moscow and in other regions.
Sergei Sobyanin: Mr Mishustin, colleagues.
At the President’s instructions, we continue the work within this State Council working group, exchanging information with our colleagues and discussing arising issues in the State Council. We are cooperating with all the ministries and agencies to promptly address arising issues.
As soon as tomorrow, we will hold a teleconference on the autumn season, the start of the new academic year, including the re-opening of schools and higher educational institutions, as well as the seasonal epidemiological situation – specifically, increased flu, acute respiratory infection morbidity and so on. Naturally, the COVID-19 situation is an additional circumstance to deal with. We must do everything we can to prevent it. Large-scale flu vaccination is required. We will discuss this and other issues tomorrow.
In my opinion, the overall situation has significantly improved and every week we see positive developments. However, the regions can be roughly divided into three groups. The first group includes some areas that have not been through peak morbidity and not acquired herd immunity yet. These are the regions where we are seeing the case count grow. But this category is on the decline. The majority of regions are past the peak. We are seeing decreasing cases of pneumonia, fewer new patients and so on. The third group is regions that peaked one or two months ago and are now moving towards the lowest numbers, similar to many other regions in the world. Where there were high infection rates and the population developed significant herd immunity, the situation is stable. I am talking about Moscow and the Moscow Region, St Petersburg, Central Russia and a number of other areas.
Speaking of Moscow, the situation has been stable for the past two months. The number of cases remains at the same level, with some positive trends, despite the fact that we reopened everything and people can move around freely. Ninety-one percent of traffic in Moscow has resumed. The majority of companies and organisations have also resumed operations. Small and medium-sized businesses are showing sales that are even slightly above the pre-crisis level. All facilities are fully operational, including industrial and construction companies. Despite the population being very active, the situation is stable and the most recent statistics show an increase of just over 0.3 percent.
Moreover, we continue to increase and expand testing. More than 300,000 tests have been conducted in the past week. Is it a large number? It is twice as many tests as in New York and six times more than in Madrid. Moscow is the number one metropolitan area in terms of testing. We are not scaling down yet in order to promptly detect new cases and provide timely medical help to our people.
At the same time we see that the number of asymptomatic carriers is quite high, around 60 percent. This number is substantially higher than in the other regions because of wide availability of PCR and EIA testing in Moscow, including by voluntary appointment. By the way, testing by voluntary appointment has contributed to higher detection rates. Common screenings such as employee screenings in companies and other organisations proved five times less efficient than voluntary appointments. Residents who may feel unwell or may have been exposed come in for testing, which results in faster diagnostics.
What trends have we noticed in the past month? The cases of pneumonia related to COVID-19 have dropped by almost half; 25 percent fewer patients are connected to ventilators; 22 percent less of hospital beds are occupied. Twenty-three major clinics have been relieved from the responsibility of receiving coronavirus patients and have returned to elective care.
The increasing number of acute respiratory infections and flu is, of course, a cause for concern, as I said. But first, we will be preparing for vaccination. And second, as recommended by Anna Popova, Head of the Federal Service for Consumer Rights Protection, we have divided patient traffic more clearly into those with common pneumonia, COVID-19 pneumonia, severe flu, acute respiratory infection and so on. It is very important to make sure these categories are separated from each other. This is difficult but it must be done.
Of course, Mr Mishustin, registration of a Russian
vaccine is highly anticipated. Once the vaccine has been registered, we will be
able to start mass production and vaccination of the public, which will be the
biggest solution to this problem.
Mikhail Mishustin: Thank you, Mr Sobyanin.
We are also expecting this: I hope this happens soon. I would like to say that the President has stressed many times that even under the increased loads in autumn and winter our hospital and polyclinic operations have to remain stable so people can fully receive emergency and regular medical care. At the same time, there must be a reserve of specialised beds to treat patients with the coronavirus in the regions, including patients with complications from the flu, as you said.
Mr Murashko, how are things going with this? Are any other government decisions necessary?
I would like you to report on the preparations for the vaccination against the flu among other things.
Mikhail Murashko: Good afternoon, Mr Mishustin, colleagues. First, I would like to say that the general situation in Russia shows a small but positive trend regarding the number of patients being treated in hospitals. We note that the number of patients in intensive care with ventilators has decreased to less than 3,000 in recent weeks. However, the situation still requires focus and certain measures such as distancing and personal protective equipment.
Right now there are 142,336 designated beds, and 35 percent of them are unoccupied. We strongly recommend that the regional executive authorities use the beds for double purposes and, if not necessary, return them to normal use in order to admit patients with different diseases and provide regular and emergency aid. This is why we would like you to issue a directive on the effective and rational use of double-purpose beds, as we are calling them now, or repurposed beds, for the regions.
We can see that excessive capacities are also affecting the efficiency of medical care. We started holding meetings in the regions to decrease medical and demographic indicators and return to normal operations, including regular health checkups.
Regarding flu vaccinations, we said that on 10 August we started to deliver the vaccine to remote Russian districts: 50 percent of the vaccine for this year’s regular vaccination programme will be delivered by 31 August 2020. The rest will be delivered to the southern regions in September and October, according to the vaccination plan. Under the President’s instructions, we have developed additional materials for vaccination, which are now in the final stage of agreement with the Finance Ministry.
I would like to note that the infectious disease facilities (to date, 22 new facilities have opened) comply with all the latest standards: they have gasification, intensive care units and, importantly, they provide almost 100 percent hospitalisation in Meltzer's boxes. This means they are being used today in preparations for the autumn and winter, including as provisional hospitals, in order to separate patients with the coronavirus from patients with other infections. Today we plan to open an infectious diseases hospital in Kazan with 232 beds, which you visited. It will open today.
We are also continuing our international activities. Our experts have returned from Kazakhstan after fulfilling their task. An expert group is preparing to go to Uzbekistan.
Moreover, experts have visited more than a half of the regions to consult. Consultative intensive care centres continue their expert work. Today, the system in general is functioning satisfactorily and running smoothly.
Mikhail Mishustin: Thank you, Mr Murashko.
I would like to ask Anton Siluanov together with the Ministry of Health to study the possibility of allocating the funding needed for the upcoming flu vaccination in the near future.
I would also like to draw the attention of the regional leaders to the need for monitoring the use of specialised beds to treat coronavirus patients and to assure the required reserve. They should also include the possibility of quickly deploying these beds that can be used for their main purpose. If necessary, they should be converted for treating patients with infectious diseases. Any extra beds should be used for regular medical treatment again.
Now I would like to give the floor to Anna Popova. Ms Popova, what do you think about the entire epidemiological situation in the Russian regions?
The epidemiological situation in the Russian Federation is stabilising. We are seeing a very confident trend, and fewer people are becoming infected each day, that is, new cases. I would like to draw your attention to the fact that the daily increase in the number of coronavirus cases is now at about 0.6 percent. Since 31 March when restrictive measures were introduced, it has dropped almost 50 times over.
We continue to monitor the incidence of community-acquired pneumonia cases. We consider this indicator very relevant. It is listed in our methodological recommendations. In the past four weeks, the number of community-acquired pneumonia cases has decreased all over the Russian Federation, and this trend has become somewhat stable. Adults are about 97 percent and children account for about 3 percent of these cases.
We monitor the socio-professional lineup of cases, and I would like to draw attention to the following changes. All economic sectors are now open, and industrial workers account for over 16 percent of new COVID cases in the past 31 days. The breakdown for healthcare employees is 13 percent; civil servants, 6 percent; educators, 5 percent; and retail workers about 6 percent. By the way, the education has just begun to reopen. This indirectly confirms the fact that not everyone is complying with Rospotrebnadzor requirements and recommendations during the organisation of working processes. I would like to note the need to unfailingly comply with these requirements and recommendations because the disease at companies, especially those whose employees work with consumers, is a certain epidemiological risk.
Since July, we have been monitoring people returning from Russian and foreign resorts for COVID cases. In terms of intensive indicators, the most obvious factors, and epidemiology uses the most intensive factors, then, by analysing the number of infected persons who have returned from resorts in the Krasnodar Territory, the Republic of Crimea, the Stavropol Territory, the Republic of Daghestan and foreign countries… there are about six infected persons per every 10,000 people who have returned from Russian resorts. This figure remains the same for all regions in the Russian Federation. It may not seem so high, but it is there, and this, too, highlights the need to comply with the recommendations at the Russian resorts. These people have had their vacations, they are back home, and their bodies have provided certain clinical manifestations after a present incubation period or have tested positive following polymerase chain reaction (PCR) tests.
At the same time, one person who returned from Spain, one from Kazakhstan, and four people from Turkey, have fallen ill in the past seven days. This too is being closely monitored.
We continue monitoring serology testing for COVID-19. We have conducted these tests in 26 regions in all age groups of the population. The highest number of anti-body positive patients in the group of people that were chosen by special methods is as follows: 24.5 percent in the Tyumen Region, 27.8 percent in the Tula Region, 26 percent in St Petersburg and 31.5 percent in Tatarstan. We see a clear dependence between the time of conducting the studies and the beginning of the surge of the epidemic and the maximum number of infected people in a region.
The same trend is clearly demonstrated by our testing of Moscow medical workers. We have already conducted more than 19,000 tests. The tests of medical workers that we made in April showed that the due amount of G immunoglobulins is revealed in 17.7 percent. We repeated these studies in a little over 30 days. The same people had a share of hyper immunity of 49.4 percent. In other words, what scientists say is being confirmed through the scientific and practical results of the studies – in a definite amount of time people develop a due amount of memory cells. Our period of studies is justified. We conduct them not during the surge but during the period from 48 to 52 days that is necessary for the formation and assessment of immunity.
We are also continuing to monitor the circulation of the virus in the environment. At this point, we have taken almost 3,000 samples, which is a lot more than before, of water reservoirs and places with water: swimming pools, water parks, sources of the centralised water supply and distribution systems, wastewater and food product wipes. As of today, we have not identified any positive results. This confirms that all requirements in this area are being followed. We have not identified either a live virus or any remnants through PCR testing.
In accordance with the instructions of the President and your instructions, Mr Mishustin, we continue working to help our colleagues in the post-Soviet republics and further abroad. Our colleagues continue working in Guinea and Vietnam. In Vietnam, our mobile laboratory that is permanently based in the tropical centre, has been sent to the hotbed of the disease and continues to operate there. In Guinea, all studies for many people, including the country’s leaders are being conducted in our laboratory in Kindia. Our specialised anti-epidemic team is helping our colleagues in Beirut. A group of our scientists and people on the ground have been working in Abkhazia for over a week, monitoring the spa and tourism season outside Russia.
Our colleagues have returned from Tajikistan, Kyrgyzstan and Kazakhstan. We continue consulting them online. Today, the results of our joint efforts in these countries are clearly obvious. The increase rates are dropping, the dynamics are improving and we hope that jointly we will achieve positive results on stabilising the situation beyond Russia’s borders as well.
Mr Mishustin, I would like to ask you again to draw the attention of our colleagues in the regions to the need to observe all methodological recommendations, considering that we are carefully watching the current opening of the concert and theatre seasons. Concerts and plays have already started. Rehearsals are beginning. The sports season is continuing. Competitions at different levels are being held in the country. As of today, this is going on fairly successfully with the observance of all recommendations and without any complications.
Mikhail Mishustin: Thank you, Ms Popova