The briefing agenda included the regions’ preparedness for coronavirus vaccinations, providing cancer patients with medications, progress in upgrading primary care, and the latest Rosstat data on natural population changes.
Briefing by Tatyana Golikova
Excerpts from the transcript:
Question: Ms Golikova, the battle against the coronavirus remains at the top of the agenda. You had a conference with the regions yesterday to discuss, among other things, their preparedness for the vaccination. Can you please tell us about the results of the conference?
Tatyana Golikova: Yesterday, following the instruction from Prime Minister Mishustin, a videoconference was held with the heads of all 85 regions of the Russian Federation and the project committee of the Healthcare National Project. Three issues were discussed at the conference including vaccinating the population against the novel coronavirus, reviewing upgrade programmes for primary care as drafted by the regions, and the subject of providing medicines for the population, especially cancer medications.
What decision were taken?
First, regarding the vaccination. Let me remind you once again that under the President’s instructions all regions are to launch the large-scale vaccination of the population against the novel coronavirus later this week. The delivery of the vaccine into civilian circulation and maintaining supplies at medical institutions are being organised as the vaccine’s qualities are being confirmed by tests. Along with Sputnik V, 7,800 doses of the EpiVacCorona vaccines from the Vector State Research Centre will enter the market this week.
At the conference, all the regions reported their preparedness for vaccination. Today, under Government instruction, the Ministry of Healthcare began tentative distribution of the vaccine to be delivered to the regions in December 2020 and January through February 2021. Distribution is based on estimates from Sputnik V producers. Over 6.9 million doses of the Sputnik V vaccine are expected to enter the civilian circulation from December through the end of February. In addition, the Vector vaccine, the delivery volumes for civilian circulation are currently being assessed.
Apart from that, categories of people for priority vaccination have been defined. The regions can change the priorities as defined at the federal level depending on the epidemiological situation in each particular region.
Prime Minister Mikhail Mishustin has weekly meetings with the vaccine producers to coordinate production volumes and civilian distribution as well as other issues requiring Government oversight. Tomorrow, Friday, the next meeting is due with the manufacturers of Sputnik V and EpiVacCorona vaccines.
The second issue discussed with the heads of the regions was the drafting of upgrade programmes for primary healthcare, as instructed by the President. We reviewed all 85 programmes. As I said at the joint meeting of the project committee on the Healthcare National Project and the regions, these programmes have been approved with minor amendments. Let me remind you once again that over five years the federal government will allocate 500 billion roubles to the regions for this purpose. The regions are to contribute at least another 50 billion.
In the next three years, 2021, 2022 and 2023, in accordance with the budget signed by the President today, 270 billion roubles will be allocated to this end.
In addition, after project committee approval, the regions are to adopt these programmes before 15 December and enact them from 1 January 2021. What is most important, they should not only approve the programmes, but following the instruction issued at the project committee meeting, they must inform the regions’ residents in an accessible manner about the steps to be taken in particular towns and villages and in specific medical institutions as regards the modernisation of community-based primary healthcare. This concerns local medical stations, regional clinics and central clinics in a particular region.
Third, in pursuance of the efforts launched by the Government to provide the public with cancer medications and depending on the situation in the regions, their top executives were instructed to analyse the sufficiency of drug inventories for cancer patients and take measures to ensure the treatment of patients in strict compliance with the standards of medical treatment and clinical recommendations. Also, it was recommended that the Federal Mandatory Medical Insurance Fund and medical insurance organisations check the medical records of cancer patients undergoing chemotherapy to establish if the respective standards for medical treatment and clinical recommendations have been followed in full. This is being done, among other things, to understand how efficiently patients in follow-up care are being treated. The regional leaders, the Healthcare Ministry, the Ministry of Industry and Trade and Roszdravnadzor were also notified of the need to ensure the provision of enough medicines during the holiday season so that no distribution disruptions occur during the fairly long period from 1 January to the end of the winter holiday season.
I should also say a few words about the key Government decisions in healthcare that were taken this week in connection with the passing of the federal law on the 2021-2023 federal budget. With account of the fund being established under the President’s instruction to provide medicines for children suffering from life-threatening and other orphan diseases, nearly 780 billion roubles will be allocated by the federal budget over the next three years for the provision of medicines. I stress that this sum is set aside in the federal budget alone. Of this amount, 251 billion roubles will be allocated in 2021. In addition, the Government decided at today’s meeting to send an additional 2.7 billion roubles to the regions to provide medicines for coronavirus outpatients.
Under the decision, the regions must now sign respective contracts and purchase medicines so that in January outpatients being treated for the coronavirus will have a sufficient amount of these drugs.
Also, amendments were made to the Healthcare Development national programme. They pertain to the rules for subsidising some tracks that were not included in the Healthcare National Project. I would like to talk about three of these tracks.
First is high-tech medical treatment for citizens of the Russian Federation. I would like to report that 345 billion roubles are earmarked for these purposes in the coming three years, including 116 billion in 2021. This will make it possible to provide medical treatment to 314,000 patients in 2021 and to 872,000 patients over the next three years.
In addition, the Government has been closely monitoring and coordinating the situation with palliative care in the regions for several years now. In the next three years, over 11 billion roubles will be allocated for this this purpose, including 3.7 billion in 2021. Financing will be provided to all 85 regions of the country to pursue regional programmes on palliative care. The money will be used to provide medications, including painkillers, for people in need of such care; to supply regional medical facilities which render palliative care with medical items, including for home use; as well as to buy new vehicles for them for a separate mobile palliative care service for adults and children. Such vehicles must be equipped in accordance with standards under the regulations on organising palliative care.
And another track that I would like to dwell on in detail are steps on preventing cardiovascular diseases and cardiovascular complications in high-risk outpatients.
The regions will receive almost 30.5 billion roubles from the federal budget for this, over 10 billion each year. These sums will go to provide medications to outpatients who had a serious cerebrovascular accident, a cardiac infarction and other acute cardiovascular diseases. This year, around 75 percent of such patients receive these drugs. The number of patients will increase next year. I mentioned this because it is becoming more relevant these days.
Now I would like to move on to the issue of the mortality rate in the past ten months. You are aware that today the Federal State Statistics Service (Rosstat) will publish data for these ten months. Here I would like to mention several key issues.
Unlike some nations who publish crude death rates and novel coronavirus mortality rates, we do not conceal mortality statistics; we publish them regularly 40 days after the end of the reporting period. Russia continuously sweeps the records of the natural population changes through entries in the single state registry. Since the onset of the pandemic, the Russian Federation has opted for a strategy of separate records for COVID mortality rates as well as recording all cases where the virus exacerbated existing chronic diseases and, unfortunately, led to death.
Meanwhile, in order to take prompt management decisions to assess the load on the healthcare system, the emergency response centre has been publishing daily statistics on new COVID-19 cases as well as data on recovered patients and, sadly, on the deceased, without altering the methodology, I stress, since the start of the pandemic. However, we publish statistics on deaths every day but only for an unequivocal diagnosis of COVID-19. Later, within the 40 days, the data are being checked and specified based on autopsy reports and are released by Rosstat as official statistics.
I would also like to say that we closely monitor the incidence of the disease and the mortally rates worldwide, and we see that some countries tend to change their data either to underreport or over-score official COVID-19 mortality rates due to different rules of cause-of-death recording regulations or coding.
Judging by open-source data, for example, a COVID-19 death is recorded in Spain when a positive test is available while an outpatient mortality from COVID-19 is not recorded. In Belgium, practically all deaths are recorded as COVID-caused. In England and Wales, mortality rates significantly increased due to so-called “symptoms, signs or imprecisely defined conditions and other symptoms including debility and senility.” These causes of death are classified as “other causes” and show the misleading nature of the true cause of death.
We have repeatedly said that in compliance with WHO recommendations, four groups of mortality have been defined with diagnosed COVID-19. Let me remind you: Group 1 - COVID-19 as the major cause of death; Group 2 - COVID-19 is presumed to be the main cause of death, however, more research is needed to confirm the diagnosis; Group 3 - COVID-19 tested positive and the coronavirus affected the course of a chronic disease that led to death; and finally, Group 4 - COVID-19 tested positive but it did not contribute to death.
Regarding the four groups, the April-October data when we first began recording COVID-19 mortality data, Group 1 had 37,566 deaths, Group 2 – 8,307 people died, and Groups 3 and 4 with positive COVID-19 tests, another 32,374 people died.
The data on the last three groups may be corrected in the subsequent official statistics for the 11 months (let me stress – may be corrected) following the results of the autopsies. But if adjustments are made based on medical reports, it always, in all cases is reflected in the statistics.
As for the overall mortality rate increase in the ten months of 2020, it was 9.7 percent over the same period last year. Meanwhile, we clearly see that at least 19 regions in the country would not have recorded increased mortality rates in the absence of COVID-19; on the contrary, they would have shown decreases.
Another trend we are watching, which I talked about in the previous briefing, is our observations, based on specialists’ reports, of increased deaths from cardiovascular diseases. You know that cardiovascular diseases are the first and leading cause of death in the Russian Federation. I want to approach it a little differently – this growing death rate is caused not only by the regular course of a cardiovascular disease but also by the course of the disease exasperated by previous COVID-19 , even in a light form. The causes of death in these cases are an intensified course of atherosclerosis, failing decomposition of cardiac distress or sudden heart failure against the background of fatal arrhythmia. This is why I said at the beginning, when speaking on mortality rates, that financial resources from the federal budget to provide medications to cardiovascular patients are of key importance for helping such patients.
Considering all the factors we have been analysing today and continue to identify, as well as traditional mortality rate increases in the winter, something that has been recorded in all statistical data in past years, we expect a higher number of deaths this November and December. Nevertheless, I want to reiterate that our medical workers are doing everything possible, and at times impossible, to save a human life, and we are endlessly grateful to them for that.
In this regard, I would like to address our esteemed citizens. Dear friends, our favourite holiday, New Year, is coming. We are getting ready for this, but please, take care of yourselves and your families: limit the celebration to a narrow circle, wear masks in public places, avoid travelling to the regions and countries where COVID-19 incidence rates are high. And then, together, with the vaccination which has already begun, we will definitely overcome this dreadful virus. I have great hopes that you will hear us.
Question: Ms Golikova, the New Year is traditionally welcomed with a glass of Champaign. Meanwhile, specialists are advising people who have been vaccinated against the coronavirus to abstain from alcohol. But opinions about the time vary greatly – from several days to six weeks. What is the truth?
Tatyana Golikova: First, I am very pleased that the topic of a healthy lifestyle has been a top news item for a week now. Second, I would urge everyone to listen very attentively to the official information we are providing. This information does not, let me stress, ban alcohol, but calls for limiting the amounts of alcohol and medicinal drugs that influence and suppress the immune system. Third, I would advise our citizens who voluntarily opt for the vaccination, to abstain from alcohol for at least three days prior to and after the vaccination. This is critical for the forming of the immunity we are all expecting; and check the antibody tests – whether they are there after the vaccination or after the person recovers from the disease.
I would like to say one more thing. It is important to understand that when we are going to have a blood test or have a gastroscopy, we should certainly never abuse foods or drinks before going: we do not eat fatty or salty foods, we do not drink alcohol, we do not do any of that either in the evening or in the morning, and then nobody will feel uneasy about this. If we get sick and take drugs to help our body defeat the ailment, we don’t drink either. This is why I have a request to help your body build immunity: hold back from alcohol for a little while. Let’s rejoice at seeing the New Year in and have a happy holiday season.
