Covid-19 pandemic. Episode 2

• Russian officials had several months to prepare for the second wave of coronavirus: how did they deal ?
• In Russia, the “Return of Names” was held in Russia, which is held on the day of memory of victims of political repression.

PANDEMIC. The episode is the second

Crowded hospitals, and in some regions - morgues. The third day in a row in Russia is recorded a record number of new coronavirus and dead with this diagnosis. In the regions there are not enough doctors, beds and oxygen cylinders. Says Anastasia Tishchenko .

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In the Radio Studio Liberty - President of the League of Patient Defenders Alexander Saversky .

Alexander, what's going on?

Alexander Saversky: There is a panic created to a huge extent artificially. And all that we have seen now is to a huge extent part of this show. Your journalist carefully said that "relatives are not taking their bodies, and there are not enough pathologists." Why is there not enough?

Video version of the program
Maryana Torocheshnikova: She reports why they do not take the bodies - because they are on isolation. And the administration reports that there are not enough pathologists.

Alexander Saversky: This is not because people suddenly began to die a lot. This is a technical problem. And a pathologist, maybe he was also sick, sits at home, like many doctors: a huge number of doctors sits home, because the departments are closed to quarantine, and there are not enough doctors. And it may turn out that there is no pathologist, so the corpses are not buried. And these pictures walk immediately on the Internet, cause horror-uzhas: a nightmare, a plague ...

Maryana Torocheshnikova: And the situation when an ambulance travels all over the city of Omsk for ten hours and cannot hospitalize a person?

Alexander Saversky: Maryana, let's begin to dispel panic, otherwise this whole horror-uzhas will lead to the fact that people will continue to die more actively than they died with any other SARS. I ask the press one question: "How many people get sick in an ordinary epidemic season?" Why does the press in the eighth month of the so -called Pandemia not know the answer to this simple question? And coronavirus is SARS.

Maryana Torocheshnikova: Because such reports have never previously reported, representatives of state power have not organized headquarters to prevent SARS.

Alexander Saversky: Where did you get it? We had all sorts of situations. Epidemias exist almost all the time.

Maryana Torocheshnikova: Previously, this did not sound from the lips of the presidential spokesman, the president himself, the Minister of Health, Rospotrebnadzor ...

Mathematics is inexorable: 140 thousand a day is sick in the epidemician

Alexander Saversky: But mathematics are inexorable: 140 thousand a day is ill with SARS in the epidemic season. And then there is a panic. We are told that Covid is almost a plague. Here is my friend, a candidate of medical sciences, sent a picture: 1820-Osopa, 1920-Spanish influenza, 2020-coronavirus, such as: "Save yourself who can! There is a quiet selection." Are you a doctor or who? What does the plague have to do with it? This is not a plague - this is what you need to understand.

Maryana Torocheshnikova: Listen to the commentary of Mikhail Favorov , Doctor of Medical Sciences, Epidemiologist.

Mikhail Favorov: We are faced with the most terrible infectious pandemic since the end of the First World War. We have already lost so many people, that is, additional mortality is so exceeding the previous ones ... I think that this pandemic will be a leader in the significance of fatal outcomes during the new time. The epidemiologist cannot know this, and if he does not know, then he is not an epidemiologist. When a mother gets sick with such an epidemiologist, she must be sent to the hospital, because if she does not breathe, she will die, and if the device will breathe for her, then the mother will still live, maybe he will recover. And this epidemiologist immediately understands: "I said something wrong." Such “sofa” experts are people pushed away from reality, who simply are not in hospitals, do not see what is happening with an ambulance that takes a person who no longer breathes, and she holds him on a temporary apparatus. And where to put him, they do not know, because all the beds are busy. This is a complete profanity of modern science and medicine. And of course, this is an outrageous fact.

Alexander Saversky: I heard other virologists and epidemiologists, who, fortunately, can count, and do not reason in general. Favorov can say anything, but he frankly lies.

Maryana Torocheshnikova: This is from your point of view. He expresses his opinion.

Alexander Saversky: I will show this on numbers. In 2014, 42 thousand people died in Russia from pneumonia. Now only 22 thousand have died from the Covid-19. Covid almost always ends with pneumonia, and now we have practically no ordinary pneumonia.

Maryana Torocheshnikova: But she is not considered separately?

Alexander Saversky: This is a good question! For example, we have practically no flu. It seems to be, but we have everything "covid". So, additional deaths that he speaks of (50 thousand deaths), they are not “covid”, but panic, that is, many causes of death were created by panic, in particular, Mr. Favorov. Maybe for him the "sofa" specialist and Nikolai Filatov, the former chief epidemiologist of Moscow? And he says directly opposite things: "When we had Hong Kong influenza, there were 102 thousand sick people per day in Moscow." And nothing, no Lokdown, we coped! And there was no plague, smallpox and everything that he tells us, in 100 years. This is a frank lie!

Maryana Torocheshnikova: Why is all this now? All crazy, or what?

Alexander Saversky: Do you know about the existence of "panic bonds"? These bonds were issued by the World Bank in 2017. How does the World Bank produce such strange papers in anticipation of panic - a security for pandemic? Are they waiting for a pandemic? Yes, they are waiting. It turns out that in four years we had four types of exercises, the last of them-in October 2019, in the same October, when the teachings of the Americans went to Uhan. Such strange coincidences - you just wonder! And we have in October 19th ... Take the technical conditions of the masks that everyone is now worn. For the first time, the concept of “asymptomatic” patient, dangerous to others, appears.

Maryana Torocheshnikova: I know the people who have ill -made Covid in severe form.

Alexander Saversky: I do not deny! I was too ill. And what?

If the sense of smell had not disappeared, I would not even know that I was sick, I walked and infected other people

Maryana Torocheshnikova: And I was ill with Covid. And if the sense of smell had not disappeared, I would not even know that I was sick, walking and infecting other people.

Alexander Saversky: And where did you get that you would infect? Who told you this?

Maryana Torocheshnikova: Doctors!

Alexander Saversky: And other doctors say that this is a circus, this does not happen. I wonder if Mr. Favorov is actively connected with allocated monetary resources. Here Filatov, for example, is definitely not connected.

Maryana Torocheshnikova: Favorov is also not connected. He works in an independent laboratory.

Alexander Saversky: And the laboratory is not financed in the "covid" era? Do you believe it yourself?

Maryana Torocheshnikova: But the whole world could not go crazy. Europe is now closing to quarantine, Israel has closed ...

Alexander Saversky: Can you believe that China really localized the infection? There the population is one and a half billion. Despite the fact that they learned about her at least three weeks after people began to suffer seriously, that is, she walked until this time. This is impossible! This is not there.

Maryana Torocheshnikova: Let's see a small report from Primorye, the region that is near China. There, on October 29, 187 new cases of Covid-19 were officially recorded. It is now possible to pass the PCR tests there in private and state clinics, but the record on them only from mid-November.

The editors suggest that in the comments to the ether, which is now broadcast, including on YouTube, people ask: "What kind of conspiracy theories?"

Alexander Saversky: No conspiracy theories! Let the pandemic bonds of the World Bank watch. You have now shown a report about the region that is next to China, so there is nothing in China. During any other ARVI, 140 thousand people are sick per day, and a million per week. And we have a million people got Covid from March 1 to September 1, that is, in six months. But if you make people panic, inspiring them that this is a really deadly disease, then you will not have any capacities, personnel, drugs, ambulance, nothing. It will be the price of panic. Because people at the first sneeze ... Remember, where did we start? People with suspicion of Covid, that is, on SARS, were obliged to hospitalize!

Maryana Torocheshnikova: It was at the beginning. Now they are no longer taken even with bilateral pneumonia and lung damage.

Alexander Saversky: Because 140 thousand a day: there is nowhere to put them. They were scared: of course, they go. Well, normal, of course, do not go anywhere, and those who need to, can’t get there - this is the worst. The Ministry of Health announced that week that 20% of people who are hospitalized do not need it. Let's figure out: out of ten thousand beds in Moscow, two thousand are occupied by patients who do not need it. A huge figure!

Maryana Torocheshnikova: How did they end up there?

Alexander Saversky: They are scared.

Maryana Torocheshnikova: Because no one explains anything about this virus, everyone says: "You will immediately begin to choke."

Alexander Saversky: Well, you will figure it out - and it will not be scary.

Maryana Torocheshnikova: But how to figure it out if you don’t even understand where to look for information?

Alexander Saversky: But do you understand that this is not a plague?

Maryana Torocheshnikova: I understand.

Alexander Saversky: This is critical. And if this is not a plague, guys, why did you cancel all our rights? And why do people begin to die from the fact that you forbid them to live normally? We have the number of additional deaths not from Covid twice the “covid”. Well, let all 22 thousand lie with Covid ... 72 and 22 - 50 thousand additional deaths not from Covid! And from what?

Maryana Torocheshnikova: From ongoing medical care.

Alexander Saversky: From in time the help, from depression, suicides, alcoholism and heaps of other new diseases. But from masks, by the way! People who say: "We cannot breathe, we fall into fainting." Aunt writes: "I fainted three times." I write about this to Rospotrebnadzor. And he now answered: "Put over masks to everyone!" Frame from Kemerovo September 25: a woman lies on the street - she died right in a mask. After that, Popova issues this completely criminal decree. The number of deaths from cardiovascular diseases has grown by 10%in Russia! Plus new methods of treatment.

Maryana Torocheshnikova: Here is another statement by the virologist Mikhail Favorov .

One of the principles of the fight against pandemia is the maximum knowledge of all people about their status in relation to this infection

Mikhail Favorov: One of the principles of fighting pandemia is the maximum knowledge of the population, that is, all people, about its status in relation to this infection. Therefore, diagnostic tests and rules for their application are fundamentally important. At the time of the beginning of the epidemic, everyone rushed to use the reaction of the PCR, which determines the nucleic acid of the virus. This is a very sensitive reaction, it allows you to determine the minimum particles of nucleic acid. But recently, a fairly large number of scientific works have appeared, where it is shown that at best, PCR can determine only 60% of the total number of infected people: such a test has a very serious restriction.

On the other hand, antique tests show, say, class G antibodies and indicate that a person is ill. The risk of such a person is to be a source of infection, to get sick again not comparable than those who do not have antibodies. When a person knows that he has Covid, he behaves differently and becomes much less likely to become a source of infection (this is shown dozens of times on the example of various infections). These are the so -called behavioral things that are completely not taken into account in the routine, official epidemiology, which is wrong. It is necessary that there are a lot of tests to be available to anyone, anywhere, anywhere, anywhere. This will lead to a decrease in the spread of infection.

Maryana Torocheshnikova: Alexander, from your point of view, can generally stop panic or bring people to normal so that they correlate their well -being with analyzes?

Alexander Saversky: The worst thing that happened in April was that from the process of making a diagnosis practically excluded doctors. Mr. Favorov did not say that the diagnosis is made by the doctor, not tests. This is a key point, especially considering those testing errors. How can you trust the test when you have no clinical manifestations?

Some German doctors generally say that we have a pandemic of false positive tests. If you have at least some false positive percentage, for example 5%, imagine that out of a million tests you will have 50 thousand false diagnoses! WHO in April introduced the Covid-19 to the ICD-10 and ordered it to be encoded only on the basis of tests, without, despite the patient's condition. This is a violation of the basics of making diagnoses, the meaning of medical work! The doctor is not needed at all. He was simply turned off from the process. This is some kind of nonsense!

Maryana Torocheshnikova: It also surprised me very much. When I was diagnosed with Covid by the test, no one even asked any other details, they did not take blood tests from me to establish if there is an inflammatory process.

Alexander Saversky: In this situation, Covid can continue endlessly, because if you have at least 5% of false positive tests, then the epidemic will occur almost constantly, because 5% is an epidemic threshold. And if the doctor does not participate in this, then as a result the number of patients will grow all the time.

Maryana Torocheshnikova: Surprisingly, of course! In the spring, with a much smaller number of the sick, the whole country was sent to self -isolation, and many honestly followed the rules - they wore masks, sat at home, showed social responsibility. And now it seems that everyone has already spit on these rules - masks are worn on chins or are not worn at all, they do not observe the distance.

Alexander Saversky: People realized that this was not a plague.

Maryana Torocheshnikova: But for someone this is a really deadly disease. The same Mr. Filatov, the former chief sanitary doctor of Moscow, to whom you refer, says in an interview that there are young people who carry this disease easily: maybe they do not need to observe special measures, and, moving from one to another, the virus will lose their strength, but if he begins to walk among pensioners ...

This is not a plague, and people understand this, because there is no mora around them

Alexander Saversky: We look at mortality - and we understand that nothing terrible happens. This is not a plague, and people understand this, because there is no mora around them.

Maryana Torocheshnikova: Why then a mess in hospitals?

Alexander Saversky: Because panic was artificially created. And people go there with fear, because they were told to go: in particular, with the help of you, Maryana. All spring people complained to me that they could not even call an ambulance with a broken leg, for example. And what could I do in this situation when even the prosecutor did not work at that time? All our rights with you are destroyed by what is happening.

Maryana Torocheshnikova: Let's listen to an ambulance paramedic from the eagle - this is the coordinator of the “action” trade union Dmitry Seregin .

Dmitry Seregin: I categorically disagree with your guest. Alexander says that we offer patients hospitalization that they do not need: this is not so. Now throughout the country, especially in the regions, the situation has significantly deteriorated compared to spring. In our eagle there are practically no beds, that is, it is lucky only for those lucky ones who fall into the places of those who are discharged from the hospital. Literally the day before yesterday, we had the entire ambulance hospital for Covid, that is, all patients were taken from the "clean" departments to another hospital.

If we talk about statistics, then I do not trust her: there is reason to believe that the situation is much worse than they draw it. For example, I have a forensic medical examination: a person died of pulmonary edema caused by Covid virus, and he is written "acute respiratory failure." That's how it is encoded and does not fall into Covid statistics!

I have been working on an ambulance for eight years and have never observed so many patients with pneumonia in my life. Moreover, I work in a "covid" brigade and go mainly to those people who have reason to suspect a new coronavirus infection. People do not cause an ambulance just like that, they have already passed the stage of fear and are now sitting at home, they are afraid, but they are afraid and get to the hospital, because all the hospitals are “covid”, even if you have pneumonia of bacterial genesis. And the saddest thing: people are sitting at home, and they develop respiratory failure. With me, patients with pneumonia, with lung defeat in the region of 15–20%, send home with recommendations: “If it gets worse, bring it,” that is, they take mostly the most difficult ones that do not cope, begin to suffocate.

Yes, all the years before that there were SARS, flu ... I found both pork flu and other viruses. But there have never been so many pneumonia! И такого количества вызовов, с такими задержками... А в Орле задержки неделю назад достигали 10 часов ожидания, даже местами 12. Вчера на смене мы приехали на вызов с задержкой в три часа (повод – высокая температура и пожилой возраст). Нам не открыли дверь. Мы позвонили в диспетчерскую, и нам ответили, что человек уже находится в морге, то есть он просто не дождался помощи.

Марьяна Торочешникова: Страшная история!

Александр Саверский: Дмитрий, вы все говорите правильно. От вас другого и не требуется, и не ждет никто. Вы прекрасно делаете свою работу. Но вы ездите к больным пневмонией, а всем сейчас рассказали про пневмонию, и именно этого все ждут. Я в своей жизни дважды перенес пневмонию на ногах и узнал об этом потом случайно, сделав рентген. У нас пневмонию народ давно уже привык и дома лечить. Но сейчас всех напугали. Да, это ОРВИ бьет по легким, я не спорю. Но вопрос в смертности.

Марьяна Торочешникова: Но людям надо помогать.

Александр Саверский: От чего помогать – от психоза или от реальных заболеваний?

Марьяна Торочешникова: И от того, и от другого.

Александр Саверский: Для этого надо делать совсем другие вещи, прямо противоположные тому, что вы делаете в этой программе. Объясните, что это ОРВИ, а не чума!

Дмитрий Серегин: Есть COVID-диссиденты, которые не признают наличие новой коронавирусной инфекции, и я тоже сталкиваюсь с такими в своей деятельности. А есть люди, которые ввиду слабой нервной системы и панических настроений чрезмерно боятся заразиться, причем это уже переходит в фобию. Я вижу минус в том, что такие стрессы подтачивают иммунитет.

Но я категорически не согласен с Александром в том, что пневмонию можно переносить на ногах. Пневмония – это угрожающее жизни состояние. На фоне пневмонии может развиться отек легких – и человек умирает, причем даже в молодом возрасте. Возникает так называемый "цитокиновый шторм", воспалительная реакция. Мы уже знаем, что новая коронавирусная инфекция – это коварное заболевание, оно вызывает такие осложнения, которые до этого грипп, например, не вызывал: массовое тромбообразование в сосудах, ДВС-синдром, дыхательную недостаточность и так далее. Людей с пневмонией нельзя оставлять дома. Никто не говорит, что нужно госпитализировать человека с температурой 37,5, чистыми легкими и высокой сатурацией. Нет, мы таким пациентам даже и не предлагаем госпитализацию! Но проблема в том, что тех, кого надо госпитализировать, отправляют домой (у людей сниженная сатурация, и есть основания полагать, что есть поражение легких). То есть берут только тех, которые уже, как рыба на суше, хватают воздух. А людей с поражением легких 15–20% отправляют домой с рекомендациями.

Люди отрицают вирус и в результате своих поведенческих моментов являются причиной заражения других людей, которым этот вирус страшен

Конечно, у некоторых присутствует психоз. Но мы также видим и обратную сторону, когда люди отрицают вирус и в результате своих поведенческих моментов являются причиной заражения других людей, которым этот вирус страшен.

Александр Саверский: Дмитрий сказал, что с пневмониями дома не лечатся. К его сведению, в 9-м выпуске рекомендаций Минздрава по лечению COVID: не госпитализируются люди с сатурацией от 93% и выше. И, по-моему, меньше 50% поражения... В эти две недели трое моих знакомых с поражением 10–20% находятся в стационарах. И повторяю: Минздрав, проведя проверку, выяснил, что 20% пациентов не должны были находиться в стационарах. This is official data.

Марьяна Торочешникова: На видеосвязи – молекулярный биолог, научный журналист, автор книги "Вирус, который сломал планету" Ирина Якутенко . На днях Ирина опубликовала подробный обзор различных мировых практик лечения коронавируса. И, как я понимаю, вы приходите к выводу, что это очень часто идет вразрез с тем, как предлагают лечить эту инфекцию в России. Неужели российские врачи не интересуются последними тенденциями и до сих пор впихивают всем антибиотики и гидроксихлорохин?

Ирина Якутенко: Да, получается, что так. По какой причине российские врачи игнорируют мировые практики, это большая загадка. Хотя ответ может лежать не в медицинской, а в экономической плоскости. Ну, это все слухи. Естественно, я ни на что не намекаю, ни в коем случае! Если мы посмотрим этиотропное лечение коронавирусной инфекции, то есть лечение не осложнения, а непосредственно самой болезни, то увидим там ноль препаратов с доказанной эффективностью против коронавирусной инфекции. А доказанная эффективность – это эффективность, доказанная в двойных слепых рандомизированных клинических испытаниях или хотя бы, если нет возможности их провести, в каких-то больших, масштабных испытаниях.

Но я не соглашусь с вашим спикером. То, что он говорит, идет вразрез с мировыми практиками, так же как и российские клинические рекомендации Минздрава, хотя слова вашего спикера и клинические рекомендации и разнятся между собой. Безусловно, COVID – это серьезная инфекция. Тем не менее, на ранних этапах этой инфекции большинство стран с развитой медициной, которые и в первую волну неплохо справились, придерживаются мнения, что не нужно госпитализировать и хоть как-то лечить людей на ранней стадии коронавирусной инфекции, пока у них еще не проявились признаки "цитокинового шторма", гиперактивации иммунной системы, и пока у них нет затруднения с дыханием, пока их организм не страдает от гипоксии. Это большинство заболевших коронавирусной инфекцией. Люди очень пугаются, потому что у них может быть сильный кашель, высокая температура, головные боли, ломота в мышцах. Это крайне неприятные, но, по мировой классификации, легкие симптомы. Пока нет резкого падения сатурации, дыхательной недостаточности, это все считается легкой стадией коронавирусной инфекции, и от нее нет лечения, потому что мы не знаем, как предотвратить переход легкой стадии в более тяжелую, когда начинается гиперактивация воспалительного ответа, и тут нужны уже другие препараты.

Марьяна Торочешникова: Никто не знает, как это лечить?

Ирина Якутенко: На этой стадии мы знаем, как лечить. Но когда пошла гиперактивация воспалительного ответа, у нас нет стопроцентного лечения, но есть стратегии, которые позволяют вытаскивать очень многих людей из смертности. Если сравнить с тем, что было в начале весны, то смертность гораздо ниже, и не в последнюю очередь потому, что врачи уже знают, какие параметры посмотреть в биохимии, чтобы понять, что у человека уже пошло увеличение плотности крови, уже надо давать антикоагулянты, которые предотвращают микротромбоз. А если они видят, что пошло неконтролируемое воспаление, уже надо давать главным образом стероиды. Сейчас проходят испытания различного рода моноклональные антитела, которые тоже должны загасить это воспаление, но пока, к сожалению, результаты не очень хорошие, кроме случая президента Трампа, но это единичный случай.

Марьяна Торочешникова: Как вы думаете, почему российская система здравоохранения не слишком поворотлива, во всяком случае, в Москве людям с легкими проявлениями COVID приносят антибиотики и противомолярийные препараты, даже не объясняя, как их надо пить?

Ирина Якутенко: Тут врачи оказались заложниками ситуации. Не существует врачей-ковидологов. На борьбу с вирусом бросили врачей общей практики – терапевтов, офтальмологов, неврологов, кого угодно, потому что не хватает врачей и нет ковидологов. Врачу, который не является специалистом, выдают клинические рекомендации Минздрава, и он не может напрямую им противоречить. На самом деле может, но если вдруг, не дай бог, пациент умрет, врач попадает под ответственность: начинают проверять, как он его лечил, выясняют, что он не дал ему, например, антибиотики или гидроксихлорохин. И получается, что он пошел вразрез с рекомендациями Минздрава, пациент умер, и попробуй докажи, что он умер не из-за того, что не получил гидроксихлорохин или азитромицин. Обычные врачи, которые приходят к обычным больным на участке, ничего не могут сделать, они вынуждены действовать так, как прописано в рекомендациях. А вот почему рекомендации такие – это очень хороший вопрос к экспертам из отрасли, на который очень хотелось бы получить ответ.

Александр Саверский: С гидроксихлорохином ситуация очень простая. ВОЗ в марте включил его в общемировые исследования, они пошли во многих странах, в дозе, в два раза превышающей максимальную. И ходят разные объяснения. Одно из них... поверить в это трудно, но типа был скандал по тому поводу, что должен был быть другой препарат.

Марьяна Торочешникова: Что-то перепутали.

Александр Саверский: Дело в том, что конкретно этот препарат вызывает аритмию даже в норме.

Марьяна Торочешникова: У него много побочных эффектов.

ВОЗВРАЩЕНИЕ ИМЕН

В России прошла акция "Возвращение имен", которую проводят в День памяти жертв политических репрессий.