“We have everything to treat severe pathologies.” The new clinical centre in Voronovskoye

June 11
Healthcare

On April 17, the Moscow Infectious Disease Clinical Centre opened in the village of Voronovskoye. The Moscow city authorities managed to complete this large and ambitious project (almost 80,000 square metres) from scratch in a month.

The new clinic is a prefabricated structure. But this is not just a temporary hospital to counter the coronavirus pandemic, it is a clinical hospital that will serve the city for decades. When the epidemic is over, there will be a modern and well-equipped infectious diseases hospital in Voronovskoye.

The Voronovskoye Moscow Infectious Disease Clinical Centre is an autonomous infectious inpatient facility where various types of medical care are provided. It is part of the Demikhov City Clinical Hospital.

Capabilities will gradually be built up at the new hospital. To date, there are over 200 coronavirus patients, and about two dozen are accepted daily.

Chief Physician of the Demikhov City Clinical Hospital Sergei Perekhodov told mos.ru how the clinic works, how the staff is being established and what the hospital’s future is after the pandemic.

Sergei Perekhodov, Chief Physician of the Demikhov City Clinical Hospital

I like our personnel’s fighting spirit”

Question: Mr Perekhodov, how is the infectious disease clinical centre organised and what are its main functions?

Sergei Perekhodov: Our medical centre covers over 40 hectares and has 800 beds. A bit less than a half are intensive care beds. In addition to four intensive care units, there are seven infectious disease units, with 80 beds each, which means we have 560 beds to treat infectious disease patients. The units in the infectious disease wards are designed to accept two or three patients.

The entire area is loosely divided into two zones: green and red zones. The green zone includes warehouses, support units and accommodation for more than a thousand medical personnel, technical workers and security. Why do we need living accommodations? After a busy day, our specialists can stay here instead of going home.

The centre uses completely new logistics for medical care. It was designed by Russian specialists but took into account foreign experience.

The main design parameter is treating infectious disease patients in isolation to prevent inter-hospital infection. Ambulances bring patients to the ER and they are sent to a special room where they are examined, and symptoms are recorded. After assessing their general condition, our sanitary transport carries them to the hospital wing.

Question: What is the state of the technical equipment? Are there enough ventilators for so many beds?

Sergei Perekhodov: The centre has a large diagnostic base: two CT scanners and an MRI machine, which are located in the diagnostic building near intensive care units. This is good because patients can be brought in both from separate entrances and infection units.

I would like to note that we have a lot of ventilators, over 200. In fact, every intensive care bed has a ventilator as well as modern monitoring equipment. In addition, the centre uses various methods of extra organ detoxification, in particular, extracorporeal membrane oxygenation. We haven’t used it yet because there have been no indications, but we are ready to use it.

Moreover, the centre has a large laboratory capable of up to 10,000 tests daily. At full capacity, it will be possible to do over 3,000 PCR tests.

We have our own oxygen station that covers almost all the units. All the beds in all the units in our buildings have oxygen, and it is possible to deploy an intensive care bed if necessary.

 

Question: How difficult was it to organise this system at such a large centre so quickly?

Sergei Perekhodov: Of course, it is difficult because the centre is new. My deputies and I came here just after construction had begun. The centre was built quickly, in just about a month. More than 10,000 people worked around the clock.

There were difficulties at first. We had to plan our actions while the buildings were not completed and equipment wasn’t in yet. When everything is in place, like in other hospitals, there are specialists and equipment and you just come and treat. Here, we had nothing. This is why everything, starting from hiring personnel to receiving, placing and adjusting the equipment, not to mention construction and opening, was done quickly, in coordination with the builders.

I would like to thank the builders: over a short period of time, they put up such an enormous building, which, I hope, will operate for decades. Some people think the centre is temporary and will only serve to treat the coronavirus. But they are incorrect: the centre’s main purpose is to treat the infectious pathologies of various diseases.

Question: What is the typical day like for a Chief Physician at such a large clinic?

Sergei Perekhodov: I get up early, at 5 am every morning, to leave for the office at 6. Somewhere about 7 o’clock, I get here; and all my deputies are already at work too. I review the duty shift reports, and at about 8 or half past 8, my ordinary work begins: I meet with my deputies for administration and accounting. Later, when there are operations, I operate, but this only happens once or twice a week.

Most of the working day is needed to organise the working process at the hospital. Over the last month, it took all of my time to organise the Moscow Infectious Disease Clinical Centre.

Photo: Press Service of the Mayor and the Government of Moscow. Maxim Mishin

Question: How long is a doctor’s shift at the centre?

Sergei Perekhodov: All doctors and medical personnel have different shifts and their own schedule: 24/12 or 24/24 hours.

Question: How many people are on the staff?

Sergei Perekhodov: So far there are over 600 staff members. Over 1,000 are expected once the centre reaches full capacity.

Everyone is new here, not all of them know each other. However, I like the fighting spirit of our medical and support staff. I’m always glad to see that other people want to achieve or do something good. Management is always glad to see this.

All of our employees came from different places. This is why training them to work with the latest medical equipment is our priority, especially in intensive care, where we use modern ventilators and monitors. We train specialists almost every day. This is why there is a simulation centre at the hospital.

Photo: Press Service of the Mayor and the Government of Moscow. Maxim Mishin

Question: How does your centre ensure the health of the doctors and nurses?

Sergei Perekhodov: Protecting the medical staff is our priority. We have enough personal protective equipment both for medical personnel and support staff.

The centre is built in such a way that all employees can only come in through a transition zone and nowhere else. There, they go into a locker area, and change their clothes, take a shower, undergo decontamination and put on special scrubs in certain colours. After that, they pass into the building and go to their units.

There is a kind of dispatch control room here, or the heart of the centre where all the information from all the units is sent. It has a control panel for the unique ventilation system that can pump out almost all the infected air through special locks and later disinfect it.

Everything necessary to treat severe pathologies

Question: How many patients does the centre admit daily on average?

Sergei Perekhodov: On average, we admit 20 patients each day. For now the centre is only treating patients with COVID-19 and pneumonia.

As of 4 June, 213 beds were taken. For now, the number of patients with COVID-19 and pneumonia is stable, at the same level. Over a bit longer than a month, we have treated almost 1,000 people.

Question: How long does it take to cure a coronavirus patient?

Sergei Perekhodov: It depends on the severity. The centre admits patients in medium and severe condition; mild cases are not treated here.

Initially, the centre’s structure and large resuscitation service were designed to treat severe cases. We admit about 20 patients daily, and conditions depend on how long they were ill. About 40 percent of patients treated here are severe cases. Some are on mechanical ventilation.

Photo: Press Service of the Mayor and the Government of Moscow. Maxim Mishin

Question: What habits and previous diseases can result in complications for patients with the coronavirus?

Sergei Perekhodov: In fact, any coexisting severe disease can be aggravated in patients with the virus, especially for the elderly. This is the main problem.

I see that lately the number of young patients has increased. It’s difficult to say why. Perhaps this happens at the beginning of self-medication or an untimely visit to a doctor, but we can see a trend: young people are falling ill with severe virus pneumonia.

Question: How many patients are released daily now?

Sergei Perekhodov: We release about 15 patients every day. It can take up to two weeks for a coronavirus patient to recover, and the rehabilitation period can take another several weeks.

I would like to say that here at the centre we have everything we need: medicines and various methods to treat severe pathologies quite quickly.

Question: Does the clinical centre cooperate with other Moscow medical institutions?

Sergei Perekhodov: First, all the Moscow city units and Healthcare Department centres help us.

We are cooperating with other institutions quite actively. Cooperation between hospitals and medical institutions that treat COVID-19 continues almost all day and all night. We also use all prospective and positive methods to treat the coronavirus.

Question: Doctors can use an advanced and updated medical base. What do you think the hospital’s future will look like once the pandemic is over?

Sergei Perekhodov: The hospital will fulfil its purpose to treat patients with various infectious diseases, for example, respiratory or intestinal diseases. I’m sure that it will operate quite successfully for many decades. We have all the conditions for this.

Photo: Press Service of the Mayor and the Government of Moscow. Maxim Mishin

I can see gratitude in our patients every day”

Question: Mr Perekhodov, how did you decide to become a doctor?

Sergei Perekhodov: I had no doubt that I would become a doctor, although no other family member worked in medicine: not my parents nor grandparents. Somewhere back in the 1960s, when my father had surgery, I smelled medical glue for the first time, and ever since then, I have believed it was my calling. After school, I had no doubt that I should study medicine.

Being a doctor is my job. I was a military doctor before, and after almost 30 years in the army I left the office of Defence Ministry Chief Surgeon and joined the Moscow Healthcare Department. For me, this is not just a job as a surgeon but also one of organising. This is my life.

Question: How does your family see your work during the pandemic? Which precaution measures do you take when going home?

Sergei Perekhodov: My family is a military family, so my wife and children know where I am and what I do. They are used to it.

The precaution measures are quite simple: elementary rules of personal hygiene. Hand treatment with a skin antiseptic, a mask and self-isolation for everyone. It is almost impossible for us now, because a doctor’s job means working directly with patients. Nevertheless, I believe that all Russians have to comply with the elementary rules necessary in today’s sanitary and epidemiologic conditions.

I believe the restrictions introduced in Moscow and the Moscow Region helped decrease the virus indicators and prevent a more negative scenario.

Question: Today our society has finally realised how important and heroic a doctors’ work is. Do you see people’s attention and gratitude?

Sergei Perekhodov: I have been working as doctor for 35 years. I see gratitude in patients every day.

However, today, due to such a large number of patients, we see gratitude more often. When travelling around Moscow, I am always very pleased to see the faces of doctors and nurses who selflessly work all day at their places of work instead of advertisements for some show or something.

Source: mos.ru

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