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‘We are the infection’s main carriers’ Response workers outside Moscow describe the lack of PPE and coronavirus testing, which is forcing local patients to wait more than 24 hours for emergency assistance

Source: Meduza

Emergency responders outside Moscow say they are working without necessary protective equipment, even after appeals to the regional governor and the Health Ministry

On the morning of May 10, the inter-regional medical workers’ union “Deystvie” (“Action”), reported that employees of the Moscow Regional Ambulance Station had been complaining to their organization about a lack of PPE since April. The union emphasized that some emergency response workers had already fallen ill and that there had even been fatalities. According to the “Memory List,” a document compiled by Russian doctors to commemorate medical workers who have died during the coronavirus pandemic, at least three employees of the Moscow Regional Ambulance Station have died so far. 

The union also underscored that the staff had already made complaints about the lack of PPE to the ambulance station’s head doctor, Oleg Kakurin, as well as to the Russian Health Minister, Mikhail Murashko, the Governor of the Moscow region, Andrey Vorobyov, and Russia’s federal public health chief, Anna Popova.

On the evening on May 10, the news outlet Baza also reported on Vorobyov receiving complaints about a lack of medical suits and other protective gear from healthcare workers in the Moscow region. The governor reportedly received appeals from the staff of ambulance substations in the Shchyolkovsky, Istrinsky, Krasnogorsky, Pushkinsky, and Mozhaysky districts, as well as from ambulance substations in the town of Ivanteevka, and the cities of Zheleznodorozhny and Korolyov. Moreover, the messages reported that doctors are working in painter’s coveralls rather than actual protective suits, and that single-use protective suits were being used repeatedly.

Doctors say they are hardly being tested for COVID-19 and that dozens of medical workers have fallen ill

Meduza spoke to five Moscow Regional Ambulance Station employees, who work at different substations throughout the region. They claimed that in the last two months, either they themselves, or their colleagues, have sent complaints to Governor Vorobyov and the regional emergency response leadership.

In their words, healthcare workers have been working in disposable coveralls from hardware stores since day one. Many of the ambulance substations received actual protective suits in April, but medical workers only wore them when they knew in advance that a patient had coronavirus symptoms, such as a fever.

“We have reusable suits, which a sponsor, a local restaurant owner, sent to us. There are also disposable suits, but for us they are not single-use, but rather [reusable]. That is, [after] we responded to a call, we sprinkled them with disinfectant and packed them back in a bag. After some period of time, we give them to a nurse’s aid, who will wash them in a laundry machine, dry them like regular linens, and [do it] all over again,” explains Snezhana Murashova, a paramedic from Ivanteevka. 

As a result, according to the medical workers interviewed, a significant number of employees have become infected with COVID-19. The healthcare workers told Meduza about dozens of staff members who have fallen ill at their substatations — between 30 and 50 percent of personnel. They also reported several deaths among their colleagues.

However, the official number of infected healthcare workers remains unknown: they have not been diagnosed with the coronavirus and they are not included in the official statistics, the emergency response workers say. According to them, this situation arose due to an insufficient amount of testing: medical workers undergo swab tests every seven to ten days, but management at some of the substations have prohibited CT scans.

An employee from one of the ambulance stations said that the medical workers there had not been tested for the coronavirus at all since the start of the pandemic. “You can [only be tested] at a clinic, like everyone else. That is, you go if you feel sick, like a civilian, not like an ambulance worker,” he explains.

If a medical worker begins to show symptoms — a cough, a fever, and so on — they are sent home to self-isolate, but all of the staff members who came in contact with that person keep on working. Patients who come in contact with sick doctors are not tested either. All of the emergency responders interviewed confirmed this information for Meduza. 

“We are not being tested for one reason: If they were to test us, then no one would be left at work. The substation would need to be closed. But as a result, we are now the infection’s main carriers,” Murashova says. 

The emergency response leadership denies everything

On the evening of May 10, the regional ambulance station’s head doctor, Oleg Kakurin, gave a comment to RBC, denying the complaints from the staff. “In connection with the current epidemiological situation, all ambulance crews are being provided with additional personal protective equipment: medical masks, protective glasses, special protective suits, shoe covers, gloves, antiseptic and disinfectant products, which correspond with the necessary level of protection,” he said.

According to Kakurin, management did not receive any reports about a lack of personal protective gear among the ambulance crews, and the substations have the necessary reserves of PPE. “They are using PPE once. Repeated use is categorically forbidden,” he underscored.

On May 11, Kakurin gave Meduza a similar response in a comment via his secretary. When asked about testing among employees and limiting CT scans, Kakurin said: “All medical ambulance workers in the Moscow region are regularly undergoing screenings for the coronavirus infection.” He did not respond to questions about the number of infected healthcare workers. Meduza also sent an official request for comment on the situation at ambulance stations to the Moscow region’s Health Ministry, but had yet to receive a response at the time of publication.

At the same time, the emergency response workers that Meduza interviewed confirmed that supplies of PPE had improved in recent days, with hospitals receiving shipments of suits and other protective gear. “I believe that the noise will help. We will hope for the best,” says Evgeniya Bogatyreva, the chairman of the Deystvie workers’ union’s committee for emergency responders in the Moscow region. 

Patients already have to wait more than 20 hours for emergency services due to a lack of medical workers

In conversation with Meduza, the emergency response workers underscored that all of the employees remaining in their ranks are taking on extra shifts. Many are working “24 hours every 24 hours,” instead of the usual “24 hours every three days.” 

But even this is not enough to save emergency services from getting overloaded — doctors say they are working “in survival mode.” “Several patients have waited 24 hours for an ambulance. The hospitals are crowded and there is a catastrophic lack of doctors. We respond to the emergency calls first: loss of consciousness, seizures, arrhythmias, and so on. And then to the urgent ones: high blood pressure, head pain, and so on,” one of the employees explains. 

Snezhana Murashova emphasized that several patients were forced to wait between 22 and 28 hours for a doctor — an eight hour wait is considered “good luck.” Sometimes, by the time an ambulance arrives, it’s difficult to help the person in need, and due to overcrowding at the hospitals, some severely ill patients have to be left to at-home treatment. “Effectively, we are condemning people to disability,” a doctor says.

Even Governor Vorobyov acknowledged the lack of emergency medical workers. “We are working with students, and have turned to federal universities. There are no problems with the [ambulances] today, but doctors are needed,” he said. In other words, the authorities are planning to recruit medical students to resolve the issue. Oleg Kakurin also responded to Meduza’s questions by saying that the regional emergency response leadership is looking for new employees. 

The medical workers themselves think that the situation will get even worse by the end of May: when the remaining healthcare workers fall ill, there will be virtually no one left working. “Our department head said that everyone will be working as they have worked. All families have loans [and] mortgages. The fact that all of us are getting re-infected and that we are re-infecting people is the last thing they think about. Now they’re being tasked with getting organizations in supposed working order,” one of the local medical workers underscored.