"Nightmare Management In Healthcare Is The Main Problem Now" - Ilya Fomintsev

"Nightmare management in healthcare is the main problem now" - Ilya Fomintsev

Director of the Cancer Prevention Foundation "Not in vain!" Ilya Fomintsev spoke live to MedPortal about the difficulties doctors face throughout the country during the pandemic.

Director of the Cancer Prevention Foundation "Not in vain!" Ilya Fomintsev / facebook.com/i.fomintsev

Recall that in March, Fomintsev and his colleagues urgently created a consulting service "What to do" to help doctors in the fight against the COVID-19 pandemic. The project brought together the Cancer Prevention Fund "Not in vain!", The "Living" fund for helping adults, the "Pravmir" charitable fund, the AdVita charitable fund, and the "Shop of Joy" fund for supporting social programs and initiatives. They jointly raise funds to purchase medical supplies for hospitals and food for doctors. Physicians throughout the country can submit requests for assistance on the website, and the What to Do experts, if necessary, supplement these lists in accordance with a checklist developed by leading Russian intensive care physicians.

According to Fomintsev, who has been communicating with doctors across the country every day for the past two months and reviewing their applications, the main pain point now is the lack of organizational skills at all levels of healthcare.

“Nightmare healthcare management is the first and foremost problem. This is manifested at all levels, both in federal and regional orders. When we had a completely terrible situation with personal protective equipment, an emergency decree was adopted, which gave rise to a state monopoly on the trade in PPE. And a week later it was canceled. When people cancel their own decisions, it becomes clear that the work is not quite professional. It's good that it was canceled, I had the courage to do it, "says Fomintsev

According to the expert, ill-conceived decisions and communications both within the system and with patients exist at all levels. “They intimidate, then they say that everything is fine, in general, who in what way,” Fomintsev noted. According to him, the acute problem of the shortage of PPE in hospitals across the country began to be solved only when she entered the public field, including with the help of bloggers.

The second important problem Ilya Fomintsev considers is the lack of a unified understandable mechanism for recording deaths of patients from coronavirus. Now the mortality rate in Russia, according to official data, is less than 1% and for this, according to the expert, now there are no prerequisites, at least obvious. And now there is no clear way to compare and research accounting methods. Fomintsev did not rule out that the real mortality rate is simply hidden:

“This was the case with the first death. An elderly woman was there, they said she died of a blood clot, and this is not a covid. Cause of death is a complex concept. You can write that he died from circulatory arrest, then it is not clear what death from covid is. This is the only way we can find out how we cope with this, if we do not know how the accounting is carried out."

The director of the Cancer Prevention Foundation also noted the lack of provision of intensive care units and hospitals with modern equipment. According to him, now in hospitals there is not enough access to oxygen outside intensive care. Oxygen concentrators, oxygen supply systems, modern non-invasive ventilators, and even pulse oximeters are far from everywhere - devices that monitor blood oxygen saturation.

“We need a large-scale study of what everyone needs, and we are taking the first step towards it - we collect data on hospitals in order to imagine where someone is missing something,” says Fomintsev. According to him, the "What to do" project sends all received data from doctors to the federal authorities.

There is still a problem of lack of protective equipment, including the most basic ones - respirators, goggles, protective screens. At best, they are allocated for medical facilities repurposed as "covid", but an infected patient can easily end up in any hospital.

“The idea of dividing hospitals into covid and non-covid hospitals seems crazy to me. Any number of cases when patients infect staff. Glasses, respirators, screens, protective suits are now needed by all doctors,”the expert said.

Ilya Fomintsev urged doctors to hush up the problems and go to the site "What to do", where you can get expert advice and leave a request for protective equipment and equipment. Also, everyone can support the project, including independently purchasing and delivering everything necessary for individual hospitals.