KSMU News

MIKHAIL MURASHKO: STOP TESTING THE SYSTEM FOR STRENGTH!
15th November 2021

About Complaints, Anti-Axis, Frontline, Fork, Air Rescue and Social Circle

– What are you complaining about, doctor?

– Is this already an interview?

– The most, in my opinion, the obvious question to the head of the Ministry of Health …

– What should I complain about? Nothing! We’re here to win. That kind of mood.

– Coronavirus?

– First of all – disbelief, disdainful attitude of many people to their own health. I would like to defeat ignorance and obscurantism in relation to vaccination.

“In my opinion, given the availability of preventive measures, it is simply indecent today to disregard medical recommendations and believe in something completely crazy, in some otherworldly forces. This, of course, most of all worries and worries … “.

– Because of the non-working days introduced after a year and a half, the feeling of déjà vu did not arise, Mikhail Albertovich? That in November 2021 the country returned to March 2020?

– The situation is changing, comparison with last spring is hardly appropriate. Then we knew almost nothing about the virus, there were no vaccines that could protect against the severe course of the disease …

This pause was necessary. Primarily because of the people who, as they say, have not yet had time to get vaccinated. Over the past ten days, the leadership of the Ministry of Health and Roszdravnadzor has traveled to 17 regions of Russia. Last Saturday I spent in Ryazan, a week earlier I was on a business trip in Vladimir …

– Itineraries of the day off.

– Well, yes, especially considering that we have been working seven days a week …

Everywhere the picture is the same: in covid hospitals there are mainly patients who have not been vaccinated against coronavirus, while intensive care units are almost 100 percent filled with this particular category of compatriots. Therefore, the state is forced to introduce strict restrictive measures. This is a response to the indiscipline of some citizens or their delusions.

– You ask why people shy away from vaccinations?

“Yes. Yes, of course. Most often they say: here, they say, they were going, but they delayed it, did a foolish thing, now we regret it. Only one person continued to question the need for vaccination. This is rather an exception to the rule. Everyone who is on oxygen therapy or has already left intensive care is very frightened by the situation in which they find themselves.

– In your opinion, the ten-day lockdown was enough to turn the tide? Judging by the latest statistics, there was no radical change in the number of cases.

– The increase in new cases has decreased, but it is important to understand: weekends by themselves do not heal anyone. Vaccination and adherence to preventive measures can help.

– How do you rate the introduction of QR codes in public places?

– At this stage, it is an effective tool. Most countries have followed this path; we must move in the same direction.

– In the meantime, in the rating of the fight against COVID-19, Russia is located in a far from honorable 35th place out of 53 – between Mexico and Bangladesh (data for September, in October – 46th place, the “COVID resistance rating” was compiled by Bloomberg TASS Due to the number of anti-axers in the homeland, have you become disillusioned with the human race?

– It’s not even about them. There are only a few convinced opponents of vaccination, a lot of doubters, who prefer to listen to a not-too-literate neighbor, and not a doctor with experience and knowledge.

– But even among doctors there are those who, so to speak, privately do not advise patients to vaccinate.

– Yes, we know about this category of doctors, but, thank God, it is not numerous. After all, doctors are people like everyone else. Among them there may be both erring ones and insufficiently professional ones.

There are also overconfident, living according to the principle of Porthos.

What do you mean?

– I fight because I fight. And I don’t want to think about the consequences.

A completely reckless approach to your own and other people’s health. Yes, any drug, including a vaccine, has a risk profile. But a qualified doctor has the knowledge, strength, and other tools to predict possible consequences, prevent them, and, if necessary, help. Это разумно? At the same time, we must not forget that the covid itself poses a much more serious threat.

– How do you assess the state of emergency in the city of Obluchye in the Jewish Autonomous Region, where the staff of the ambulance station were going to resign in full due to unwillingness to be vaccinated?

– The conflict situation there was quickly resolved. On my instructions, the head of the emergency medical department of the First St. Petersburg Medical University, Vadim Teplov, flew to the region, who himself headed the covid hospital for several months. He met with the team, talked about everything confidentially.

Today the applications have been withdrawn, people want and will work.

As far as the situation is concerned, healthcare providers have no right to create risks for patients. – Under no circumstances must any This is unacceptable. The responsibility of doctors has always been very great, and now the workload has increased even more. Therefore, the health worker himself must be protected so as not to risk his own and patients’ lives. This applies not only to the coronavirus, but also to the flu. There is nothing to discuss here.

– Somehow, after all, it is necessary to fight those who persist in their own obscurity?

– Fighting in this case is an ineffective method.

– Let them die themselves and not interfere with the death of others?

– Recently I talked on this topic with colleagues from European countries. General rules. Only those people are allowed into the social environment who can ensure the safety of themselves and those around them. If you have a vaccination certificate, please. In France, you will be allowed to ride the metro with him, buy a plane ticket, go to a theater or a cafe. If there is no such document, be so kind as to stay at home. This is called collective security. Why should there be gaps in it through someone else’s fault? Imagine: we are together in a room where there are explosive substances, and someone suddenly declares: they say, I don’t care, and starts lighting matches near a barrel of gasoline. What will the rest of them answer? In Russia, more than a thousand unvaccinated people die every day for several months. Is this an accident? Or maybe this is not enough?

– Even in excess.

Why is this happening? Are we missing something? There are free vaccines and a well-functioning healthcare system. This means that the reason is different. In people, in their relation to the same collective security … Still, population is a serious thing.

– If I say that you look tired, won’t you argue?

– There were four flights in three days, so everything is understandable …

– It is unlikely that the matter is only in the load of the last days.

– I have already explained to you: we have been working without days off for a long time. Something new is happening all the time. A few months ago we joked: they say, it is not known how the day will end, and now you do not even know how it will begin. Time is compressed, compressed.

It seems to me that today it is important to insure yourself against any accidents, unreasonable actions.

“Like?”

– Just before our interview, we talked about a patient who got into an accident. It was necessary to transfer from one hospital to another, from region to region, since the trauma is serious. And the reason is that the person was driving in the car without wearing a seat belt.

Nonsense.

– Disregard for basic safety rules. And now we need to save our lives …

Every day. You see, teaching people to follow the rules is the hardest part. Refusal from them takes on the character of some kind of outrageousness. Like, I am strong, I will not obey general requirements, they do not concern me.

In reality, this is a weak and dangerous position.

– And you never violate anything?

– Well, I try not to. Life has taught me. Working as a doctor disciplines and obliges you to follow certain rules. They are written in blood. Not only doctors, but also pilots, sappers, military …

– By the way, about the latter. When they took up the post of minister in January 2020, they hardly imagined that you would soon find yourself on the front line. What was Mikhail Albertovich aiming for when he came to the Ministry of Health?

– In fact, this is the kind of department where it is always hot. There are no quiet times.

– How in the Ministry of Emergency Situations?

“Maybe one.” We are actively interacting. But apart from emergencies, we also have a lot of daily work. It is important, on the one hand, to set up the medical staff so that they treat all patients responsibly, and they, in turn, listen carefully to the recommendations of doctors in order to preserve their health. When we talk today about interaction in this connection, we are increasingly repeating the phrase about trust between a doctor and patients. Otherwise, there will be misunderstanding, suspicion, tension and, as a result, mistakes. The price of which is life.

– The pandemic, paradoxically, played a positive role in this. The attitude towards doctors has changed for the better …

– You know, if doctors were treated differently, then anti-axers would not have sounded so loud. But I’m talking now about mutual trust between doctor and patient. Fundamental.

Therefore, having headed the ministry, I aimed primarily at the further development and improvement of the health care system that has developed in our country, which people sometimes do not value, taking for granted.

We are accustomed to what used to be called socially accessible goods. When I tell my foreign colleagues that Russia has introduced a compulsory free medical examination for those who have had COVID-19, they say: great, but very expensive!

However, our state is doing this. And people take it for granted.

Nevertheless, it is necessary to further adapt, transform the system for a personalized approach. It’s totally possible For example, my doctoral dissertation is about perinatal care.

– Full title – “Modern aspects of providing obstetric care in a region with a low population density.”

“Yes,” she replied quietly, almost whispering. In fact, it contains the main theses illustrating what is being done in our country to help motherhood and childhood. This multi-level system – from perinatal centers to all kinds of consultations for the observation of outpatients – has proven its effectiveness, it works successfully. Russia now has the lowest infant mortality rate in history.

I think I was lucky. What I wrote about, what I developed and did, is 100 percent implemented, and my friends – colleagues in their specialty go further. After joining the ministry, I planned to extend a similar practice to all domestic health care. The main thing we were aiming at was to make the individual approach to the patient more systematic in order to see everyone.

This can be achieved through a set of measures, including digitalization, prevention of serious diseases, constant monitoring of chronic patients, emergency high-tech care and rehabilitation.

In simple terms, without medical or bureaucratic terms, the patient should be the key link. Do you know how many visits to polyclinics in the country per year?

XXX

– Within the framework of the compulsory medical insurance – about 900 million, and if you add VHI, you get more than 200 billion visits. And this amount, of course, should be systematized. Therefore, we planned to continue introducing modern technologies. Including access to medicines. Something has already been done, including the labeling system, when each drug is visible in the admission prevention database, in order to exclude falsified and poor-quality drugs. Please: check the QR codes – and you will immediately understand whether this is a legal device or a fake. Simple, easy and convenient.

“But it’s obvious that most of the time you had to deal with the pandemic and what is associated with it.

– Yes, it still takes up the lion’s share of the time, but if at the initial stage it was necessary to react faster and more aggressively, today there is a feeling of annoyance. We know how to stop the spread of the disease, we have the necessary tools, but not all citizens hear the calls to reason. That is why I am talking about a crisis of confidence. It’s time to cross the line and move on.

– What was the most difficult moment for you from the past two years?

– Autumn 2020. The second wave of coronavirus turned out to be high, requiring the utmost mobilization of domestic medicine. Although it is also difficult now.

It is already clear: the end of autumn and the coming winter will not be easy. This is always a dangerous period, when the growth of respiratory infections is traditionally noted, and many chronic diseases are exacerbated. In 2020, thanks to active vaccination against influenza, it was possible to avoid its wide spread, this year it appeared early, and, of course, one cannot relax. This is fraught with additional problems …

– I listen to you, Mikhail Albertovich, and I think: after all, the post of the head of the Ministry of Health is considered to be the pinnacle of a doctor’s career. Is this so under the circumstances?

– Doctors have at least two ways for self-realization in the profession. One road is a practicing doctor, a specialist who is constantly improving his qualifications. The second is the health care organizer. In my opinion, the real peak is not a specific position, but the achievement of a philosophical level of understanding of the matter to which he devoted his life.

– Can you decipher?

– Any doctor at a certain stage begins to look not only at a particular patient, his illness and method of treatment. A good specialist sees the scale of problems arising in his field of medicine and knows how to solve them or at least prevent the source.

This is what I call the level of philosophical perception.

The position of a minister allows you to understand the processes. In this sense, it can be considered the top point. But I can honestly admit that I never aspired to head the department.

– Well, that’s what everyone says.

– I am not responsible for everyone, but I am telling about myself. Yes, at a certain stage, a fork appeared: to move further in clinical medicine and science, or to move towards the organization of healthcare. At that moment, I really thought about what, let’s say, path to choose.

And when was this?

“This has happened twice in my life. For the first time while working as the head physician of the perinatal center in Syktyvkar. If I’m not mistaken, this is 1996.

In such a position, the ratio changes immediately. While you remain a clinical specialist – even in the rank of deputy chief physician, the proportion between the treatment load and the organizational load remains at 70 to 30 in favor of the former. You become the main thing – and everything turns exactly the opposite: the lion’s share of the time is consumed by organizational work, and a maximum of a third remains for the clinical component. The higher you go, the less you do pure medicine.

This is the first fork.

– And the second?

– I have already worked for five years as a regional minister, and again the question arose: return to clinical medicine and science, or move to the federal level of government.

– And you moved to Moscow?

“Yes,” she replied quietly, almost whispering. Veronika Skvortsova offered a job at Roszdravnadzor, for which I am very grateful.

An interesting detail: when I was studying at the Physics and Mathematics School in Sverdlovsk and it was already going to graduate, which means that I had to decide on my future profession, my great-uncles began to talk together that there is such an interesting direction – medical technology. Like, you have good knowledge of mathematics, physics, chemistry, you gravitate towards medicine – so move in this direction. But then I chose the specialty of a doctor. And then, decades later, he came to Roszdravnadzor, and it turned out that one of the huge blocks that the department deals with is medical equipment. Then I remembered my grandparents.

– Why did they focus on this particular area? Did you have anything to do with her?

– My grandfather was in charge of the department of strength of materials at the construction department of the Ural Polytechnic Institute, my grandmother was an assistant professor there.

The point is that you cannot escape fate …

– By the way, where did you serve in the army? For some reason, the fact is omitted in the biography.

– This is the end of the 80s, then they removed the reservation from medical universities and almost all of my fellow students were called. I ended up in the troops of the Ministry of Internal Affairs. Since we were taken away after the second course, we did not have the right to serve as medical workers. Then, of course, it was hard to recover, to get involved in studies.

– In what rank did you return?

– In the same one in which he was called. Ordinary.

– Becoming the chief physician at the age of 33, you continued to treat the sick, although not as actively as before. Is it possible as a minister?

The run is steady. Especially in the surgical specialty. When he headed the Ministry of Health of the Komi Republic, he tried to combine, but … You see, the doctor must constantly guide the patient, as they say, 24/7. If something goes wrong, you must return to the ward at any time and help the patient. When you are a minister, sitting at a meeting, then your head is busy with other issues. But the heart is out of place. How is the patient, what’s the matter with him? You can’t drop everything and run to the hospital. However, you cannot help but run, because the doctor …

This is where the danger lies. You cannot risk someone else’s health in order to retain some percentage of clinical practice.

– When was the last time you had to provide emergency assistance to those in need?

– Regularly! I’m lucky with this. But that’s okay, we were taught to help.

– Tell us.

– There was an episode while working at Roszdravnadzor. I flew from somewhere from Siberia to Moscow, returning from a business trip. The plane had just climbed ten thousand meters when the passenger fell into a coma.

The flight attendant announced: Is there a doctor in the cabin? I got up from the chair …

There were two boxes with medicines on board: one for professional doctors, the other for non-medical use. They brought me the one that was required. At an altitude of ten kilometers, we brought the patient out of the coma, and then the man got out of the plane with his own feet, went down the ladder.

– Did you do without an emergency landing?

– The ship’s commander was ready to land, but we managed to stabilize the condition of the passenger.

Everything ended well, I even made it to the meeting.

– And did something similar happen in the office of minister?

– I say, there are minor incidents from time to time. But in that episode, there was a real threat to life.

– And when was the last time a patient was diagnosed?

“Look, I regularly take part in medical rounds. I went to Perm with my colleagues after a well-known incident at a local university, held a consultation there, and walked around each patient. Then he monitored the condition of those evacuated to provide assistance to the federal centers of the Ministry of Health.

We are really discussing case histories! This is very important.

And the fact that we consult on the phone no longer counts. A common practice, a norm between colleagues.

– After becoming a minister, has your social circle changed a lot?

“Yes. Yes, of course. Physically, there is not enough time to communicate with everyone with whom I could talk before. Now I solve some specific situations more, but in such a way as to chat in everyday life … This is the problem. I hope my friends and comrades do not take offense at me.

PART 2

About calls, vaccinations, damage, statistics, immortality and the system

– But did you leave your mobile phone number the same?

– Yes, I haven’t changed it for ten years.

– Whose calls are you answering?

– I try everything. If I miss it, it is rather an exception. It happens that you completely wind up … The number of calls and messages after the start of the pandemic has grown exponentially.

There was a wild overload several times.

Once I went to an important meeting and left my phone at the reception. I come back in half an hour, I see: 72 missed calls and SMS. Some kind of flurry of information! In my opinion, this is my personal best. Or an anti-record …

When I am in my office, landline telephones are ringing, there is a government connection, people are flowing. Of course, the amount of information is huge. No, I’m not complaining, I understand: someone’s load is much higher.

– How do you filter, who to help?

“Where do I sign up?” I laughed. We try to help everyone. There are no other options.

Thank God, most of the callers understand that the head of the Ministry of Health is not a federal registry of all medical institutions in the country. There is a health care system, and it must be fulfilled. Here everyone must clearly fulfill their role – the junior staff, the nurse, the doctor, and the minister. That’s the main thing.

– But, I suppose, almost every Russian has a doctor’s phone number in his notebook for an emergency. Personal connections are still a big deal.

– I don’t see anything wrong with that. It’s great when you can ask for competent advice and shorten the path, bypassing intermediate points.

This is accepted throughout the world. Run of the mill practice. You call a doctor you know and ask for help, advice or advice. Do not take it as something pathological

It is more important to talk about improving the efficiency of the system. Do you know what the essence of the reform of the provision of medical care to pregnant women is? For each patient, a medical facility was selected that was most closely related to her risk profile. Sometimes we were told: why are you closing the rural maternity hospital, where you gave birth for five generations and where everything was fine? They say that everything suits us now, but now we have to go 50 kilometers to another hospital.

We explained that in your village the infant mortality rate is 30 ppm, in other words, 30 out of every thousand newborns die. If the system is changed, patients with the risk of complications will be referred to higher-level institutions, albeit more remote geographically, the rate will drop to four per thousand. There is a difference?

Unfortunately, people are not always ready to listen to reasonable arguments … It’s like getting vaccinated. We reiterate every day: herd immunity is the only effective way of protecting against a pandemic. No, they are vaccinated very slowly and reluctantly. And then they are surprised at the number of cases.

– Vaccination plans have practically failed. Deputy Prime Minister Tatyana Golikova has repeatedly said that the campaign should have ended in September.

– I believe that it can and should be completed. Literally within a few weeks.

– Having made the vaccine mandatory for everyone who does not have a medical withdrawal?

– The question is not coercion. The alternative is simple: if you don’t want to get vaccinated, stay at home. The principle is one – do not pose a threat to others. Otherwise, you can agree to the fact that every driver is free to drive a red light. I want and I will! Only then you shouldn’t be surprised if another car rushes into your side at a speed … You cannot bring everything to the point of absurdity.

– Answer definitely, Mikhail Albertovich: are you for compulsory vaccination?

– In today’s situation, I think people need to be encouraged to make the right decision …

– Force?

– Why do you use this word? I said “induce”.

– And if the citizens rested and in any? Don’t move

– So, let them sit at home.

– Losing your job?

All rights reserved.

Why should you threaten others by refusing to vaccinate? Why?! Then do not wash your hands, do not monitor your health. By such behavior, people take themselves out of the box, oppose society. How and what to negotiate with them?

– Describe the changes in your attitude towards coronavirus as the number of cases increases.

– At first they were afraid, then they began to understand what was happening, learned to manage the situation.

Everything is standard, as in any process of cognition.

– Now what stage?

– We still do not know how to treat COVID-19 in 100 percent of cases. If a unique drug appeared that would allow you to quickly jump out of a painful state at the first symptoms, perhaps they would not insist on vaccination today.

– Pfizer said Paxlovid was highly effective against the corona.

– This is just one of the drugs for which the second stage of clinical trials has been completed. We must wait for the conclusion from the regulator. In addition, the drug must cost a reasonable price to be available to everyone. So far, unfortunately, no one has it, although we are also completing the development of a drug that interrupts the course of the disease at the initial stage of infection.

What exactly was this about?

– Now we will complete the tests, then we will tell you.

– And what about those drugs that have already been registered?

– In principle, everything is available. Perhaps, only one foreign drug faced restrictions in supply: manufacturers physically do not have time to produce what is needed for the whole world.

We made an alternative drug. It is necessary to have a domestic line …

– Again, will you tell me the name?

– I do not like to mention trade names in the media, this generates unnecessary excitement. Practice shows that the word sometimes both heals and, alas, cripples. I try to be more careful in my statements.

You see, there are vaccine-preventable infections that we know how to fight. A universal remedy has not yet been found against coronavirus that guarantees a cure, but there are vaccines that make it possible to prevent the disease in more than 90 percent of cases, while minimizing the risk of complications and death.

Vaccines are free for a person, and they cost the state quite affordable money.

– What damage did the pandemic inflict on the healthcare system? Not only direct, but also indirect, when planned care for patients was postponed.

– How can these losses be measured? Once again, we return to the topic of responsibility: why should a patient who has been waiting for an operation or treatment in a hospital for a long time to suffer because someone has not been vaccinated and hospitals are forced to urgently unfold beds, re-profile surgical, obstetric and other departments for covid hospitals? Do you think this is normal? We had to remove specialists, break the well-functioning work of leading medical institutions. For example, today the clinics of the First and Third Medical Universities in Moscow have been transferred for treatment for COVID-19, where they provide high-tech, truly unique assistance.

It is especially offensive that we understand how to avoid such situations. Once again, during our interview, I repeat: people, you need to go and get vaccinated! Sorry to return to this topic again …

– The people are wary of what they diligently impose on them. And he stubbornly does not believe in official statistics. The number of cases, deaths …

– Let’s show the pivot table on my phone. Information for this morning: in Russia, almost a million 400 thousand people are under the supervision of medical workers. These are those who are treated in hospitals and outpatients.

Here is the incidence graph. For the last days, weeks, month … What is there not to believe, then?

– Remember how long the number of deaths per day circled around 800, without crossing the psychological threshold. 799, 790, 798 … Then a similar picture was with a mark of a thousand victims per day. They walked around the bush for a long time, until October 16, they crossed this line. As if someone artificially held the horses …

“No! Until the school year began, the incidence was declining. Then the growth began. Every day we publish statistics on the Stopkoronavirus.rf website. And the number of cases per day, and the total number of patients under observation. We do not hide anything, we speak openly. If you need more information, we will provide it. What’s the point of hiding it?

More than a million patients are very, very many. In 2020, at the peak there were a million 100 thousand of those whom we led. This October, last year’s record was broken. And now it’s not even December on the calendar …

– Is the system ready for new loads?

– I have been hearing this question for the last year and a half. Medicine can continue to be tested for strength, to check which is stronger – the head or the wall. The forehead is still weaker, I am convinced of this even without experiments …

Look, the system, of course, will withstand, will work with one or another level of efficiency. When the load on ambulances, outpatient clinics, hospitals increases, the quality may decrease. Since the spring of 2020, doctors, nurses, nurses, drivers – all staff are in colossal, incredible tension

Low bow to each of them.

Where is the limit of possibilities? I don’t know.

Doctors alone cannot cope. They need to be assisted. Ours with you, the population of Russia.

We have said many times that the most severe complications occur in older people. In fact, among the deceased, about 80–90 percent are those who are over 60 years old. And the number of vaccinated among them remains just over 50 percent. Is that enough?” No, of course not.

In addition, after the appearance of the “delta” strain, young patients also get sick with an unfavorable outcome. 30 year olds, 20 year olds. As they say, there is a resource who can get infected and die. Only is it necessary to bring to this?

Statistics show: about six months after the disease, there is an increased risk of complications, and hence death. We need an in-depth clinical examination – please, we have given an opportunity. Examinations are carried out to diagnose thrombotic problems, heart attacks, strokes …

Come check it out!

I’m tryin’.

– Yes, but slowly. Now imagine: tomorrow the state will announce free maintenance for every private car. Will the people quickly run to the service station?

– For free, then? Of course!

– And here isn’t it for nothing? It turns out that we treat the car better than our own health?

– We are immortals! Until we die …

– It’s already clear … Recently I heard an anecdote. A man bought a cool phone, looks at it, cannot stop looking at it. Then he shoves it into the back pocket of his jeans, sits on a chair and suddenly hears a crunch. Something broke. The thought in my head: “If only the spine.”

Do you get it, right? If only the spine!

– What do you think about and what do you say when you find out about buying and selling fake vaccination certificates?

What can you say? I’m speechless. None. Formulate something yourself and write.

“But these fakes are made by doctors and nurses.

– Doctors are the same people as everyone else. Не лучше и не хуже… Someone is trying to trick the system. With or without a fee.

Probably, the internal culture should change over time, and then this will become impossible, but it will not happen overnight.

– Maybe for such crimes should be imprisoned?

– You have a wide soul, you urge to immediately send to jail! ..

Yes, we need measures of influence. Defined Administrative, criminal …

– And how do you like the idea of treating those who were not vaccinated, but got sick, for a fee, for money?

– I’ve seen such emotional statements. They come from people who are tired of persuading others.

This is hardly a sensible way. I really like the word “motivation”. A system of motivation for a healthy lifestyle must be created. It’s okay for someone to lead you to deliberate, meaningful actions. You need to learn to listen to the smart in order to do less stupid things.

– Have you been vaccinated against the flu?

– Like every year. Always

– And when did you get the injection for the first time with Sputnik?

– In May last year, if not confusing. Early research.

– How is the guinea pig?

– I went voluntarily and deliberately. He acted according to the principle: in order to convince others, one must believe in the vaccination oneself …

– Revaccinated later?

– Yes, my whole family too. First they took root, then they added the “Sputnik Light” booster.

By the way, we have already given information about the completion of research on the combination of “Sputnik” and the flu vaccine. The first results show that such a combination is possible and even enhances the effect. Two injections in one visit to the doctor. It is easier, faster and more convenient.

I think my parents survived thanks to Sputnik. They got sick after vaccination

Mom coughed during the day and recovered, and Dad had a high temperature for several days. Since his age was solid, there was a risk of complications, he was admitted to the hospital for a couple of days to be observed there. When the condition stabilized, dad was discharged immediately and went home.

I have already said a million times: those who have not been vaccinated suffer the disease much worse. And then they have problems for a long time. In particular, there is a decrease in the level of memory and cognitive activity, certain neurological symptoms, anxiety, fatigue …

By the way, in countries that have been in lockdown for a long time, these problems are more pronounced. Any person strives for freedom. When it is closed within four walls, making it impossible to move, it severely affects mental health.

So there is no need to delay the vaccination process, otherwise new restrictive measures cannot be avoided.

– You said that all problems with the World Health Organization for the recognition of “Sputnik” have been eliminated …

– There were a number of administrative procedures that needed to be performed. Then the vaccine can go its own way, be registered. Colleagues from WHO are positive. I assure you there is no politics or bias here. We are talking about a complex bureaucratic system with its own rules and protocols. No one doubts the effectiveness of Sputnik, but certain formalities must be observed.

– It seems that the production standards have been violated at the factories where the vaccine is produced.

– There is a so-called risk profile assessment. According to foreign experts, a number of other activities were required. The final report should now be submitted. I saw it, it is very voluminous, multi-page.

– Can you give a forecast on the timing of the completion of prequalification?

– It is clear that the prospect is foreseeable, but why am I going to guess, name any specific dates? This is not the applicant, the Ministry of Health, we are not registering.

In the case of Sputnik recognition, it is important to understand that there are two procedures. One concerns WHO approval for market use of the vaccine. Here it must be confirmed that the drug is safe for people, does not pose a threat to others. This is the first.

The second protocol is the technical part concerning vaccination certificates, their mutual recognition. What form will they have – a paper document or an electronic carrier with a QR code? All this needs to be legally fixed.

PART 3

About rigor, godchildren, teachers, team, guitar, bicycle and concentration

– What do you think about social networks, Mikhail Albertovich?

– I look, I read, but I won’t say that I disappear on the Internet all day. Everything should be dosed. One evening I spent two and a half hours on the Web. It seems to be called surfing. I climbed on different nets and branches, watched some groups. He stayed up late until his wife said: “Enough, tie it up …”

– Are you carried away?

– It’s amazing how much absurdity there is!

– Have you read about yourself?

– No, I was interested in certain behavioral communities. Other points of view are curious, different perceptions, the way some people think … To be honest, there are some really dangerous behaviors. I will not dwell in detail, so as not to popularize the topic, but there is something to think about.

Once again I was convinced that the book “What is good and what is bad?” correct.

– When Mayakovsky wrote it, there was no Internet.

Now what’s the difference? You might think that this choice has only appeared today. Remember Dante Alighieri’s Divine Comedy, the funnel from the Abyss of Hell by Sandro Botticelli. “Good” and “bad” have always existed. There were no social networks, but great poets and artists already said everything back then. And our Fyodor Mikhailovich, whose 200th birthday was celebrated the other day, added in Crime and Punishment: “Am I a trembling creature or have I the right?”

Listen, well, nothing has changed!

– Do you think you are a strict boss?

– I can be tough. Although the older I get, the more I understand: this is not the main thing. Sometimes it is more correct to explain, to convince, even to persuade, but there is not always enough time, unfortunately.

I think I have become more tolerant with age. This trait, apparently, comes over the years. At 30, I would have turned more sharply on heels …

– Happened?

“Yes. Yes, of course. I remember when I worked in the perinatal center, a drunk midwife replaced me. Honored person, really great professional, I treated her very well. Even now, decades later, it is difficult to tell.

Passed away

– Without talk and a shadow of doubt. Goodbye!

– And take into account the circumstances?

– My colleagues came to me, persuaded. There is no reason to show up drunk in the workplace. Then the situation was still risky, fortunately, everything ended well, the patient did not suffer, although she could. Who would be responsible for this?

I can understand a lot, but alcohol in the hospital is taboo, it shouldn’t be.

– Now, what would you do?

– In a similar situation – the same. Well, maybe I would not have fired right away, I would have thought about transferring to another department. Although this is unlikely. There is always a decision point, but the lives of patients should never be risked.

– Did you have losses during the pandemic, Mikhail Albertovich?

– I will not talk about personal …

As for colleagues, in 2020, five of my classmates who worked in the red zone died. Doctors are at war, all medicine is now fighting … I had to turn to older colleagues who had retired at the beginning of the pandemic, asked them to get vaccinated and go back to work. Medical students also volunteer in hospitals. Hands are missing!

I will repeat once again: there are weapons to fight the coronavirus, but people refuse to use them. How should we deal with this?

– When did you feel like a doctor, at what moment?

– I came to the medical institute in Sverdlovsk and immediately felt a sense of involvement in the profession. True, the students have a so-called third-year disease. Suddenly it seems that you know everything and you can, but it seems that I have had this “ailment” in a mild form, without complications.

Of course, when you start to practice yourself, completely different sensations arise. The responsibility is different.

I must say thank you to the mentors for trusting me, a young doctor. Roza Georgievna Savelyeva, Vladimir Anatolyevich Lyuskov, Alevtina Ivanovna Schegoleva, who, alas, passed away in 2020. They literally stood behind my back, belaying.

—No, commander.

– Do you have godchildren among your patients?

– Of those saved? Yes, of course. A lot As with every practitioner, especially those who provide emergency care.

– Do you keep in touch?

– I am even friends with some. This is normal.

– What are you proud of as a clinician?

– Probably, I could give examples from past practice, but I was already beginning to tell you that at a certain stage the doctor reaches the philosophical level of understanding the essence of the problem.

Now such specialists are called top managers, earlier they were referred to as philosophers. They went to Diogenes in a barrel for advice …

It is clear that many people associate my name with a pandemic today, but I hope this will not always be so. At one time, I managed to do something for the medical care of the mother and the child. We have changed our approach on some regulatory issues.

– Is the head of the Ministry of Health obliged to be a doctor by profession, or are the skills of an experienced manager sufficient?

– You need to understand the subject, there is nothing to argue about. In theory, the doctor should quickly understand what exactly is needed by the patient and the medical staff, but in any case, he will have to gain experience.

Although today there is a type of leaders who know everything only from textbooks. In my opinion, without practice, such information is of little use. “Dry theory, my friend, and the tree of life is magnificently green …”

– At the school for personnel reserve, one of your teachers was Mikhail Mishustin. What did the current prime minister teach you?

– He gave a great lecture, demonstrating the capabilities of digital technology and process management analytics based on raw data. Mikhail Vladimirovich is a super professional! I think I am very lucky in my life to work with such a purposeful, strong and result-oriented person.

– And what did you retrain as a minister?

– For example, in each department there are certain apparatus rules. You can’t come and break everything. It was necessary to understand, to understand the staff culture. Again, the people around are different. Someone tried to help, but there were those too, then they looked: yeah, come on, come on, now you will fill the cones, and we will sit, wait …

– Did you reshuffle the team a lot?

– Some left, others stayed. The staff and apparatus must be updated in any case. After all, tasks change, new goals and specific tools appear to achieve them.

– Are there those who go with you, as they say, through life?

– Some have been with me for more than a dozen years. We studied with someone at the institute. There is even a former student of mine among my subordinates. A very smart guy.

– Are you not afraid of reproaches that you are recruiting a state based on the principle of personal loyalty?

– I have no such installation. strongly Of course, initially you focus on those you know well. They are easier to rely on when you need to quickly assemble a team on demand. But then I still delegate a certain level of responsibility to people, I trust them. For mistakes you will have to pay together. The price is very high …

We have a psychologist on our staff who checks our employees, including for stress resistance, and helps them. There is no other way today.

– How do you relieve stress, Mikhail Albertovich? Once, I know, they played the guitar.

– Now I rarely pick up an instrument, although sometimes I can still play in the company. It’s nice to remember your youth …

Actually, I graduated from music school, class of accordion. He became seriously interested in the guitar already in the student vocal and instrumental ensemble.

– Did you go to the Sverdlovsk rock club? “Nautilus Pompilius”, “Chaif”, “Agatha Christie” …

“They were older than us.

– Did you regret not becoming a professional musician?

– What prevents you from going over today?

But seriously speaking, of course, I love medicine and I think that I was lucky in my life. And I was not mistaken with the choice of specialty. Definitely Obstetrics and gynecology is a very interesting area, there is surgery, therapy, neonatology, and a lot of other things. The amount of knowledge is huge.

– You did not answer how you relax. Maybe the traditional Russian folk method?

– No, it doesn’t go. I have sports every morning. No matter how much you slept, you must sweat in the morning. I get up no later than half past six in the morning and go for a bike ride or a run.

Cool stuff! The best option for me. I do not like to swing and “pull iron”. I gain muscle mass very quickly. And then there is cardio and muscle training. The rocking chair, I repeat, is not mine, it is better for me to be, as they say, dry, lean, so I feel more comfortable. The bike is optimal in this sense. In addition, when you are driving, you involuntarily distract yourself from the routine, relax, look around at the changing picture. I try to diversify the route so that the landscape does not repeat itself. I have a folding bike, put it in the trunk of my car, drive off somewhere to the side and ride there. It’s very convenient.

– What distance do you usually drive?

– At least 12-15 kilometers. The minimum is such a bar. If time permits, I can do more.

When I don’t have time to ride, I run about three kilometers.

– Do you take your phone with you to training?

– I have to, but while driving it is better not to be distracted by conversations. Danger. Therefore, I switch to silent mode. Once he answered the call and … fell.

Who phoned Any government has to.

– It was a long time ago, about 12 years ago, or even more. The supervisor of my doctoral dissertation called, I pulled out the phone, held it in my right hand, and there was an obstacle on the road. I had to brake with my left, the front wheel blocked, the bike tumbled under me, I more or less successfully flew off it and ran forward with the phone in my hand …

Better not to repeat such experiments. Even with an earphone.

One must always maintain attention and concentration. You will be more whole. As an experienced doctor, I am telling you this …

Power

https://minzdrav.gov.ru/news/2021/11/15/17779-mihail-murashko-hvatit-ispytyvat-sistemu-na-prochnost

https://tass.ru/top-officials/12895023