Sergei Sobyanin: A new environment for treatment of infectious patients to be created in Moscow

Sergei Sobyanin: A new environment for treatment of infectious patients to be created in Moscow
Photo: Photo by the Mayor and Moscow Government Press Service. Yevgeny Samarin
New buildings will be added to the Infectious Disease Clinical Hospital No.1, St. Vladimir Children's City Clinical Hospital and a multi-profile hospital with a maternity clinic in Kommunarka township.

Moscow Infectious Diseases Service will undergo a comprehensive upgrade. The Children's Infectious Disease Clinical Hospital No.6 will be provided with a state-of-the-art medical building. A major overhaul is already underway.

"Infectious disease control, both for Moscow medicine and for others, is one of priority activities. It is essential to upgrade the existing network, maintain it, provide the clinic with new upgraded equipment. For this purpose, large-scale works are underway in this children's hospital.  In fact, a new environment is being created, and new opportunities for treatment of people suffering from infectious diseases," said Sergei Sobyanin.

He added that many buildings of the infectious diseases hospitals are outdated and cannot provide modern conditions for treatment: "There is really much work to do in Moscow: about 80,000 people are now under medical treatment at hospitals. Attempts to make new buildings out of the old ones, unfortunately, have not always been successful. So we’ve made a hard but essential decision to construct two new hospitals with a total area of about 140,000 sq m," Sergei Sobyanin added.

New buildings will be constructed for the Infectious Disease Clinical Hospital No.1, St. Vladimir Children's City Clinical Hospital and a multi-profile hospital with a maternity clinic in Kommunarka township.

According to Moscow Mayor, it will require large resources, but as a result Moscow will have new clinics with unique equipment: "In three to four years, patients suffering from infectious diseases will be treated at the highest level."

All new buildings will offer updated conditions for infectious patients ― common boxes and Meltzer boxes. The buildings will house laboratories, diagnostic equipment, operating rooms, so that infectious patients can get all the necessary treatment on the spot.

A meeting with discussion of the  infectious diseases service development issues was held in the Hospital No.6.

 "This day will go down in Moscow’s history. Upgrading of the existing base is coming to an end. And today we will discuss our plans for the next 20 years," said State Duma Deputy, Doctor of Medicine Gennady Onishchenko.

Present hospital facilities

Children's Infectious Disease Clinical Hospital No.6 was built in 1973. Currently, it consists of four medical buildings. Two of them are located at 2B 3rd Likhachevsky Pereulok, and two more at 28 Bolshaya Akademicheskaya Street. The total area of the grounds is 3.8 ha, with area of all buildings 22.100 sq m.

Hospital No.6 has 365 beds for full-time stay, including 165 neonatal beds for infected patients. The Intensive Care Unit can accommodate 24 patients, including 15 new-borns and premature babies.

The hospital has 438 employees, including 95 doctors and 189 nursing personnel employees with one honoured doctor of Russia, two honoured healthcare professionals of Moscow, four Doctors of Medicine and eight Candidates of Medicine.

Hospital No.6 employees are constantly improving their skills. At least 30 percent of doctors have two or more professional certificates in neonatology, paediatrics, infectious diseases, paediatric cardiology, pulmonology and functional diagnostics. Hospital No.6 neonatologists have been trained in Italy, Israel and Germany in the Theoretical Neonatology Course. Hospital staff conduct lectures for Moscow paediatricians and paediatric cardiologists.

Over the past year, about 11,000 children have been treated at Hospital No.6. The institution helps young patients to combat various infectious diseases, from intrauterine infections to severe forms of respiratory viral infections, as well as infections associated with congenital heart disease.

Intrauterine and Postnatal Infections Centre

Children's Infectious Disease Clinical Hospital No. 6 helps children with severe forms of influenza and SARS, pneumonia, meningitis and complicated herpes, infectious mononucleosis, whooping cough, rotovirus and bacterial intestinal infections.

In 2016, the Hospital opened an Intrauterine and Postnatal Infections Centre for new-borns with intrauterine infections, skin and venereological  diseases, purulent inflammatory diseases, including sepsis and infections of the central nervous system. Doctors of the Centre treat and care for premature babies with very low and extremely low body weight, that is less than one kilogramme. They help new-borns with acute HIV infection, early congenital syphilis, children born to mothers with tuberculosis, babies with rubella, chickenpox and other highly contagious infections.

Children are accommodated in special boxes with a street-side separate entrance. Due to this, patients are completely isolated to prevent infection from spreading. Modern ultrasound expert class devices, X-rays, ECG devices and electroencephalographs help to conduct comprehensive studies right besides the patient's bed. It greatly reduces time required for making diagnosis and fastens treatment start.

One of the Centre's activity fields is the treatment of new-borns with infection associated with congenital heart disease before and after cardiac surgery. In addition, for the first time in Moscow medicine, the clinic doctors have introduced nebuliser therapy in new-borns with bronchopulmonary dysplasia, a disease that develops in low birth-weight babies due to lung tissue underdevelopment. The Centre's physicians have taken the lead in Holter ECG and daily blood pressure monitoring in new-borns, and in neonatal cardiac screening for critical congenital heart diseases, followed by medical therapy in new-borns.

Parents are allowed to stay in the Centre with their child, including in the Intensive Care Unit. Since 2016, the Centre has helped 5753 young patients.

Repair works and new equipment

Since 2011, a programme for the development of the Hospital No. 6's infrastructure and facilities has been implementing. During this time, the hospital received 619 units of medical equipment, including one mobile digital X-ray unit, 7 ultrasonic devices, 47 units of operating rooms equipment, 113 units of neonatal equipment and 363 units of equipment for anaesthesia, replacement, maintenance and  functions control. The medical building No. 2 and the catering department have been overhauled, and the territory has been improved and landscaped.

Last year, the overhaul started in the three-storey medical building No.1 with an area of 5,400  sq m. It was built in 1973, but currently it does not meet modern requirements. It has no boxes, patients are placed in ordinary wards for four or five people with a shared bathroom in the corridor.

After the overhaul, the medical building No. 1 will turn into an up-to-date hospital with 57 comfortable boxed wards providing possibility for mothers to stay with their children. Seven individual boxes will be arranged for young patients with severe infections. Each box will have a private bathroom and entrance. There is also a special passage connected with a common corridor for medical staff.

"Meltzer boxes allow to provide complete isolation of an infectious patient. The box has street-side entrance to admit patients," said Olga Zhdanova, Hospital's Chief Physician.

After the overhaul in the Department No.1, resuscitation department with 15 beds will open for new-borns, where parents will be able to visit their children.

Upgrading Moscow Infectious Diseases Service

Presently, eight Moscow hospitals are engaged in treating infectious diseases ― three specialised infectious diseases hospitals and five infectious diseases departments in city multi-profile hospitals.

Most of the equipment of infectious diseases hospitals and departments is outdated, despite the ongoing work on hospitals infrastructure and facilities upgrading. Almost all medical buildings were built in 1970-1980s. They fail to provide reliable isolation of patients. But this is a key requirement to stop infection from spreading.

Therefore, it was decided to construct new buildings. They will have admission departments with separate rooms ― isolation wards with separate entrances. Small capacity and Meltzer boxes, diagnostic services, operating rooms and intensive care units will be arranged. This will allow to do surgeries on the spot, there will be no need to send patients to other facilities. In-house laboratories will help doctors with quick diagnosis and prescribing required treatment.

After the new buildings are built, the number of Meltzer boxes in Moscow will grow more that twice ― from 348 to 901 for adults and from 196 to 480 for children. Patients will be accommodated in isolated boxes, not in general wards, as it was before.

New infectious diseases hospitals

The old buildings of Infectious Disease Clinical Hospital No.1 will be demolished, and at their location a state-of-the-art hospital will be constructed, with 546 Meltzer boxes, including 18 boxes in the department for highly infectious diseases and 60 boxes in the department for pregnant women. Maternity department will have four Meltzer blocks ― for childbirth, for patients with tuberculosis and especially dangerous infections.

The Otolaryngology Department will house 17 boxes and its own  mini operating room. Intensive Care Unit will have 25 boxes, with five of them for new-borns. The hospital will be provided with a laboratory, MRI devices, CT and other equipment. The dialysis unit will open for patients with nephrological diseases.  Construction is to start next year.

The new infectious diseases building of St. Vladimir Сhildren's Сity Сlinical Hospital will house 350 Meltzer boxes, as well as a diagnostic surgical rehabilitation service. There will be an admission department and ward departments. The hospital will accept patients with all kinds of infectious diseases, so Meltzer boxes will be provided in all departments ― the Department for neuroinfections, intestinal infections, SARS, respiratory infections and others. In addition, three boxes will be equipped for patients with particularly dangerous infections.

All departments will have boxes for HIV-infected people. 11 boxes will be adapted for patients who require hemodialysis or peritoneal dialysis. Construction is to start next year.

The multi-profile hospital with a  maternity clinic in Kommunarka township will house infectious department for 100 boxes, including 40 Meltzer boxes. The first half of them will accommodate adults, the second one ― children.

Two years without epidemics

Infectious diseases in Moscow are controlled not only in hospitals. Much attention is paid to prevention.

"In recent years, we have significantly increased a number of vaccinations, it is a record-breaking number, and thus reduced, for example, the incidence of SARS, influenza in Moscow almost twice, and the last two years there were no epidemics in the city,'' said Sergei Sobyanin.

This season, 7.5 million people have been vaccinated against influenza, including 1.26 million  children. 60.7 percent of the Moscow residents have been vaccinated (compared to 55.2 percent in previous season).

"This is an excellent result. The number of additional types of immunisation that Moscow currently carries out at its own expense is six additional vaccinations. For all or for those risk groups present in Moscow today, it also means a decrease in the incidence," said Anna Popova, Head of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing.

Moscow residents and guests had a possibility to be vaccinated in mobile units near 29 metro stations, three MCR stations and two railway stations. This opportunity has been provided for the third year running. This season it was used by 196 176 people.

Two years in a row it was possible to receive vaccination against flu in My Documents public services centres. This season, 70 offices joined the campaign. 108 970 people have been vaccinated there.

In addition, Moscow citizens suggested arranging mobile vaccination stations in nine shopping centres. 13 887 people were vaccinated there.

In total, 319 033 Moscow residents have been vaccinated in mobile vaccination stations. It is 81 571 people more than last year. Thanks to this, there were twice less incidents of flu than in 2016 ― 24,800 people per 100,000 of population that year and 12.900 people per 100,000 of population now. The proportion of patients with severe run of a disease decreased from 8 percent in 2016/2017 to 4 percent in 2018/2019. For the second year running, the winter season in Moscow passes without an epidemic of influenza and SARS.