Listeriosis and the COVID-19 pandemic

Listeriosis is a saprozoonotic infection that occurs when eating foods contaminated with Listeria. Invasive forms of listeriosis can have extremely severe consequences. Respiratory viral diseases predispose to the occurrence of combined viral-bacterial infections. With a mixed infection of listeriosis and COVID-19, a severe course of the disease is observed, which has a serious prognosis. The aim of the study was to analyze the frequency of various variants of invasive listeriosis and their outcomes in the period before the COVID-19 pandemic and against the background of its development, as well as to determine the genetic diversity of L. monocytogenes isolates. Material and methods. We analyzed 55 cases of invasive listeriosis in patients observed in 2018-2021 in various medical organizations in Moscow. The diagnosis was established on the basis of epidemiological, clinical and laboratory data, listeriosis was confirmed by bacteriological and molecular genetic methods, COVID-19 was confirmed by the detection of SARS-CoV-2 RNA in an oropharyngeal swab using real-time RT-PCR, as well as computed tomography of the lungs. Results. During the current COVID-19 pandemic (2020-2021), the incidence of listeriosis in pregnant women and invasive listeriosis occurring in the form of sepsis and/or lesions of the central nervous system did not differ significantly from similar indicators registered in 2018-2019. Listeria sepsis and/or meningitis/meningoencephalitis in association with severe SARS-CoV-2 novel coronavirus infection are at high risk of death. During the years of the COVID-19 pandemic, the diversity and range of L. monocytogenes genotypes in invasive listeriosis changed, new genotypes appeared that were not previously characteristic of the Russian Federation. Conclusion. The likelihood of developing listeriosis sepsis and/or meningitis/meningoencephalitis against the background of a severe course of COVID-19, and a high risk of an adverse outcome, require increased awareness of medical workers in the field of diagnosis and treatment of invasive listeriosis in order to conduct the earliest and most adequate antibiotic therapy.Copyright © 2022 Geotar Media Publishing Group. All Rights Reserved.

Features of the Circulation of ARVI Pathogens During of Emergence and Widespread of SARS-CoV-2 in the 2018–2021

Relevance. The long-term leadership of ARVI pathogens determines their significance in the damage caused to both health and the economy of the country. Aim. To identify the features of the structure of ARVI during the emergence and widespread spread of SARS-CoV-2. Materials and methods. The article uses methods used in epidemiological surveillance of acute respiratory viral infections. Results and discussion. The results of the diagnostic available ARVI pathogens monitoring during epidemic seasons 2018-2021 are presented. The tendency of greater engagement of aged group 15 y.o. and older in epidemic process by morbidity and hospitalization due to SARI was shown. 49 818 nasal swabs from patients with influenza infection, 36 044 – with ARVI and 59 062 – with SARS-CoV-2 were tested. The top three in the structure of ARVI were INF, HEV-D and HRSV (in the 2018–2019 season);INF, SARS-CoV-2 and HEV-D (2019–2020);SARS-CoV-2, HEV-D and HPIV/HCoV (2020–2021). The activity of viral pathogens also differed: for HPIV, HAdV, HEV-D, HMPV, a decrease in activity was noted during the appearance of SARS-CoV-2 (2019–2020) and some of its growth in the following season;in relation to HRSV and INF-a decrease in activity during the last two seasons, and for INF – extremely low activity in the 2020-2021 season;the activity of seasonal HCoV even increased slightly. The data of genetic analyses of SARS-CoV-2 positive samples showed the heterogeneity of its population with a representative of variants (Alfa, Delta) as well as endemic for Russia and Moscow variants only. The recommended composition of influenza virus vaccines for use in the 2021–2022 northern hemisphere influenza season and in the 2022 southern hemisphere influenza season are presented due to their drift changeability. Conclusions. SARS-CoV-2 was influenced by the activity of ARVI pathogens with the almost complete displacement of influenza viruses from the circulation in the period 2020–2021. © Burtseva EI, et al.

Listeriosis and the COVID-19 pandemic

Listeriosis is a saprozoonotic infection that occurs when eating foods contaminated with Listeria. Invasive forms of listeriosis can have extremely severe consequences. Respiratory viral diseases predispose to the occurrence of combined viral-bacterial infections. With a mixed infection of listeriosis and COVID-19, a severe course of the disease is observed, which has a serious prognosis. The aim of the study was to analyze the frequency of various variants of invasive listeriosis and their outcomes in the period before the COVID-19 pandemic and against the background of its development, as well as to determine the genetic diversity of L. monocytogenes isolates. Material and methods. We analyzed 55 cases of invasive listeriosis in patients observed in 2018-2021 in various medical organizations in Moscow. The diagnosis was established on the basis of epidemiological, clinical and laboratory data, listeriosis was confirmed by bacteriological and molecular genetic methods, COVID-19 was confirmed by the detection of SARS-CoV-2 RNA in an oropharyngeal swab using real-time RT-PCR, as well as computed tomography of the lungs. Results. During the current COVID-19 pandemic (2020-2021), the incidence of listeriosis in pregnant women and invasive listeriosis occurring in the form of sepsis and/or lesions of the central nervous system did not differ significantly from similar indicators registered in 2018-2019. Listeria sepsis and/or meningitis/meningoencephalitis in association with severe SARS-CoV-2 novel coronavirus infection are at high risk of death. During the years of the COVID-19 pandemic, the diversity and range of L. monocytogenes genotypes in invasive listeriosis changed, new genotypes appeared that were not previously characteristic of the Russian Federation. Conclusion. The likelihood of developing listeriosis sepsis and/or meningitis/meningoencephalitis against the background of a severe course of COVID-19, and a high risk of an adverse outcome, require increased awareness of medical workers in the field of diagnosis and treatment of invasive listeriosis in order to conduct the earliest and most adequate antibiotic therapy. © 2022 Geotar Media Publishing Group. All Rights Reserved.

Partnership in healthcare system sustainability and resilience: Russian healthcare system analysis

Background. In 2020 the global community faced a serious unexpected challenge - COVID-19. Fighting the aggressive spread of the coronavirus required rapid reconfiguration of the Russian healthcare system, while exposing its weak spots and pressure points. Critical evaluation of the Russian healthcare system's resilience to crises offers new perspectives on the most effective management and organizational solutions for resolving this crisis. Research objective. The main goal of this study is to make a significant long-term contribution to the Russian healthcare system by developing a set of recommendations for increasing the system's sustainability and resilience to crises. Methods. For this study, specialists developed a framework that includes a set of questions in the 1) domains of governance, 2) financing, 3) workforce, 4) medicines and technology and 5) service delivery, which align closely with the well-recognised WHO health system building blocks. In each domain, a series of targeted questions concerned both sustainability and resilience. Findings. The main areas of work for increasing the Russian healthcare system's sustainability and resilience to crises include: adapting the existing legislative framework to the current crisis, and to prepare it for similar crises in the future;increasing healthcare funding;improving the image of the medical profession;promoting healthcare digitalization;reducing the pressure on the inpatient and emergency care services by strengthening preventive and rehabilitative care services. Conclusion. The synthesis and analysis of materials relevant to understanding the impact of the coronavirus pandemic on the Russian healthcare system, supplemented by expert assessments and examples drawn from practice, allowed the authors to compile a list of recommendations for ensuring the healthcare system's sustainability and resilience to future crises. This list offers potential for healthcare industry development.

[The impact of the COVID-19 pandemic on vocational education in Russia and foreign countries].

The article is devoted to the study of the impact of the COVID-19 pandemic on the sphere of higher education in conditions of limited attendance of educational institutions, the transition to a new format of education and the search for solutions in response to the challenges of the education system in a critical situation. In the context of the outbreak of a new coronavirus infection, the pandemic has had the greatest impact on the field of education (including vocational) on a global scale. However, this area, despite a number of certain problems, has become one one of the few industries that turned out to be prepared to transfer most of their processes online. Currently, national governments, international organizations and research centers are conducting research on the problems of the education system common to most States that arise on the way to the transition to the digital format of education. Study of the impact of the pandemic COVID-19 in the field of higher education was conducted based on the results of a report by the Vladimir Potanin Charitable Foundation, the National Training Foundation and a VTSIOM survey in June 2020.

[SELF-ASSESSMENT OF THE SOCIO-ECONOMIC SITUATION OF CITIZENS UNDER THE INFLUENCE OF THE COVID-19 PANDEMIC].

The article deals with topical issues of changing the socio-economic state of citizens under the influence of the situation with the spread of a new coronavirus infection that swept the entire world at the beginning of this year. Currently, society is asking whether people's attitudes to each other will change, how the economic situation in general and the financial situation of citizens will develop, in particular, in the conditions of active use of remote technologies, the development of Internet resources and the transition to digitalization, which are gaining popularity in conditions of self-isolation and restrictions on mass events. The article uses the results of a survey of the research project «Self-organization and mutual assistance in countering the spread of coronavirus infection¼, conducted by the center for research of civil society and the non-profit sector of the Higher School of Economics. The responses of respondents regarding the introduction of digitalization, increasing online opportunities, both in terms of work, training, and entertainment and communication, converge and confirm the prospects for development. However, while volunteers are optimistic about digitalization, representatives of the civilian population are more concerned about strengthening the digital control of the state over the lives of citizens.

[MOTIVATION OF MEDICAL STAFF DURING THE SPREAD OF THE COVID-19 PANDEMIC].

The article is devoted to the consideration of the issues of motivation of medical personnel to work effectively in an extreme situation of a pandemic (COVID-19). The paper presents a sociological analysis of the working conditions of medical workers in the situation of the spread of a new coronavirus infection and the problems faced by medical workers in providing medical care in a pandemic. A content analysis of Russian regulatory documents regulating the requirements for the prevention, diagnosis and treatment of coronavirus was carried out. A survey was conducted by the method of a semi-formalized interview from June 15 to June 30, 2020 among employees of medical organizations. The authors analyzed the results of the study and concluded that medical workers remain the main resource in the fight against a new pandemic, and, unfortunately, one of the most vulnerable groups.

[On the Need for Psychological Support for Citizens in the Context of the COVID-19 Pandemic].

The article deals with issues related to the psychological support of citizens during the most acute periods of the COVID-19 pandemic. Even before the COVID-19 pandemic, global statistics on mental illness and disorders (including neurological and substance use disorders; suicide risk and related psychosocial and cognitive impairments) were already disappointing. In this connection, the world economy is suffering serious financial losses, and the social sphere is faced with the need to organize socio-psychological support and rehabilitation of citizens experiencing certain psychological problems. The purpose of this work is to present data reflecting the work of psychiatrists and psychologists in providing counseling and rehabilitation psychological assistance to citizens during the COVID-19 pandemic through indicators of the depth of anxiety of citizens who applied for appropriate services.

Organization of remote rehabilitation of moscow children with cerebral palcy during COVID19 pandemic using cross-cutting digital technologies

The tense epidemic situation in the Russian Federation in connection with the spread of the new COVID-19 coronavirus infection has caused the need to search for new forms of medical care for children that ensure a step-by-step and continuous process of providing medical rehabilitation to children, and, at the same time, do not provide for daily visits to medical institutions. The aim of the work was to develop and implement a project for rehabilitation of children with diseases of the nervous system and musculoskeletal system using digital technologies. The results of the work was a unique joint project of the state medical Research and Clinical Centre of Pediatric Psychoneurology Moscow Department of Public Health in collaboration with the Research Institute of Health Organization and Medical Management Moscow Department of Public Health on the remote day hospital. The results of an open prospective follow-up of 680 children with cerebral palsy who received a remote rehabilitation course showed the effectiveness and safety of the new rehabilitation approach in patients of this nosological group. Постановка проблемы. Напряженная эпидемическая ситуация, сложившаяся в Российской Федерации в связи с распространением новой коронавирусной инфекции COVID-19, вызвала необходимость поиска новых форм медицинской помощи детям, обеспечивающих этапность и непрерывность процесса оказания медицинской реабилитации детям, и, при этом, не предусматривающих ежедневного посещения ими лечебных учреждений. Цель работы - разработка и реализация проекта реабилитации детей с заболеваниями нервной системы и опорнодвигательного аппарата с применением цифровых технологий. Результаты. ГБУЗ «НПЦ детской психоневрологии» ДЗМ в сотрудничестве с ГБУ «НИИОЗММ» ДЗМ создан уникальный совместный проект дистанционного дневного стационара. Практическая значимость. Результаты открытого проспективного наблюдения 680 детей с церебральным параличом, получивших реабилитационный курс в дистанционном режиме, показали эффективность и безопасность нового реабилитационного подхода у пациентов этой нозологической группы.

[Recreational potential of medical tourism of Russia].

Since January 1, 2019, the Russian Federation has entered the global medical tourism market thanks to the approved federal project "Development of the export of medical services". The level of attractiveness of a country as a global destination for medical tourists is determined by a number of factors: the level of medical technology, transport accessibility, proximity to donor countries of foreign patients; the level of realization of export potential, international reputation, medical marketing; the level of healthcare organization, international staff training, etc. Among the factors determining the success of the country as the destination of medical tourism, a special place is held by the recreational complex, spa treatment. The level of development of the recreational complex within the framework of medical tourism performs several tasks at once: it provides a full cycle of medical assistance to foreign medical tourists - from outpatient admissions and in-patient treatment to rehabilitation and recovery; sanatorium-resort treatment and rehabilitation are considered not only as an integral part of the complex of medical services, but also as an independent promising direction for the export of medical services by domestic health resorts. Also, the fight against the consequences of COVID-19, when hundreds of thousands of neighboring states citizens need qualified rehabilitation, can become a driver for the development of the sanatorium-resort complex of Russia. The purpose of the study is to identify bottlenecks in the development strategy of the recreational potential of the regions of the Russian Federation and make suggestions for its improvement. The number of foreign patients who received medical care from January to May 2020 in the federal districts is 729,000. This indicator was achieved during the pandemic, and therefore does not reflect the true potential of rehabilitation as an element of the full cycle of medical care for foreign patients. The target audience for rehabilitation programs is up to 100,000 foreign patients.

[Ð ROBLEMS OF MEDICAL SERVICES EXPORT IN RUSSIA].

The relevance of the study is due to the fact that the export of medical services as one of the areas of the national project "Healthcare" is determined by the level of involvement of the constituent entities of the Russian Federation in the implementation of this project. The aim of the study is to identify how many medical institutions in Russia need qualified personnel for the export of medical services based on a survey of students in the educational cycle "Export of medical services" and an online survey. The analysis shows that at the moment, in medical institutions both in Moscow and the whole Russian Federation, there is a shortage of qualified managers in this area. 25 students of the educational cycle on the export of medical services were interviewed. 100% of the respondents do not know where to start exporting medical services and want to gain knowledge on promoting medical services in their organization. An online survey of 70 regions of the Russian Federation showed that representatives of medical organizations in 64 regions want to receive knowledge on this program, which is more than 90%, the remaining representatives of 6 regions gave not very specific answers. This is a serious problem hampering medical institutions to occupy their segment in the international market. The results of the study show that 100% of the respondents do not know where to start exporting medical services to a medical organization, they want to gain new knowledge and skills in the learning process in order to form their own project for their medical institution, to organize and promote medical services both for domestic and international market. All 25 respondents (100%) would like to receive new knowledge from specialists in this industry who know this problem from the inside, solving the key tasks step by step. The conditions associated with the COVID-19 epidemic make it possible to recommend medical organizations in Moscow and the constituent entities of the Russian Federation to implement the educational program in a remote format, providing for a regional component and methodological recommendations taking into account regional specifics.

[Human resource management in healthcare organizations].

The article deals with changes in the human resources potential in the Russian health care system, which are the result of the reform of the medical sphere carried out in recent years. The COVID-19 pandemic, which began in early 2020, exposed significant shortcomings of the Russian healthcare reform, showing serious problems in the shortage of specialists, hospital beds, protective equipment, ventilators, tests, and medicines. The reduction of hospital beds and the number of infectious diseases doctors in order to increase the average salary in healthcare has led to the inability of the Russian healthcare system to cope with the spread of coronavirus infection without involving residents, professors, teachers and students of medical organizations. At the present stage of development, the issues of combating the spread of coronavirus infection, mobilization and professional training of medical workers are of particular relevance. Nevertheless, despite the results of the health care reform, which led to a massive reduction of medical organizations in our country, the number of doctors per 10,000 people in 2018 was 47.9 employees, over the past 20 years, has not changed much in the direction of reduction. In our view, we should not talk about a global reduction in human resources in healthcare. The existing personnel problems in healthcare are the low qualification of medical personnel and the General shortage of specialists in the labor market.

[Basic aspects of organizing medical training in the context of a coronavirus pandemic].

The article discusses the changes made to the existing procedure for continuing medical education and the accreditation of medical workers due to a pandemic that began with the outbreak of coronavirus infection COVID-19 in early 2020. Under current circumstances, medical organizations encountered difficulties in organizing quarantine, purchasing disinfecting drugs, personal protective equipment and additional medical equipment, the need to introduce an emergency mode of work for employees, so there was a need to review and develop new rules for the work of medical workers during a coronavirus pandemic. Medicine is one of the progressive fields of scientific and entrepreneurial activity, making high demands on medical workers. Therefore, continuous training of doctors and medical personnel is caused by vital necessity, especially in the context of the coronavirus pandemic. Currently, the legislative level provides for the re-profiling of doctors of other specialties and the involvement of teachers and general medical organizations in the fight against coronavirus infection. In the face of the threat of the spread of coronavirus infection, on the recommendation of the Ministry of Science and Higher Education of the Russian Federation, it was decided to transfer educational institutions to distance learning using educational technologies, which also requires great efforts on the part of doctors, as medical specialists need not only a large amount of theoretical knowledge , but also a sufficient number of practical skills. The article presents statistical and analytical data, the results of surveys of Russian doctors, expert estimates that allow us to draw conclusions regarding the effectiveness of educational programs and courses for the professional retraining of doctors in the context of a coronavirus pandemic.