Impact of anti-epidemic measures on the dynamics of the incidence of COVID-19 in medical organizations with a psychoneurological profile

Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.

Principles of laboratory service management in modern conditions

Introduction. Today, the medical laboratory is focused on operational efficiency and cost control. Our work presents the experience of transforming laboratory practice, its informatization and reorganization of the management model. Purpose of the study. Creation of a management model for fast, economical and high-quality testing in laboratories of various levels to provide Muscovites with laboratory services in full. Materials and methods. An assessment of the resource support of clinical diagnostic laboratories (CDL) of the Moscow City Health Department (MCHD) number of attached population and the need for tests, made it possible to develop and implement concepts for their centralization in the outpatient clinic link, unify the nomenclature of laboratory studies and tests, create a unified reference book of laboratory studies (IF) for the centralized laboratory service (CLS) of the unified medical information and analytical system (UMIAS), develop a plan for the development of a quality management system based on international standards and begin the activity on the standardization of laboratory services through accreditation of medical laboratories in the national accreditation system, manage centralized large-scale screening for SARS-CoV-2;implement sequencing technology (NGS) for genomic surveillance. Results. The MCHD laboratory service is built according to a 3-level system. There is a complex IF EMIAS. Laboratory studies are computerized, test results are transferred to the personal account and the patient's electronic medical record. A single information space has been created for all CDL MCHD. The tariffs for laboratory services of the registry of the Moscow City Compulsory Medical Insurance Fund (MCCMIF) have been changed, the list has been optimized. Under the control of spending, the productivity of laboratories has increased. Moscow's needs for laboratory services have been met. Research limitations. The scenario of managerial approaches was carried out in a strategic partnership with MCHD, proved to be viable only in the conditions of the city of Moscow. Conclusion. The problems of precision medicine have been solved and the sustainable provision of laboratory services to the population by the clinical diagnostic laboratories of the MCHD has been ensured. © AUTHORS, 2022.

Impact of anti-epidemic measures on the dynamics of the incidence of COVID-19 in medical organizations with a psychoneurological profile.

Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.

[ORGANIZATION OF GENOMIC SURVEILLANCE FOR SARS-CoV-2 WITHIN THE MOSCOW CITY HEALTH DEPARTMENT].

An important goal of COVID-19 surveillance is to detect outbreaks using modern molecular epidemiology techniques based on methods to decode the full genome of the virus, since rapidly evolving RNA viruses, which include SARS-CoV-2, are constantly accumulating changes in their genomes. In addition to using these changes to identify the different virus lines spreading in the population, the availability of sequence information is very important. It will allow the identification of altered variants that may be more transmissible, cause more severe forms of disease, or be undetectable by existing diagnostic test systems. The global scientific community is particularly interested in changes in the spike protein (S-protein, Spike) because they are responsible for binding and penetration into the host cell, lead to false-negative results in diagnostic tests, and affect transmission rates, health outcomes, therapeutic interventions, and vaccine efficacy.Genomic surveillance uses next-generation sequencing (NGS) applications and makes data on the full genome of the virus available. These methods offer new means to detect variants that differ phenotypically or antigenically. This approach promotes earlier prediction as well as effective strategies to mitigate and contain outbreaks of SARS-CoV-2 and other new viruses long before they spread worldwide.Today, molecular typing of strains is playing an increasingly important role in this process, as it makes it possible to identify samples that share a common molecular «fingerprint¼.

Comparison of the Physical Properties and Effectiveness of Medical Swabs for Sampling Biomaterials

The COVID-19 pandemic has induced a sharp rise in demand for consumables for laboratory diagnosis and, in particular, for swabs for sampling biomaterials. Test quality depends strongly on swab quality. The aim of this work was to run experimental studies to evaluate the physical and operational properties of fiber-type medical swabs. This study compared swabs from leading manufacturers traditionally regarded as the quality standard on the Russian market in the premium sector: Copan Diagnostics (Italy), Puritan Medical Products (PMP) (USA), and PharmMedPolis (PhMP) (Russia). The following properties were studied: absorption, zeta potential, and surface morphology (by scanning electron microscopy). The techniques for biomaterial collection and release were also considered. Experiments using Streptomyces pneumoniae cultures as an example showed that the Copan Diagnostics swab had a recovery rate (RR) of 78.3%, compared with 84.15% for the Puritan Medical Products swab, 87.49% for the PhMP swab, and 93.72% for the HydraFlock® swab. The HydraFlock® swab was found to be especially effective due to its high ability to absorb water and protein and its high bacterial recovery rate. The second best results were for the PharmMedPolis® swab, followed by the Copan swab and the nylon swab from Puritan Medical Products.