coming soon many modern munitions are designed to create an additional burden on the medical service and thus make it more difficult for the enemy to conduct combat operations. they often cause non-fatal damage to a person, but various alloys are used in striking elements that cause additional damage to soft tissues and bones, the head of the burdenko main military clinical hospital, major general of the medical service, doctor of medical sciences denis davydov said in an interview or not zakamskaya look, and the interview immediately after the commercial.

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ogo loan at four and a half percent per annum with a guaranteed rate guarantee without surprises mail bank denis vladimirovich i welcome you to our studio. thank you very much for taking the time today good afternoon denis vladimirovich fighting. this is always a challenge for doctors , a challenge for doctors, as nikolai ivanovich pirogov said, war is an epidemic of injuries. what is the characteristic feature of this special military operation of the special military operation in ukraine, what is the peculiarity for doctors? it's really another war is another traumatic epidemic, because even if we compare the great patriotic war and the afghan war and the

georgian one to extinguish the rural conflict. with the current special military operation, this is indeed a different, uh, situation and is connected. it is with the fact that very often it does not stand still. uh, medicine itself, and uh, the technique that is used to defeat the enemy is the killing industry. she, too, as they say on the spot. yes, and the weapon develops, it becomes different, it increases, striking ability, but the combination of factors among themselves increases and deepens. damage, but systems that do not become fatal, because this is uh, the damage industry uh, went from fatal to minor damage and now uh is in the trend, some kind of modern armed

confrontation, but more welcome in quotes. hi inflicting non-fatal damage to the enemy to make it harder to fight , while at the same time, it imposes serious m-m. well, such strains on the medical a service that is forced to cope with a large number of wounded medicine. they say that the most lethal war. they were ancient, because the weapon was, as they say, piercing and cutting , applied at close range, and therefore they died from it, for sure. the further, the more. really. these injuries are very significant, very painful and tangible for human health, but not fatal, is it fair to call this military operation and these military operations trauma of the epidemic of injuries of shrapnel wounds. here e, shrapnel damage. it is said that firearm storage has become less unconditionally. we now see a lot of shrapnel damage and practically do not see field damage. yeah, which are easier

sometimes and easier for the doctor at the same time splintered. uh, the ammunition is different now. they began to combine different metals in themselves, different alloys, which cause significant damage, and then they don’t let the wounded man and the doctor along with him easily jump out of this situation, since this is such a bunch. but tell me what it means, uh, special alloys and other metals. this means that they take longer to heal soon after injury or are more difficult to remove or are smaller in fragments. that's what it is for you not with your hands. it’s all of them that we have to chase after each fragment, and often, we understand how difficult it will be to extract. we don't touch. it 's dreary if it's an ordinary plain steel alloy. no, this is not scary and we often explain

to our patients that the presence of metals in his body will not lead to fatal injuries or violations, but when we deal with shrapnel, which is now used in cluster munitions, which are often up to a thousand in one munition, and they simply have monstrous, destructive power, then do not extract. they are impossible, and extraction requires significant costs and, above all, costs. e for life assurance. that is, it's hard to do for hmm patient to endure this operation is difficult. e, various alloys are used, which, when damaged, exfoliate, break down and introduce additional damage to soft tissues. that's what it comes down to collide. much more often now. and how

long does it take to recover to put a person on his feet? how long can patients stay with you? i mean, you mean, all stages of medical care, including the main military clinical hospital. it's like here's the top level of care. well, how many here, uh, uh. and this is also a feature of this special military operation, that i don’t know with a bullet wound a person can go back to being slender in a month. and here are extremely individual the characteristics are an extremely individual one. maybe in a few days it will take months to return to duty, while rehabilitating and recovering depends on the damaging elements on which tissues were damaged. but i can say that, unlike, for example, the great patriotic war and the afghan conflict, we now manage to put the human system in 2-2.5 times faster than it could be done then by guilt, again in quotation marks modern technologies

that now we can not only use individually in different patients, we can still combine them inside one victim, we can combine, uh, with uh, highly specialized mini-invasive technologies that allow not chasing a fragment, but opening the body for access. and we can go through the vessels. we can enter through small openings. and if earlier, for example, a head wound required the removal of a fragment. and this was necessarily accompanied by trepanation, it was necessary to open it. yes, and a lot of open. somehow now some damaging elements, we can remove through there natural hole in the head. yes, the nose of the ear and we get access that a less painful less traumatic person, in fact, does not experience

re-trauma after being injured in order to extract the damaging elements. he recovers faster, of course, it can become faster, but is the assertion, again, of the military of those who are now participating in special military operations, that most of the injuries are usually associated with the lower limbs. or everything, by the way, there is even a percentage of this calculated always 70% of the damage to the limbs. we began to protect the body well. we began to protect our heads well. it doesn't mean we're uh completely. yes, these injuries were completely ruled out, but the limbs remain the most vulnerable point, it is very difficult to fully protect them, plus the war is explosive, we have a huge amount of high-explosive mine damage that really damages the limbs. and with uh, damaged

lower limbs. hmm, a fighter is no longer a fighter because he cannot perform his basic functions, therefore it is important in such a situation as quite special. in my opinion, the role of tactical medicine is acquiring the role of rendering before medical. assistance to the so-called medical assistance, which is provided by a fighter to himself or to his comrade on the battlefield and the first hours when he is delivered to a medical institution. by the way you. tell us, perhaps, about how they are generally organized now. and what happens to the fighter before he gets to you. e to the main military clinical hospital. and what time passes and uh, after all, the role, this self-help turns out, there is something to ask you, there is such a thing, how do you take a fighter. you see that here is a serious wound, you understand that he could have been helped and the consequences would have been much less deplorable if he or his comrades knew how

to help, if they knew how to properly apply a tourniquet. and how to fix it early, it would be possible to avoid amputation and other consequences . yes, probably absolutely right. here, uh, because if we compare the stages itself and mutual assistance, and the first stage. indications of medical care it's like and now the shots from the presidential press service dear colleagues, good afternoon hello we recently met with dmitry yuryevich grigorenko, he spoke about a new stage in the reform of control and supervisory activities and improvement of licensing activities. uh, we agreed, uh, with mikhail vladimirovich what grigorenko will tell about this, in such a broader composition, he will inform all of us once again and of course. eh, everyone it concerns. uh,

participants in economic activity will also once again hear and orient themselves in what the government plans to do. but first, as we have been practicing this throughout. the previous e, our previous e activities, we will talk about current issues of particular interest and i would like to start, of course, anna yuryevna popova with the current epidemiological situation. so i see that, unfortunately, on my sars, and says it grows almost 30-35% per week, in my opinion, it is probably some kind of situation. good afternoon, dear vladimir vladimirovich vladimirovich's colleagues are certainly right, and they are. we do not see how tense this situation is in the russian federation today, and it is due to two ip-addresses. this is, uh, an increase in the incidence. e blood.

yes, we see it small, we observe it for the fourth week after the previous two-month decline. it is at the level of 11-10-11% every week. well it is, it will continue. and uh, a pronounced increase in the amount of arvi in the group of respiratory infections and influenza, and in fact, week by week, this is a plus of 30-35%, here last penultimate week. it is precisely this increase that occurred, both among the sick and among those hospitalized, and therefore more stress for the healthcare system today is caused by the epidemic situation with influenza and sars and i want to note that at the beginning of november of this year the situation began to worsen in many countries of the world northern hemisphere, and uh, our monitoring and spotting system worked earlier. we discovered the first influenza viruses in october, and in the russian federation more than 80 are predominant .

hmm from influenza viruses. eh, viruses. this is a flu virus, and h1n1 a, is called another 0.9 , because it is a pandemic version of influenza of the ninth - 2 years then it appeared for the first time caused a pandemic quite severe, especially because at that time there was no vaccine, they had a specific medicine and treatment. and today , uh, after 6 years, and the previous time he showed high numbers in the season of the fifteenth-sixteenth year. he returned to the russian federation and is today. uh, prevailing. and we found it in october, and our monitoring system and the system of scientific research made it possible to evaluate it and we saw that the virus absolutely coincides with the vaccine headquarters, that is, everything that was used to prepare our four russian vaccines is completely opposed to this variant of

the influenza virus and also this virus flu has not changed its sensitivity to those drugs that are produced in the russian federation and are specific for this influenza virus. and in the following months, ongoing research we conduct them all the time sequencing and analyzing, and confirmed this is our primary. ah, knowledge today. uh, accordingly, we can say that the situation uh, caused by this virus, maybe, uh, regulated, but what was done to preserve the health of our citizens, but in july a decision was issued by the chief state sanitary doctor to counteract acute respiratory infections and influenza, as well as c. development in all constituent entities of the russian federation, the subject plans were updated to counter the development of prevention, but acute respiratory viral infections of influenza, not hospital-acquired pneumonia and covid. within the framework of these plans, two stages before the

epidemic and already in the process of recovery and all activities are being carried out in the constituent entities of the russian federation, and i also want to say that in preparation for the current situation, measures were taken to vaccinate the population against influenza, all vaccines were made on time from september. we started vaccination 3 months in advance. almost 52% of the population of the russian federation was greeted, which is 75 million 100.000 people. and uh, today we can talk about the high effectiveness of vaccination, because among the sick with laboratory-confirmed influenza. and, unfortunately, not all cases of influenza today are laboratory examined. i'll talk about that a little later. hmm uh, the number of vaccinated people is a little over three hundred, only three hundred. that is, this is a very small percentage less than 1%, which indicates the effectiveness of our measures, and mass immunization in the

russian federation has been completed, but each individually according to the doctor's prescription and according to indications maybe today up to c one - this is already an individual vaccination. and at the same time, i would like to note that, as in the whole world. today we note the high activity of viruses not influenza theology, and in the general structure of the viruses that we allocate the amount is summed up weekly, we see that the high proportion of irina viruses is about ten percent, and respiratory synthetic viruses a and the method of pneumoviruses, and the first 10 %, the second seven are battles, which, unfortunately, often cause pneumonia in the future, and their an increase in total shares is also not typical. while for the russian federation it continues to happen all over the world, and before we did not observe such, specific large values, this requires special ones. uh, hmm, assessment methods and, most importantly, differential

diagnosis, we need it is very very important today to distinguish between covid flu and other viral infections, because, uh, the treatment is fundamentally opposite. if you treat the flu, you need one scheme, if you treat it, but kind, another scheme, you can’t go wrong here and also consider between gizmos today flows in 90% more than 90% in the form of arvi , the beginning is the same mm. ah, the operational headquarters under the leadership of knitted by all golikova decided to use the scheme that was adopted for covid for testing for covid for testing for influenza. we appreciated the possibility of having a good enough supply of laboratory equipment, as well as domestic tests. according to the ministry of industry and trade, and because we see enough on the market and therefore today it is quite possible to start testing for the detection of influenza, all in the same way as for the code, who has a clinic for

acute respiratory viral infections. in this way, we will reduce the risks for these people. and the relevant decisions taken by the operational headquarters on december 9, we are amending the decision of the chief state sanitary doctor so that this decision is legal and today we have already submitted this to the ministry of justice. we are waiting for registration, but at the same time, uh hmm, i would like to say a few more words, but to the view that oka views that have not gone anywhere and obviously are not going anywhere will leave. but in november in december, we were and now are in 106th place in the world in terms of morbidity and ee, at the same time, morbidity is low, it is five times less than ee. a year earlier than in november last year, but it still causes us some concern. that's why we keep testing at 25,300,000 tests per day. and that's enough

today to clearly identify all the cases and, uh, we remain in the top ten countries in the countries with the largest coverage of testing, a in the world. uh, i would like to note that 97% of all cases are acute respiratory viral infections. yes , i already said, and therefore we need to carry out differential diagnostics, but at the first stages and also as long as the result will come out within 24 hours, the first risks that are associated with covid that we see are risks of possible variability of viruses and the appearance new variant genes. uh, coronavirus, which can give complications and drinking situations. for this , monitoring is carried out, on your instructions. she is called created was a system of genomic surveillance. for this virus. she works. still inefficiently more than 220,000 are uploaded there and every

week more than five thousand genes are replenished . well, that is, we have a dense monitoring system throughout the country. we see that there are no high risks yet. uh, here, uh, the stamp that causes hmm and stress in europe, the so-called bq-1 and bq-11, and in the russian federation, it is detected in isolated , uh, cases, uh, less than 1% of the total number of studies. while in spain 78% in france almost 60 and in germany 16%, but a significant impact on these situations in these countries. we do not see, but at the same time, the risks are associated with the fact that today the specific treatment for this variant has not yet been proposed by our scientists, but by scientists. and uh, dear vladimir vladimirovich, we are also captivating new territories, and we have organized ibnadzor and pet monitoring, and in the new four territories , money is connected to all our analytical

systems and weekly, several times a week, we hold seminars, the track is very interested involvement in our regulatory framework practically formed on 2 december. uh, formed, but two territorial bodies. this is the first territorial bodies. e in the luhansk people's republic and in the donetsk people's republic and today the chief state sanitary doctors have been appointed there, the management system has been built and we are working in close contact with colleagues. well, and there we see, uh, the growth of influenza, uh, systems uh, the epidemiological situation situation e is approximately similar to what is happening in the russian federation this is also the subject of our special attention, and everything to work. we are coordinating, through the operational states, the operational headquarters of the government of the russian federation, for the time being, uh, naturally transformed into operational states, for the time being, for sars and influenza, and all the decisions that we make

at this level, they are taken together with the subjects and the work organized together with subjects of the russian federation i would like to draw your attention to the fact that the new year holidays are ahead and these are additional risks for spread and increase in the incidence of acute viral infections, and today, in order to minimize the risk, as a preventive measure, a well-known and familiar, but quite effective, routine measure is used to separate children from the suspension of the educational process. and this measure is introduced taking into account the actual incidence in the absence of 20% of children in the classroom or at school or in the kindergarten in the group e, this class and the school are quarantined, the children are separated and this does not allow it to spread not among children, nor in with other age groups. not not in older not more younger. well, today it is partially suspended. uh, the educational process is almost uh, in six hundred schools and in 12.662 classes. uh, these measures

will continue, but at the same time, i would like, uh, to draw the attention of the leaders of the constituent entities of the russian federation to the fact that the decision in action of certain sections of the plan that i have already said is the authority of the subject at the suggestion of the chief state sanitary doctors and i i ask you to be as careful as possible today. organization of all events and to the organization. and uh, all the fulfillment of all points of the plans. and, of course, it is extremely important. this is an information communication company with the population to explain all the rules of conduct. e. today they are known, they are understandable. well, once again to remind and convey, in my opinion it is extremely important thank you vladimir vladimirovich thank you. uh, remember him a few days ago asking you to get vaccinated. no, he told me to do it. here i report yesterday did. thank you very much. everyone

collector too. i advise you to go in for sports today in the morning, as usual, everything is fine as usual, without any questions. here is michael beach, is there anything to add? yes, dear vladimirovich , dear colleagues, it is true that in the last week the proportion of cases has fallen ill. uh, increased. this is almost one and a half million citizens who today, e, sought medical help and the proportion of influenza, and among verified sars exceeded 50%, i want to note that among those sick, a high percentage of school-age children from 7 to 14 years old. it's 23% and preschool children. this is more than 18%, i want to note that the main share of influenza cases today actually falls on h1 e 2009 . and this disease has caused a really

high level of morbidity and the most severe always occur, and this infection is found in pregnant women over 60 years of age and diabetic patients. as well as the street, and those with overweight, of course, are a category similar to quid, and therefore, in general, for this category of people, of course, routine vaccination is of paramount importance, and for the russian federation has been provided with the possibility of a significant coverage of the population of testing during the period of the fight against the code to strengthen the head of government. we saw a dedicated tool and created large laboratories in all regions of the russian federation for testing. and this is more than 1200 laboratory in the whole country, operating medical organizations and payment is provided for by an amendment to the program of state guarantees, and 18 domestic test systems are registered for diagnosing influenza and a.