Marat Sadykov: 'Total mortality in Tatarstan has increased by 11,5%'
Board meeting of the Ministry of Healthcare of the Republic of Tatarstan discussed readiness to reflect the new wave of Covid-19 and the disappointing results of the second pandemic year
“We are very concerned about the accident rate. Against the background of Russia, we look positive, but I think routine care and prevention are insufficient, and we see the result," the president of Tatarstan voiced the alarming trend at the board meeting of the Ministry of Healthcare of the Republic of Tatarstan. Rustam Minnikhanov set the task — to staff the primary care with specialists, not only in Kazan, but also in the regions of the republic. About vaccination against coronavirus, the causes of the increase in mortality, unfulfilled and overfulfilled plans, and new initiatives of Tatarstan doctors — read the details in the report of Realnoe Vremya.
Vaccine against death
Coronavirus and Covid-associated diseases took the 2nd place in the structure of causes of death in Tatarstan — 18,1% (1st place — diseases of the circulatory system). This is the result of the second pandemic year, the head of the republican Ministry of Healthcare, Marat Sadykov, said at the board meeting.
“The healthcare system not only of the republic, but also of the whole country, has been working in a difficult epidemiological situation for the last two years," the minister stated. “If at the beginning of 2021 the epidemiological situation was still stable, then at the end of the summer holidays, with the beginning of the school year, we received a twofold increase in morbidity.”
The minister reported on the efforts of the department in the fight against the spread of coronavirus. Marat Sadykov said, addressing the president of Tatarstan:
“In 2021, 175 vaccination points were deployed in the republic, 79 of them worked in a mobile format, including at home. Dear Mr Minnikhanov, currently more than 2,3 million people or 77,8 percent of the adult population have been vaccinated with the first component, in the group of people over 60 years of age — the percentage of vaccinated is more than 71 percent.”
But then Marat Sadykov reported another sad fact:
“According to operational data, life expectancy in the republic is 71,25 years (compared to 70,03 years in Russia), and we have not achieved the planned value of this target indicator of the national project (71,46 years). The total mortality rate increased by 11,5 percent compared to 2020 and amounted, according to operational data, to 15,5 cases per thousand population. This year, the rate of mortality growth has slightly decreased, in 2020 it was 26 percent.”
According to the Ministry of Healthcare, mortality among people of working age increased by 3% (18,2%) and mortality among Tatarstan citizens aged 80 years and older decreased by 3,5%.
At the same time, Tatarstan still has the lowest mortality rate in the Volga region, the minister noted, but the birth rate has fallen — 662 fewer children were born in 2021 than in 2020, and as a result, the population decline has become more noticeable.
Conditions are the same — the results are different
Mortality rates are an objective characteristic of the quality of medical work, the minister made it clear. He said that the highest mortality rates among the able-bodied population were recorded in Novosheshminsky (862,4 per 100 thousand population), Verkhneuslonsky (821,1), Menzelinsky (794), Sarmanovsky (791,7), and Kaybitsky (736,5) districts. It would seem, they are very different for some reason in localities and municipalities that are almost equally equipped from a medical point of view:
“Thus, of the two major cities of the republic, mortality in Kazan is 11 percent higher than mortality in Naberezhnye Chelny. In Leninogorsk, the mortality rate is 35 percent higher than in Nizhnekamsk. The difference in indicators in the Buinsky and Pestrechinsky districts is 42 percent! The highest mortality rates were registered in areas with a population of less than 30 thousand — these are Muslyumovsky (23), Kamsko-Ustinsky (22,3) and Drozhzhanovsky (22,1) districts. So, the total mortality in the Muslyumovsky district is by 35 percent higher than in the Tyulyachinsky district.”
Marat Sadykov noted that the organisational conclusions regarding the heads of “distinguished” medical institutions in this regard were made and added somewhat threateningly:
“The chief physicians of Muslyumovsk, Kamskoye-Ustye, Drozhzhanoye, Buinsk, Sarmanovsk, Aznakaevo, Leninogorsk, Chistopol central district hospitals need to concentrate their efforts on the work of the outpatient care, improving the professional competence of doctors. It is necessary to do this personally and on an ongoing basis.”
The head of the Ministry of Healthcare also noted that in Cheremshansky, Buinsky, Muslyumovsky and seven other districts of the republic, mortality from diseases of the circulatory system significantly exceeds the national indicators:
“The chief cardiologist of the Ministry of Healthcare, together with the curators of these districts, needs to conduct an external audit of the work of central district hospitals. First Deputy Minister Almir Abashev needs to coordinate this work, there must be strict control.”
Offers that cannot be refused
Marat Sadykov's message that an increase in maternal mortality was recorded in 2021 and the cause of death of seven out of eight women was Сovid-19, was, in fact, the prelude to the appeal to the president of the republic with the business offer:
“Dear Mr Minnikhanov, today Kazan needs its own perinatal centre. The number of pregnant women with a high risk group is growing every year, and the number of premature babies in need of high-tech care is also growing. The issue of assisted reproductive technologies (IVF) is also acute. The available bed capacity of the Republican Clinical Hospital's perinatal centre is not enough. We have prepared calculations and financial justification. Please support our proposal.”
Noting that the creation of an oncological cluster in Tatarstan with the formation of three zones made assistance to cancer patients accessible to all residents and ensured a 6% reduction in cancer mortality in 2021, the minister reminded:
“According to the chief oncologist of the Ministry of Healthcare of Russia, Andrey Dmitrievich Kaprin, due to the suspension of planned preventive work, medical examinations, an increase in morbidity and mortality from malignant neoplasms is predicted. Therefore, it is necessary to take appropriate measures now.”
Sadykov said that the head physician of the Republican Clinical Oncological Dispensary should take special control of the work of primary oncology offices, ensure that specialists travel to areas with high mortality rates and submit to the Ministry of Healthcare “a detailed analysis based on the results of six months to make appropriate decisions”. He proposed to make Outpatient Oncological Care Centres structural units of oncological dispensaries in order to maintain continuity and a systematic approach in the diagnosis and treatment of oncological diseases.
Reminding that the year 2022 has been declared the Year of Digitalisation in Tatarstan, he again addressed the president:
“Today, as part of the implementation of federal and regional programmes, the fleet of medical equipment has increased several times. This requires a new management system. We have studied the experience of colleagues in Moscow Oblast and, together with interested organisations, have prepared a project for a Radiological Data Centre. Using artificial intelligence, we will be able to significantly save both time and resources, control the efficiency of using expensive equipment. We are ready to submit a draft for decision-making.”
Decision has been made, thank you all!
“We are summing up the results," Rustam Minnikhanov began his speech at the board meeting. “Of course, we are very, very concerned about mortality. In principle, we look positive against the background of Russia. But I think that planned care and prevention are insufficient. And we the the result.”
Then the president casually announced the news, anticipating it with words that the second serious cause for concern is the fall in the birth rate:
“There are objective reasons, but we are not doing everything yet [to increase it]. We need to see where we have reserves. Today we have visited the 7th city hospital, and the decision to build a perinatal centre there has already been made.”
At this moment, the doctors applauded in unison.
“I would like to draw attention to one detail," the president turned to the problem of personnel shortage. “In recent years we have acquired quite a lot of 'heavy' high-tech equipment that requires highly qualified specialists… We can build and buy a lot, but finding people who are willing to work not only in Kazan is the main task of both the republican and municipal authorities. Until we provide the primary link with specialists, the problem will not be solved. We need to work more purposefully on the interest and consolidation of specialists.
In conclusion, Rustam Minnikhanov thanked the doctors for their efforts in the fight against Covid-19:
“Two years of working in this mode is very difficult, we understand that. Financial incentives is not bad. But it is very difficult to work in such conditions. Therefore, convey words of sincere gratitude to everyone who works in your teams. And take care of yourself! We can be replaced, but it is very difficult to replace you!”
