Organization of the activities of the infectious diseases hospital for the treatment of a new coronavirus infection (COVID-19) at a large construction site

Abstract

Relevance. The emergence of a large number of cases of a new coronavirus infection (COVID-19) required the formation of a new system of medical care and, above all, the creation of infectious hospitals for the treatment of patients with COVID-19.Intention. Analysis of the organization of the work of a temporary infectious diseases hospital for the treatment of COVID-19 in workers involved in the construction of the Amur Gas Processing Plant (AGPP). Methodology. The object of the study was a temporary infectious diseases hospital organized for the diagnosis and treatment of COVID-19 in workers mobilized for the construction of AGPP. During the study period from March 2020 to April 2022, the total number of employees participating in construction work daily at AGPP ranged from 17,759 to 39,437 people. Construction personnel worked on a rotational basis, the duration of the shift was from 2 to 6 months. Along with citizens of the Russian Federation, citizens of foreign countries from near and far abroad worked on the site. All shift workers lived in hostels on the territory of temporary construction camps, ate in common canteens. Development of the organizational and staff structure, completeness of medical equipment, medicines and property, evaluation of the effectiveness of the temporary infectious hospital performed using the methods of historical analysis and comparison, system and logical analysis, and expert evaluations. Results and Discussion. The results of a retrospective analysis of the measures for the construction and organization of the work of the temporary infectious disease hospital at the AGPP site presented. The hospital built based on a quickly erected building of block-modular type, passed sanitary-epidemiological examination and licensing in 45 days. The hospital has two departments with 44 beds each for the treatment of patients with COVID-19 (88 beds in total), an intensive care unit with 6 beds, two isolation wards with 2 beds each, a clinical and diagnostic laboratory that allows conducting studies by polymerase chain reaction (PCR) methods and immunofluorescence assay (ELISA), as well as the full range of general clinical laboratory tests, computed tomography unit, vaccination unit, medical gas supply station. The organizational and staffing structure and the number of medical personnel changed dynamically, depending on the epidemiological situation and the arising tasks of medical support of AGPP workers; at maximum staffing the hospital had 22 doctors, 1 pharmacist, 45 nurses, 30 paramedics and support personnel. From July 12, 2020 to April 10, 2022, inpatient treatment received 2622 people in the hospital’s infectious disease departments, and 198 people in the intensive care unit. Outpatient treatment provided to 4127 workers, of which 462 hospitalized for inpatient treatment and 3665 discharged to work upon recovery. There are 17,893 lung examinations including 12,582 primary and 5311 repeated (control) examinations performed and 6547 viral pneumonias detected in the computed tomography unit. The clinical and diagnostic laboratory performed 302,695 tests by PCR, 14,037 tests to IgM and IgG levels by ELISA, 9065 general clinical hematological and biochemical tests, 7832 coagulograms, and 20,782 tests to evaluate specific markers of inflammatory response characteristic for COVID-19. Medical personnel of the hospital carried out a mass vaccination against influenza for 42620 workers of AGPP, vaccination against COVID-19 with the first component of the “Sputnik” vaccine was given to 13678 workers, the second component – to 12,598 workers, the “Sputnik Lite” vaccine – to 19,214 workers. Conclusion. The construction of a temporary infectious diseases hospital on the basis of quickly erected building, its equipping with modern medical equipment and medicines, staffing with highly qualified medical personnel made it possible to organize laboratory and instrumental diagnostics of COVID-19, inpatient and outpatient treatment of patients, as well as vaccination for shift workers of all contractors involved in the implementation of the AGPP project.