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По всей России на 13 апреля развернуто только около 40 тысяч коек в больницах для лечения коронавирусных пациентов. Всего к концу апреля их общее число должно увеличиться до 95 тысяч, доложила президенту России Владимиру Путину вице-премьер РФ Татьяна Голикова на очередном совещании по санитарно-эпидемиологической обстановке в стране.

Чтобы понять, насколько малы эти цифры, следует просто обратиться к официальной статистике из открытых источников.

Из этого общего "потенциального" числа в 95 тысяч коек надо вычесть около 30 тысяч коек, которые для "ковидных" больных выделили в Москве. В начале апреля заммэра столицы по вопросам социального развития Анастасия Ракова говорила об общем количестве в 20 тысяч коек, но накануне сообщила, что до конца апреля выделят еще до 10 тыс. коек. Сейчас в Москве для приема больных с коронавирусом работают 29 стационаров в федеральных, городских и частных клиниках.

Но с учетом резкого роста количества заболевающих (к концу предыдущей недели в больницах Москвы находилось около 7 тысяч больных с пневмонией в результате COVID-19), к концу апреля все места в больницах Москвы могут быть уже заняты. Не говоря уже о том, что ждет все остальные 84 региона РФ, ведь на всех больных там коек будет всего в два раза больше, чем в Москве. И власти признают, что ситуация развивается уже не по оптимистическому сценарию.

Кроме того, далеко не все эти обещанные 95 тысяч коек являются койками интенсивной терапии, оборудованы аппаратами искусственной вентиляции легких (ИВЛ) или даже просто оснащены кислородом. "Процент реанимационных коек должен составлять не менее 30% в общем количестве, койки должны быть на 70% оснащены кислородом", - заявил глава Минздрава Михаил Мурашко. То есть ИВЛ предусмотрены для примерно 32 тысяч коек.

Даже если забрать все существующие и работающие в России ИВЛ только для обслуживания "ковидных" пациентов, то аппаратов все равно не хватит. По данным на конец марта, которые обнародовал портал "Медвестник", в российских медучреждениях имелось в общей сложности около 43 тысяч аппаратов искусственной вентиляции легких. И в эту цифру, скорее всего, входят ИВЛ для транспортировки больных, а они не могут применяться для круглосуточного лечения. По другим данным, в российских отделениях реанимации и интенсивной терапии имеется всего около 35 тыс. аппаратов ИВЛ. В конце марта правительство РФ выделило 7,5 млрд руб. на закупку еще 5,7 тыс. ИВЛ и ЭКМО, но поставки этих аппаратов в лучшем случае начнутся не раньше мая.

Как заявил ранее глава Минздрава, можно развернуть сотни тысяч коек на стадионах, на катках, в шатрах в парках, но это будут просто койки. И как бы врачи между ними ни бегали, помочь пациентам они не смогут.

В правительстве заверяют, что российские регионы на 3-4 недели отстают от Москвы и Московской области по заболеваемости коронавирусом, поэтому там еще есть запас времени, чтобы "активно подготовить коечный фонд". Но учитывая, что в среднем каждый день количество инфицированных в Москве увеличивается на 25-30%, больницы и "скорая" работают на пределе, а на "плато" заболеваемости Россия еще даже не вышла, не сложно предположить, какие именно "тяжелые испытания" ожидают нас в ближайшие две-три недели.

И вот тут всем аукнется "оптимизация" здравоохранения, которая проводилась в России все последние годы. В результате реформы здравоохранения только в период с 2000 по 2015 год в стране были закрыты более 5000 больниц, признанных "неэффективными" - их число уменьшилось с 10,7 тыс. до 5,4 тыс. С советских времен в 2,4 раза сократилось число коек инфекционного профиля - со 140 тысяч в 1990 году до 59 тысяч к 2019-му. Инфекционистов по сравнению с 2011 годом стало меньше на 10% - сейчас в России их всего около 7 тысяч.

По данным Росстата, с 2013 по 2019 год число младших медработников сократилось в 2,6 раза, до 265 тысяч человек, среднего персонала - на 9,3% до 1,314 млн, врачей - на 2%, до 704 тысяч человек. В первичном звене здравоохранения просто "провал", заявил в августе прошлого года президент РФ Владимир Путин.

Общее количество коек в больницах Москвы на конец 2019 года составило 46807 коек. Для сравнения, в 2013 году было более 120 тысяч коек, то есть за шесть лет их количество было сокращено в три раза в целях "оптимизации" и "структурных преобразований". Это значит, что выделяя сейчас в авральном режиме 30 тысяч коек для пациентов с коронавирусом, здравоохранение Москвы, перепрофилирует места, предназначенные для других пациентов, которым тоже требуется срочная помощь - и аппараты ИВЛ, и аппараты ЭКМО (экстракорпоральная мембранная оксигенация). Эти больные никуда не делись, но в помощи им придется отказывать.

Теперь, по словам президента Путина, скорее всего, для борьбы с коронавирусом придется задействовать средства и койки Министерства обороны РФ, которые учитываются отдельно от расходов на здравоохранение. А также привлечь "кадровый потенциал всех медицинских учреждений", включая не окончивших обучение студентов вузов и училищ.

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