Behind closed doors: are Russian boarding schools ready for the second wave?

At the end of October, Russia again started talking about cases of infection in nursing homes and boarding schools. In the spring, such institutions became one of the most vulnerable – the infection among people living in the same territory and were often at risk, spread faster, due to the shift to rotational work, the employees got tired and burned out faster, for many such work was impossible due to family circumstances. In addition, the guests were literally cut off from the outside world for several months – some were not even able to leave their wards. Izvestia spoke with representatives of the charitable sector about what had changed by the second wave.

Between the waves

This week, the problem of preparedness of boarding schools for the spread of coronavirus was discussed at a round table in the Public Chamber… In addition to NGOs, the event was attended by representatives of the Ministry of Labor, the Ministry of Health, Rospotrebnadzor and regional institutions.

At the same time, Assistant Minister of Labor and Social Protection Taras Vasko gave official data on the incidence of coronavirus in boarding schools. In total, he said, COVID-19 was registered in almost a thousand of them (956), those living in 611 institutions have already recovered. In total, 19.6 thousand people were infected, of which 5.7 thousand were employees…

It is important that all the participants, including representatives of other regions, were able to hear these figures, notes one of the moderators of the round table, the first deputy chairman of the commission of the RF OP on charity and social work, head of the Starost in Joy Foundation Elizaveta Oleskina. but there was no break in the boarding schools between the first and second waves, she clarifies, so it is possible that many departments or institutions were simply afraid to report cases of diseases that occurred during the break.

Now, Elizaveta Oleskina told Izvestia, requests for help began to come more often… So, only recently, information has appeared in the media about several cases of infection – on October 21 that more than 100 people were infected in the Babushkinskiy neuropsychiatric boarding school, the Ministry of Social Development of the Republic of Buryatia reported. In the middle of the month, at least 17 people were infected in one of the boarding schools, the Minister of Health of the Republic of Chuvashia reported (according to him, 35 people were hospitalized in total). At the end of September, the virus was found in at least 41 people living in the Ust-Ilimsk neuropsychiatric dispensary in the Irkutsk region.

Comparing the situation with the spring one, representatives of the charitable sector note that in many respects the boarding schools were better prepared – first of all, this concerns the presence of at least some algorithms and regulations, as well as the mood and awareness of the employees themselves, who a few months ago were forced to act “blindly” … During this time, both regional and federal departments managed to prepare their own documents and algorithms for working in a pandemic, a testing mechanism for COVID-19 appeared, which makes it possible to identify cases of infection faster.

On the other hand, the shortage of personal protective equipment, personnel and doctors remains relevant, especially in the regions (given that many institutions are transferring employees to rotational work). Burnout plays an important role – both staff and donors are tired of the pandemic, whose help the boarding schools need…

The experience of the Russian social sphere as a whole is very close to what has happened and is happening in Europe and the United States, says Elizaveta Oleskina. But this means that the problems in this case are the same for everyone – and now the question of how to cope with the consequences of rigid isolation has come to the fore – in the regions, tough measures, up to a ban on leaving the building, are still preserved…

– In the first wave, everyone could not cope with PPE for the social sphere, because there was not enough of them for medicine either. In general, they realized late that the social sphere bears no less burden than healthcare. Because of this, there was not enough staff for social assistance everywhere, for example. And in the second wave, everyone realized that they had gone overboard with isolation. And now they are thinking how to deal with the dire consequences, – she says.

“People seem to have gone out”

Boarding schools and orphanages were almost completely closed to visitors since the beginning of spring… According to the recommendations of Rospotrebnadzor, the Ministry of Labor and the Ministry of Health, published in April, only employees were invited to enter there – they most often switched to rotational work – and volunteers. Relatives of people who are in PNI and orphanages were completely deprived of the opportunity to visit them.

– Then it was possible to communicate only with the guys who had their own means of communication – for them live communication simply moved to the online format, so the changes were minor. The situation was more difficult with heavier children who did not have access to verbal communication, they needed eye and tactile contact that did not replace the tablet screen, ”says Maria Rilnikova, Coordinator of the Be Nearby project of the Volunteers to Help Orphans Foundation.

In some boarding schools, isolation was very harsh – people had to stay on their floors or in wards. All this greatly influenced the psycho-emotional state of the wards, says Maria Sisneva, clinical psychologist, coordinator of the PNI Volunteers movement. As a result, according to her, “people seemed to have gone out,” especially the elderly.

– They lost any social motivation, this affected interpersonal relationships. They even stopped going out for walks – employees, volunteers, rehabilitation therapists persuade them, but they don’t want to. Vitality and energy potential fell very much. It’s very hard to sit in your wards, on your floors, ” she explains.

The situation was aggravated, according to her, by the fact that at that time the work of psychologists and rehabilitologists was not established. – they did not switch to rotational work and worked remotely, which was not very effective.

By the beginning of the second wave, the situation had improved – but only in Moscow and St. Petersburg… So, according to Maria Rylnikova, today, one way or another, about 80% of the institutions in the capital region with which they work are open for visiting. At the same time, the employees of the administration meet halfway and, despite the inconvenience, in each case solve the issue “manually”, since there is no single guide on this matter.

First of all, the difference is noticeable in the approach on the part of the employees themselves, told Izvestia Svetlana Mamonova, director of external relations of the St. Petersburg charitable society “Perspektiva”, which is in charge of a project to support the wards of one of the children’s homes in St. Petersburg.

– I visit different boarding schools in St. Petersburg and I see that the people who work there are no longer in a state of panic and know how to act, she notes.

In addition, the St. Petersburg boarding schools, she said, now provide a sufficient amount of personal protective equipment (PPE), and the employees themselves began to wear them, while in the spring volunteers who used protective equipment often encountered misunderstanding.

Maria Rilnikova considers the openness of boarding school staff and willingness to make contact with volunteers one of the most important changes: “In contrast to the first wave of the pandemic, constructive interaction between volunteers and institutions is being built. And there is no such prohibition , which was before. “

In the position of serfs

In the regions, the situation remains much worse, most experts draw attention… Many boarding schools have not opened since the beginning of the pandemic: “And everything is very tough there, based on what they write to me – the departments are divided, the buildings are divided, no one is allowed in,” says Maria Sisneva. – Before that, people were often in the position of serfs, since in the regions control over the PNI is much worse. Now the situation has worsened. “

In general, the situation is very different from region to region, notes Elizaveta Oleskina: “We have a very large country, very different regions, and thousands of institutions. So the picture is colorful. Some “institutions” can be set as an example – they are fighting for everyone, but some lack awareness, resources – human and material – and sometimes the courage even to ask for help. “

At the same time, according to her, there is a lack of a common understanding of how work should be organized in these conditions and, in particular, where the mitigation of restrictive measures should begin.… As a result, somewhere part of the staff is left on a rotational schedule, and some go home in the evenings, somewhere people are deprived of the opportunity to go out to the territory to take a walk, or even walk from the ward to the canteen, despite the fact that the staff has been going home for a long time. evenings. And somewhere they try to find a balance between precautions and common sense.

In the absence of uniform rules, most often unnecessary measures are taken at the insistence of relevant regional departments wishing to hedge, says Elizaveta Oleskina. So, in one of the boarding schools, with which Starost in Joy cooperates, according to her, representatives of the regional Rospotrebnadzor after the outbreak of the virus demanded to destroy all mattresses, blankets, pillows, dressing gowns and other soft equipment at once. They, as a rule, are in favor of isolating guests in wards or on floors. “It’s sad when certain measures are dictated not by an understanding of how to deal with coronavirus, but by the fear of responsibility and the desire to shift it to neighboring departments,” the source said.

“Let’s think about how to do it differently”

Despite the fact that the general level of preparedness has increased, boarding schools lack clearer instructions and regulations on how to act to stop the spread of infection in case of detection of coronavirus, Svetlana Mamonova is sure. For example, a clear algorithm on how to separate “clean” and “dirty” zones, how and where to disinfect PPE – everything that, according to her, Russian hospitals have already learned to do.

Another important point – providing not only control measures, but also targeted advice and support…

– It is important to include representatives of Rospotrebnadzor not only from a supervisory position, but also as a participant in educational programs and trainings. It is important that each boarding school has its own epidemiologist and a representative of Rospotrebnadzor, who will come and literally draw a drawing for this particular boarding school, she notes.

Now boarding schools belong to the district departments of the department and are under the jurisdiction of the district epidemiologist along with other institutions. As a result, a specialist simply does not have the opportunity to come there in person and conduct training or education for employees.

– I would like the boarding schools to be helped, and not only scolded and controlled. Because we all find ourselves in a situation that we have never encountered. And you can scold endlessly, or you can reach out and say: “Let’s think about how to do it differently,” concludes the interlocutor of the publication.