GSAC Аналитика

Pandemic and “military” modernization

Pandemic and “military” modernization

In the social space, it turned out roughly what is called a cytokine storm in immunology. We are fighting a pandemic as a biological organism. And most of the problems are caused by your own immune response.

Both bureaucrats, medicine, and society in most of the post-Soviet countries with an exam called First modern Pandemic, as Bill Gates solemnly called it, cope badly, but badly in different ways. An epidemic is like a war – they always prepare for it, but it always catches by surprise. She makes the survivors change.

Neither states nor citizens needed independent expertise during the first wave of the pandemic. The authorities preferred police measures and manipulation of statistics instead of common sense, and instead of analyzing epidemic processes for decision-making, they preferred political slogans. Enthusiasts from among the progressive public perceived the same statistics through the filter of combating crown-skepticism. It is enough to hear how a German journalist attacks Swedish Foreign Minister Ann Linde on DW to get a sense of how public opinion, from the layman to the observer, is involved in the “pandemic” project.

Even inveterate oppositionists in March and early April approved the police measures and the unreasonable hospitalization of almost asymptomatic patients: “Let everyone see that the hospitals are full and understand that everything is serious.”

But by the second, autumn wave, when everything really turned out to be serious, society began to come to its senses and, right before our eyes, learn to work with expertise. Medical workers have adapted in places, began to bypass administrative barriers and treat serious patients not only with covid. Only politicians and officials have learned nothing. Some endowed with power and responsibility to the authorities continue to interfere with citizens’ lives, and doctors, volunteers and relatives – to save the sick. Others rush to cynically make money on other people’s fears, building covid hospitals, selling tests, vaccines, ventilators and oxygen concentrators to the budget, and “fuflomycins” and the possibility of hospitalization to citizens.

I will try to analyze in three texts the pandemic dynamics of three processes. First, changes in relations between society and the state. Secondly, the interaction of doctors with the health care system. And, thirdly, the formation of a new and influential institution based on volunteering and a network community, using social networks to organize expertise, fundraising and logistics, as well as to shape the political agenda and implement global educational projects.

Hyperimmune response to COVID-19

The driver of the unprecedented fight against the pandemic in the post-Soviet space was not the state, but civil society, or rather, the progressive community, mobilized around the Facebook network of authors. It is this politically active community, out of 1.7-1.8 million Russian members of which 825,000 are in Moscow, that formed a critical agenda and mobilized, including through Telegram channels, public opinion throughout the post-Soviet space.

Here, of course, not only Muscovites have worked. If in Russia FB has 13.1 million users (9% of the population), then in Ukraine – 9.5 million (20%), in Belarus – 3.85 million (40%), in Georgia – more than ⁠2 , 5 million for almost 4 million of the population (over 60%). It was in this social network that authoritative authors and opinion leaders appeared. The audience of the popular scientific post of a young Moscow doctor about the pathogenesis of the severe course of coronavirus pneumonia reached several million in April. The most public crown-politician of Russia, Moscow Mayor Sergei Sobyanin, reported to the audiences of Facebook and Twitter. In Ukraine, where Facebook has greater penetration, and civil society has won real leverage over the government, rather tough quarantine measures were introduced throughout the country, and not only in the capital, on March 17: the Kiev metro was closed, a mask regime was introduced, and mass events, street trading and shops closed (only banks, pharmacies and grocery supermarkets remained). In Georgia, a state of emergency (full lockdown, air traffic closed) was in effect from March 21 to May 22. President of Belarus Lukashenko underestimated the problem, but more on that below.

What real epidemiological processes are hidden under the frightening numbers of infections and deaths, we do not yet know for sure. And in Russia, because of the killed statistics, we will never know. It is understood that, on average, deaths from coronavirus are two to five times higher than those from seasonal flu. According to the WHO, the number of deaths associated with COVID-19 in early December exceeded 1.5 million people, and seasonal flu claims 290,000-650,000 lives per year (as of December 2017).

As Bloombergquint wrote back in August, analyzing the situation with food security in the world, due to transport restrictions associated with the pandemic, 130 million more people may remain hungry than the UN predicted for 2020, and the death rate from hunger may be by the end of the year 12 thousand people a day.

It would probably be correct to draw parallel graphs – mortality from infection and the consequences of fighting it. To understand the consequences of the decisions made, to realize how catastrophically different is the political cost of life in different countries, and to remember that the victory of the “forces of Light” on the “forces of Reason” often costs millions of lives.

A more or less objective integral indicator of the severity and dynamics of a pandemic, which simultaneously compensates for the overestimation of mortality due to limited testing and underestimation of mortality for political and administrative reasons, is excess mortality. According to independent demographer Alexei Rakshi, who publishes his analytics on Facebook, in different regions of the country, both the first and second waves of the pandemic led to short-term local peaks of excess mortality (in some regions or municipalities, people died within 2-3 weeks or even a month 2–3 and even 4 times more compared to the usual period).

It can be preliminarily stated that the current pandemic also has a larger epidemiological base than previous epidemics of swine flu A / H1N1 and other epidemics of recent decades. To do this, you do not need to look at the statistics – almost everyone has relatives, friends or friends of friends who died from complications or were seriously ill with coronavirus infection.

This real epidemiology is multiplied by several social circumstances.

First, the demographic changes that have taken place in developed countries in recent years. Life expectancy has increased by 10 years in 60 years and by 5 years in the last decade. In 2020, the proportion of people in the EU over 65 years old (belong to the risk group for ARVI) should have been 19.8%. In Russia and other countries of the former USSR, such a quality of life and health care has not yet been achieved – for example, people over 65 in Russia are 13.5%, in Georgia – 14.8%.

Secondly, this is a new global media structure, when social networks, primarily Facebook, combine political and everyday content in one media space. Previously, national newspapers wrote about politics, medical magazines wrote about epidemics, and about funerals and weddings were advertised in small local publications. Social networks have combined political and everyday content, and smartphones have provided total access to it.

The New York Times has 5 million subscribers. Circulations of medical and biotechnological publications rarely reach 100 thousand. Circulation of local newspapers ranges from several hundred to tens of thousands of copies.

Facebook, available to users since 2006, had 1 billion registered users in 2012, and in 2020 the total audience of all applications of Mark Zuckerberg’s company exceeded 3 billion. birthday and condole on deaths.

Third, investors and participants in the medical and biological technologies market have long tried to draw public attention to the need to develop antiviral vaccines and other methods of treating diseases that claim hundreds of thousands and millions of lives every year. Opportunities, including in the media, for this industry have grown rapidly in recent years. The Bill & Melinda Gates Foundation alone, which aims to support and improve the healthcare system, had $ 51 billion in assets in 2019, according to a KPMG audit.

A serious epidemic, the development of social networks, demographic changes, the dominance of populists in politics, the efforts of the beneficiaries of the biotechnology market converged in time and space. Political bureaucracy, medical officials, big technology business, big media, social media and experts, sometimes urgently retrained from Islamic terrorism specialists to epidemiologists, have multiplied this effect.

The textbook on infectious diseases has become available to a mass audience and has become a means of education and propaganda. It doesn’t matter what this has achieved more: reducing the burden on health systems through panic self-isolation and administering a hard lockdown, or increasing this burden with the panicky desire of enlightened citizens to escape from an insidious disease in a hospital ward. According to medical workers, people, frightened by the terrible statistics and journalistic reports, demanded hospitalization, even without symptoms.

The leaders were also frightened. The mayors of the Ust-Kutsk and Kirensky districts in the Irkutsk region were delivered with the coronavirus to the regional center by air ambulances. And, if the mayor of Kirensk was really in serious condition and was lifted aboard on a stretcher, then Ust-Kutsk leader Sergei Anisimov arrived in his car and got on the plane himself, and ambulance was used, because the regional Ministry of Health “was afraid that he will die”.

The atmosphere of fear that arose in regions where official statistics were refuted by deaths among relatives and friends, as in Dagestan in April 2020, is visible in a colorful sketch of everyday life. A sick woman without a mask stood in line at a store in one of the Dagestan cities. She was asked to go home and leave the address where to bring the groceries. She was indignant: “All the masks were put on, you bastards! you brought this infection here! Do you want me to die alone, or what? ” The women around move aside: “Astaghfirullah!” (God forbid). And the only man in the line “pulled out a pistol (traumatic), twitched:“ If you don’t close your mouth and move five meters away, I’ll shoot you right here, bitch. ” Move away immediately! ” (interview, man, born in 1962, Dagestan).

In the social space, it turned out roughly what is called a cytokine storm in immunology. We are fighting a pandemic as a biological organism. And most of the problems are provided by their own immune response, and not directly by the virus, as the doctors themselves say:

«The trouble with the coronavirus, in general, its entire philosophical meaning is that if someone smart looks at this situation from above, he will understand that, most likely, the problem is not in the coronavirus as in a virus, but in how we were formed for this attitude in a very short time – we were not allowed to breathe air … articles marked “lightning” fell every 20 minutes ”(male, doctor, born in 1985, Moscow).

Destructive success

Politicians in general successfully straddled the first wave of the epidemic and lockdowns. The police quarantine measures were supported by the population, and the politicians who introduced them received their portion of approval. The mask and strict self-isolation, exposure of the Swedish experience and criticism of crown dissidents on social media pages have become the hallmark of an enlightened citizen. Even attempts to understand the intricacies of coronavirus statistics could make the skeptic not shake hands. But in the case of a real anti-epidemiological policy, this success was destructive.

In the short term, the most devastating were the economic and medical consequences of ineffective epidemiological quarantines, insane bed restructuring and the rape of the medical community at the forefront of this war.

Displaced from work, from squares and parks, people still become infected in the metro, in the halls of clinics, health workers are massively infected and transmit the virus to their families and patients, nursing homes are on fire. The virus was rapidly spread across the country by shift workers and labor migrants during a vacation announced, for example, by the president. At the same time, planned and even emergency medical care is totally paralyzed by the quarantine of medical institutions, partially ousted by covid hospitals. Lives are not saved, the economy is at a standstill.

In the medium term, the lie about the preparedness of the health care system was equally disastrous. Instead of optimizing the triage of patients, creating and implementing a clear outpatient protocol and mobilizing hospitals for resuscitation measures (providing oxygen, medicines and trained personnel, for example), the bed fund is being increased, which is still not enough and for which there are simply no specialists and equipment.

The authorities took the path of least resistance, began to take the most prepared city and regional hospitals under the covid hospitals. In practice, this means that COVID-19 literally pushed all other medicine out of equipped clinics and forced a reorientation of most of the qualified personnel. According to publications and personal interviews, it can be seen that an economic and geographical factor also worked in Russia: Moscow has pulled together qualified and efficient personnel from the regions.

In the long run, the destruction of statistics and wild manipulations with the registration of the causes of death make all the victims of the first and second waves in vain: no work on mistakes is possible, because these mistakes are irreversibly swept under the carpet. We will never even know how many lives we paid for the transfer to covid hospitals of emergency hospitals and other large regional specialized and multifunctional centers.

Features of the national hunt for coronavirus

In Russia and other post-Soviet countries, the propaganda nature of the first wave of lockdowns is remarkably demonstrated by the coming out of elections and various votes necessary for the authorities: the state suddenly interrupts quarantine, recognizing either its unfoundedness, or its real attitude to people’s lives. On the other hand, society criticizes the authorities for organizing elections as if polling stations are more dangerous than metro, shops and clinics. This was especially prominent in Russia during the voting for amendments to the Constitution, in Belarus during the presidential elections and in Georgia during the autumn parliamentary elections. As one doctor noted, “The point of propaganda is that the state is trying to show that it is acting – bad, ill-considered, but it works and it helps at least someone. If it had been inactive, or it would have looked like inaction … It would have left us altogether. This would turn into the logic of not intellectual understanding, but emotional betrayal ”(man, doctor, born in 1985, Moscow).

The price of this betrayal was fully felt by the highest-ranking crown dissident and at the same time the victim of the pandemic – President of Belarus Alexander Lukashenko. Even before the falsification of election results and the brutal suppression of peaceful protests, Lukashenka lost some of the support of Belarusians, who did not forgive the lies, inaction and hypocrisy during the first wave of the pandemic.

The Belarusians not that they really wanted quarantine – the Belarusians wanted the feeling that they were being cared for: “even if he is a tyrant, he cares somehow. And he showed the complete opposite ”(male, born 1986, Belarus).

The Belarusian case should disappoint fans of Soviet medicine, preservation of beds and centralized management. It became suddenly obvious that this system can do nothing. The recorded increase in the number of infected in the amount of about 1000 new cases per day was explained by the fact that the laboratory simply cannot process more tests. For years SES went to hospitals, scolded doctors for nail polish and took swabs for gonococci. But there was a real, not a training epidemic – and the medical officials could not do anything at all.

Volunteers and non-state information channels were able to do something, which now provide the most powerful network infrastructure of Belarusian protests.

During the first wave, the Russian authorities turned out to be smarter and, after a short time of confusion, overcame the temptation to recognize the virus as a fake, introduced quarantine, sent militarized aid to Italy and Serbia, and opened covid hospitals that Vladimir Putin visited.

More than half of Muscovites supported the quarantine measures of the Moscow government and the introduction by Sergei Sobyanin of passes in Moscow. The mosaic of quarantine measures in Russian regions, from the closure of borders with neighboring regions to the abolition of quarantine in individual municipalities, is worthy of a separate qualitative study. There were also protests, for example, in Vladikavkaz, attempts to protest in Krasnoyarsk and Krasnodar.

WHO praised Russia’s anti-epidemic policy. Civil society supported the authorities’ actions. In Dagestan, activists accused the regional leadership of inaction and concealment of real mortality – Moscow sent disinfecting equipment and deployed field hospitals. People in anti-plague suits, spraying some kind of detergent, and sprinklers, sprinkling the streets and buildings of Makhachkala, resembled stills from a civil defense training film during the Cold War.

But, most likely, the reasons for the Dagestan tragedy were not the clumsy actions of the regional administration, but the holidays introduced by the Russian government from the end of March to 5 April with a subsequent extension until 30 April with the preservation of wages. Mass infection in the villages occurred somewhere in the second decade of April: “In the first days of April, all St. Petersburg and Moscow came in large numbers – all these our guest workers – laborers, builders, shift workers. We arrived and began to walk around the village, visit the old people and amaze everyone. And those old people who later began to go to the taraweeh [night prayer in the mosque in the month of Ramadan, which began in 2020 on April 23], who did zikr [collective prayer], who went to the mosque in the evenings, almost all of them died “(man , Born in 1962, Dagestan).

Contracts for construction of covid hospitals, financing of vaccine development and procurement of medical equipment, work permits for some commercial structures and bans on others – all these new administrative markets in Russia have increased the presence of the state in the economy.

The autumn wave of the pandemic was perceived differently by both society and the state. Health systems, especially regional ones, have not coped with the growth of severe patients. Problems began with the supply of medicines, which were swept off the shelves by citizens visiting pharmacies.

In Ukraine, similar trends were traced: against the background of a tough lockdown in the spring and summer of 2020, the work of all service and retail establishments was prohibited, except for banks, pharmacies, large food chains and some preferred manufactured goods chains, which continued to work, finally ousting small businesses and less from the market. influential competitors.

The Ukrainian media constantly discusses abuses and corruption related to the procurement of medical equipment and the distribution of funds from the coronavirus fight fund.

And the same as in Russia, the craving for large-scale projects, which experts cannot talk about without irritation: “We will open a hospital in the expo center, but who will work there? And what will they do there? Those who need hospitalization, as a rule, need oxygen ”(doctor, man, born 1969, Ukraine).

Nevertheless, the tumultuous imitation of the end of the world in Russia – especially in Moscow, St. Petersburg and Dagestan – in March and April looked a little odd against the backdrop of complete calm in Ukraine. The absence of an alarming vertical of power in Kiev allowed Ukrainians to survive the spring and summer of 2020 quite calmly. The bans on walks in parks and forests actually operated for several days, and then replaced by the recommendation to limit these walks. Of course, there was an outflow to villages and regions from Kiev, but the return of Zrobitch residents from Poland was more discussed.

The introduction of red zones, suggesting regional lockdowns, met with resistance from the mayors of Ternopil and Lutsk, which Prime Minister Denys Shmyhal called political. The cancellation by regional leaders of the “weekend quarantine” announced from November 14-15 in Ukraine was also political. The lockdowns of the second wave in Ukraine, the weekend quarantine and the full lockdown planned by the government for December, were generally postponed to January under pressure from business.

In Georgia, the ruling Georgian Dream party scored points in the spring with the toughness and apparent effectiveness of quarantine measures. The rating of Dream, according to the NDI, in January, before the pandemic, was 20%, Mikhail Saakashvili’s United National Movement was gaining 13% then, they did not know who to vote for, 12%, for European Georgia – Free Democrats 6% of voters would vote.

Before the second wave of the pandemic, from August 25 to September 7, Edison Research conducted the same poll, and the results were fundamentally different: for the “Georgian Dream” – 38%, for the “United National Movement” – 15%, for “European Georgia” – those the same 6%. The number of undecided also increased – 23%.

The results of the fight against the autumn wave of the pandemic were not so successful. The country has overtaken most countries in the region and the world in terms of the number of cases and mortality, signs of a crisis in the hospital sector have appeared.

The opposition criticized the authorities for the misuse of funds received to fight the pandemic. Business in disaster in small Georgia has seen well whose hotels receive orders for observation of visiting tourists and citizens, or whose companies receive contracts for landscaping.

The results of the exit polls at the parliamentary elections on October 31 (we will be guided by the data of the IPSOS company) showed that Georgian Dream has lost the advantage it gained over the spring and summer. The ruling party gained 41%, UNM – 33%, European Georgia – 5%, other opposition parties (Lelo, Giorgi Vashadze – Amganshenebeli’s Strategy and Girchi) received another 10%. That is, the opposition gained 48% in total, and the Georgian Dream was losing its ability to independently form a government. Bidzina Ivanishvili’s party required significant rigging to try to maintain the ability to form a new government without a coalition. As a result, “Georgian Dream” got 48%, “UNM” – 27%. However, it seems that the Georgian society this time is not going to agree with these 5-7% of the votes transferred from one pile to another. According to political scientist Gela Vasadze, it is under the pressure of public opinion that the Georgian opposition refuses to accept the election results and enter parliament.

So far, all presidents and prime ministers, except for the Kyrgyz one, are in their places in the post-Soviet space. Even Alexander Lukashenko is trying to sit out the protests that have been going on for four months. But it is too early to sum up the results: the final loss of sacredness by the bureaucracy may turn out to be one of the main complications of COVID-19.

Denis Sokolov, material from the Republic portal