Experience in conducting anti-epidemic and medical evacuation measures at a large construction site in the conditions of the spread of the first wave of a new coronavirus infection (COVID-19)

Abstract

Relevance. The greatest difficulties in emergencies of biological nature arise if health care is provided to significant contingents of persons engaged in work activities outside large settlements and united by common living, food and recreation conditions, for example, shift workers engaged in the implementation of large construction projects. Despite the pandemic of the new coronavirus infection (COVID-19), the construction of large industrial enterprises should continue, which makes the problem of medical support for shift workers extremely urgent. Intention. To analyze the experience of organizing and conducting anti-epidemic and medical evacuation measures during the medical support of personnel engaged in the construction of the Amur Gas Processing Plant (AGPP) in the conditions of the spread of the first wave of a new coronavirus infection (COVID-19). Methodology. The subject of the study was the medical support of shift workers employed in the construction of the AGPP. The total number of employees working on the construction site of the AGPP daily from March to September 2020 ranged from 30,390 to 39,120 people. Citizens of the Russian Federation as well as of foreign countries from near and far abroad worked on a shift basis. All employees lived in dormitories on the territory of temporary shift camps for construction workers, and ate in common canteens. Anti-epidemic and medical evacuation measures were developed and their effectiveness assessed using methods of historical analysis and comparison, systematic and logical analysis, expert assessments, statistical analysis. Results and Discussion. The results of a retrospective analysis of measures for medical support of workers employed in the construction of the AGPP are presented. Starting from 03/28/2020, the following anti-epidemic measures were implemented: disinfection of dormitories, canteens, transport and offices; the use of protective masks and gloves; daily measurement of body temperature; disposable tableware. Since 04/27/2020, there were restrictions on entry and exit from the AGPP; employees lived either in shift camps on the territory of the construction site, or in city dormitories with isolated perimeter (for engineering and technical personnel). After detecting the first case of COVID-19 infection, isolation of COVID-19 cases with contact tracing took place. From 29.05 to 06.06.2020, polymerase chain reaction (PCR) and immunofluorescence analysis were performed in 30,445 workers. As a result, a quarantine regime in shift camps was introduced, and medical prophylaxis was prescribed to their inhabitants in accordance with the Temporary Methodological Recommendations “Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)”, version 7.0 of 03.06.2020. During repeated mass testing from 12.06 to 19.06.2020, 95.9% of primary SARS-CoV-2-positive employees became negative after treatment with hydroxychloroquine and recombinant interferon-alpha, thus suggesting high effectiveness of anti-epidemic, therapeutic, and preventive measures. For treatment of COVID-19 cases, a hospital base was deployed, including three provisional hospitals, infectious disease department of the Svobodnenskaya Hospital and a temporary infectious disease hospital built in June-July 2020 directly on the site of the AGPP. The above facilities had all the necessary medical equipment and supplies. Due to the shortage of available beds in health facilities, on 14.06 and 19.06.2020 44 patients with COVID-19 of mild and moderate severity were evacuated by air to medical institutions of the Khabarovsk Territory and the Republic of Sakha (Yakutia). More than 150 healthcare workers, including doctors, nurses, paramedics and medical assistants were involved in anti-epidemic, therapeutic, and preventive measures at the AGPP. Conclusion. Thanks to the anti-epidemic and medical evacuation measures, the construction of the AGPP during the first wave of new coronavirus infection went on, and after the epidemic situation stabilization in August 2020, mass engagement of shift workers was resumed.