The national and regional hotlines are the first point of contact for managing cases. Rospotrebnadzor runs the dedicated national hotline. At the request of Rospotrebnadzor, all regions have established their own COVID-19 hotline. Operators answer the most frequently asked questions; for detailed/specific information they connect with local Rospotrebnadzor specialists, or provide their telephone numbers.
The triage of calls is based on two main questions: have the callers recently been to countries with COVID-19 cases or have they been in contact with people who have. If the answer to one or both questions is positive, callers are asked to stay at home, not self-medicate, refrain from going to medical institutions and call their clinics or the national emergency service to arrange a home visit. Cases in self-isolation, or with mild symptoms in Moscow, are followed up by a home care team (by telephone, plus periodical temperature measurement for contact cases). As of 23 June, more than 340,000 teleconsultations had been conducted for 114,000 people with COVID-19 (https://mosgorzdrav.ru/ru-RU/news/default/card/4214.html).
The Ministry of Health has set up a centralized dispatching system for COVID-19 confirmed patients, triaging the severity of their symptoms. (http://static.government.ru/media/files/Bq29Y1AZ6KusGYGyZ2mQCZXD1SjBARyZ.pdf). Each medical institution has been informed of the MoH recommendations and rules for the reception, diagnosis and treatment of patients with possible and confirmed COVID-19. Clinical treatment protocols are specified in the “Temporary guidelines on the prevention, diagnosis and treatment of COVID-19” which is regularly updated;the latest is version 10 of 08 February 2020 (https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/588/original/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_COVID-19_%28v.10%29-08.02.2021_%281%29.pdf). The guidelines include specific treatment protocols and patient pathways. Specific recommendations for alcohol and drug users were issued on 25 June (https://minzdrav.gov.ru/news/2020/06/25/14302-minzdrav-rossii-napravil-v-regiony-metodicheskie-rekomendatsii-po-profilaktike-upotrebleniya-alkogolya-psihoaktivnyh-i-narkoticheskih-sredstv-v-period-pandemii-covid-19).
Since early April, Moscow tertiary care centres started experimental blood plasma transfusions from recovered COVID-19 patients to critical and severely ill patients. The plasma is collected from voluntary donors who have fully recovered from COVID-19 and the donors receive financial incentives. Another experimental treatment with helium has been given to patients at an early stage of the disease, while hyperbaric oxygenation is being experimented for serious cases (https://mosgorzdrav.ru/ru-RU/news/default/card/4097.html). MoH also published and regularly updates, guidelines on outpatient treatment of acute respiratory viral infections during COVID-19 epidemic, providing support for differential diagnostics and treatments (https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/033/original/RESP_REC_V2.pdf ). Guidelines dedicated to the medical care and treatment of children with COVID-19 were published on 24 April and updated on 3 July (https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/050/914/original/03062020_%D0%B4%D0%B5%D1%82%D0%B8_COVID-19_v2.pdf).
The Russian Ministry of Health has developed and sent to the regions temporary guidelines on medical rehabilitation of COVID-19 patients on 31 July 2020 ( https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/051/187/original/31072020_Reab_COVID-19_v1.pdf).
The Federal Medical and Biological Agency obtained a permit from the Ministry of Health to undertake a clinical trial of a COVID-19 treatment (https://fmba.gov.ru/press-tsentr/novosti/detail/?ELEMENT_ID=41576).
On a daily basis, medical doctors at the Moscow Telemedicine Centre provide approximately 5,000 consultations for Moscow patients who get treatment for COVID-19 at home. They work 24/7 and communicate with patients via video and audio. The Telemedicine Centre has been operating since March 2020. Telemedicine addressed two key objectives: arrange for continuous monitoring of patients, alleviate the workload of outpatient care and avoid overloading on the health system (https://www.mos.ru/news/item/85794073/).
The Department of Health of Moscow jointly with researchers from Lomonosov Moscow State University developed a CT calculator based on Artificial Intelligence (AI) technologies. A neuron network makes it possible to predict severity of lung damage according to the patient history and laboratory tests. The software is integrated into the Moscow healthcare information system and available to users from other regions (https://ct.emias.mos.ru/).
Russian company Intellogic developed a platform for the analysis and processing of images by AI technologies “Botkin.AI” which can analyze large amounts of data with high diagnostic precision (https://botkin.ai/ ).
The Russian government allocated more than 5 billion rubles to the regions for patients with COVID-19 being treated as outpatients to receive their medicines free-of-charge (Order No. 2805-r, 29 October 2020, http://static.government.ru/media/files/089hQQwnVA9Mlg32gBBjybAWHUGTzboC.pdf). According to Resolution of the Government No. 3300-р of 12.12.2020, additional 2.7 billion Rubles were allocated to the regions to make outpatient drugs available free-of-charge for the treatment of COVID-19(http://government.ru/news/41126/).