19 Jun 2020, 09:38
At the government session chaired by the Prime Minister Askar Mamin, the Acting Minister of Healthcare Lyazzat Aktayeva reported on the sanitary and epidemiological situation in the country.
Aktayeva noted that the epidemiological situation of infectious diseases, with the exception of coronavirus infection, in the whole Republic of Kazakhstan remains stable.
Monitoring is carried out on 64 infectious diseases; according to the results of 5 months, the incidence of 49 infections has been reduced.
This year, people’s diseases of plague, cholera, typhoid fever, rabies, tularemia, diphtheria, tetanus, rubella and other infectious diseases have not been registered.
Compared with the same period last year, there was a decrease in the incidence of salmonellosis, measles, purulent meningitis, serous meningitis, and tuberculosis.
The incidence of acute viral hepatitis A (1.8 times), botulism (3 times), scarlet fever 4.3 times.
At the same time, in the territory of Kazakhstan there are active natural foci of especially dangerous infections — plague, tularemia, hemorrhagic fevers (CCHF, HFRS), anthrax and other zoonotic infections.
In order to prevent plague and other natural focal infections, preventive measures are carried out. For 5 months of this year, anti-plague organizations examined with a laboratory study of 223.1 thousand square meters. km and 4 million ectoparasites and rodents, 14 plague pathogens have been isolated, which indicates the circulation of the pathogen.
Anti-plague stations created a protective zone around 21 settlements, settlement deratization, settlement disinsection have been conducted, and more than 50 thousand people were vaccinated against the plague.
As of June 12, 2020, three cases of the disease of the Congo-Crimean hemorrhagic fever, including two in Turkistan and one in Zhambyl region, have been laboratory-confirmed.
In order to prevent CCHF, the Sanitary and Epidemiological Service has created a sanitary protection zone around 313 settlements disadvantaged by CCHF.
5.8 livestock were processed by local executive bodies in areas unfavorable for CCCH against ticks, 362 thousand livestock premises in 1,001 settlements, buffer zones with an area of 19.8 square meters were created. km
Over the 5 months of 2020, 1,411,647 people were vaccinated, coverage by vaccination in the Republic of Kazakhstan amounted to 92% of the number of subjects.
“The lack of vaccination coverage is due to the suspension of routine vaccinations during the state of emergency. Currently, routine vaccination has been resumed, including for children who have not been vaccinated during the state of emergency,” noted the acting minister.
For the I quarter of 2020, the republic took into account 1,423 refusals of preventive vaccinations, compared with the same period in 2019, an increase of 13% was noted. At the same time, the number of vaccinated against the number of those who refused was halved from 725 to 309.
For reasons of refusals, the largest share falls on personal convictions and makes up 52.9% of the total, religious considerations — 29%, distrust of the vaccine — 11.2%, negative information in the media — 6.4%. Of the refused, 309 have been vaccinated.
Over the 5 months of 2020, compared with the same period in 2019, due to the additional vaccination, a decrease in the incidence of measles by 2.8 times was achieved.
“In order to reduce the incidence rate of measles, additional vaccination of children aged 9-10 months was carried out. More than 260 thousand children were vaccinated. This allowed us to reduce the incidence rate in this age group by 2.5 times. In addition, given that among the diseased adults, more than 55% are in the 20-29 year old group, an additional vaccination against measles of this age group has been carried out, 1,759,459 people have been vaccinated,” Aktayeva informed.
There is a positive trend in reducing the incidence of meningitis in the Republic of Kazakhstan.
The average long-term incidence rate of meningococcal infection in the Republic of Kazakhstan is 2.1 per 100 thousand of the population. Moreover, at present, the incidence rate in Kazakhstan is 0.15 per 100 thousand of the population, which is 14 times lower than the threshold level. However, in Shymkent there has been an increase in the number of cases from 2 to 6 cases.
Aktayeva also informed that 23,960 patients with coronavirus were registered in Kazakhstan, of which 16,351 were symptomatic and 7,609 were asymptomatic.
13,716 patients are under treatment. 10,139 patients were discharged with recovery, 105 patients died.
A total of 1,271,471 tests for covid-19 have been conducted nationwide since March.
“At the same time, Kazakhstan has 78 tests per patient, which is higher than the level of Russia, the USA, Italy, Canada, Austria, the number of tests per 100 thousand people is 6,824,” Aktayeva said.
Currently, testing is carried out according to epidemiological indications, with a preventive purpose and as part of surveillance. According to the Decree of the Chief State Sanitary Doctor, the following are subject to laboratory examination:
• Patients and virus carriers;
• Patients with SARS, influenza, pneumonia;
• Persons in contact with patients;
• Persons hospitalized in hospitals and medical and social institutions;
• Health workers;
• Persons entering the territory of the Republic of Kazakhstan.
In total, 56 laboratories for PCR testing on COVID-19 are functioning, the capacity has been increased to 28 thousand tests per day.
In order to ensure testing coverage of the subject population determined by the decree of the Chief State Sanitary Inspector, it is planned to increase the capacity from the budget to 30 thousand tests per day, and throughout the country to 35 thousand tests per day, taking into account the capacity of public and private sector laboratories.
Over the past week (from June 8 to 14), 5,485 cases were registered in the country. Compared to the previous week (from June 1 to June 7), the incidence increased 1.9 times (from 2,908 to 5,485).
Of the total number of cases, 44% (2,422 cases) were registered among contact persons, 36% (1,989 cases) were identified during professional examination, 19% (1,035 cases) were among patients with acute respiratory viral infections, and 1% were imported (39 cases).
At the same time, the number of cases with disease symptoms increased 1.3 times (from 1,551 to 1,950) and amounted to 35.5% of the total number of infections, asymptomatic 2.6 times (from 1,357 to 3,535 cases) or 65% of total number of cases.
For 3 days (from June 15 to 17) of this week, the situation is also characterized as unsuccessful, so for 3 days of this week, 3,007 cases were recorded (1,068 with symptoms and 1,939 asymptomatic), whereas for the same period last week (June 8-10) — 1,871 cases, 1.6 times growth.
At the same time, growth is observed in 15 regions (with the exception of the city of Shymkent and the Mangystau region) from 1.2 times to 6 times.
In order to objectively assess the situation, the Ministry of Healthcare has introduced additional criteria for assessing the epidemiological situation.
First, the dynamics of the epidemiological situation is taken into account.
“Here we are moving away from the ‘growth rate’ indicator used earlier, because in conditions when the number of general cases began to differ greatly from the number of active patients, this indicator does not fully reflect the rate of development of the epidemic. To assess the situation, we use the R indicator — the reproductive number, that is, the number of contacts who, on average, infects one patient with coronavirus infection,” the acting minister said.
Second, one of the tasks of restrictive measures is to prevent overloading the health system when it ceases to cope with the flow of patients. Therefore, the second criterion is an indicator of the employment of the hospital bed for patients with coronavirus infection.
Additional indicators will also be taken into account. One of them is mortality — an increase in the mortality rate from CVI, the proportion of patients with severe and extremely severe severity (increase).
“Strengthening of quarantine and restrictive measures should be carried out if the indicator R exceeds 1.3, or if it is in the range from 1.15 to 1.3, while the occupancy of the beds will be above 70%, or when the percentage of occupancy of the beds will be above 90% regardless of the reproductive number,” Aktayeva noted.
In the absence of positive dynamics of the criteria, restrictive measures are proposed to be maintained at the current level.
The criteria for mitigating restrictive measures are the occupancy of beds less than 50% and R less than 1.
Only for three regions (West Kazakhstan, Kostanay and Mangystau) restrictive measures can be left unchanged. To date, additional tightening measures have been introduced in all 17 regions.
Given the increase in the incidence of CVI, the Intergovernmental Council on June 18 adopted additional measures to strengthen quarantine in the cities of Nur-Sultan and Almaty, Karaganda, Shymkent, Pavlodar, Ekibastuz on the weekend of June 20-21:
And also in the settlements of regions with a population of more than 50 thousand people: