Tuesday, 21 July 2020, 22:49:55
Today, within the framework of the online conference, Minister of Healthcare Alexey Tsoy and Vice Minister of Healthcare Azhar Giniyat spoke about the current trends in the spread and control of coronavirus infection.
As noted by Tsoy, in the three weeks of this month, the total bed capacity was increased from 30.4 thousand to 49.7 thousand infectious and provisional beds. The growth of the hospital bed was 19.3 thousand.
In provisional hospitals, the occupancy of beds decreased by 20%, the occupancy of intensive care beds — by 6%. At the outpatient level, 2,962 mobile teams of primary medical and social care were created to provide medical care at home.
Today, infectious diseases and provisional hospitals have 1,958 ventilators, together with akimats, more than 4,183 additional devices were purchased.
21,855 beds will be provided with oxygen. Of these, 17,762 — through oxygen concentrators, which come both from the state and from patrons and citizens.
Additionally, it is planned to supply 100 mobile medical complexes that will be able to provide assistance on a regional scale and, most importantly, in the countryside. The planned equipment of these medical complexes include X-ray, ultrasound, ECG, gynecological, examination rooms, points of material collection.
In Kazakhstan, there is a steady trend toward reducing hospitalizations and calls to ambulance
In general, taking into account the operational measures taken over a two-week period, the following positive results were achieved:
- The daily increase in COVID-19 infection reduced from 4% to 2.1%;
- The number of people recovered from COVID-19 increased by 60%;
- The number of ambulance calls reduced by 23%.
“These indicators clearly show that the dynamics have now stabilized. When talking with our doctors in various regions, we see that doctors are slowly entering their usual routine, measures have begun to be systematically provided. It is clear that the healthcare system will not reboot quickly overnight, but we already have clear positive shifts. We see that the work has been systematized, availability is increasing, and mobile teams are expanding. Two weeks ago these mobile brigades did not exist yet, but now we see a big growth,” Tsoy said.
Great emphasis is placed on quality planning and procurement of medicines.
1) The procedures for certification and registration have been simplified, as well as procedures for one-time import (the terms were shortened and procedures for certification of medicines were reduced from 1 month to 3 days, one-time import was issued within 24 hours, the procedure for registration of new drugs for the treatment of COVID-19 was accelerated).
2) The saturation of retail with medicines is carried out at the expense of special aircrafts (6 special flights to Russia and India for 4 million packs of medicines were organized, the medicines are evenly distributed among the regional akimats).
3) Special Stabilization Funds have been formed in the regions.
4) The list of outpatient treatment drugs is being expanded (the COVID-19 nosology is being introduced at the outpatient level, including 5 types of drugs, coverage of about 1 million people, worth more than 8.6 billion tenge).
5) SK-Pharmacy has formed a month's supply of medicines (medicines will be shipped to all regional hospitals by the end of July; in the future, it is planned to fill a two-month stock in SK-Pharmacy's warehouses to saturate the market and hospitals with medicines).
“We helped our domestic wholesale suppliers in retail. We have organized 6 special flights to Russia and India. More than 4 million packages have already been delivered to Kazakhstan. In parallel, each region is dealing with this issue, additional boards are being put in order to increase the availability of these drugs. These drugs have already appeared. Yes, in some places, we see that there is still a certain deficit, but on the whole the situation has stabilized. These drugs are coming in. We have created such special conditions for the market so that it is easy to enter the market and import these drugs. This process should get better. Our companies, I think, will supply the necessary medicines to the market on time,” the minister said.
At the same time, the issue of including 5 key pharmaceuticals for the treatment of coronavirus infection and coronavirus pneumonia at home and on an outpatient basis is being worked out. According to Tsoy, the issue of supplying these drugs is being worked out so that patients can receive help at home without bringing their disease to the hospital.
Also, according to the instructions of the Head of State, it is planned to increase the laboratory capacity up to 64 thousand PCR tests per day by September 2020.
“Taking into account the fact that we will reorient some veterinary laboratories of the Ministry of Agriculture, which already have PCR devices, and we will reorient them for the needs of the health care system. Here the Ministry of Agriculture met us halfway, allocating premises, specialists, analyzers, which will be distributed to regions where there is a shortage of testing now, and this work will continue,” the minister explained.
The capacity of modular laboratories is planned to be increased in Nur-Sultan and Almaty. Akimats of these cities are now working on this issue and want to increase the total capacity to 10 thousand tests per day for two laboratories in the two cities.
“We are now seeing a steady trend towards a decrease in the number of hospitalizations in hospitals, a decrease in calls to emergency medical care. This is an indicator of the effect of restrictive measures, actions of primary health care, saturation of the market with drugs. Admittedly, there are cases when certain medications are absent, but in general the situation has more or less stabilized. We see this firsthand, both from our friends and from our colleagues,” Tsoy said.
Kazakhstan is considering procurement of vaccines from different countries
Answering journalists' questions, Tsoy said that compensation is legally paid only to those medical workers who contracted coronavirus infection in the workplace, as well as to those who died from COVID-19, having become infected at work.
“There are no other normative acts now. But we are considering this issue, combining statistics, when they combine and we have a clear code. We are now considering this approach,” the minister said.
According to him, at the moment, there are 123 and 59 deaths of confirmed cases of infection in medical workers directly from KVI, which were received at workplaces, which are also now being considered at the level of the Ministry of Labor and Social Protection of the Population today.
“Yes, indeed, we received such lists from the regions and sent them to the Ministry of Labor and Social Protection of the Population. Further payments are made through the State Center for Internal Medicine, the task of the Ministry of Healthcare is to collect the lists and transfer them, there are also separate epidemiological cards that study where this health worker got infected — at work or at home,” Tsoy said.
The head of the Ministry of Healthcare also noted that the number of applicants may increase, since the regions are still working on this issue.
“These are the lists that came from the regions, now the regions are working on each medical worker, and, perhaps, they will increase, but at the moment this is what we have at the central level,” the minister said.
Tsoy also said that Kazakhstan is studying the procurement of vaccines from different countries. Now these drugs are at different stages of clinical trials.
“We know the Russian vaccine, we also actively cooperate with our Russian colleagues. Delivery dates will depend on when there is official confirmation that the vaccine has passed all stages of clinical trials and is approved for use in the general population. When such data are received, we will consider,” the minister said.
According to the minister, there are preliminary agreements with other manufacturers of vaccines that are at the testing stage, including Chinese vaccines, which are undergoing clinical trials together with the UAE.
All consultations of local doctors carried out online
According to the Vice Minister of Healthcare Azhar Giniyat, in order to prevent infection at the level of the primary health care network in polyclinics and outpatient clinics, the work of district services was transferred to a remote format. All consultations with local doctors, nurses are conducted online. In case of emergency, the appearance of any complaints, chronic diseases, mobile teams have been created that go for consultations at home. One such brigade is created for 5 thousand of the population. If on average 50 thousand people are served in polyclinics, more than 10 mobile teams are created at a medical facility.
There are teams that go to patients with symptoms of coronavirus infection, ARVI. They take tests, examine, prescribe treatment depending on the severity of the condition. There are teams in which nurses go out and take tests for PCR. There are so-called "clean" brigades. They visit patients with other diseases, for example, chronic diseases, to examine pregnant women and children.
Also, call centers are being created in clinics and outpatient clinics, through which specialized doctors advise the population on treatment, answer questions.
In addition, filter cabinets have been installed. If a patient goes to a polyclinic, he is served through a filter cabinet. The temperature is measured there, all the physical data of the patient. The technicians work in fully protected suits.
Clinics have departments for pregnant women with separate entrances and exits. They are also being monitored and screened according to the plan, as ordered by the Ministry of Healthcare.
How victims of coronavirus buried in Kazakhstan
Giniyat also spoke about the rules for burying the dead from the coronavirus. According to the vice minister, no special permission is required for the funeral. In accordance with the decree of the chief sanitary doctor, the body of the deceased from COVID-19 is decontaminated in the pathological department of the institution in which the death occurred, after which the body is given to relatives. Relatives themselves choose where the deceased will be buried.
Also, the vice minister noted that during the funeral it is necessary to adhere to elementary sanitary and epidemiological requirements.
“It is necessary to maintain social distance, wear masks. People who give out the body must follow these rules. This is controlled by the departments of regional committees under the ministry. Also, compliance with the norms should be monitored by the leadership of the department that issues the body. There are no special rules,” she said.
Not a single death of child from COVID-19 recorded
Azhar Giniyat denied speculation from social networks about the alleged increase in infant mortality from coronavirus infection.
Answering journalists' questions, the speaker cited statistics:
“There are 73,400 confirmed cases of COVID-19 in the country now. 61.8% of them were cured. There are about 8 thousand cases of pneumonia in hospitals. More than a thousand children have been ill since May. There are over 100 children in hospitals. All of them had mild symptoms. And not a single case of death from the disease has been recorded,” the vice minister said.
She also drew attention to the fact that various viral infections, such as influenza, parainfluenza and others, are activated in autumn. Most of these lead to viral pneumonia. Therefore, the Government is taking measures to isolate children precisely in the autumn period so that during this period there is no increase in the disease of coronavirus infection among children.
Lopinavir and hydroxychloroquine excluded from CVI treatment protocol
Vice Minister of Healthcare Azhar Giniyat spoke about the changes made to the protocol for treating coronavirus in Kazakhstan.
“The whole world is looking for new effective treatments. We all know that there is no etiotropic treatment specifically against this virus. Therefore, our Kazakhstani scientists are studying the international experience and implementing the best methods and improving the protocol. July 15, the Joint Commission on Quality with the participation of leading specialists reviewed and made additions and changes to the 10th edition of the Protocol for the Treatment of Coronavirus Infection,” Azhar Giniyat said.
First of all, according to her, the drugs lopinavir and hydroxychloroquine were excluded. On WHO recommendation, these drugs were recognized as ineffective, so our specialists decided to exclude these antiviral drugs as a commission.
“Today there is evidence that remdesivir and favipiravir have an effect in severe CVI. Therefore, these drugs were additionally included in the clinical protocol for the purpose of clinical research and in severe cases of CVI, these antiviral drugs were used. The outpatient stages of treatment are also included for the first time. Antipyretic drugs and oral anticoagulants have been added at the outpatient level. They are included in the list of outpatient treatment,” Azhar Giniyat said.
These drugs should be provided free of charge for clinic-level treatment.
Can those recovered from COVID-19 be re-infected
In addition, Giniyat answered the question of how long immunity lasts in those who have had coronavirus. According to her, to date, no re-infections with coronavirus have been registered in Kazakhstan.
“There have been cases when patients got sick, the acute period passed, the re-analysis was negative, and after a while it showed a positive result. In this case, our experts say that these may be “fragments” of the virus, to which PCR reacts, the analysis shows a positive result in the absence of clinical manifestations, therefore, it is not considered re-infection. Now there is no such data that it is possible to be re-infected with the coronavirus,” Azhar Giniyat said.
The speaker added that scientists all over the world are now studying the issue of the duration of immunity in those who have been ill.
“There is evidence that short-term immunity is developed, that is, up to 6 weeks, but there is no exact answer, this is due to the course of the disease. A person is easily tolerated or in a severe form, while scientists do not have an unambiguous opinion on immunity,” Giniyat noted.
Is outbreak of bubonic plague possible in Kazakhstan?
Giniyat also commented on the danger of an outbreak of bubonic plague in Kazakhstan.
"Bubonic plague is not transmitted from person to person, unless this form is complicated by the pneumonic or septic form of the plague," the vice minister assured.
According to her, today there are natural foci of plague in Kazakhstan. The sanitary services of the anti-plague station throughout the country carry out sanitary-preventive work and keep this situation under control.
“And our Kazakhstanis will not be infected with the bubonic plague from Mongolia, unless suddenly an infected with a pneumonic form of plague or with a complex form does not get into our country,” she explained.