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Since introduction of quarantine in Kazakhstan, 29% decrease in CVI cases recorded

Tuesday, 28 July 2020, 10:00:28

At the government session chaired by Prime Minister Askar Mamin, the epidemiological situation and measures to combat coronavirus infection were considered. Minister of Healthcare Alexey Tsoy reported on the current situation in the country.

Since the introduction of strict restrictive quarantine measures (from July 5), 35,951 new cases of CVI have been registered in 3 weeks, the minister said. Overall, there is a 29% decrease in reported cases.

“The situation with the incidence of COVID-19 has stabilized at an average of 1,600 people per day. There is also a decrease in the occupancy of beds by 43%, of which intensive care beds — by 27%. The number of those who recovered increased to 63%. Thus, the main indicators of the burden on the health care system have been reduced,” Tsoy informed.

According to the developed criteria for the mitigation of quarantine measures, the ministry monitors the rate of infection reproduction (the number of people that one patient infects before isolation) and the percentage of employment of infectious hospital beds for the treatment of CVI.

So, in 3 weeks of quarantine, the following was achieved. The reproductive rate of infection decreased from 1.2 to 0.99. And the bed occupancy rate dropped from 90% to 47%.

Thus, the above positive dynamics of the main indicators of the burden on the health care system indicates the possibility of a phased mitigation of quarantine measures.

“I would like to emphasize that further stabilization of the situation in terms of morbidity and mortality from COVID-19 depends on the coordinated work and involvement of all sectors of the economy. In particular: the effectiveness of the stabilization measures taken depends only 30% — on the quality of medical care and epidemiological measures,” said the head of the ministry.

At the same time, the remaining 70% in aggregate are adherence to the mask regime and hygiene (30%), as well as adherence to the norms of social distancing (40%).

As the minister emphasized, today the entire Kazakhstani society needs to take all measures to ensure that safety and healthy habits become "infectious", not the coronavirus.

“For this, first of all, it is necessary to ensure the further observance of the mask regime and hygiene. It is a known fact that wearing masks outside the home reduces the transmission of infection by 30%. Hand hygiene also plays a special role in the spread of infection,” said Tsoy.

In this regard, it is necessary:

First, to strengthen the control and responsibility of business for observance of the mask regime, with the involvement of interested civil society organizations and local executive bodies (for example, the mandatory use of seat belts).

Second, to ensure that hand sanitizers are installed in all public areas.

Third, to ensure the conduct of information and explanatory work with the population through all information channels.

The principle of social distancing must also be respected, which includes:

  • Remote office work (in a 20/80 ratio) and distance learning for schoolchildren and students.
  • A ban on mass events of all kinds — due to the impossibility of observing the mask regime and social distance.
  • Increased business responsibility — for compliance with zoning, markings and occupancy rates, with increased control.

These measures should also be accompanied by intensified information and explanatory work with the population through all information channels.

Thus, according to Tsoy, subject to compliance with the enhanced sanitary and disinfection regime, wearing masks and social distancing, from Aug. 3, 2020, when the infection reproductive rate is less than one (R ≤ 1), as well as when the bed occupancy rate is less than 70 % during the week and the stable dynamics of reducing the mortality rate, the following infrastructure facilities will be allowed to operate.

  • Shopping and entertainment centers, trading houses, retail chains with time and day restrictions, covered food, non-food markets.
  • Children's correction rooms, educational centers, children's development centers, circles in groups of no more than 5 people;
  • Preschool institutions in the mode of duty groups;
  • Beauty salons, hairdressing salons, centers and salons that provide cosmetic services, manicure and pedicure by appointment;
  • Remote work should be retained for at least 80% of employees of state bodies (organizations) and office workers.

The Minister of Healthcare noted that individual and group outdoor training is allowed with respect to social distance. And also sports training for national teams of no more than 30 people.

The following requirements remain for movement of people:

  • Movement of people along the streets, visiting parks, squares and embankments — in groups of no more than 3 people;
  • The operation of public transport in compliance with time limits and occupancy of no more than 50% in compliance with the mask, sanitary and disinfection regime and the presence of conductors

In this case, it is necessary to maintain the ban:

  • For all types of public events, the work of entertainment establishments, cinemas, food courts, banquet halls.
  • The work of restaurants, bars, nightclubs and gaming clubs.
  • The work of cultural objects, museums, conferences, exhibitions, forums.
  • The work of gyms, fitness centers, swimming pools, beaches, water parks.
  • The work of religious sites.
  • The movement of suburban passenger trains (electric trains, except for working trains), the formation of common wagons, intercity buses (minibuses).

Akim of Almaty Bakytzhan Sagintayev noted that the introduction of enhanced restrictive measures on July 5 was correct.

According to Sagintayev, the epidemiological situation in Almaty shows a comprehensive stabilization. The increase in people infected with coronavirus in the metropolis has decreased to 2.2%. To date, 10,965 cases of COVID-19 have been registered in the city. Of these, 6,341 people or 60% are recovered. The death toll from coronavirus is 73 (0.68%). The number of ambulance calls with suspected pneumonia and COVID-19 decreased by 4 times. Hospitalizations in hospitals decreased by more than 2 times. Visits to polyclinics also decreased by 2 times.

To counter the pandemic and prepare for a new wave, the work system has been strengthened. A new ambulance routing model has been built. An institute of chief freelance specialists in the main clinical and diagnostic areas has been created. The centralization of the citywide laboratory network was carried out.

The role of PHC is adapted to combat COVID-19. Mobile teams work at the outpatient level. Leading specialists from the Patient Monitoring Center work with patients at risk.

A rapid response resuscitation group has been created to monitor all resuscitation services in the city. Separation of infectious hospitals and triage of patients has been introduced. The processes of monitoring the safety of doctors, compliance with measures to prevent nosocomial infection have been strengthened.

Additional measures have been taken to monitor the city's sanitary and epidemiological protection. To date, 27 medical organizations are involved in the fight against covid-19. The total bed capacity was 6,096 beds. The bed occupancy rate has been reduced from 90 to 50%. As of today, this figure has been reduced to 42%.

In preparation for a new wave of the pandemic, it is planned to increase the number of infectious beds in hospitals of the first echelon for seriously ill patients by 1,015 beds. By the end of August, a new hospital with 500 beds will be commissioned. Another pre-fabricated infectious diseases hospital with 300 beds will be commissioned by mid-September. Until Oct. 1, full-fledged co-shaped clinics with a capacity of 215 beds will be created on the basis of two hotels at the expense of private investments. By the end of August, a new pathology bureau will also be commissioned.

A personnel reserve has been formed of 1,689 employees. Their constant retraining is underway.

To date, 394 thousand PCR tests have been carried out. The daily capacity is currently 9,550 PCR tests. By Sep. 1, the capacity will be increased to 19,950 per day.

In parallel, work is underway to study population immunity in Almaty residents. There are already 2 private laboratories for enzyme-linked immunosorbent assay, which to date have conducted 7 thousand studies. Three state ELISA laboratories are preparing for the opening.

In total, 68.5 billion tenge was allocated from the local budget for the material and technical equipment of medical organizations, drug supply, purchase of PPE, provision of medical workers and other purposes.

A stabilization fund has been created for socially significant drugs and medical products. It allocated 10 billion tenge. Including to provide the pharmacy network — 5 billion, hospitals — 5 billion.

A stock of 94 drugs is being formed. More than 9 million packages have been received since July 1. Of these, with four sides, 3.6 million at the expense of the Stabilization Fund.

“Today there are 2.8 million drugs in stock in the city's warehouses. By the end of this week, another 3.8 million packs are expected from the Stabilization Fund. The work continues. The situation is stable. There are no queues,” the akim of Almaty said.

This is evidenced by the number of calls to the hotline. If at the peak (July 14) there were 1.1 thousand applications, then on July 26, about 90 applications were received.

The city is provided with personal protective equipment until the end of August 2020.

The implementation of the city program for the centralized provision of hospitals with medical gases has begun. Until Sep. 10, 8 basic hospitals will be provided with centralized oxygen. Upon completion, we will continue to work on the rest of the hospitals. Within a month, the city will receive 308 ventilators and 2,022 oxygen concentrators at the expense of the local, republican budget, as well as sponsorship. Arrival of 55 ambulances is expected. Additionally, the delivery of another 35 vehicles through the DBK is being considered. Construction of a system for disinfection of sewage has begun in all covid hospitals, and modern medical waste disposal stations will be built at each infectious disease clinic. Both directions of work will be completed in September.

In turn, the Akim of Shymkent Murat Aytenov said that today the number of people infected with the COVID-19 virus in the city was 4,708.

“Over the past day, 54 infected with the virus have been registered, an increase of + 1.2%. Compared to the beginning of the month, there is a 2-fold decrease in growth. In the first five days of July, the number of people infected with the virus was 84-100 cases, or an increase of 2.5-3 percent. During this period, 2,938 people were treated. Unfortunately, 31 people died (including those from the Turkistan region-3),” the akim of Shymkent informed.

In infectious and provisional hospitals in the shortest possible time, 3,050 additional beds were organized, the number of beds was brought to 3,860. Of these, 650 infectious, 3,210 provisional beds. The number of resuscitation beds in them increased from 30 to 151 beds. Additionally, 58 ventilators, 250 Bobrov breathing apparatus and 26 resuscitation monitors were purchased.

“Resuscitation beds are 88.7% equipped with 138 ventilators. The number of oxygenated places has been increased to 861, or 22.3% of the total. The issue of constant oxygen supply is being resolved. In addition, work is underway in 2 hospitals to launch oxygen stations. Three more hospitals will be connected within a month. The work on the provision of primary health care has been strengthened. In addition, 197 mobile brigades were created, 15 693 patients were provided with inpatient services at home,” the akim said.

In addition, 45,074 citizens were delivered medicines at home by mobile brigades. The work done contributed to the improvement of the epidemiological situation in the city. The number of ambulance calls per day dropped from 2,320 to 1,321, that is, by 43%.

“The number of patients treated in hospitals decreased from 2,882 to 1,240, or by 56.9%. The occupancy of beds in hospitals at the beginning of the month was 78.7%, and today it has decreased to 33%,” the akim of Shymkent summed up.

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