Nothing has changed in health care system since summer, old problems remained.
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Daily registration of new cases and lethal outcomes from coronavirus in recent weeks both in Kyrgyzstan and in the world proves that SARS-CoV-2 gathers pace again. If people do not follow the advices of medical workers, the critical situation that took place in summer in the country can repeat. Kyrgyzstanis can again have problems they used to have – lack of beds in hospitals, shortage of medications and medical equipment, lethal outcomes.
The country sees growth dynamics since September 24, when the number of patients was 127.
Last week, 24 people died, and 93 people died from coronavirus and pneumonia since September. As of November 3, according to official data, Kyrgyzstan has 60 thousand 279 new coronavirus cases and 1 thousand 159 deaths.
After loosened lockdown in June, Kyrgyzstan has seen a sharp increase in the number of new coronavirus cases, thus adding load on domestic medicine. Hospitals did not have free beds, medical staff, there was a deficit of medications. Social media published videos of patients dying on the threshold of hospitals. There was a critical shortage of oxygen concentrators and medical workers did not have personal protection equipment.
In July, the number of patients was growing exponentially. Thus, as of July 21, Kyrgyzstan had a record number of new cases – 1,108.
By the end of August, indicators decreased, and there were no lethal cases registered. However, coronavirus started to grow since September 25, when the number of new cases increased from 50-60 per day to 145 cases.
Readiness of the ministry of health to the second coronavirus peak
The head of Republican research centre for virus infection control of Preventive Medicine Association of health ministry, Zuridin Nurmatov, said the stock of medications left is sufficient for 1.5 months.
“Today, all hospitals are equipped with necessary medications. Later on, whenever necessary, we’ll invite bids,” he said to CABAR.asia.
According to him, health facilities increased the number of necessary equipment this year due to humanitarian and sponsor aid, republican and local budgets.
Thus, as of January 1, 2020, there were as few as 458 lung ventilators, today we have 585. The number of fixed X-ray units has increased from 78 to 102, anaesthesia-respiratory apparatuses has increased from 206 to 230, CT and NMR units from 4 to 5, pulse oximeters from 2179 to 9554, thermal imagers from 445 to 3558, oxygen concentrators from 1361 to 8315.
It should be noted that the ministry of health reported in April that hospitals of Kyrgyzstan have only 649 lung ventilators. However, only 365 of them were in good order.
Moreover, Nurmatov said the agency was going to handle the lack of medical staff by involving medical students.
“In July, when we had a surge of cases, we involved students of all medical institutions. Especially, senior students, interns. They have taken a special course, are familiar with clinical protocols, some of them worked as doctors, others worked as medical attendants. Therefore, they are prepared now and will be involved later, as necessary,” the representative of the health ministry said.
“We’ve counted the required number of medical staff at the local level and designated individuals who will work in new clinics. We are going to have a shortage of staff, so medical workers will be working with heavy load,” Nurmatov said.
Unpaid compensations
However, social media are full of messages reporting that doctors with coronavirus were not paid compensation in the amount of 200 thousand som (2,465 dollars) as promised, so some doctors refused to work in “red” zones.
Ekaterina Kolosova is a paediatrician of Issyk Ata district hospital who worked in the “red” zone. According to her, on June 27, 66 doctors entered the “red” zone after taking a PCR test on the same day.
“On the third day, some medical workers were tested positive for the disease, and were immediately isolated from us. Later on, the majority of us tested positive on PCR. Some of us developed pneumonia, but PCR tested negative. When we were at the dormitory, we started treatment, but the hospital administration did not write sick notes to all of us, so those who had Covid-19 cannot get the compensation now. Only 28 medical workers out of 66 were paid the compensation; some workers were denied, and others are still pending approval,” Kolosova said to CABAR.asia.
Besides, Kolosova said that doctors who were in the “red” zone had to cook and clean the floor by themselves in the dormitory for doctors and then in observation.
“As a matter of fact, we should have had a care staff, but we had to make infusions, cook food and clean the premises by ourselves. But fortunately the volunteers provided us with food and other necessary things, otherwise there would have been fatalities among our doctors,” she said.
The infectious disease physician Dilshad Mamazhanov who worked in the “red” zone for 7 months at Nookat infectious diseases hospital said the problem of infection among medical workers is yet to be solved.
“The reason for infection among medical workers is in the dormitory for doctors. After every shift, we come to the same premises, eat and sleep there. Theoretically, every medical worker must be in a separate room to make as few contacts as possible. Also, when doctors are on observation, every medical worker needs to be apart from others as we have new cases there as well. Currently, the situation is getting tougher as it is cold now, and not all hospitals have shower facilities because they are not infectious diseases hospitals,” he said.
As of October 27, the total number of new cases among medical workers is 3,597.
How coronavirus patients can hospitalise themselves?
Despite the slower Covid-19 dynamics as compared to July, there are still problems with hospitalisation. For example, recently, despite the available beds in medical treatment facilities, volunteers could hospitalise a woman with severe Covid-19 symptoms on the fourth try only, after they reported this case to social media.
“It’s all about treatment protocols that determine the hospitalisation of patients,” Bermet Barktabasova, an expert in evidence-based medicine, said. “Why did we have so many deaths in summer? Because they asked for PCR test results during hospitalisation. If it was negative, they did not admit the patient to a hospital despite all symptoms of coronavirus and pneumonia. Also, they divide patients into those who test positive and negative. They must not do it now, when flu season is coming. Hospitals must admit a patient and then diagnose him or her by an X-ray or the course of disease.”
According to Barktabasova, a patient needs to be hospitalised on the basis of a clinical picture, without waiting for a PCR test, because the disease pattern is the same and people die the same.
“A test is not the main criterion,” she said to CABAR.asia.
Help yourself. No stock of medications against coronavirus symptoms
Meanwhile, according to the health ministry estimates, coronavirus infections that used to be before always surged at the end of November and lasted until February.
“If we assume that SARS-CoV-2 also has a seasonal factor, we can suggest that we’ll have high morbidity rate from November thru February. It also should be noted that every year 150-300 thousand people have flu and acute respiratory viral infection in Kyrgyzstan, and the majority of cases is registered from November thru February,” health ministry representative Zuridin Nurmatov said.
According to him, the first stage of study of Covid-19 spread in various regions of the Kyrgyz Republic is over.
“The results show that 30 per cent of people in the republic have antibodies to SARS-CoV-2. It means that 30.8 per cent of people in the country contacted the virus and developed antibodies to it, so they won’t be infected, in theory,” he said.
From all that has been said, it follows that each of us must rely on ourselves only, provide ourselves with medications and money.
Former advisor to the health minister, Elena Bayalinova, said it is more difficult to buy medications and PPE in advance because of closed borders.
“Six months ago it was much easier to buy medications and other necessary things in advance. Everyone remembers how we used to seek medications at all hazards three months ago. I think it would be the same now, we’ll have shortage of supply,” she said to CABAR.asia.
According to her, the government has warned many times that the people should be ready for any situation.
“They say, be cautious, wear masks, wash your hands. However, it [the government] failed to provide us with stable conditions so that people didn’t take to the streets to protest and spread the infection. It is not really fair to blame people now and demonstrate their needs relying on volunteer organisations and international institutions,” expert Elena Bayalinova said.
This article was prepared as part of the Giving Voice, Driving Change – from the Borderland to the Steppes Project.