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Doctors Got Infected in Kazakhstan. Who Is to Blame and What Is to Be Done?

As of April 27, 820 healthcare workers are infected with coronavirus in Kazakhstan. According to the Ministry of Health, 66% of them were not involved in the care and treatment of COVID-19 patients.

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Doctors infected with coronavirus addressed the president complaining that they were accused of being infected. The letter was written by the employees of one of the biggest infection outbreak zones – the Central City Clinical Hospital of Almaty. 263 cases of infection of healthcare workers are registered there.

Addressing the president, doctors wrote:

We assume that the Ministry of Health’s administration is not interested in an objective investigation of the reasons that led to a massive outbreak of infection among medical workers. The accusation of the junior medical staff is the easiest, but also the most ineffective solution of the problem, since it does not provide the understanding of the existing danger.
The Central City Clinical Hospital of Almaty is under quarantine since April 13 due to massive outbreak of infection among medical staff. Photo: official page of the Central Clinical Hospital on Facebook

The hospital was closed for quarantine on April 13. Simultaneously, Almaty’s chief sanitary doctor Aizat Moldagasimova accused doctors of this; supposedly, they did not take sufficient protective measures against coronavirus.

Immediately after this statement, the head doctor of the Central Clinical Hospital Almaz Dzhuvashev was fired, and inspection began in the hospital. Moldagasimova was temporarily suspended. Later, the new head doctor got infected with the coronavirus as well.

Meanwhile, in the Vremya newspaper interview, Magripa Bapaeva, the deputy head doctor of the same hospital, said, “A huge mistake was made when the multidisciplinary clinics continued to work as usual and accepted patients with pneumonia or signs of acute respiratory viral infections”.

She also added that the massive infection outbreak could have been avoided if sufficient protective measures against coronavirus had been taken from the very beginning of quarantine in the hospital:

“We wanted our employees to work in special protective suits from the moment of the emergency introduction. However, the city healthcare administration slowed us down; they told us, “Stop scaring people!” Yet, on April 1, we purchased protective suits ourselves and distributed them to workers on April 4. In addition, everyone working in the emergency room was equipped with masks and gloves.”

She also noted that an employee of the Sanitary-Epidemiological Service, who came to their hospital for MRI testing, perhaps, could be the patient zero:

“If we knew that the public health officer who came here was infected with coronavirus, we would close the hospital department. However, there were no orders! We even were criticized for the fact that our employees wore protective suits. Our clinic has single ventilation system, which contributed to the massive outbreak.”

Who Is to Blame – Patient Zero or Doctors Themselves?

On April 29, Chief state sanitary doctor of Kazakhstan Aizhan Esmagambetova said that the preliminary version of the doctors’ infection at the Central Clinical Hospital of Almaty was the violation of the rules in the hospital. In particular, incorrectly placed patients, division into zones, changing the profile of the hospital without a sanitary-epidemiological report by the Ministry of Health.

Meanwhile, at a press conference, the new Almaty’s chief sanitary doctor Zhandarbek Bekshin said that the commission considered several reasons of the doctors getting infected. One of them is patient zero, as the first cases of infection were registered in the MRI department.

At the same time, Bekshin said that there were violations in the hospital:

“The treatment of infected patients was carried out without permission. The quarantine room for five patients was opened without informing the state authorities. People with pneumonia and acute respiratory viral infections were treated there. There is a CCTV footage, which shows that employees walk around without the necessary protective equipment. All this led to infection of both staff and the patients.

After the doctors’ address to the president, the Minister of Health Yelzhan Birtanov held a meeting on the situation in the Central City Clinical Hospital of Almaty, and talked online with the doctors.

“The hospital employees published an emotional request for compensation payments, where they claimed that they were infected during work from the patients. Due to this, hospital staff demanded compensation. We reviewed each statement from their appeal,” he wrote on his Facebook page.

Following the meeting, the Minister invited colleagues from the city administration and the city’s health department to review once again the order of the Ministry of Labor and Social Protection. This order grants powers to create commissions that would examine the details of payments and allowances for doctors in case of infection at the work and make a final decision.

On March 30, the State Commission for Ensuring State of Emergency under the President of Kazakhstan approved increase of salary for employees countering the coronavirus spread.

Three risk groups were identified, according to which bonuses will be paid. Payments will be made within three months. In case if the healthcare worker is infected with coronavirus, he/she will be paid 2 million tenge ($ 4,765) from the State Social Insurance Fund, and 10 million tenge ($ 23,823) in case of death.

Late Measures

Many doctors refuse to comment on the problems, referring to the ongoing inspection and possible persecution.

On April 8, Tolkynay Ordabaeva, an infectious disease doctor at a district hospital in the Jambyl region of Kazakhstan, who got infected with COVID-19 at work, wrote a Facebook post saying that doctors and nurses do not have personal protective equipment in the Merken district hospital and they sew masks themselves. In addition, there are no PCR tests for coronavirus.

“Jambyl region: regional health department hides the facts of healthcare workers’ infection. The question is, why am I not hospitalized in a separate room and why, at the time of my reception, the epidemiologist and I were not tested with PCR tests of blood and pernasal swab for coronavirus. The question is, where is the money allocated by the regional health department of the Jambyl region for personal protective equipment, masks, antiviral drugs, for rewarding the doctors by category,” wrote Ordabaeva.

The next day, she reported that she found 400 masks in her office that did not belong to her, and expressed concerns that she might be fired.

Raushan Turysbekova, an ophthalmologist at polyclinic No.19 in Almaty, said that since March 26, she, her husband, and other colleagues had been living in the dormitory of the Academy of Civil Aviation, where there were only two ladies’ restrooms and two showers per 110 people. On May 7, Raushan received the result of the PCR test for coronavirus, which was positive.

“The first coronavirus patient in our dormitory was detected on April 24. We were tested on April 25. However, the result, which was negative, was told on the phone, nobody showed it to us. The second test on May 6 turned out to be positive. Police came to send us to the infectious diseases hospital RV-90, where, in addition to coronavirus patients, there were also tuberculosis patients,” the doctor says.

Her husband, radiologist at polyclinic No.19 in Almaty Temirlan Turysbekov added that it was necessary to separate the first coronavirus patient from those who had negative tests as soon as the first case was discovered. Nevertheless, it did not happen.

Kairgali Koneev. Photo: topdoc.me

“We were going to work from here. Some drove their own cars, some used the public transport. We shared shower, toilet and there we go! Disinfection was carried out only two times,” Turysbekov says.

Candidate of Medicine, neurologist Kairgali Koneev notes that Kazakhstan realized the threat of coronavirus too late. Healthcare facilities were divided into infectious hospitals, quarantine and provisional hospitals for the treatment of patients with COVID-19 only on April 1.

“Prior to this, all hospitals continued to accept and treat patients without isolating them from others. Therefore, doctors’ infection was inevitable. Clinic employees were not ordered to wear protective suits. The clinic could not decide whether the doctors should wear personal protective equipment or not, since it could be considered as the spread of panic during emergency,” says Koneev.

This article was prepared as part of the Giving Voice, Driving Change – from the Borderland to the Steppes Project.

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