Kazakhstan has overcome the critical situation in July caused by the outbreak of Covid-19. At the height of July, hospitals were overcrowded, ambulance services were overwhelmed by telephones calls from citizens, and there was a general turmoil at overcrowded hospitals. However, coordinated action enabled Kazakhstan to overcome the epidemiological crisis and take health care under control. To date, 92,662 coronavirus cases have been registered in Kazakhstan, around 69% of which have recovered. The workload of hospitals has dropped to 36%, and the increase in morbidity does not exceed 1.2% per day.
On the recommendation of the World Health Organization, since August 1, Kazakhstan has been publishing the combined statistics of those infected with Covid-19 and those suffering from pneumonia caused by the new coronavirus. It took about two weeks to combine the statistics, as the Ministry of Health developed new coding algorithms, regulated the information system, and most importantly, trained medical staff to identify the symptoms of coronavirus pneumonia. Such a laborious process is due to the incredible complexity of defining the disease. Often, PCR tests of patients with coronavirus pneumonia give a negative result, which means further diagnosis becomes much more difficult. In particular, thanks to the new counting system, any misinformation and groundless statements that could serve as a pretext for misinforming the population have disappeared. The authorities aim to provide comprehensive coverage of Covid-19 in order to provide timely and high-quality care to the population and to avoid the spread of non-traditional methods of self-medication.
Fighting ahead of the curve – this is how the current situation in the country can be characterized. The Ministry of Health, in close collaboration with a number of other departments, is carrying out painstaking work to ensure epidemiological stability. Taking into account the annual increase in acute respiratory viral infection and influenza diseases in the autumn-winter period, the Ministry of Health of Kazakhstan is intensively preparing for a similar scenario. In this regard, vaccinations are planned against influenza. Literally all the country’s resources are devoted to preparing for the autumn period. The available beds and those that are in reserve are equipped with everything necessary and are fully ready to accept patients. Stocks are replenished for PCR testing. Medicines are being purchased for stockpiling in the retail sector and in warehouses. Much attention is paid to providing medical organizations with supplies of personal protective equipment in all corners of the country. The Ministry of Health has also revised a number of mechanisms to provide quality and timely medical care to citizens in need. In order to provide comprehensive medical care to the population, for patients with coronavirus-like pneumonia, Covid-19 treatment regimens are being prepared for subsequent transferral to health care facilities. In addition, the list of drugs has been expanded to five names, which are recommended to be used during the early treatment of such types of pneumonia and coronavirus. Absolutely all regions of the country are carrying out in an enhanced capacity the purchase of ventilators and oxygen concentrates.
In order to stabilize and prepare for the possible next wave of Covid-19, the Ministry of Health has increased the bed capacity from 30,400 to 49,700. In order to provide timely medical care at home at the outpatient level, 2,962 units of mobile teams have been created at primary health care units. It is planned to increase the number of mobile brigades to 3,500. Furthermore, the number of call-centres have increased by 16% in order to provide timely advice and receive calls at clinics.
According to the latest data, there are about 1,958 ventilators available in infectious-related and provisional hospitals. It is planned to additionally purchase around 4,183 units of equipment, as well as connect approximately 21,000 beds to oxygen and 6,237 points to oxygen concentrates. At the moment, the laboratories are capable of producing 32,000 PCR tests per day; by the beginning of September, research capacity will be increased to 64,000 per day.
The procurement of medicines, sufficient to provide effective medical care both in clinics and at home, is also under control. The government has instructed SK-Pharmacia LLP to purchase medicines for a two-month supply. This takes into account the need to supply drugs to be sold through retail to the population for home treatment.
In order to provide medical care in due time in the regions, the Ministry of Health also took into consideration the necessary level of medical care. To provide outpatient care in the countryside, 1,493 mobile teams have been created and are already operating, which essentially covers 94% of the overall need. 641 ambulances are being used to provide medical care. According to the order of the government, local government offices and ministries of health and industry are obliged to provide the regions with the necessary number of ventilators by the end of August.
A number of ministries have also received important instructions in the framework of equipping the regions with effective medical care. The ministries of industry, health and finance should urgently resolve the issue of equipping the regions with mobile diagnostic equipment, and transfer digital X-ray machines of domestic production to regional hospitals. Local government offices and the Ministry of Health, as before, are responsible for the timely delivery of oxygen concentrators and medical gases to all parts of the country.
The initiatives taken by the Government also include a number of important measures aimed at a rapid response in the regions. For example, the Ministry of Health and local government offices have been instructed to organize the work of PCR testing in the regions on the basis of veterinary laboratories and, accordingly, to staff the newly-established points with the personnel necessary for work. Local government offices, in turn, have been instructed to be responsible for organizing efficient logistics for the delivery of tests to new laboratories in the regions.
To date, the situation has stabilized in a number of regions. The best indicators for the epidemiological situation have been found in the West Kazakhstan, Almaty, Turkestan, Kostanay, Akmola and Mangistau regions. An equally encouraging situation is developing in the capital of Kazakhstan – around 73% have recovered in Nur-Sultan. The number of ambulance calls regarding Covid-19 in the capital has decreased by 10 times. If earlier there were about 500 calls per day due to the coronavirus, then today there are around 50 calls. The main task of health care at the moment is to maintain the current trend, since due to the establishment of quarantine measures, the peak of the infectiousness has passed. Moreover, the current lockdown is fundamentally different from the one in spring. Taking into account the experience of other countries, the government of Kazakhstan introduced a number of exemptions for the population during the quarantine, including permission to walk in small groups, exercise outside and visit cafés and restaurants that operate outside.
The government has repeatedly noted the need not only to continue intensive work to treat infected citizens, but also to conduct an awareness campaign among citizens aimed at observing sanitary standards and established quarantine requirements. According to the warnings of the Prime Minister of Kazakhstan, Askar Mamin, the alarming situation in the world still persists and a surge in Covid-19 infections has been recorded in about 126 countries. In accordance with the current global epidemiological map and taking into account the approaching autumn-winter period, Kazakhstan is taking all possible measures to prepare for a potential new wave of diseases and is preparing a set of preventive measures. Despite the fact that the Ministry of Health has developed a Plan for the phased lifting of quarantine measures, the government also notes that in case of signs of a worsening epidemiological situation, additional restrictive measures may be taken.
Together with the aforementioned measures, the Ministry of Health is also actively working on the production of a Kazakh vaccine against Covid-19. The whole world is striving to develop a vaccine and Kazakh scientists are also keeping up with their international colleagues. At this stage, the Kazakh vaccine has successfully passed preclinical trials in mice, pigs and macaques. Moreover, a number of researchers from the Biological Safety Research Institute have volunteered to test the vaccine on themselves. To date, five volunteers who have injected themselves with the vaccine do not have any alarming symptoms, such as allergies, fever, or general deterioration in well-being. Pre-clinical trials are coming to an end on August 20, after which the data obtained will be handed to the Ministry of Health.
The Ministry of Health has selected 44 volunteers who were not previously infected with Covid-19 and therefore do not possess antibodies. In September, with the permission of the Ministry of Health, the first stage of human clinical trials will be launched. The second phase of the trials will involve testing the vaccine on more people. About 200 people have volunteered to retest the vaccine between October and December of this year. These studies are planned to be carried out at the Almaty clinics. The next step on the road to vaccinating citizens against the threat of Covid-19 will be the establishment of a manufacturing factory for the production of immunobiological drugs at the Research Institute of Biological Safety in the Zhambyl region. Thanks to this factory, up to 60 million doses of vaccines will appear on the domestic market annually.
At the same time, Kazakhstan is not relying solely on the creation of its own vaccine. According to the meeting of the Interdepartmental Commission, the Ministries of Health and Foreign Affairs are actively involved in concluding preliminary contracts for the purchase of a Covid-19 vaccine. At the moment, the departments are establishing the groups of people to be vaccinated, calculating the likely financial costs and calculating the possibility of Kazakhstan’s participation in the COVAX Facility program. Participation in this program provides the opportunity to gain access to a range of potential vaccines for Covid-19.
Summing up, it is safe to say that the epidemiological situation in Kazakhstan has stabilized. The acute period has passed and now the leadership of Kazakhstan is aiming to maintain the won positions and further strengthen the health care system.
