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By the end of 2021, it is planned to vaccinate up to 6 million Kazakhstanis — Ministry of Healthcare

Tuesday, 19 January 2021, 11:02:18

Prime Minister Askar Mamin held the first session of the government in the updated composition. Minister of Healthcare Alexey Tsoy reported on the sanitary and epidemiological situation in the country.

The coronavirus pandemic has spread to all countries of the world without exception and is characterized by varying intensity depending on the availability of medical care, testing, quarantine measures taken and the population's commitment to measures to prevent the spread of CVI.

As the minister of healthcare informed, to date, more than 95 million cases of CVI have been registered in 220 countries of the world. More than 2 million people have died, the global mortality rate is 2.1%.

In three of the six WHO regions (America, the Western Pacific and Africa), the incidence of the COVID-19 virus continues to grow steadily.

The European and Eastern Mediterranean regions have consistently high incidence rates with no signs of decline. The downward trend is observed only in the countries of South-East Asia.

In terms of the level of incidence of the disease, the Republic of Kazakhstan is in the zone of moderate risk or in the “yellow zone”, where Turkey is also located. In a high risk area, i.e. countries such as Ukraine, the Russian Federation, Belarus, Germany, Italy, France, and the United Arab Emirates are in the "red zone". South Korea and Singapore are in the ‘’green zone.’’

“Since the beginning of the pandemic, 170,098 patients with a positive result of COVID-19 and 46,866 cases with CVI have been registered in Kazakhstan. 154,449 patients with CVI + and 34,656 patients with CVI- recovered. The number of deaths is -2,423 people with CVI + and 542 with CVI-. Including 999 cases of CVI + and 18 cases of CVI- were registered in the last day, 9 of them were fatal,” Tsoy said.

The ministry assesses the epidemiological situation on a daily basis according to the matrix.

So, since the beginning of this year, three regions — Kostanay, Pavlodar regions and the city of Nur-Sultan — have moved from the moderate risk zone to the high risk zone or from the “yellow” to the “red zone”. From the low risk zone to the moderate risk zone or from the “green” to the “yellow zone”, 2 regions have moved: Almaty and Karaganda regions.

Thus, as of Jan. 19, 6 regions are in the “red zone”: Akmola, Atyrau, Kostanay, Pavlodar, North Kazakhstan and the city of Nur-Sultan. There are 3 regions in the "yellow zone": West Kazakhstan, Almaty and Karaganda regions. The remaining 8 regions are located in the "green zone.’’

According to Tsoy, in general in the republic since November there has been an increase in the incidence of CVI, in November compared to October, the incidence increased by 4.5 times, in December compared to November, there is an increase of 1.2 times.

“The trend towards moderate growth persists in January as well, which is a consequence of the population's failure to comply with all preventive measures during the long holidays in December and January. So, for 19 days of January, 14,625 cases of CVI have already been registered. An increase in the incidence is noted in all regions except the East Kazakhstan region,” the minister said.

As of Jan. 19, 2020, the occupancy of infectious and intensive care beds is 32% and 23%, respectively.

According to the monitoring data, the occupancy of the bed capacity is at a controlled level, with the possibility of additional deployment of reserve beds, if necessary, in each region.

Given the epidemiological situation, in a number of regions, measures have been taken to strengthen restrictions aimed at reducing contacts of the population in crowded places, including in Akmola, Kostanay, Pavlodar, Atyrau regions and in the city of Nur-Sultan.

Taking into account the tendency of the virus to mutate, the Ministry on an ongoing basis carries out molecular genetic sequencing of the virus strains isolated in the Republic of Kazakhstan.

The analysis showed that:

  • the investigated samples are genetically close to the strains identified in Germany, Spain, Ukraine, the Russian Federation, the USA and China;
  • symptomatic and asymptomatic forms of the disease, as well as the contagiousness of the virus and the severity of the disease, do not depend on the belonging of the virus to any genetic line;
  • mutations with the highest detection rate have been identified;
  • No "British" strain of coronavirus was detected in the samples studied.

Work in this direction continues. As Tsoy assured, in order to implement the instructions of the Head of State to accelerate the start of vaccination against CVI, the following work is being carried out:

On Jan. 19, 2021, it is planned to sign an agreement between the Karaganda pharmaceutical complex and the Russian Direct Investment Fund for the supply of 20 thousand doses of Sputnik V vaccine;

Jan. 20, 2020, it is planned to issue a permit for a one-time import and send a letter from the Ministry of Healthcare to SK-Pharmacy for the purchase under a special order;

Feb. 1, 2021 — it is planned to start vaccination against CVI of the affected population groups.

Vaccination will be carried out in stages, taking into account the receipt of the vaccine. At the same time, the contingents are distributed as follows:

  • Stage I — medical workers of infectious diseases hospitals, emergency medical care, ICU, PHC, hospital admissions, employees of the Sanitary and Epidemiological Service — 100,000 people — from Feb. 1, 2021;
  • Stage II — teachers of secondary schools, secondary specialized educational institutions, universities, medical workers of departmental medical services — 150 thousand people — from March 2021;
  • Stage III — teachers of boarding schools, preschool institutions, students, people with chronic diseases — 600 thousand people — from April 2021;
  • Stage IV — employees of the Ministry of Internal Affairs, Ministry of Emergency Situations, Ministry of Defense, National Security Committee, medical workers of other hospitals, personnel of preschool institutions and persons with chronic diseases — 600 thousand people — from May 2021;
  • Stage V — the contingent and personnel of medical and social institutions, employees of closed children's institutions and persons with chronic diseases — 600 thousand people from June 2021;
  • Stage VI — the remaining people from the risk group from July to December 2021 — 600 thousand people.

Thus, it is planned to vaccinate up to 6 million Kazakhstanis by the end of the year.

In order to ensure the quality of the vaccine all the way from the manufacturer to the medical organization, the GDP Standard provides for the presence of responsible persons at every stage of the cold chain.

The vaccine supply chain consists of 4 stages:

Stage I — from the manufacturer to the warehouses, where the responsibility for observing the "cold chain" principle lies with the vaccine manufacturer / supplier;

Stage II — from warehouses to pharmacy warehouses, where the responsibility for observing the “cold chain” principle lies with the Single Distributor;

Stage III — from regional health departments to medical organizations in districts and cities, where the responsibility for observing the principle of the "cold chain" lies with regional health departments;

Stage IV — storage in medical organizations.

“To date, a draft Regulation on the storage and transportation of vaccines for the prevention of COVID has been developed for all participants in the cold chain. The vaccine storage containers were verified at each stage of the cold chain. Regions and medical organizations were instructed to ensure the procurement of the missing volume of freezing equipment, thermal containers, thermal indicators and ice packs,” stressed Tsoy.

In order to ensure readiness for the organization and conduct of vaccination against CVI:

  • A draft resolution of the Government of the Republic of Kazakhstan has been developed in terms of including vaccination against CVI in the National Vaccination Schedule;
  • Guidelines for vaccination against CVI have been prepared;
  • A plan for organizing and conducting vaccination against CVI was approved;
  • Jan. 18, 2021, training of specialists of national and regional level was carried out. Online training of specialists of medical organizations is planned from Jan. 20 to Jan. 27, 2021.

At the same time, for the purpose of systematic accounting, an electronic vaccination passport has been developed. Vaccination data will be kept in electronic format in the centralized information system of the Ministry.

It is possible to enter information manually in the m-gov mobile application by the patient and the healthcare professional in the web application. The system is able to integrate with global information systems and will allow all vaccinated persons to provide information at the place of demand and for free movement.

Taking into account the deterioration of the epidemiological situation, as well as in order to ensure readiness for vaccination against CVI, it is necessary: ​

1. Akims of regions, cities of republican significance:

  • to immediately introduce restrictive measures depending on the zone of epidemiological risk;
  • to strengthen the work of monitoring groups;
  • to ensure the readiness of medical organizations to start vaccination against CVI from Feb. 1, 2021;
  • to complete the purchase of refrigeration equipment and thermo-containers for storing and transporting vaccines against CVI;
  • to provide training on vaccination from CVI to all professionals involved in the vaccination process;

2. The ministries of finance and justice, local executive bodies, within one day, should agree on a draft resolution of the Government of the Republic of Kazakhstan regulating the inclusion of vaccination against CVI in the National vaccination calendar;

3. The Ministry of Healthcare must ensure preliminary control of the readiness of vaccination points in all regions for vaccination against CVI;

4. The Ministry of Information and Social Development should provide information and explanatory work on the prevention of CVI, including vaccination of the population.

The working group of the Ministry of Healthcare has drawn up a forecast for the development of the epidemiological situation until the end of 2021, while maintaining the current restrictive measures, including mandatory mask regime, observance of social distance and expected vaccination.

“The probable peak of registration of cases is possible already at the end of March 2021. According to the optimistic scenario, it is expected to register up to 3 thousand cases per day, and the maximum occupancy of the bed capacity may reach 24 thousand beds. Nevertheless, the introduction of strict quarantine measures under this scenario is not planned,” Tsoy said.

Under realistic and pessimistic scenarios, daily registration can reach up to 6 and 9 thousand cases, respectively, and the occupancy of the bed fund will be up to 45 thousand beds, that is, it will not exceed 52 thousand beds that are available for patients with CVI, but will lead to the need to introduce rigid quarantine measures to avoid overloading the health care system and ensuring quality health care.

Vaccination of 2 million people at the first stage will have a positive impact on the development of the epidemic, which will be limited by the time required to develop immunity after vaccination, the impossibility of simultaneously vaccinating a large number of the population.

“According to our calculations, vaccination of 2 million people will reduce the number of registered cases by 40 thousand. Accordingly, the greater the vaccination coverage, the lower the morbidity and mortality from CVI and the higher the likelihood of returning to life without restrictive measures and lockdowns. At this stage in the development of the pandemic, the whole world realized that the only alternative to self-isolation and quarantine is vaccination,” Tsoy concluded.

Minister of Information and Public Development Aida Balayeva reported that information and explanatory work on the topic of coronavirus has been strengthened in a number of regions.

In particular, last week, in comparison with the previous one, the number of information materials published through all tools increased by 27%. The number of TV spots, printed materials, Internet materials released since the beginning of the year amounted to about 6 thousand. In order to inform the population, the coronavirus2020.kz website was launched. Currently, more than 80 thousand users visit the site daily and receive relevant information.

Akim of Pavlodar region Abylkair Skakov said that 616 cases of CVI were registered in Pavlodar region last week. The increase in the incidence was 5.8%. Over the past day, 155 cases have been identified. 396 contacts identified. Epidemiological investigations were carried out in all household foci and new foci were localized.

“The regional health care system is operating normally. The occupancy rate of infectious beds is 37.7%. A total of 1,635 beds are now deployed. There are 2,168 more in reserve. There are 21 patients in intensive care, 3 of whom are in critical condition,” said Skakov.

169 mobile brigades work in the region. Up to 2,520 PCR studies are carried out per day. The situation is under control.

In connection with the entry of the region into the red zone, restrictive measures have been strengthened. Thus, a weekend lockdown was introduced: on weekends, the activity of food and non-food indoor markets, shopping and entertainment centers, spa centers, saunas, sports facilities, sports complexes, fitness centers, and public transport were suspended. The movement of intercity, interdistrict bus, minibus passenger regular transportation has been suspended. 176 monitoring groups are working in intensive mode, paying special attention to crowded places.

All medical and social institutions have switched to a round-the-clock stay of personnel with complete isolation and the exclusion of all contacts from outside.

There is a unified information and analytical center for covid infection for the prompt localization of foci of infection, control of contact persons. A single contact center operates 24/7 to inform residents of the region about the epidemiological situation and related issues.

At the end of the report, Skakov noted that the work continues in all directions and is under special control.

Akim of Akmola region Yermek Marzhikpayev, in turn, reported that work is also underway in Akmola region to stabilize the epidemiological situation.

In total, over the past week, the average increase in incidence was 0.8%, over the last day — 1.2% or 99 cases. 526 people are receiving treatment in hospitals, of which 41 are in serious condition.

All necessary measures are being taken to prevent an increase in morbidity and tighten quarantine measures.

“The mode of operation of non-food stores, shopping and entertainment centers is limited from 10 a.m. to 10 p.m. with occupancy rate of 30%, the activity of public catering facilities is from 9 a.m. to 8 p.m.,’' Marzhikpayev said.

Since the beginning of the year, monitoring groups have conducted 346 raids, covering 1,212 objects.

Last week, the number of beds in infectious diseases hospitals, including in the countryside, was increased. Resuscitation beds are 100% equipped. Today there are 6 laboratories, integrated with the Single portal of the National Center for Expertise. From 1,700 to 2,000 tests are carried out per day. If necessary, the reserve capacity of the laboratories will allow up to 7 thousand tests. Measures for the activities of primary medical and social care organizations have been strengthened. 18 polyclinics already in the new year are additionally provided with 37 units of vehicles to serve the population with mobile teams.

“Preparatory work is being carried out to vaccinate the population. There are 2 freezers to store 100,000 doses of Sputnik V vaccines, and 4 more are being purchased. In addition, 38 thermal containers, 19 temperature recorders, 2 refrigerated trucks will be purchased in accordance with the cold chain,” Akmola region’s akim said.

The created 2-month stock of medicines is used as needed and replenished on-line. The order of free provision of medicines has been brought to the attention of the population and amounts to 98.7%. To date, 90 items of medicines have been shipped to the amount of 61 million tenge, by the end of January the cargo for the remaining 180 million tenge will arrive. For the additional purchase of drugs in demand, the regional stabilization fund provides for 500 million tenge.

The epidemiological situation in the region is under special control.

Akim of Kostanay region Archimed Mukhambetov said that 8,672 cases of COVID-19 have been registered in the region since the beginning of the pandemic. Currently, 1,096 inpatient beds are deployed, the workload is 39.5%. If necessary, the number can be increased to 3 thousand beds.

“Since Jan. 18, 2021, due to the increase in morbidity, quarantine measures have been tightened for a period of 2 weeks. So, some changes have been made to the Resolution of the chief sanitary doctor of the region. The activities of religious sites have been suspended. The work of public catering facilities and public service centers is limited. The activities on Saturday and Sunday of non-food trade facilities, with an area of ​​more than 2,000 sq. m, indoor food and non-food markets, saunas, spa centers, indoor sports facilities, including fitness centers, as well as public transport have been suspended,” Mukhambetov said.

With the aim of monitoring compliance with quarantine measures, monitoring groups have carried out 942 raids since the beginning of the year, inspections have covered 2,823 objects, and 26 violations have been identified. Based on these facts, 26 administrative fines were issued.

In order to provide pharmacies with medicines, the stabilization fund was increased to 538 million tenge.

Preparations are under way for mass vaccination against coronavirus infection. Competitive procedures for the purchase of 72 units of medical freezers are nearing completion. The delivery of the first batch will begin on February 10 of this year. In the region's pharmacies and hospitals there is a minimum two-month supply of medicines and personal protective equipment.

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