2. Ensuring sufficient physical infrastructure and workforce capacity
ENSURING SUFFICIENT PHYSICAL INFRASTRUCTURE AND WORKFORCE CAPACITY is crucial for dealing with the COVID-19 outbreak, as there may be both a surge in demand and a decreased availability of health workers. The section considers the physical infrastructure available in a country and where there are shortages, it describes any measures being implemented or planned to address them. It also considers the health workforce, including what countries are doing to maintain or enhance capacity, the responsibilities and skill-mix of the workforce, and any initiatives to train or otherwise support health workers.
2.1 Physical infrastructure
The initial availability of medical equipment (e.g. ventilators) was reported as 393 items; no stocks of pharmaceuticals or medical supplies have been created, but the business entities have been told to be prepared for an increasing demand for some pharmaceuticals and personal protective equipment (PPE).
A Government Decree has been developed and communicated to the private sector on the introduction of a waiver from market authorization for medicines listed in the national essential medicines list which has been enforced on 25 March 2020.
A shortage of protective equipment and medical supplies has been reported in the local media. The shortage mostly has been observed with regard to PPE (mostly masks, gloves), pharmaceuticals (paracetamol containing medicines) and some antibiotics. To mitigate the effects, the Ministry of Health issued orders on 17 and 31 March 2020 to achieve a re-orientation of existing hospital resources to manage COVID-19 patients.
In order to increase testing capacity, several additional laboratories, such as the laboratory of the National Phthisiology Centre, the AIDS centre, the disease prevention, sanitation and epidemiology centre, as well as a chain of private laboratories were engaged.
The Ministry of Health decree No. 179 of 21 March 2020 endorsed a list of pharmaceuticals, laboratory equipment and medical devices required for diagnostics and treatment of COVID-19. The list also includes PPE items and medical equipment, including ventilators.
Under the leadership and coordination of the UN Resident Coordinator and the UN Disaster Response Coordination Unit (DRCU), all UN agencies will provide substantial support during the implementation phase (see the section on Health Financing).
A number of hospitals were repurposed to receive patients with pneumonia.
A new hospital from quickly erectable structures is ongoing on the territory of the National Infectious Diseases Hospital. The National Infectious Diseases Hospital is designed for 400 beds, most of them in the pediatric department. “Since the coronavirus outbreak, 204 beds were prepared for patients with COVID-19 and a dormitory for hospital workers was prepared. During the peak of cases, we had to admit up to 260 patients and put beds in hospital corridors," Hospital Chief Gulzhigit Aliev told AKIpress. The new hospital building will have oxygen supply for all beds. 30 beds will be intensive care units, 15 of them will be isolated wards.
7 computer tomographs will be purchased from the World Bank's funding. The tender will be announced. They will be installed in 7 regions of the country with training of specialists provided by the end of September. 7 X-ray machines will be brought on August 24. Another 12 X-ray machines will arrive from South Korea as humanitarian aid. 38 machines will be purchased using the funds saved under various projects. The regions will be provided with computer tomographs and X-ray machines by autumn 2020.