Policy responses for Ukraine - HSRM


Policy responses for Ukraine

1.5 Testing

Family doctors or healthcare facilities (PHC or hospital) should refer all suspected cases that meet the national case definition (see Section 1.4 Monitoring and Surveillance) to the Oblast Laboratory Center (OLC) in the respective territory. Testing is largely conducted by the OLCs with a number of samples tested by private laboratories, laboratories in hospitals, HIV laboratories and laboratories in veterinary sector. As of 09 October, the proportion of lab.testing conducted by state laboratories compare to private once is 65,48% to 34,52%. No new laboratory structures have been set up so far, but numbers of OLCs facilities had been renovated. In July 69 laboratories were involved in COVID-19 PCR testing (excluding those which processed less than 100 samples since the beginning of the outbreak) and the number increased by 89 in September and 96 in November. From the beginning of the epidemic in Ukraine the testing capacity evolved from 200 tests per day up to 32,000 as of 07 October and 49 323 as of 26 November. By the end 2020 the MOH plans to increase the number of PCR tests to 75,000. On 27 October the Minister announced that healthcare workers should consider the symptoms and disease patterns for the hospitalization of a patient, as passing a PCR-test is not the only requirement, due to 30% of PCR-tests showing false results.

By 27 November , there were 4 349 370 conducted PCR-tests – amoung those 893 463 (20.43%) positive. The OLCs use RT-PCR and ELISA assays for diagnostic and screening purposes, and reconfirmation of all positive ELISA tests are done using RT-PCR. There is a COVID-19 National Reference Laboratory established in Ukraine, based at the Virology Laboratory of Ukraine Public Health Centre (UPHC), Kyiv. All OLCs are equipped with one to three thermo cyclers, and 25 new RT-PCR thermovcyclers have been procured. Furthermore, new semi-automatic extraction equipment is currently being installed at the Ukrainian Public Health Centre and six other OLCs, and seven more are to be installed.

Eight OLCs also have Especially Dangerous Pathogen Laboratories equipped with PCR. Apart from OLCs, there are six PCR laboratories at the Ministry of Defence, 13 in the veterinary system, one in the Ministry of Interior, and also a number of municipal hospitals and academic institutions have laboratories. The majority of those laboratories are currently not involved in testing for COVID-19, but on 22 May the National Emergency Commission took a decision to engage the laboratory network of the State Service of Food Safety and Consumers Protection to the PCR testing.  

As of 14 April 2020, PCR detection of SARS-COV-2 was conducted by all 25 OLCs with the maximum capacity to test around 14 000 samples per day. The 25 OLCs had around 400 000 SARS-COV-2 tests in stock. Since 27 January, when PCR testing for COVID-19 began, as of 09 October there were over 2,4 mln samples tested in Ukraine (which is 57,74 per 1000 population) by at least 89 laboratories, including private ones. The time to receive the results ranges from 2 to 5 days depending on the oblast (region).

All tests are conducted on a commercial basis with a mandatory notification on the results to public health institutions.
As of 23 April according to the MOH Order # 953, the healthcare workers who engaged in treatment COVID-patients required to undergo regular PCR testing every fifth day.
On 20 May, the MOH introduced amendments to the national COVID-19 guidance (MOH Order # 722 as of 28 March 2020) and supplemented tasting strategy with ELISA testing.

Additionally, to monitor laboratory capacity, WHO has developed an appropriate form and, together with the Ministry of Health, initiated the collection of relevant information for the purpose of qualitative and quantitative resource planning and calculation of needs for supplies. In partnership with the national authorities and international partners (WHO, US CDC, UNICEF) the scaling up testing capacity strategy and the implementation action plan were developed and endorced by MOH.
In September, the UPHC launched online course in laboratory diagnostics, which includes basic theoretical concepts and general laboratory molecular biological methods required for the use of PCR for the diagnosis of infectious diseases and biomonitoring. The course materials developed by an international expert, virologist, Dr. Christian Lange (Metabiota, USA), within the Biological Threat Reduction Program in Ukraine with the support of the US Department of Defense Threat Reduction Agency.

Within the frame of WHO technical support to the national laboratories a series of on-line weekly workshops on laboratory biosafety and biosecurity conducted, particularly on “Biosafety cabinets operation”, “Personal protective equipment”, “Disinfection and decontamination”, and “Good microbiological practices”. Also WHO provided numbers of on-site trainings on the laboratory biosafety and real-time PCR.
Addressing the request for the technical support from the Office of the President of Ukraine and MOH, in close contact with OLCs, UPHC, and the Expert Centre of the National Medical Academy of Postgraduate Education, following the large procurement of the laboratory equipment, reagents, and consumables for more than four million US dollars (donor support of the European Union), WHO continues supporting the delivery of the laboratory goods to 27 laboratories in OLCs across Ukraine.

As of 26 November, the option to call for a testing mobile team through the nationwide COVID-19 contact center of the Ministry of Health started to work in a pilot mode.