Traditionally, capital cities tend to be wealthier and more prepared for unexpected situations that require financial and human resources, like the coronavirus pandemic.
Ukraine has 24 regions and, according to the latest data, 2,777 confirmed COVID-19 cases. But this number has been growing since the first confirmed case on March 3. The peak for the disease in Ukraine is predicted to happen in mid-April.
If things continue to head north fast, are Ukrainian infectious disease hospitals ready for mass hospitalization and do they have sufficient equipment?
Hromadske requested official statistics from health departments, as well as gathered the opinions of doctors, from nine regions.
Official statistics: There are two infectious disease hospitals in the Ivano-Frankivsk region.
Ivano-Frankivsk's regional districts and "developed" cities (i.e. cities with a population of over 50,000 and developed culture and economy), have infectious wards with 405 beds. There are 112 ventilators in the region, and 5,000 rapid tests have been obtained so far.
Volodymyr Kyforuk, Chief Doctor of Kolomyia Infectious Disease Hospital:
There were problems with medicines, with foodstuffs. But now there are absolutely no problems. Entrepreneurs, the city council, the district council, and the united communities have brought us so much that it would be enough for half a year. We have gasoline, medicines, everything.
During a session at the Kolomyia City Council, the previous decision to liquidate the Kolomyia District Hospital was cancelled.
There are suspected patients. Some returned from abroad, some are in the risk groups. They’re admitted to our hospital. All the quarantine measures are taken.
I do not see organizational problems. We already have masks, rapid tests are in transit, Ivano-Frankivsk has them already. There are no protective clothing yet, but funds have been allocated – suits, masks, helmets, and respirators have been ordered in Kyiv. There is simply a shortage of the product itself. I think in a day or two we will have them.
We already have an X-ray machine, which we never had before. We were helped with [obtaining] ventilators.
There is no panic, there is alertness. But this trouble affect the whole world.
Nurse in protective suit in the Ivano-Frankivsk Regional Clinical Infectious Disease Hospital, February 26, 2020. Photo: Kashuba Taras / UNIAN
Official statistics: There are no infectious hospitals in the region, there are 15 infectious wards with 410 beds in city and district hospitals. The region has 137 ventilators and 4,727 coronavirus tests.
Yaroslav Chaikivskyi, Director of Ternopil City Municipal Emergency Hospital, Honored Doctor of Ukraine:
Patients with confirmed diagnoses of COVID-19 have been in the infectious ward. We have everything we need. There are PPE for approximately 30 days, some products for a longer term, and overalls for 20-25 days provided that we have 20-30 patients in the infectious ward.
We search and purchase everyday, the warehouse is regularly refilled, but it is impossible to buy anything on the Ukrainian market now due to the deficit. So we look for other suppliers and place orders. Suppliers are not very interested in working with the government establishments – everyone would like to have a prepayment, and we cannot do it, so we beg people [to help]. The city council is allocating quite big funds, but we have a very tricky situation both with clothes and with medical equipment.
As of today, we have eight mid-range and expert class ventilators. Of course, there are many more devices available, but domestically produced apparatuses are not good enough for treatment of patients with COVID-19-caused pneumonia. In addition, we have already ordered more than 10 apparatuses funded by the city council. We've made preliminary arrangements and are expecting more than 10 devices from abroad.
We have 114 rapid tests as of today, but we are a medical institution, we do not have an outpatient service, we only have a hospital service. When a patient is admitted, he or she either has already been tested, or we use a laboratory method.
But we have a staffing problem with regard to mid-level and junior staff. Eight workers have quit last week – three nurses and five junior nursing staff. And I think more people will quit.
We are now resolving employment issues with the local government. In addition, the city authorities took care of the motivation. We have paid workers bonus payments in the size of one month salary, and next month, all workers who are treating COVID-19 patients will be paid extra 10,000 hryvnia ($366). We also have hope in the central government – they promised that doctors will receive bonuses.
There is fear, risk. With a monthly salary of 4,000-5,000 hryvnia ($150-185), people do not want to endanger themselves and their family. There are people of retirement age, some have chronic illnesses, some live far from the city center while transport issues are not resolved.
Official statistics: There is one infectious disease hospital with 300 beds in the region; 10 ventilators. As of March 30, the hospital received 2,000 coronavirus tests.
Ihor Bernyk, Deputy Chief Doctor of the Lviv Infectious Disease Hospital:
We currently have about 40 patients with suspected coronavirus infections who are awaiting results.
The hospital has all the necessary special equipment, antibiotics, solutions, all the medical equipment. The only thing we do not know yet is how many patients in serious or very serious condition to expect. Our hospital is designed for 300 such patients.
We initially had six beds in the department of infectious therapy, but now we have 10 and plan to expand to 16. All the beds in intensive care are provided with oxygen supply mechanisms.
We have PPE: suits, respirator masks, goggles, masks, protective pajamas. We have ventilators. There are currently 10 of them, but we have some arrangements for additional supply because, if we are going to operate continuously, breakdowns may occur.
Our staff are ready to do their job. We did not invite students and haven't planned on doing so.
Medical worker checks the body temperature of the emergency doctors who are delivering the patient to the ward in Lviv, Ukraine, March 26, 2020. Photo: EPA-EFE / MARKIIAN LYSEIKO
Official statistics: There are two infectious disease hospitals in the region – in Dnipro and Kryvyi Rih. The number of ventilators and tests is unknown.
Tetiana Boyarova, Acting Chief Nurse of City Hospital №21 in Dnipro:
We have enough of everything right now because there is no influx, plus there are daily deliveries of personal protective equipment, antiseptics, ventilators, masks, and oxygen concentrators.
In total, the hospital can accommodate 180 people. In the event of an outbreak – up to 250.
We also have tests. There are at least 200 of them, if not more, but we still do not have that many patients with suspicion. Now all those suspected are immediately examined, and then if necessary, we do rapid tests. There are currently no more than 20 people like this.
Official statistics: There are two infectious disease hospitals in the Kharkiv region with 470 beds; if necessary, another 50 beds can be added. There are 19 ventilators in infectious disease hospitals.
Yulia Tanchuk, Head of the Medical-Diagnostic Department №1 of Kharkiv Regional Clinical Infectious Disease Hospital:
We work regularly. We have 126 patients now, no more than usually. None with suspected or confirmed coronavirus infections.
We have enough equipment and medicines, we are ready for work. There is no panic, we have doctors who worked through the flu in 2009-2010, so all is well. And if necessary, we can accommodate up to 240 people.
Nurse of Kharkiv Regional Infectious Disease Hospital in a protective suit near the hospital, March 31, 2020. Photo: Marienko Andrey / UNIAN
Official statistics: There are 14 infectious wards in the city and district hospitals of the region. The total number of beds is 338. The wards have 33 infectious disease doctors. The hospitals have 166 ventilators and 5,000 tests.
Eduard Kravchenko, Chief Doctor of the Rubizhne Central City Hospital:
We do not have enough breathing equipment – respirators, oxygen concentrators. And those present have been in use for a long time and had been continuously repaired.
There are 30 beds in the infectious ward. We can also place 20 more.
In our hospital, there are four ventilators in the anaesthesiology and intensive care wards. Another was presented to us at the end of last week. This is a high-end machine, others are worn out. We need at least another five ventilators.
Olha Martynenko, Head of the Rubizhne Central City Hospital Infection Department:
There were 10 people with suspected COVID-19 in March. Five suspicions were not confirmed. One patient has a laboratory-confirmed diagnosis. Three [other] people have the first results negative, we are waiting for the seconds results. And another woman was admitted recently. Her first test was sent to Kyiv. All patients are in moderate condition.
The staff of the infectious ward fulfills all its duties, none of us have quit.
We received 750 tests for coronavirus antibodies, which a person develops after 7-10 days of infection.
Halyna Horbachenko, Chief Doctor of Starobilsk Regional Territorial Medical Association:
Our infectious ward is designed for 30 beds, and now we have 10 additional beds. We are the reserve institution of the Rubizhne Clinical Hospital – if there are no beds for patients there, they will be admitted to Starobilsk.
We have 11 ventilators. We have made an advance payment for two more devices, which should be delivered by April 15.
There were no patients with suspected [COVID-19]. We have 300 rapid tests. The tests were ordered using the district's budget. We have already spent over 1 million hryvnia ($36,838) on personal protection equipment for staff, tests and medicines to treat COVID-19.
Official statistics: There are five hospitals for COVID-19 patients in the region. The number of ventilators and tests is unknown.
Volodymyr Shynkarenko, director of the Infectious Disease Hospital of Zaporizhzhia region:
We ordered respirators, [protective] suits – people kindly helped us. We do not use rapid tests. And ordinary citizens should not have picnics and hang out with each other. Because here we are, standing on the edge, and they are "feasting in time of plague" (a reference to Aleksandr Pushkin's play -ed.).
The transport issue will probably never get addressed due to complex logistics: a lot of our staff live in villages, it is difficult for them to commute, and when they manage to, the question is whether to go back with the risk of infecting their relatives.
Salaries did not increase. Are people quitting? You understand that with such salaries not only can I not keep people, but I have no right to persuade them.
America wasn't ready, too, so what are we talking about? The capacity of the hospital to date is 280 beds. We have four ventilators, plus the city of Zaporizhzhia is lending us at least another four. So we are ready for the first feat. But what will happen next, I do not know.
Medical Training for Prevention of Viral Infections in Zaporizhzhya, March 4, 2020. Photo: Oleksandr Prylepa / UNIAN
Official statistics: There are seven hospitals for patients with COVID-19 in the region. In total, they have 2,105 beds and 48 ventilators,
Employees of the Odesa Regional Clinical Medical Center recorded a video, in which they said that the official data from the National Health Service of Ukraine was untrue and overstated. According to them, they have only six, not 19 anaesthesiologists. The statistics also indicates 10 ventilators, but, in fact, medical workers say the hospital has six, three of which have only recently been donated by philanthropists.
“Our hospital is in no way adapted for treating patients with infectious diseases. We don't even have a division into conditionally clean and dirty areas, let alone isolation rooms. We've been addressing the chief doctor with these issues for a week, but did not receive any answers. On Friday, we had a visit from an epidemiologist who stated that we are not ready. There was an answer from the chief doctor that he was prepared for losses. We, however, did not understand the loss of whom: us, doctors, or people who will be admitted here,” stated the doctors.
Official statistics: There are 10 medical institutions in the Kherson region for the treatment of patients with COVID-19 that have 499 beds. The number of ventilators is 172 for adults and 21 for children, all in working condition. Another 25 machines are to be bought. As of March 24, the region received 5,000 tests.
Volodymyr Mitkovskyi, Director of Kherson Regional Infectious Disease Hospital:
In case of simultaneous mass admission of patients, we are provided with means of personal protection for medical staff, medicines, and oxygen for 15 days. We have 9 beds in the intensive care ward and 25 specialized beds in the ward №2 to provide emergency care for patients in serious condition.
As of today, we had one patient with a suspected coronavirus infection, but a laboratory test did not confirm it. The patient is treated as per standard procedures.
The hospital has seven ventilators, oxygen concentrators, and we are waiting for additional equipment. We are provided with the medicines needed for treatment, according to the Health Ministry protocols. We received the ministry’s decree on the algorithm of inpatient treatment of patients with coronavirus who are in critical condition. That is, we know what to do and are ready to provide qualified treatment.
The costs the hospital has now are sufficient to purchase additional personal protective equipment for medical staff and medicines if needed. From the reserve fund of the regional budget for the needs of the hospital, we received 649,000 hryvnia ($23,908), and we have 333,000 hryvnia left after recent purchases.
The hospital can have extra beds – there are 29 isolation rooms with separate entrances, where 82 people can be hospitalized.
/By Victoria Roshchina
/Translated by Vladyslav Kudryk
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