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  • Report of the Belarusian Medical Solidarity Foundation on the situation with COVID-19 in Belarus

    October 27, 2021

    On October 26, Sviatlana Tsikhanouskaya's Office, National Anti-Crisis Management, Coordination Council, and Belarusian Medical Solidarity Foundation sent a letter to the EU leadership, EU Member States and COVAX leadership with an appeal to urgently provide assistance to Belarus in the amount of at least a million doses of vaccines. Leaders of Belarusian democratic forces issued a joint appeal, where they called to accept the help of the international community and offered a tool that would help a million of Belarusians.

    Representatives of the BMSF prepared a report on the current situation with COVID-19 in Belarus and how the regime is aggravating the situation. This report became the basis for the letter sent by the democratic forces to the European Commission.

    Full text of the report:

    1. Morbidity and mortality.

    The Ministry of Health officially reports about 2,000 new cases and 15 deaths in the country daily. Other evidence, received by the Belarusian Medical Solidarity Foundation from doctors working in infectious disease departments and other specialists, suggests that in Minsk alone, about 4,000 new cases are reported daily based on positive PCR tests identifying SARS-CoV2 RNA. In addition to that, the diagnosis of COVID-19 is made according to other criteria, e.g. a positive SARS-CoV2 antigen test or a typical CAT scan of lung lesions, as well as clinical manifestations. Moreover, only people with symptoms are eligible for laboratory testing for COVID-19. Thus, the real number of infected people in Belarus exceeds the official figures by dozens of times.

    Doctors also report that between 5 and 15 patients die every day in each hospital repurposed for COVID-19 in Minsk. This suggests that the official COVID-19-caused death statistics are underestimated by more than 10 times.

    2. Testing.

    At present, laboratory testing for COVID-19 is available for level 1 contacts with clinical manifestations; the rest are not included in the statistics. Recently, the SARS-CoV2 antigen has become the preferred method of rapid testing. This approach reduces testing time, but also reduces efficiency, as the rapid test has lower sensitivity and specificity than PCR, which can lead to false-negative results and facilitate the spread of infection.

    3. Vaccination.

    To date, Belarusian authorities reported that 28% of the population has received the first dose of vaccine, and 20% have been fully vaccinated. Clearly, this rate is not sufficient to provide population-based immunity (herd immunity) capable of halting the spread of the virus in the population and protecting vulnerable unvaccinated people from infection. In addition, some of the fully vaccinated people received their 2nd dose 6 months ago or earlier. Thus, it is likely that their immunity strength has already declined by this time and they should consider revaccination in the near future.

    Two vaccines are available in Belarus: Sputnik V (Gam-COVID-Vac) and VeroCell (Sinopharm). Due to the inconsistency of the authorities in their attitude to the coronavirus epidemic, underestimation of the danger of the disease, lack of available information, and discrediting of the Russian vaccine, the confidence in vaccination among many Belarusians is unfortunately undermined. The main reason why Belarusians do not vaccinate is the reluctance to use the two vaccines available in Belarus. If vaccines from other manufacturers were available, more Belarusians would decide to take the vaccine. This underscores the need to ensure that Belarusians have access to foreign vaccines in order to vaccinate as many people as possible.

    4. Repurposed hospitals.

    Most of the hospitals have been converted to accommodate COVID-19 patients. In Minsk alone, to provide medical care to patients with COVID-19, units in 12 hospitals have been repurposed, which is more than half of the medical institutions providing inpatient medical care. This hinders the provision of not only routine but also emergency medical care to patients without coronavirus infection. Many do not receive care at all. 

    Units for the treatment of patients with COVID-19 are overburdened by more than 20% according to the Belarusian Medical Solidarity Foundation. Dining rooms, compartments in corridors and operating rooms are redesigned for wards. At the same time, doctors and paramedical staff do not get paid for overtime hours, although they have a heavy workload. 

    5. Medical oxygen.

    The problems of supplying hospitals with medical oxygen have not yet been solved. The existing distribution systems are not designed for such a high load, which regularly leads to oxygen outages, causing the death of patients. In addition, there are no oxygen outlets at all in the canteens and corridors that have been converted to wards. There is a shortage of transportable oxygen cylinders required when transporting oxygen-dependent patients for examinations, so necessary diagnostics are often not carried out.

    6. Equipment, reagents, medicines.

    In some facilities, there is a shortage of laboratory reagents to assess disease severity and make clinical decisions. There are regular interruptions of reagents such as: D-dimers, interleukin-6, procalcitonin, troponin etc. Some hospitals have problems even with standard sets of biochemical markers. This makes it difficult to determine the severity of the condition and choose a treatment tactic.

    There is still a shortage of drugs with proven efficacy in the treatment of patients with COVID-19: 

    • low molecular weight heparins (mostly unfractionated heparin is used, which has the worst indicators of efficacy and safety); 
    • methylprednisolone for systemic use;
    • biological therapy drugs that are critical for patients with cytokine storm – tocilizumab; 
    • antiviral drugs – remdesivir, which reduces the severity of disease and shortens the duration of the disease; 
    • many anaesthetic and intensive care units lack fentanyl (!) – an extremely important opioid needed to induce anaesthesia in ventilated patients.

    There is a shortage of consumables for resuscitation equipment (breathing circuits, filters for ventilators, catheters, etc.). There is also a shortage of portable ultrasound machines (one of the largest clinics in Minsk has only two such devices per 1000 beds). Some hospitals do not have new equipment because there are no specialists trained to use it.

    7. Staff shortages.

    In the last year and a half the shortage of medical workers in Belarus has increased from 3,000 to 10,000. The shortage of medical specialists comes at a time when hospitals are experiencing a very high workload and therefore are not able to provide the necessary care. 

    Belarusian healthcare is losing high-class specialists who already have experience and who are still very active and motivated. The average salary in medical care in August 2021 was just over $500. This forces doctors and nurses to either relocate abroad, where they have prospects for development and decent pay for their work, or they are leaving medicine for other fields. 

    You can find out more information, get help, and support the Belarusian Medical Solidarity Foundation by following this link.

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