“We have accumulated knowledge, studied the disease and learned how to work with COVID-19”

Professor Bayan Nurgalieva, Chief Physician at the Almaty clinic: "The most difficult months for us were June and July. The whole city was in quarantine, but we continued to work".

The clinic worked with patients with COVID-19, providing primary health care (PHC). Since March 2020, the team of medical workers of the clinic has been studying the disease, learning to work with infected patients in additional personal protective equipment PPE).

“At first, it was very difficult, of course, because we didn’t know the disease and were not ready. I think the whole world wasn't ready,” Professor Nurgalieva says.

The schedule of medical workers has become even more irregular, especially for the district service and specialists in CT (computed tomography), MRI (magnetic resonance imaging) and X-ray. Patients required constant care, and doctors worked the night shift.

According to Professor Nurgalieva, during the first months almost 80% of the clinic's staff were infected with COVID-19. Even with additional PPE, it was easy to get infected since doctors were in daily contact with COVID patients during the very first wave of coronavirus.

“All my colleagues who collected the material for the study by PCR (polymerase chain reaction) have had COVID-19. At the same time, they all worked in masks, gloves and face shields,” says Bayan. "We’ve lost a lot of colleagues we know. Among them there were some quite young people who, unfortunately, also died.”

Bayan says that it was especially scary during the peak of the coronavirus infection, and it seemed that the circle was narrowing every day because all the doctors were sick.

At this time, clinics began to create mobile teams on behalf of the Ministry of Healthcare. A mobile team consists of a doctor, a nurse and a driver. They go to patients' homes, take a PCR test, make appointments and monitor the patient's condition. The doctor of the team must make an important decision – to hospitalize the patient or not. They detect the deterioration of the condition, monitor the saturation. And if pneumonia is determined, then a computed tomography of the lungs (CT) is performed.

"The mobile medical team are heroes. They work very efficiently,” says Professor Nurgalieva.

“There were also very difficult cases when a patient had 10% of the lungs affected. We sent him to the hospital, and he came out recovered, but with 75% lung damage. That is, our patient experienced a cytokine storm. There are a lot of patients like that," Professor Nurgalieva notes.

Bayan believes that now COVID-19 has changed and "rejuvenated". While in the first months of the pandemic, only the elderly were at risk, now young people, adolescents and even children can get sick.

“We have had cases where a 9-month-old baby was PCR-positive. Unlike their parents, they can tolerate the disease more easily” says Professor Nurgalieva.

According to her, the first peak of infection was in July 2020, then the number of cases increased in November 2020, and the third wave occurred in March–April 2021. However, people have already become accustomed to the disease and do not panic so much.

”But we must not forget that COVID-19 is a very contagious disease," says Professor Nurgalieva. “One person can infect up to 17 people.”

"The concept of a filter has emerged. Previously, it was organized only for the duration of the flu. Now it is used all the time," says Professor Nurgalieva. "Our epidemiologists have divided the entrances to the clinic into "clean" and "dirty" zones so that the infected patient can be isolated immediately."

There’s a nurse in ‘the filter’, who measures the temperature, asks for anamnesis. If a person has a fever, they are immediately isolated and taken to a separate room to avoid infecting other people.

“All doctors also work with a pulse oximeter. Previously, resuscitators worked with it, and now the ambulance uses them to determine saturation – the oxygen content in the blood. Every PHC nurse works with a pulse oximeter and knows that if the saturation drops, it is very serious," says Professor Nurgalieva.

In December 2020 and May 2021, UNICEF in partnership with the European Union delivered 72,200 ampoules of dexamethasone and 433 pulse oximeters to the Almaty region and Almaty to support the protective measures of the Government of Kazakhstan in the fight against the COVID-19 pandemic and to assist medical workers. In total, more than 330,000 ampoules of dexamethasone and 2,000 pulse oximeters were delivered as humanitarian aid from the European Union to Kazakhstan within the framework of this partnership.

“Our clinic has joined the vaccination programme, and we have already vaccinated 10% of the population assigned to us (end of May 2021),” says Professor Nurgalieva. "Vaccination began with the elderly, who have a lot of diseases. They are treating it with more understanding than the young ones. Young people believe that they can easily cope with the disease and are not afraid.”

According to the Ministry of Healthcare, as of 16 June, in Kazakhstan, the first dose of the coronavirus vaccine had been received by 2,587 thousand people – 13.6% of the country's population; both components of the vaccine had been received by 1,480 thousand people – 7.8% of the population.

”In order to get collective immunity, it is necessary to vaccinate from 60 to 80% of the population," says Professor Nurgalieva. “It is very sad that people have such a frivolous attitude towards vaccination. As a doctor, it scares me."

Professor Nurgalieva believes that vaccination should be treated with great care. It needs to be implemented and done.

“We need to explain to people, educate them, show positive videos and share our experiences. People should tell their families and colleagues about the vaccination themselves,” says Professor Nurgalieva. “And in any case, you need to continue to wash your hands, wear masks and maintain a social distance."

Additional information:

A cytokine storm is an uncontrolled inflammation that damages the body's own tissues. During the disease, the tissues of the focus of inflammation are destroyed,

the immune system begins to work at maximum capacity to fight the infection, and as a result, the inflammation spreads to neighboring tissues. Therefore, the percentage of lung damage becomes greater. This can happen with the COVID-19 disease.

Funded by the European Union Humanitarian Aid. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union. European Union cannot be held responsible for them.