Ukraine’s health care system on brink of collapse under Covid surge

This week, Ukraine ranks as one of the top three countries in the world by daily number of deaths from Covid-19, and is first in Europe by hospital admissions, both in absolute numbers and as a share of total population. Those are the “symptoms” of a new coronavirus wave that has hit Ukraine leading to a shortage of hospital beds in some regions. We take a look at key numbers, hospital situation, and government response.   

Daily numbers and deaths hit record levels. On October 21, Ukraine hit a record high number of daily deaths and new cases since the pandemic began, recording 546 deaths and more than 22.4 thousand daily cases. The previous record was reported at the peak of the spring wave on April 3, 2021, with 20.3 thousand daily cases.

On the global map of deaths, a current spike in Covid cases in Ukraine also raises concerns. According to Worldometer’s website, on October 19 and 20, Ukraine ranked fourth and third in the world respectively by daily number of deaths, exceeded only by the U.S., Russia, and Romania. The death toll on those two days exceeded that of India, once ravaged by the Delta Covid variant, the UK now recording more than 40,000 daily cases, and Brazil.    

By the number of active cases, on October 20, Ukraine ranked seventh in the world and third in Europe with 272,543 cases, exceeded by the UK and Russia, with 1.4 million and 802 thousand cases respectively. The number of tests performed across the UK is much higher.

Overwhelmed labsrecord hospital admissions, and record high positivity rate. Systems analyst Yevhen Istrebin analyzes Covid data in Ukraine. He highlights records numbers that continue to grow:

-a record high absolute number of positive PCR test results (30,417 on October 20);

-record high positivity rate – the percentage of all coronavirus tests performed that are actually positive (42.3 per cent on October 20);

-record high weekly test positivity rate (37.6 per cent reported on October 20);

-overwhelmed labs have a record backlog of PCR tests (19,000 tests on October 20, an increase by 4,000 from the previous day);

-record bed occupancy of children’s hospitals that surpassed the previous peak in spring (as of October 20, there are 851 active hospital admissions of children with suspected or confirmed Covid-19). Hospital admissions of kids in Kharkiv, Odesa, and Dnipropetrovsky regions are at the highest levels;

-hospital admission rates are higher than in the EU. On October 20, Ukraine ranked as the top country in Europe by the number of hospital admissions, both in absolute numbers (40,531 patients hospitalized) and by the rate of hospital admissions (1,045 per 1,000 population).

Patient triage is already happening. In recent days, hospital admissions have dipped, as in many regions (especially in Kharkiv and Odesa) hospitals ran out of beds to treat Covid patients, Istrebin said.

During the spring peak, 80,000 beds were made available. This time, 67,000 beds were made available, of which 41,000 beds are taken, the analyst continues. “With 60,000 beds available, hospital admissions are below the levels of the spring wave, as the caseload varies across regions. The data also includes maternity hospitals and children’s hospitals. (…) Not all new hospitals are ready to admit patients, so that growing hospital admissions are constrained by available beds. Patient triage is already happening in many regions,” Istrebin said. 

A positivity rate of more than 42 per cent is evident of insufficient testing. The actual numbers can be much higher than officially reported.

Vaccinations on the rise. In recent days, set against a backdrop of an uptick in Covid-19 cases and new coronavirus restrictions in a number of regions, vaccination numbers have gone up. On October 19 and 20, Ukraine administered a record number of vaccine jabs. On October 20, health care workers administered 251,254 vaccine doses (165,649 people received the first dose of a Covid vaccine, and 85,605 people were fully immunized).  

Since vaccinations began, Ukraine has fully immunized more than 6.7 million people, and more than 8.3 million people received at least one dose of a Covid-19 vaccine.

Yet, Ukraine has low numbers compared to the EU and the world’s vaccination leaders.

According to Our World in Data, 36.39 per cent of the world population has been fully vaccinated, and 47.8 per cent have received at least one dose of a Covid-19 vaccine. Those numbers are higher in the EU: 54 per cent have been fully immunized, and almost 58 per cent have received at least one jab. In Ukraine, the numbers are 15.3 per cent and 18.9 per cent respectively.  

In Ukraine, unvaccinated people are accounting for a majority of hospitalizations. 

Covid restrictions tighten. Starting October 21, new rules apply to passengers travelling between the regions. The government requires travelers to show a Covid certificate (confirming vaccination with the first dose or full vaccination), or a negative result of a PCR test or a rapid antigen test performed a maximum of 72 hours prior to travel.   

On October 15, Kherson region was the first to enter the red zone since the spring lockdown. On October 18, Zaporizhzhia, Odesa, Donetsk, and Dnipropetrovska regions joined.

On October 23, Sumy region is to be flagged a red zone.

Zhytomyr, Luhansk, Lviv, Mykolayiv, Rivne, Khmelnytskyi, and Chernihiv regions may turn red soon in response to a growing positivity rate.