Ukraine's Health-Care System, Economy Struggle To Cope with COVID-19

BORYSPIL, Ukraine — Apart from the international airport it hosts, rarely does this suburb 45 kilometers east of Kyiv make the national news. Yet Boryspil was in the headlines on October 28 after Anatoliy Fedorchuk died of complications linked to COVID-19 just three days after being elected to his fourth consecutive mayoral term and less than a month before his 61st birthday.

“It was a shock to all of us at first…we thought he was in good health,” said Yaroslav Hodunok, who, serving as city council secretary at the time, took up the vacant post until mid-November.

The mayor-elect’s death was a stark reminder to people in this nation of nearly 44 million that the coronavirus does not discriminate based on status.

A city of nearly 62,000 people, Boryspil had recorded 2,619 confirmed coronavirus cases and 34 deaths from COVID-19 as of December 30, according to the Health Ministry’s Center for Public Health (CPH).

Overall, COVID-19 has claimed more than 18,000 lives in Ukraine, according to the government. On December 24, Ukraine surpassed 1 million confirmed cases of the coronavirus.

Many in Ukraine suspect the real figures could be higher, including Hodunok, who contends that official COVID-19 statistics are a “lie” that don’t reflect the real situation.

Boryspil mayoral candidate Yaroslav Hodunok

The former opposition councilman and current mayoral candidate believes doctors in Ukraine are reluctant to test patients for the coronavirus. He said that he had COVID-19, but his physician didn’t have him tested because “I didn’t have the telltale symptoms.”

His wife and child had tested positive for COVID-19 antibodies, but Hodunok said his “severely clogged sinuses and sudden problems sleeping” didn’t concern the doctor.

“I still can’t fall asleep until around 3 a.m. and it feels like I’m sleeping awake,” he complained.

Ukraine offers free coronavirus testing and Health Minister Maksym Stepanov on December 21 expanded the list of symptoms and criteria to include people who have had contact with infected patients. People do opt to get tested at private clinics, some because they fear they won’t meet the government criteria, others because they have private insurance that will cover the cost.

Ukrainian lawyer and councilwoman Alyona Skichenko

Alyona Skichenko, a lawyer elected to the Boryspil district council in October, said her first test was free but she ended up paying the equivalent of $357 for a second test as well as vitamins and medicines after she was confirmed to have the coronavirus.

Ukraine registered its first case on March 3 and shortly thereafter implemented strict lockdown measures for several months. Schools were closed as were eateries, gyms, and hair salons. Public transport, including the subway in Kyiv, was shut down or restricted. Hospitals reacted by establishing special wards and training health-care workers to treat COVID-19 patients.

More should have been done, argued Olha Stefanyshyna, a national lawmaker who sits on the parliamentary health committee for the opposition Holos party. Speaking to RFE/RL, she noted “the Health Ministry had plans to test 75,000 people per day by October but is still averaging about 20,000-30,000.”

Ukrainian lawmaker Olha Stefanyshyna (file photo)

She also slammed Ukraine’s contact-tracing strategy, a key component in containing the virus’s spread. “This strategy is a failure…tracing isn’t happening, Stefanyshyna said.

Her colleague on the health committee, Lada Bulakh of the ruling Servant of the People party, did not respond to several RFE/RL requests for comment.

Ukraine should triple to 100,000 the number of daily coronavirus tests to get a more accurate picture of the situation in the country, argued Pavlo Kovtonyuk, head of the Center for Health Economics at the Kyiv School of Economics.

In a report published on December 24, he said Ukraine was showing an average positive test rate of 33 percent. This figure “is still five times higher than the one recommended by the World Health Organization for pandemic control,” Kovtonyuk said.

Health Minister Stepanov explained that Ukrainians were reluctant to get tested and that’s why he expanded the criteria for administering them. He also said testing for antigens — molecules that can trigger an immune response — was being ramped up.

By next year the objective “is to have no less than 1 million antigen tests conducted a month,” Stepanov said at a daily briefing on December 30.

Equipment Shortages

Another problem Ukraine faces as it struggles to curb the spread of COVID-19 is a lack of proper equipment.

Masks, protective suits, and ventilators are in short supply, according to a November report by the Organization for Economic Cooperation and Development (OECD).

Kyiv has established a $2.4 billion COVID-19 fund, a measure that lawmaker Stefanyshyna praised. However, she and other lawmakers and critics from the Anticorruption Action Center have noted that the bulk of the money has gone toward the president’s nationwide road-construction project.

The Finance Ministry said 59 percent of the fund had been allocated by November 7.

According to the OECD November report, funds went “toward healthcare, social protection, ensuring law and order, supporting culture, tourism and the creative industries, as well as the construction and repair of roads.”

Still, Stefanyshyna said the national government could have “coordinated” the distribution of medical equipment and supplies based on regional need and used its clout to purchase necessary equipment instead of leaving it to regional and local governments.

Ukrainian Health Minister Maksym Stepanov (file photo)

About 70 percent of the 64,349 beds designated for COVID-19 patients are equipped with an oxygen supply, Stepanov said earlier in December. Forty-six percent of them were vacant.

Yet, the strategy of having more beds “is dangerous,” Kovtonyuk told Bloomberg News, because they aren’t “an unlimited resource, and the number of beds does not mean that there’s always real help where it’s most needed.”

“The health system is under exceptional strain,” Lotta Sylwander, the UNICEF representative in Ukraine, told Bloomberg. “It is going to get worse and worse.”

Ukraine did not pre-order any of the three Western vaccines that are now being rolled out in the United States, the European Union, Canada, and Britain.

Vaccine Rollout

On December 30, Ukrainian President Volodymyr Zelenskiy’s office announced that it had concluded a contract to purchase 1.9 million vaccine doses from Sinovac Biotech, the biggest maker of vaccines in China. It expects clearance for the vaccine from the Chinese government in January and will send it for “prequalification” to the WHO in February, the Ukrainian presidential office said.

As a lower income country, Ukraine also expects to receive eight million doses free to inoculate half as many citizens in the first quarter of 2021 through COVAX, a WHO-led effort for poorer countries.

Stepanov has said half the population should be vaccinated in 2021, the vast majority will include medical front-line workers, first responders, the elderly, and people with underlying health conditions.

At Boryspil’s intensive care hospital, its chief doctor, Oleksandr Shchur, told RFE/RL that until the vaccine arrives “people shouldn’t let their guard down…this virus is insidious and could spread like wildfire at any moment.”

A laborer works on installing an oxygen cistern outside the Boryspil Multispecialty Intensive Hospital.

He acknowledged the city’s help in purchasing medical items and that the national government is helping more, especially in purchasing an oxygen cistern for the infectious ward.

Shchur said 80 percent of the ward’s 40 beds for COVID-19 patients have oxygen supplies and that another 45 beds are in reserve.

Ukrainian physician Oleksandr Shchur from Boryspil’s intensive care hospital. (file photo)

To make up for the shortage of oxygen and ventilators, organizations like Svoyi in Kyiv have popped up to provide oxygen machines to patients undergoing care at home.

“Some [patients] are people living with disabilities who can’t go to a hospital and others with mobility limitations,” said Iryna Koshkina, the executive director of Svoyi.

The group loans the devices free of charge “for as long as patients need them — usually those who have less than 92 percent oxygen saturation” after which the filters get changed and are disinfected for further use.

Starting off with 70 at the beginning of the year, Svoyi now distributes 250 concentrators. Some are loaned to patients who are discharged from hospitals yet still have trouble breathing, Koshkina added.

Oxygen condensators stand in the main office of Svoyi, a nonprofit group that supplies oxygen to at-home COVID-19 patients free of charge in Kyiv and the surrounding area.

The group has serviced more than 450 patients since mid-September when it started counting and Koshkina said similar endeavors exist in bigger cities like Odesa and Kharkiv.

About 69 percent of personal incomes have been adversely affected by the disruption that the coronavirus has caused, numerous surveys have found. Women have felt most of the impact.

“Almost a third of respondents reported losing their jobs, while over half spent their savings and cut their expenses on food,” UNICEF said regarding a nationwide poll of 2,000 people that it partly commissioned in June 2020. “People from rural areas, industrial workers, and households with unemployed members suffered the most.”

Economy Minister Ihor Petrashko said in a televised briefing on December 29 that the country’s economy would shrink by 4.8 percent by the year’s end — or the equivalent of $146 billion.

To mitigate the impact of a harder two-week lockdown starting on January 8, the government this month distributed $80 million in aid to 278,000 employees and small business owners, the Digitalization Ministry reported.

Starting after Orthodox Christmas on January 7, stricter measures will be imposed nationwide, prohibiting indoor dining at eateries, and the closure of nonessential stores like fitness, entertainment, and shopping centers, hostels, and all schools, but not kindergartens.

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