Infection control assessment and preparedness for intake of COVID-19 patients at healthcare facilities - Kazakhstan, 2020

  • Healthcare Acquired or Nosocomial Infections
  • Occupational and environmental health
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At unprepared healthcare facilities without good infection prevention and control (IPC), risk of SARS-CoV-2 transmission is high. The Kazakhstan Ministry of Healthcare needed baseline data to support healthcare preparedness for COVID-19 surges.

We conducted a cross-sectional study of IPC and preparedness for COVID-19 response at 95 outpatient clinics and 18 hospitals in five cities in February 2020: Almaty, Nur-Sultan, Atyrau, Aktobe, and Ust-Kamenogorsk. Using interviews and observations, we assessed triage and isolation of patients, ventilation systems, personal protective equipment (PPE), availability of an infection control program, diagnostic capacity, and readiness for intake of COVID-19 patients. We report percentages across facilities and the city-specific range.

We found that among healthcare facilities, 15% (city-specific range 0–67%) had sufficient quantities of PPE to care for >25 COVID-19 patients at a time, 55% (12–98%) had incorrect donning of PPE by healthcare providers, 16% (3–28%) lacked correct HEPA filter ventilation in infectious disease wards, 64% (34–89%) had inadequate maintenance of UV irradiators, and 59% (8–100%) lacked qualified maintenance engineers. At outpatient clinics, we found several gaps in the detection and isolation of COVID-19 patients, including missing visual alerts warning of PPE requirements in strategic places, inadequate screening questionnaires, and missing or incorrectly donned medical masks when treating patients with respiratory symptoms. In hospitals, we observed 37% (34–39%) incorrect patient swabbing and sample storage techniques, and 60% (0–100%) had an insufficient quantity of mechanical ventilators.

Given findings that showed the need to strengthen infection control in healthcare facilities, we prepared a report for the Kazakhstan Ministry of Healthcare with results and recommendations, and immediate actions were taken to 1) improve infection control measures by applying WHO and CDC recommendations on COVID-19, 2) strengthen the use of personal protective measures, and 3) strengthen engineering control measures.

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