Ukraine's Health Minister On COVID, New Lockdown, Vaccine

Let's celebrate the New Year, and then hell will break loose. Health minister explained the strict quarantine restrictions to be introduced after the holidays, and complained of the 2021 budget not accounting for recommendations of the Ministry. Maksym Stepanov spoke about raising doctors' salaries, paying compensation to medics who contracted COVID-19, reasoning behind reducing the number of tests, as well as future vaccinations.

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On 2021 budget

I did not vote for this draft budget because the calculations we submitted to the Ministry of Finance took into account our vital need to finance medicine. This amounted to 296 billion hryvnias ($10.6 billion)

The total amount allocated is 159 billion hryvnias ($5.7 billion). And this figure is totally unacceptable. It does not even provide for a salary increase.

On doctors’ salaries

It is a great shame to pay doctors who are responsible for the lives of their patients the lowest salary in the country, sometimes lower than that of a security guard in a supermarket, and which is equal to unemployment benefits. We in the Ministry of Health have developed a bill that ties the salaries of medical workers to the subsistence level. Such a practice exists, for example, in the law on the prosecutor's office. We submitted it to our fellow ministers, with whom we have to agree, to bring it to the meeting of the Cabinet of Ministers, so that the government could then make a corresponding submission to the parliament.

On problems with compensation payments to doctors who contracted COVID-19

This issue lies with the Ministry of Social Policy. As far as I know from my colleague Maryna Lazebna, they try to simplify this issue as much as possible. But at the same time, serious misunderstandings do occur now and then. For example, when a doctor died in Cherkasy region and our commission provided a clear conclusion that it was an occupational disease and the family of the deceased is due compensation of about 1.5 million hryvnias ($53,000), the Social Insurance Fund initially disagrees, and then goes to court to sue, to refute this decision.

We support the relatives as much as possible and I am sure that we will be able to prove our arguments in court.

Minister of Health Maksym Stepanov. Photo: hromadske

On buying a vaccine against coronavirus

In our budget request, we quoted the amount of 15.1 billion hryvnias ($531 million). We calculated it based on the real price of the vaccine. That is why we believe that the amount of 2.6 billion hryvnias ($91 million) - which was set in the budget for 2021 - may not suffice. We have now raised funds within the Ministry of Health. We had some savings, in particular from the purchase of medical equipment through centralized purchase of medicines. This would amount to about 2.3 billion hryvnias ($81 million) from this year’s budget on top of those 2.6. But it seems to me even this may not be enough.

Who will be vaccinated first?

During the first stage, as we see it, we have to vaccinate our health workers, especially those who work directly with COVID-19 patients, we have to vaccinate our servicemen who are in the Joint Forces Operation zone, and we want to vaccinate people who are in specialized institutions - these are boarding schools or care homes.

The second stage concerns people over 60, people who are at risk by medical parameters, have concomitant diseases of diabetes or cardiovascular disease, as well as other servicemen, members of the National Police, educators.

Vaccination will not be mandatory, we do not have such legislation that would oblige us to do so. We must ensure that people have access to this vaccine.

On the Ukrainian vaccine against COVID-19

Relevant documents are now being drawn up in order to start a clinical trial. This is quite a long process - we believe it can take from nine months to one year.

Weekend quarantine in Lviv. Photo: Petro Zadorozhnyi / hromadske

On "weekend lockdown" and post-New Year's quarantine

We have seen the results of the quarantine restrictions that have been in place since November, including the “weekend lockdown”, and we can now see this reflected in [new] numbers. We have now seen a decline. On the one hand, we have seen a reduction in the burden on the medical system, and on the other - we appreciate Ukrainians being more active, especially over New Year's holidays. We are realists, we understand that observance of those quarantine restrictions which we have today: constant use of masks, no more than 4 people at a table in public catering establishments, compulsory mask requirement within such establishments - are not always adhered to. Well, that's true. Everything related to the control system is not within the competence of the Ministry of Health.

And we understand that we may have, firstly, an increase in the number of patients after the New Year holidays, and secondly, we, from late January to early February, expect a seasonal increase in the number of patients with influenza, and the flu gives the same complications as COVID.

This was the logic behind the introduction of this strict quarantine from January 8 to 24.

On the number of beds and oxygen points

Today we have a total number of beds exceeding 64,000, this number is constantly increasing, almost every day I sign the relevant documents, about 35,000 beds have oxygen supply, and the total number of people in hospitals now is about 27,000.

A health worker collects a sample for a COVID-19 test from a woman near a hospital in the village of Toporivka, Ukraine, on October 2, 2020. Photo: AP Photo / Evgeniy Maloletka

On the decrease in the number of COVID-19 tests

We had a clear description of who we were testing, people with signs of coronavirus, those who were hospitalized with pneumonia. After fewer people began to turn to us, we made changes to the standard of care and expanded the list of people who need testing, including at the expense of the state. We also added so-called antigen tests - these are quick tests that take 15 minutes. As for PCR tests, we added any signs of any respiratory disease. The capacity of our laboratories, only the laboratories under the Ministry of Health, is about 55-60 tests per day. As a reminder, in April all the capacities of the entire country totaled 200 tests per day.

On medical reform

I support the reform of medicine. Reform itself. I support the fact that our medicine needs to be reformed, our medicine deserves to be of a different quality, and this requires change, this requires different approaches. But I do not support the destruction of medicine. I do not support any closure of hospitals, I do not support the dismissal of medical workers, I do not support the blind copying of a system that is in place abroad, and applying it to our country. I understand that some people lack the understanding and intelligence of how to turn it all around and how to conduct the process of reforming medicine, which is quite multifaceted. It’s not merely about funding, but also, for example, the quality of medical care.

We are working on all these things, but I want to reiterate - miracles won’t happen, we need appropriate funding.

On returning to pre-COVID life

We are now trying our best to get the first dose of the vaccine in February next year. Therefore, it is very important for us, at least until April, when it will get difficult with COVID, to comply with the quarantine restrictions that exist, which are now observed by the whole world. The best way to fight, of course, is collective immunity. It is achieved in two ways: either through vaccination, which should be at least 70-80%, or when people contract the disease.

I am an optimist, so I believe from April on things should get easier, and we will respond immediately. Plus vaccination will have begun.