Non-coronavirus patients struggle in Ukraine as their treatment is interrupted by COVID-19

It took the last of Svitlana Kuzmento’s strength not to fall into despair after a vital stem cell transplant for her 7-year-old son in Italy was postponed due to the COVID-19 pandemic.

This complicated and very expensive surgery abroad is, for many Ukrainian patients, the only option to survive.

“The trouble came from where no one expected,” said Kuzmento. “With every blood transfusion, we need to do because of the quarantine, the chances of a successful transplant are declining.”

As the coronavirus pandemic spreads exponentially in Ukraine, people diagnosed with rare diseases, cancer, cardiovascular problems, and AIDS are at a higher risk than ever before.

Even before COVID-19 burst into Ukraine, the mortality rate from these diseases was terrifying – out of one million people with cancer, 77,000 have died just last year. In the same period, 400,000 people have died because of heart attacks and 100,000 due to strokes. About 47,000 patients with AIDS are currently being treated in Ukrainian hospitals.

“Today, amid the coronavirus epidemic, patients with severe illnesses are forgotten,” said Viacheslav Bykov, executive director at Tabletochki charity fund.

The situation may get even worse when patients brought by ambulances to the emergency departments will have a dual diagnosis, such as a heart attack on top of COVID‑19. Since coronavirus itself provokes serious cardio problems, Sergiy Siromakha, chief doctor at Amosov National Institute of Cardiovascular Surgery, is afraid that “it is going to be another big challenge” for his team.

“The situation in the institute is one that has never happened before. This was not the case even in the crisis of the 1990s,” when medical capacity collapsed nationwide, said Siromakha, whose institute canceled all planned surgeries. Instead of the usual number of 300 patients, only 40 patients remain in the institute, mainly emergency cases, due to strict quarantine regime.

In hospitals, where children with cancer are being treated, many doctors are afraid even to think about what will happen if at least one coronavirus case is detected.

Some of these kids require dialysis because their kidneys don’t work properly. Others are recovering after the removal of brain tumors. Some are on chemotherapy. Still, others are fighting AIDS. All have extremely weak immune systems.

“If this happens, the entire hospital might be under threat,” said Yuliya Nogovitsyna, head of the department on work with families at Tabletochki, which currently helping 400 children battling cancer in 14 hospitals across Ukraine.

In addition, parents of such kids can themselves transmit coronavirus since hospitals provide food only for the children while their parents have to go and buy food elsewhere.

“Each visit to the grocery store is a potential threat for moms, their kids and medical staff,” said Nogovitsyna.

Shortage of everything, including blood donors

The coronavirus outbreak has pulled vital protective gear, sanitizers, and even medicines out of regular hospitals in Ukraine, causing difficulties for people who need treatment for non-COVID-19 diseases.

The government was focused on imposing nationwide quarantine but neglected the efficient provision of hospitals with all the necessary tools to resist the virus.

Volunteers and businesses again came to the forefront to help the country.

“From day one I feel like it is a second Maidan,” said Lera Tatarchuk, founder of Tvoya Opora charity fund, which helps children with heart diseases at Amosov National Institute. “If the first one equipped the Ukrainian army, the second will equip medical workers.”

But Tatarchuk’s fund, which is the only one in Ukraine in direct connection with the World Health Organization, still struggles to find high-quality protective gear from certified producers. For example, she had found only two companies in Ukraine making reusable safety suits.

“Many suits produced in Ukraine can protect from dust, but not from viruses,” said Tatarchuk.

For patients with heart problems, hospitals in the regions range from well-equipped to extremely poor. Siromakha from Amosov Institute estimates that only half of Ukrainian hospitals have good enough intensive care units.

Currently, the number of people with panic attacks is increasing and Siromakha receives messages from patients with heart problems every day. Constant worries might lead to heart attacks, doctors warn.

“It will only get worse,” said Siromakha.

Sergiy Siromakha (R), chief doctor at Amosov National Institute of Cardiovascular Surgery, operates patient on Sept.13, 2019. (Sergiy Siromakha/facebook)

According to Andriy Beznosenko, chief doctor at Ukraine’s National Cancer Institute, the quarantine resulted in the immediate shortage of blood donors on the very first day. Public transportation has been shut down, giving donors no alternatives.

“People cannot physically reach the blood donation points,” he said. “Cancer will not wait until the quarantine is over.”

Beznosenko also believes that the Cancer Institute will also have to buy protective gear “in turbo regime” since all reserves are coming to an end. But with a total deficit of those in the county, he doesn’t even hope to do it on time.

Ukrainian hospitals are willing to make their own decisions on how to respond to the epidemic. According to Beznosenko, the decisions across the country vary from “completely closed” to “taking every patient without preventive measures.”

On March 27, an oncology doctor from Vinnytsia Regional Oncology Clinic became sick with COVID-19, and the hospital was closed. All of the cancer patients were left alone with their illness.

“If we do not provide them with appropriate assistance, there will be a major social explosion,” said Beznosenko. “They have a high risk of mortality, but not treating cancer will lead to 100% death.”

Shortage of vital medication

While medication for patients with cardiovascular diseases hasn’t hit a critical point in drug stores across Ukraine, certain cancer drugs, mostly imported from the European Union are only in a few weeks’ supplies.

“I personally know people who can’t live with some medication. They can’t even wait two weeks. This also applies to drugs for hepatitis and HIV,” said Rodion Voronov, head of MedExpedia non-commercial project helping patients with medical treatment in Germany.

Some crucial cancer medication that is not registered in Ukraine is almost impossible to bring into the country as the borders are closed.

“Fund volunteers usually went abroad to buy these drugs, but now, in the absence of transport, we do not know how to bring in these essential drugs,” said Bykov from Tabletochki fund, which even used the last diplomatic flights from Germany to Ukraine to bring some urgent medication.

The medication distribution problem for cancer patients is also huge inside the country.

According to Bykov, some of the medication for kids with cancer, which is registered in Ukraine, was de-facto imported last month. But due to all bureaucratic changes in the government and the rapid cycling of two health ministers and their teams, signing documentation took almost a month instead of the usual three days.

“Just a few days ago documents were finally signed,” said Bykov.

Survival salaries, ruined medical system

The failure of the Ukrainian medical system in the fight against coronavirus exposed all of its dramatic problems – underfunding and lack of appreciation for medical workers’ roles.

Nogovitsyna from Tabletochki complained that many nurses from Children National hospital Okhmatdyt in Kyiv have very low wages earning a paltry Hr 4,000, or $150 per month. In other Ukrainian oblasts, oncology doctors sometimes earn even less.

“They have 20-30 severely ill children to treat and they have to make serious life decisions every day. It’s insane,” she said.

Beznosenko from National Cancer Institute is sure that the coronavirus epidemic revealed the failure of state policy. Everyone on whom the country’s medical system depended was treated abroad and top officials did not think they would “find themselves in a situation when Austria, Germany, and Israel would close their borders.”

“They are now reaping the ‘benefits’ of their actions,” he said.