As the number of COVID-19 infections mounts and hospitals fill up with patients, Ukraine’s health ministry has called the situation critical and proposed stricter restrictions. It has also urged the parliament to introduce fines for not wearing masks.
The coronavirus surge is sweeping across Europe, prompting fears that the new wave could be deadlier than the spring outbreak.
In the past 15 days, Ukraine recorded 114,641 new coronavirus cases and 1,997 deaths.
As of Nov. 5, there are 237,761 active cases and a total of 7,924 people have died from COVID-19 since the start of the pandemic.
Ireland, France, Germany, Italy, Austria, the Czech Republic, Belgium and Greece have reimposed lockdowns and curfews. Ukraine’s western neighbors, Poland and Romania, have also reported record-high daily COVID-19 cases. Bucharest closed schools, indoor dining at cafes and restaurants and theaters and cinemas until Nov. 16, and Warsaw is expected to announce new restrictions.
But Ukraine is not planning a new lockdown because the economy will not survive it, Prime Minister Denys Shmyhal told journalists on Nov. 5. Instead, the government is seeking a compromise: to increase restrictions to slow the spread of the virus, while keeping the country open.
Earlier, the authorities said a lockdown would be possible if the country hit 15,000 daily coronavirus cases.
That number is not a distant possibility. Ukraine smashed daily records of new cases during the past two weeks, going from 7,000 cases to the 9,850 reported on Nov. 5. Shmyhal said Ukraine could see 15,000 new coronavirus cases per day by the end of November.
But the prime minister insisted on continuing the localized, adaptive quarantine, which the government imposed in August.
Based on several epidemiological indicators, health officials divided Ukraine’s regions into yellow, orange and red zones of COVID-19 threat. Depending on the zone, local authorities in cities and administrative districts were supposed to tighten or relax restrictions. But they often refused to impose any drastic measures, wary of public anger.
The World Health Organization predicts that the epidemiological situation in Ukraine will further deteriorate, similarly to other European countries.
Proposed restrictions
Ukraine’s health ministry has prepared a package of new restrictions for the Cabinet of Ministers to adopt. If they are passed, the new rules might come into force as early as Monday, Nov. 9.
The ministry wants to limit the work of eateries; close swimming pools, gyms, and entertainment areas in shopping malls; and ban all mass cultural events. It also proposes to shut down businesses that ignore anti-epidemic guidelines, chief sanitary doctor Viktor Lyashko said at a briefing on Nov. 5.
Moreover, the health officials recommend stores to dedicate special hours between 10 a.m. and 12 p.m. for elderly customers, who are at the highest risk of dying from the virus. The data shows that 71% of all deaths from COVID-19 in Ukraine are people over 60.
Health Minister Maksym Stepanov said they are considering imposing a “weekend lockdown,” when non-essential shops, cafes and restaurants will be ordered to close on Saturdays and Sundays. Eateries can only offer takeout.
Pavlo Kovtonyuk, former deputy health minister and head of the Health Economic Center at the Kyiv School of Economics (KSE), said that “single, regional and adaptive measures” cannot contain the spread of the virus.
“A nationwide package of measures should be imposed proactively as soon as possible and can help avoid overburdening the hospital network,” he said.
One-third of hospitals designated for COVID-19 patients are “critically full,” according to data of the KSE Health Economic Center, and another 20% of hospitals are overloaded.
“It is a really bad trend,” senior researcher Iurii Ganychenko said.
Kovtonyuk said Germany’s “lockdown light,” introduced on Nov. 2 for a month, could be a model for Ukraine to copy.
COVID-19 rates are on the rise in Germany too, but the predicament is not yet as critical as in other European countries. Recognizing the trend, Germany shut down restaurants, bars, hotels, theaters and cinemas, swimming pools and gyms, while keeping borders, schools and shops open. The public is advised to avoid unnecessary travel and work from home if possible. Meetings in public are restricted to 10 people, although church services and protests are allowed.
KSE researchers predict that Ukraine might see as many as 20,000 deaths from COVID-19 by the end of the year if anti-epidemic measures remain at the same level.
De-facto, Ukraine is still under quarantine until Dec. 31, but there are virtually no restrictions in place and basic rules of social distancing and mask wearing are widely flouted by the public and businesses and not enforced.
“Ukraine should respond to the pandemic in parallel to slowing down the transmission rate by putting effective public health and social measures in place,” Jarno Habicht, head of the World Health Organization office in Ukraine, said in a written reply to the Kyiv Post.
This means preparing hospitals — particularly their intensive care units, oxygen equipment and medical personnel — as well as enforcing measures that could break the transmission cycle, such as detecting active cases and isolating them by testing, contact tracing, investigating clusters and superspreading events. Public awareness about mask wearing, physical distancing and hand washing must also be increased.
Hospitals
Speaking from the parliament tribune on Nov. 3, Health Minister Stepanov called the situation with COVID-19 “critical and close to catastrophic” and warned about “hard times ahead.” He urged Ukrainians to cooperate.
“Everyone is responsible for the spread of the virus. Blame the health ministry all you want, but we can’t wear a mask for you or wash your hands for you,” he said.
The health care system is under growing strain as the number of severe patients requiring hospitalization and oxygen has been growing. Currently, there are 27,841 people receiving treatment in hospitals.
The ministry has designated about 52,000 hospital beds, or around one-third of all available hospital beds in the country, for COVID-19 patients. Less than 20,000 of those beds are connected to oxygen equipment.
The capacities of Ukraine’s health care system are limited, and hospitals already experience shortages of medical personnel, Stepanov said.
“If there are no doctors and nurses, the number of hospital beds does not matter. We are deploying interns and doctors of different specializations,” he said, warning that Ukraine could reach a point when doctors will have to decide which patients have higher chances of survival and should be prioritized.
The Cabinet of Ministers has already ordered regional authorities to set up makeshift hospitals in Kyiv, Kramatorsk and Odesa.
According to media reports, the Palace of Sports, the Expo center and Feofaniya hospital are being considered for the future temporary COVID-19 hospital in Kyiv.
Long overdue fines
There is another huge issue with the response to the pandemic in Ukraine: weak enforcement.
Health Minister Stepanov has urged lawmakers to pass a bill that introduces a more efficient procedure for fining citizens for not wearing masks in public places and transport.
The draft bill was initiated by the Cabinet of Ministers and registered back in mid-July, but has only been reviewed by a parliamentary committee so far.
If it passes, the police and local authorities will be able to issue fines ranging from Hr 170-225 ($6-9) to citizens without masks on the spot, much like tickets for traffic violations.
Although fines for flouting the mask rule already exist in Ukraine, they are applied ineffectively. The fines are too high — around Hr 17,000 ($600) — and they can only be issued by a judge after a police officer files a report to the court. In practice, many judges have been hesitant to impose such a severe fine.
