National Coordination Meeting

17 March 2021 Business of the Day

1. Q&A on waste management Guest speaker: Mr. Mark Buttle, WASH Cluster Coordinator [20 minutes for presentation and 10 minutes for questions] 2. Outcomes of the Rapid Hospital Readiness and Capacity Assessment in twelve COVID-19 designated hospitals in oblast, GCA – MdM/Health Cluster [15 minutes] 3. Situation update – WHO & partners [15 minutes] 4. GIZ presentation of the Special Assistance Programme for Eastern , GCA [15 minutes] 5. AOB: • Updated Public Health Situation Analysis (PHSA)

Health Cluster Meeting COVID-19 Hospital Readiness and Capacity Assessment in Donetska Oblast (GCA)

January – March 2021 Assessment in brief

• 5 organizations carried out the assessment under the support of the Health Cluster in Ukraine.

• MdM, MSF, PUI, UNICEF, WHO (alphabetical order) • 12 hospitals assessed • Every cluster partner had 1-5 hospitals to be assessed based on the area of intervention and contextual knowledge. • The assessment form was based on a pre- validated WHO tool with adaptation to context and restricted to a limited number of questions divided in ‘mandatory’ and ‘optional Areas of the assessment

1. Hospitals general information 2. Incident Management System 3. Surge Capacity 4. Infection Prevention Control 5. Case Management 6. Human Resources 7. Continuity of essential health services and patient care 8. Surveillance, early warning and monitoring 9. Communication 10. Logistics and management of supplies 11. Essential support services COVID beds capacity Number of available beds in the hospitals

450 425

350 350 340

242

200 189 176 180

140 140 126 100 95 70 75 40 45 20

Mariupol hospital Velyka Volnovakha Pokrovsk COVID-19 city hospital hospital Ambulance hospital Infectious Novosilka Infectious hospital hospital Clinical Hospital hospital #9 hospital hospital hospital hospital of Intensive Care

Total number of beds Number of beds allocated for COVID-19 patients Extra ventilation capacity Number of ventilators available and additionally needed

2

28

8

13 12 12 11 10 6 8 8 7 6 6

Mariupol Toretsk hospital Bakhmut Mariupol Krasnohorivka Kostiantynivka Velyka Myrnohrad Avdiivka hospital Volnovakha Pokrovsk COVID-19 city hospital hospital # 3 Ambulance hospital Infectious Novosilka infectious hospital Clinical Hospital hospital #9 hospital hospital hospital hospital of Intensive Care

Number of available ventilators for COVID-19 cases Number of ventilators needed Number of Oxygen outputs Number of oxygen outputs

177

62

36 33 25 20 10 10 8 6 6

Mariupol Toretsk Mariupol Krasnohorivka Bakhmut Kramatorsk Velyka Volnovakha Kostiantynivka Myrnohrad Avdiivka COVID-19 city hospital Ambulance hospital hospital hospital # 3 Novosilka hospital Infectious infectious hospital hospital #9 hospital hospital hospital hospital COVID 19 Bed Occupancy rate Average bed occupancy rate for COVID-19 patients for the last quarter of 2020

Avdiivka hospital 94.6

Myrnohrad infectious hospital 85

Mariupol Ambulance hospital 83

Kostiantynivka Infectious hospital 76.4

Mariupol COVID-19 city hospital #9 55.6

Velyka Novosilka hospital 41.6

Kramatorsk hospital # 3 12.3

Toretsk hospital 12.1 Total admission/total deaths Total number of COVID-19 cases treated in the health facility and total number of COVID-19 death cases

986

860 796 818

547 445

353 330 282 210 144 77 73 48 31 32 35 18 18 7 14 5

Bakhmut Kramatorsk Mariupol Toretsk Mariupol Krasnohorivka Velyka Kostiantynivka Myrnohrad Avdiivka Volnovakha hospital hospital # 3 Ambulance hospital COVID-19 city hospital Novosilka Infectious infectious hospital hospital hospital hospital #9 hospital hospital hospital

Total number of COVID-19 cases treated in the health facility Total number of COVID-19 death cases Total number Total number Total number Total number of of infectious of Medical of nurses anesthesiologi disease Doctors sts specialists Mariupol COVID-19 city 13 122 4 0 hospital #9 Toretsk hospital 68 321 5 2 Bakhmut hospital 158 391 10 5 Kramatorsk hospital # 3 94 235 10 1 Mariupol Ambulance 68 194 6 4 hospital Krasnohorivka hospital 36 102 2 2 Kostiantynivka 14 37 3 5 Infectious hospital 47 144 4 1 hospital Myrnohrad infectious 8 62 2 4 hospital Avdiivka hospital 28 65 2 1 Volnovakha hospital 77 110 6 13 Pokrovsk Clinical Hospital of Intensive 135 262 12 16 Care Recommendations 1

Problem Proposed recommendations Measure of progress Implementation level Delay in recognition of COVID 19 Acceleration of recognition Recognition should be General recommendation designation in more than 60% of hospitals as COVID ones done in less than 4 assessed HFs weeks HCW are at high risk of burnout Welfare (mental health) of the A program on MHPSS for Generally everywhere with more staff during COVID time HCW is in place and focus on: Kramatorsk hospital # 3, functioning Mariupol Ambulance hospital, Kostiantynivka Infectious hospital Kramatorsk hospital # 3

Need to boost capacity Provision of guidelines and Guidelines are General recommendation trainings on COVID 19 (all distributed and sectors: surveillance, IPC< case implemented management, post rehab, etc..) Health work force is decreasing Support the involvement of a # of junior doctors General recommendation to several factors (low salaries, sufficient health workforce introduced in the lack of conditions for working, presence program shift due to COVID 19 infection, burnout…) WASH condition of HFs is to be coordinate with WASH cluster in WASH assessment of HF Krasnohorivka hospital (WASH) improved assessment and implementation Triage system is not working on To build proper triage system % of HF which General recommendation most of HFs implement Triage system Recommendations 2

Problem Proposed recommendations Measure of progress Implementation level Contact tracing still not Support of contact-tracing A system of communication General recommendation implemented or with available solution (i.e. between primary and secondary functional in most of HF Go. Data) level on contact is in place

Bed capacity is still Extend bed capacity where # of COVID 19 beds on targeted General recommendation lacking on 30% of needed hospitals assessed HF 3 out of 12 HF do not Centralization of oxygen Centralisation of Oxygen support Oblast authorities and hospitals have a centralised Oxygen support (better access of it in targeted HF owners at local level ( etc.) supply for hospitals) Especially to be done for Avdiivka hospital, Myrnohrag hospital

Testing system still not Better organization of Time between sample collection Avdiivka hospital and Volnovakha functional in 30% of HF logistics for PCR testing and results according to hospital international standards (48hrs)

There is not a plan for Implementation of activities % of patients involved in a post General recommendation Post COVID 19 on post COVID 19 COVID 19 program rehabilitation rehabilitation The need of FFP 2-3 Health Cluster partner FFP 2=3 Masks shared to Toretsk hospital protective respirators engaged to provide targeted hospital requested material Business of the Day

The updated PHSA report is available online via: humanitarianresponse.info: Ukraine: Public Health Situation Analysis (PHSA) Donetska & Luhanska Oblasts GCA Eastern Ukraine - 28/01/2021 [ENG]

reliefweb.int: Eastern Ukraine, Donetska & Luhanska Oblasts GCA: Public Health Situation Analysis (PHSA) – Long-form (Last Update: 28 January 2021)