Lessons learned for the medical system in the Republic of Moldova one year after the outbreak of the COVID-19 pandemic
The Institute for European Policies and Reforms (IPRE), with the support of the Hanns Seidel Foundation Moldova and in a media partnership with Privesc.Eu and Rlive.md, organized on Wednesday, March 31, 2021, the third #EUDebatesCafe online videoconference in 2021, dedicated to the lessons learned for the medical system in the Republic of Moldova one year after the beginning of the COVID-19 pandemic.
The speakers of this event, which was moderated by Mihai Mogîldea, Team Leader, Europeanisation program within IPRE, spoke about the main challenges for the medical system in the Republic of Moldova in the first year of the pandemic, to what extent budget allocations for the health system covered the existing needs, how can the increase of the vaccination rate in the Republic of Moldova be stimulated during stages two and three, but also to what extent the government authorities managed to conduct an effective information campaign on protection measures against COVID-19.
Please find bellow some of the keynote interventions.
Daniela Demișcan, Head of the Public Health Directorate, Ministry of Health, Labor and Social Protection: “Since the outbreak of the pandemic, we have registered over 220 thousand infected people, and we have performed over 860 thousand tests. The measures taken by the Government in response to the COVID pandemic have focused on several directions. First of all, we focused on preparedness and response measures at the health level, but also at the intersectoral level. The second direction was focused on risk communication, identifying the groups to which this communication should go. Another direction was to provide epidemiological surveillance, including laboratory investigations to track trends in the development of the epidemic process and adjust control measures. Last but not least was the provision of clinical management of the case of the disease at the level of pre-hospital care. Also, the implementation of measures for the prevention and control of infections within public medical institutions and measures for the prevention and protection of medical staff was ensured. If we return to the current stage, we can inform you that in the Republic of Moldova the second stage of vaccination against the new coronavirus has started, and this means that people over 60 years of age and those with chronic diseases can also be vaccinated. The Republic of Moldova concluded contracts with the producers of sera against SARS-CoV-2 in January and February, but the delivery will depend on the availability of the producers of these vaccines”.
Adrian Belîi, Head of the Clinical Department of Anesthesia and Intensive Care, Institute of Emergency Medicine:“Practical medicine and doctors working in the first line represent the interface of direct interaction between the medical system and society. Thus, the first-line practitioner is trapped in a vise – social pressure and system pressure. Doctors are facing increasing cases, including anesthesiologists, who are still not many in the country. The vast majority of mortality among COVID patients occurs specifically in intensive care. Therefore, the work pressure, the psychological one, the physical impact, are on the back of that person who works in intensive care. If we talk concretely about problems, they have evolved over time. If at the beginning the main problem was what to do, the second stage was to increase the technical capacity of the number of beds, of the endowments with medicines. Following the measures taken, the practices have become stable in the last 4-5 months, when the treatment protocols used in the country have approached the international recommendations. We now note that as a result of the new strain of Coronavirus, mortality has significantly increased among inpatients on resuscitation – from 29 percent to 40 percent. If we talk about predictions, 15 percent of patients tested positive for SARS-CoV-2 will develop disease, which requires hospitalization, and 10% of infected patients will need intensive care.
Ala Tocarciuc, International Public Health Expert: “When the pandemic started, it was announced as a global event, but in the end each country finalized its response to this pandemic. From the beginning, some countries wanted to save lives, respectively applied their strategy to stop the spread of the disease, other countries tried to keep the economy with moderate restrictions and focused on empowering the medical system. So, Moldova was in the second category, which did not make much effort to stop the spread of the pandemic, and the restrictions showed only on hard paper, but in reality they were liberal, but we tried to empower the medical system. These measures, however, have a limit. If we do not stop the avalanche of new diseases, our system will collapse. It is not about human potential and lack of resources, but it is also a psychological threshold. The fact that we now have over 40 deaths is a sign that our medical system is suffocating and then we cannot invest in it alone. We need to give him a breather. Because only doctors are battling a pandemic today, the rest don’t seem to have heard of the pandemic. Thus, we must all concert in this fight. If we’re talking about the vaccine. According to the results of some surveys, 55 percent of the population of the Republic of Moldova agrees to be vaccinated against the new virus, but the big problem is that in the Republic of Moldova there are not enough quantities of anti-COVID-19 vaccines.”
Stela Bivol, Director, Center for Health Policy and Analysis (PAS): “This pandemic year, on the one hand, gave us lessons to learn, and on the other hand we did not learn them. In terms of plans and policies that correspond to what the World Health Organization has said, with the preparation of the medical system, efforts have indeed been made. But, if we look from the outside, the pandemic took us by surprise and if at the political level it was the message that we are ready, it turned out that we were not ready. A very important moment was the mobilization at the beginning of the whole society, of the partners. Unfortunately, I find that the authorities have mobilized more and society less. The medical system was not bright and this is the result of years of failed reforms and the weakening of the public health system. From my point of view, the weakest pillar was communication, and the message of politicians was absolutely inconsistent, which from the beginning sabotaged the trust of the population and the titanic work that the team of communicators were trying to do. So, the lesson learned is that using COVID for political purposes has played a part in all of us and in a year we will see what we have lost. If we talk about the future, then in the next 12 months the situation regarding COVID-19 in the Republic of Moldova could worsen.”
Ana Racu, Civic Activist, member of the UN Committee against Torture: “I will refer to the mobilization of civil society since the beginning of the pandemic. This is one of the good lessons, although I must admit that it was not an ideal community mobilization. There were several initiatives that started at the beginning, such as the “Together for You” campaign, in which I participated. We collected about 5 million. lei, of which we covered the needs of 18 medical institutions. At that time, it was a hope and a support to the medical system. Another lesson that bothers me the most is the attitude towards doctors. We have thrown mud at doctors and continue to do so, we have denigrated the heroic effort of those in the front line, from teachers to ambulance drivers. We sacrifice doctors and I want people to understand that since the beginning of the pandemic, more than 100 medical workers have died, and the death of a traumatologist or a surgeon at the district hospital makes these medical services inaccessible to many people in the villages. Also, the voice of good professionals was less vocal at the level of CNESP decisions, and the opinions of these specialists appeared more often in interviews conducted by journalists. Another problem is related to fakes, and now it is necessary to sanction the people who spread these fakes about the virus and the anti-COVID-19 vaccination”.
The event was organized within the project “EU DEBATES CAFÉ: Advancing the knowledge and expertise on EU institutions and policies in the Republic of Moldova”, implemented by IPRE, in cooperation with the Hanns Seidel Foundation in the Republic of Moldova and with the financial support of the Federal Ministry for Economic Cooperation and Development.