Adoption of New WHO Disease Classification to Combat COVID-19
Nur Sultan: Kazakhstan and WHO have agreed that health conditions are safe and that there is no new serious infection. Represented in cases of pneumonia in Kazakhstan, they agreed to set new standards for the registration and identification of data related to the epidemic, while these changes entered into force today, July 18, 2020, taking into account technical discussions that took place in agreement with the WHO Regional Office for Europe.
Dr. Hans Kluge, the WHO Regional Director for Europe, noted the following in his video address for the press conference of the Ministry of Health of Kazakhstan in Nur-Sultan, : “Having received over the past few months new knowledge about the COVID-19 infection and measures to combat it, the WHO has introduced new codes to classify this disease. There have been reports from Kazakhstan of a marked increase in cases of pneumonia, one of the explanations of which is COVID-19.”
Dr. Kluge thanked Kazakhstan’s Ministry of Health for agreeing to confirm the possibility of testing in the WHO reference laboratories. As such, it has been confirmed that there is no new dangerous infection in Kazakhstan; all previously reported cases of detected pneumonia according to the WHO classification relate to COVID-19. Earlier, some foreign media outlets mistakenly indicated the appearance in Kazakhstan of some unknown disease. This caused a substantial commotion in the world.
Kazakhstan immediately turned to the World Health Organisation for assistance. After careful examination of the information, the WHO confirmed the summer outbreak of pneumonia in Kazakhstan as a result of COVID-19. The peculiarity of this pneumonia is that all cases have a negative PCR test result, but have clinical and epidemiological signs of coronavirus. Furthermore, according to the statement of Caroline Clarinval, the head of the WHO office in Kazakhstan, an additional group of experts of the Organisation will come to Kazakhstan.
Consequently, Kazakhstan is working closely with the WHO in the framework of the fight against the epidemic. Regular working consultations with the Organisation are helping Kazakhstan to adjust the methodology for reporting the development of the epidemic and to determine its various forms. Until now, only laboratory-confirmed cases of COVID-19 were recorded in Kazakhstan, as in most countries.
The situation is as follows – towards the end of June, a marked increase in viral pneumonia was observed in the country without specifying the pathogen, that is, unconfirmed in the laboratory. This, in turn, enhances the international practice of combatting the epidemic, as the new coronavirus has not yet been fully studied, and all of its possible signs are important for its treatment.
Kazakhstan’s experience is likely to be useful for those states where, according to WHO estimates, excess mortality is also currently observed, most likely due to COVID-19. Experts note that similar cases exist not just in Kazakhstan, however other places have their own specifics.
From 18th July, COVID-19 morbidity and mortality statistics in Kazakhstan will be compiled from two data sources: laboratory-confirmed cases of COVID-19 and unspecified viral pneumonia. This will automatically lead to an increase in the number of confirmed cases.
But this approach for reporting cases will make it possible to make correct forecasts of the incidence rate, adequately plan the necessary resources: medical personnel, beds, medical equipment, medicines, as well as ensure the transparency of statistics. A complete transition in Kazakhstan to the COVID-19 coding using the new codes of the international classification of diseases will be carried out from 1st of August.
The Government of Kazakhstan is well aware that this switch to a new methodology and the publication of new combined statistics will lead to a deterioration in Kazakhstan’s position in the international ranking of morbidity and mortality from coronavirus infections.
However, these Government measures emphasise the openness of Kazakhstan and its willingness to jointly confront the coronavirus pandemic and study its consequences in close cooperation with the international community.
There is no new explosive increase in the COVID-19 epidemic in Kazakhstan and no critical increase in new cases of illnesses. A sharp change in the country’s position in international statistics, for example by the Johns Hopkins University or worldometer.com, is associated with the technical addition of all cases of pneumonia associated with COVID-19, as per the WHO’s classification.
All cases of illness (confirmed COVID-19 and pneumonic cases) were initially recorded by the healthcare system of Kazakhstan. But due to the fact that there was no evidence of a connection to COVID-19, these cases were not included in the general epidemiological statistics.
Overall, the introduction of quarantine measures from July 5 to August 2 in Kazakhstan resulted in the noticeable stabilisation of the situation regarding the incidence of COVID-19 in the country; the dynamics of the growth of new cases currently remains at the level of 1700-1800 people per day.
According to Dorit Nitzan, the Regional Emergency Director at the WHO Regional Office for Europe, based on the available data, the epidemiological situation in Kazakhstan is noticeably improving. Today, the country is simultaneously carrying out a program of mass testing of the population and is monitoring the fulfilment by the population of basic requirements, such as wearing masks, social distancing and restrictions on group gatherings.
In the same time, as more information about the COVID-19 virus has become available, experts have realized that the virus behaves differently in each country. In some countries, the danger of coronavirus was underestimated, measures were taken with a delay and hundreds of thousands of cases were reported, leading to thousands of deaths. Kazakhstan was one of the first to close its borders, decisively introduce strict quarantine inside the country, and allocated huge anti-crisis funds to support the healthcare system and support the population.
Kazakh Minister of Healthcare Alexey Tsoy made an official statement with a new set of standards on recording and generating relevant data on the pandemic on July 17.
And thanks to this, Kazakhstan achieved considerable success – the сatastrophic spread of the dangerous disease was avoided, an effort which garnered praise from experts at the World Health Organization (WHO). Now, a new measure is being prepared to set Kazakhstan on sure footing for the next phase of the long struggle against COVID-19.
In an official statement approved on July 17 by Kazakhstan and the WHO on COVID-19, the Kazakh Ministry of Healthcare came out with a new set of standards on recording and generating relevant data on the pandemic. These changes will come into force on July 18 of the current year. These changes were made taking into account technical consultations with the WHO Regional Office for Europe. Laboratory confirmed cases of COVID-19 will be combined with cases of pneumonia that show a negative PCR test result, but with symptoms that indicate the clinical and epidemiological signs of COVID-19.
According to the ministry, until now, in Kazakhstan, as in most countries, only laboratory-confirmed cases of COVID-19 were recorded. However in June, an increase in viral pneumonia was noted without a specific identifying pathogen, that is, it remained laboratory unconfirmed. Going forward, the COVID-19 incidence rate and mortality statistics will be generated from two primary data sources: laboratory-confirmed COVID-19 cases and cases of unspecified viral pneumonia. A full transition to the COVID-19 coding using the new international classification codes will be carried out by Aug. 1 of this year.
This new approach will make it possible to make correct forecasts of the incidence rate, adequately allocate necessary resources: medical personnel, beds, medical equipment, medicines, as well as ensure the transparency of the statistics. The ministry believes that the adoption of the WHO recommendations on international classifications for diseases will become an example for other countries to follow. This process goes hand-in-hand with educating healthcare providers on the correct assignment of ICD-10 COVID-19 codes, when appropriate, and ensuring that the public understands the process and its implications.
1. There is no new dangerous infection in Kazakhstan, all previously reported cases of detected pneumonia according to the WHO classification are now to be classified as COVID-19. Earlier, foreign media mistakenly reported on the appearance of some unknown disease in Kazakhstan. After a thorough investigation into the issue, the WHO confirmed that the summer outbreak of pneumonia in Kazakhstan was a result of COVID-19 (negative PCR test results, but with clinical and epidemiological signs of coronavirus).
2. Kazakhstan will continue to work closely with the WHO. Regular working consultations with the Organization help Kazakhstan to adjust its methodology for recording the development of the disease and to record its various forms. Until now, in Kazakhstan, as in most countries, only laboratory-confirmed cases of COVID-19 were recorded. At the same time, since late June, an increase in viral pneumonia has been noted without the pathogen being specified, that is, it remained laboratory unconfirmed. Kazakhstan’s experience will be useful for those countries where now, according to WHO estimates, excess mortality has also been observed, and where it is most likely associated with COVID-19.
3. From July 18 of this year, COVID-19 morbidity and mortality statistics in Kazakhstan will be compiled from two data sources: laboratory-confirmed cases of COVID-19 and unspecified viral pneumonia. Such an accounting approach will make it possible to make better predictions of morbidity, and to adequately plan the necessary resources which include the allocation of medical personnel, hospital beds, medical equipment, medicines and will also increase the transparency of the statistics used to justify these measures. A complete transition in Kazakhstan to the new COVID-19 coding international coding system will be carried out from Aug.1 of this year.
4. In Kazakhstan, there is no new explosive increase in the COVID-19 epidemic and a critical increase in new cases of disease. The sharp uptick in the country’s COVID-19 rating is due to the technical re-definition of pneumonia cases to the new WHO classification of being COVID-19. The introduction of quarantine has stabilized the situation with the incidence of COVID-19 in the country, at present the increase rate in new cases remains at a stable 1,700-1,800 people per day.
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