RESOLUTION OF THE CHIEF STATE HEALTH OFFICER OF THE REPUBLIC OF KAZAKHSTAN

of April 9, 2020 No. 32-PGVR

About measures for safety of the population of the Republic of Kazakhstan according to the Presidential decree of the Republic of Kazakhstan "About introduction of emergency state in RK"

For the purpose of the prevention of spread of koronavirusny infection of COVID-19 (further - I DECIDE COVID-19) among the population of the Republic of Kazakhstan:

І. Restrictive actions on entry into the country

1. To akims, heads of managements of health care of areas, cities of Almaty, Nour-Sultan, Shymkent to provide:

1) isolation for 2 days in quarantine hospital for carrying out laboratory inspection on COVID-19 of all persons arriving from abroad to the Republic of Kazakhstan, except for government delegations of the Republic of Kazakhstan; members of official delegations of the foreign states and the international organizations arriving to the Republic of Kazakhstan by the invitation of the Ministry of Foreign Affairs of the Republic of Kazakhstan; the staff of diplomatic representations, consular establishments and representative offices of the international organizations accredited in the Republic of Kazakhstan and members of their families; pilots of airlines and members of the locomotive crews, faces tied with transportation activities on rail transport and drivers, performing international motor transportations of loads, and also persons which came from the countries of EEU and the Republic of Uzbekistan through check points through Frontier of the Republic of Kazakhstan by railway transport and autotransitions.

Persons with the signs which are not excluding COVID-19, passing quarantine hospital, are hospitalized in provisional hospital.

After receipt of results of laboratory inspection on COVID-19 of person with positive result are transferred to infectious hospital for treatment, persons with negative result on COVID-19 - are isolated at home (house quarantine) within 12 days. In case of lack of conditions for isolation isolation in the rooms determined by local executive bodies is recommended at home.

2) the staff of diplomatic representations, consular establishments and representative offices of the international organizations accredited in the Republic of Kazakhstan and the members of their families arriving to the Republic of Kazakhstan from abroad is subject to laboratory inspection on COVID-19 and self-isolation at home (house quarantine) within 14 days.

The pilots of airlines and members of locomotive crews, faces tied with transportation activities on rail transport and the drivers performing the international motor transportations of loads which arrived from abroad are subject to medical observation in the place of residence (stay) by call-down (in case of possibility of video call-down).

Persons which came from the countries of EEU and the Republic of Uzbekistan through check points through Frontier of the Republic of Kazakhstan by railway transport and autotransitions are subject to laboratory inspection on COVID-19 and self-isolation at home (house quarantine) within 14 days;

3) the Chief state health officer of the corresponding territory has the right to make the decision on karantinization of the passengers who arrived from abroad taking into account the developing epidemiological situation in the region and the world.

2. To inspection department of quality and safety of goods and services on transport, to territorial departments of Committee of quality control and safety of goods and services, structural divisions of bodies of state revenues at automobile check points through Frontier of the Republic of Kazakhstan to provide:

1) carrying out sanitary and quarantine control with obligatory thermometry of all persons arriving from abroad (including pilots, stewards, drivers, conductors, drivers, carriers and others) at all check points through Frontier of the Republic of Kazakhstan;

2) questioning of passengers, members of crews, stewards, drivers and conductors at check points through Frontier of the Republic of Kazakhstan at the international airports, on rail transport and autotransitions;

3) data processing by system of recognition of questionnaires with their transfer to the Web application of the Ministry of Health of the Republic of Kazakhstan within two hours after arrival of flight according to appendix 1 to this resolution;

4) completion of specialists of sanitary and quarantine Items at check points on frontier of the Republic of Kazakhstan individual protection equipment (further - SIZ) according to appendix 2 to this resolution and disinfectants taking into account the round-the-clock operating mode;

5) carrying out sanitary and educational and explanatory work on posts of transport control among carriers and passengers on prevention and the prevention of distribution of COVID-19;

6) the organization of placement of evident propaganda for the prevention of distribution of COVID-19, and also to inform passengers on loud-speaking communication concerning prevention of COVID-19;

7) distribution of instruction sheets to all leaving citizens of the Republic of Kazakhstan from Kazakhstan and to all citizens coming from abroad concerning prevention of COVID-19 in the conditions of threat of its delivery and distribution in the world;

8) carrying out sanitary and educational work among the population with use of mass media concerning prevention of COVID-19;

9) instructing of employees of check points on Frontier concerning prevention of COVID-19.

ІІ. Restrictive actions in the territory of the republic

3. To the central state bodies, law enforcement and special bodies, akims of areas, cities of Almaty, Nour-Sultan, Shymkent to provide introduction and control of execution:

1) prohibition on carrying out audio, photo and video filming in the organizations of health care, machines of emergency medical service, in the rooms determined by local executive bodies for quarantine and also in case of delivery of health care at home health workers, conducting epidemiological investigation in the center, holding poll and questioning sick and contact;

2) prohibition on holding mass actions (festive, sports and mass, spectacular cultural events, holding of conferences, seminars, exhibitions, etc.);

3) suspensions of operations of movie theaters, night clubs, fitness, gyms (centers), children's playgrounds under shopping malls, the organizations of out-of-school additional education (the centers of development, education, mug, open classrooms, etc.), computer clubs of sports complexes (circles, sections, etc.), except for the sports bases accredited in National Olympic Committee only during their use for training of the national teams of teams for the Olympic and Paraolimpiysky Games, Tokyo-2020;

4) departure prohibition on the international sporting, cultural, tourist events to the countries, unsuccessful on COVID-19, except for departure on medical indications. Departure on treatment is abroad allowed to citizens accompanied by no more than two people, in the presence of the following documents:

- the conclusion of the medical and consulting commission of the territorial out-patient and polyclinic organization for confirmation of the diagnosis and urgency of treatment, according to the form 035-1/y approved by the order of the acting minister of health care of the Republic of Kazakhstan of November 23, 2010 No. 907 "About approval of forms of primary medical documentation of the organizations of health care";

- the letter invitation from the foreign medical organization on treatment, with notarially attested transfer;

5) prohibition of departure and entrance on the territory of the regions/cities with the announced quarantine, except for the staff of the organizations of life support of the population, and also the persons leaving and driving on medical indications and also departure of persons which were on treatment in hospitals and under observation in quarantine and provisional hospitals during introduction of quarantine.

Entrance and departure of citizens on medical indications on the territory of the regions/cities with the announced quarantine accompanied by no more than two people, in the presence of the following documents is allowed:

- the conclusion of the medical and consulting commission of the territorial out-patient and polyclinic organization for confirmation of the diagnosis and urgency of treatment, according to the form 035-1/y approved by the order of the acting minister of health care of the Republic of Kazakhstan of November 23, 2010 No. 907 "About approval of forms of primary medical documentation of the organizations of health care";

- the letter invitation from the medical organization located in quarantine zone with indication of the diagnosis and urgency confirmation signed by the first head and certified by official stamp;

6) the exit visa and entrance is issued to separate categories of persons except for specified in the subitem 5) of Item 3 of this resolution by local executive bodies. At the same time, specified persons are subject to house quarantine for 14 days in the place of arrival.

7) prohibition on use of hookahs in public catering objects;

8) quarantine and observance of the sanitary and disinfection mode in the medical organizations, medico-social objects for elderly and persons with limited opportunities, children's homes, orphanages, the centers of social resettlement, educational institutions for children of disabled people, residential type;

9) the strengthened sanitary and disinfection mode (installation of sanitayzer for processing of hands, processing of surfaces at least two times a day, wet cleaning using disinfectants, airing) on subjects to mass stay and life support (shopping centers, the markets, TsONy, baths, subjects to religious appointment, municipal services, the food industry, public catering, stations, the airports, service industries (beauty shops, studio and others);

10) processings using washing and disinfectants of public transport before each flight, the airports, railway and bus stations, supermarkets, the markets, public transport stops (at least two times a day), handrail of above-ground and underground crosswalks, apparatuses, nurseries and sports grounds, benches and shops, ATMs, terminals of banks, POS terminals. Carry out processing according to appendix 3 to this resolution;

11) processings using detergents public above-ground and underground crosswalks, sidewalks, parks, squares, the areas, the adjacent territory to railway and bus stations, highways and the territory of the markets.

12) sales of products of food in the packed-up type, except for vegetables and fruit;

13) rendering services to the population on objects of trade, public catering in the one-time gloves which are subject to replacement at least two times in change and in case of integrity violation (the sellers, cooks, waiters, cashiers and other employees having direct contact with food);

14) observance of distance between tables at least 2 meters in the food courts located in the territory of large shopping facilities;

15) active epidemiological surveillance, identification and isolation of patients (and persons with suspicion) with the displays of viral infection similar in clinical signs to COVID-19;

16) uses of masks or respirators of high degree of protection by health workers and personnel which actions are connected with survey, transportation, work in the center, hospitalization, treatment and servicing of patients with suspicion on COVID-19;

17) the organizations and holding seminars for specialists of territorial subdivisions of Committee of quality control and safety of goods and services, the organizations of health care for epidemiology, clinical manifestations, diagnostics of COVID-19;

18) briefings with complete scope of all staff of the medical organizations of the region for holding anti-epidemic actions in case of COVID-19 with demonstration of protective suits І - the II types and individual protection equipment;

19) briefing and explanatory work among organizers of tours (specialists of travel companies) and travelers (medical, private and business tourism) on prevention and the prevention of distribution of COVID-19;

20) regular informing the population concerning COVID-19, prevention taking measures to the prevention of panic among the population.

21) the organizations in case of the announcement of emergency mode (emergency) in the certain region of sanitary and quarantine control on posts in compliance to appendix 4 to this resolution.

4. To the Ministry of Education and Science of the Republic of Kazakhstan together with akimats of areas, cities of Almaty, Nour-Sultan, Shymkent to provide:

1) exit to vacation of the organizations of secondary education from March 16 to April 5, 2020;

2) transfer into distance training of the organizations of education (to provide the maximum transfer if technically possible), including carrying out all types of assessment of knowledge;

3) observance of the sanitary and disinfection mode in the organizations of education and education (airing, wet cleaning at least three times in change, disinfection);

4) quartz treatment of rooms of groups in preschool institutions;

5) carrying out the morning filter (survey in case of acceptance of children in group) in preschool institutions;

6) prohibition of excursions of pupils during vacation and effective period of emergency state.

5. To provide to the ministry of the industry and infrastructure development of the Republic of Kazakhstan restriction of the international passenger traffics.

6. To provide to the Ministry of Internal Affairs of the Republic of Kazakhstan:

1) protection of places of karantinization and provisional hospitalization contact on COVID-19;

2) taking measures to search and the placement on quarantine contact on COVID-19;

3) observance of anti-epidemic measures with use of individual protection equipment by operational-investigations group in case of departure on the scene, further control of condition of their health, without self-isolation;

4) strengthening of the sanitary and disinfection mode and use of individual protection equipment by employees in transit corpses on forensic medical examination;

5) carrying out by health service instructing in algorithm of use of individual protection equipment in case of koronovirusny infection with the members of operational-investigations groups and employees participating in transportation of corpses.

7. To the ministry of information and social development of the Republic of Kazakhstan together with akimats of areas, cities of Almaty, Nour-Sultan, Shymkent to speed up information and explanatory work on prevention of distribution of COVID-19 among the population.

ІІІ. Organization and holding anti-epidemic actions for localization of the centers of infection

8. To akims of areas, cities of Almaty, Nour-Sultan, Shymkent to provide:

1) expansion of additional provisional hospitals for patients with the symptoms which are not excluding COVID-19 disease;

2) quarantine for persons which had the increased risk of infection of COVID-19, and transportation of persons contacting to sick COVID-19, with observance of the instruction according to appendix 5 to this resolution;

3) expansion of quarantine hospitals for isolation of persons contacting to sick COVID-19 according to appendix 6 to this resolution;

4) in case of placement of quarantine hospitals in the organizations of not medical appointment (hotel, hostels, sanatoria, etc.) the organization of the round-the-clock posts of observation of observance of requirements of quarantine in enough (not from among health workers), having provided them with individual protection equipment.

5) informing the population on the current epidemiological situation on distribution of COVID-19 and the taken measures in the region;

6) acquisition of necessary amount of medicines, products of medical appointment, resuscitation equipment (devices IVL, perfusors, pulsoksimetra, cardiomonitors) and consumable materials;

7) not reduced inventory of test systems, diagnostikum, consumable materials for sampling and carrying out laboratory researches on COVID-19, of disinfecting medicines;

8) means for remote measurement of temperature on entrances (from the settlement and the platform) in railway and bus stations, posts;

9) since April 6 transfer into distance training of all organizations of secondary education;

10) restriction of movement of children up to 18 years and citizens is more senior than 65 years on streets with ensuring delivery of food and medicines with it;

11) restriction of entrance to the building of the airports, railway and bus stations for the seeing-off and meeting persons;

12) organization activity of public catering, performing delivery of food in compliance Provisional rules according to appendix 7 to this resolution;

13) carrying out burial of corpse of the person who died of koronavirusny infection of COVID-19 with observance of security measures according to appendix 8 to this resolution.

9. To heads of managements of health care of areas, cities of Almaty, Nour-Sultan, Shymkent to provide:

1) allocation of separate beds in infectious hospital for isolation of sick COVID-19 and with suspicion of COVID-19, diseases with observance of the anti-epidemic mode;

2) allocation of separate provisional beds (hospitals) for isolation of patients with the clinical signs which are not excluding COVID-19, with observance of the anti-epidemic mode;

3) allocation in all organizations of health care of placements for isolation on case of identification of the patient with the clinical signs which are not excluding COVID-19, taking into account specifics of the provided medical care;

4) distribution of daily flow of patients (on other nosological diseases) with exception of their crossing with patients with suspicion of COVID-19 disease;

5) in case of receipt in the organization of obstetric aid of women in labor, and also in somatic hospitals of the patients needing rendering the emergency help according to vital indications with the clinical signs which are not excluding COVID-19, delivery of health care in the isolated room with observance of the anti-epidemic mode with use of individual protection equipment according to appendix 2 to this resolution. The personnel involved in delivery of health care in case of confirmation at the patient of the diagnosis of COVID-19 are subject to isolation on house quarantine and to laboratory inspection on COVID-19. In case of positive result goes for treatment, in case of negative result is on quarantine and it is allowed to work in 14 days after repeated laboratory inspection, in the absence of clinical display of respiratory infection;

6) hospitalization and physical examination in provisional hospital of patients with the symptoms which are not excluding COVID-19 disease;

7) treatment of sick COVID-19 in infectious hospital, except as specified, according to the subitem 5) Item 10 of this resolution;

8) the statement from hospital of patients with the confirmed diagnosis of COVID-19 after stay at least 14 days and twofold negative inspection by PTsR method with interval of 24 hours;

9) after the statement from hospital house quarantine and medical observation within 14 days (observation of the state of health, wearing mask, accommodation in the certain room with good ventilation or airing, exception of close contact with family members, separate food, respect for hygiene of hands). Medical observation of convalescents is performed by the district doctor at the place of residence (it is desirable remotely by video call-down).

10) quarantine at home and remote medical observation of persons which were close contacting to sick COVID-19, in the presence of isolation conditions according to appendix 9 to this resolution;

11) isolation in quarantine hospital of persons contacting to sick COVID-19, in the absence of isolation conditions at home;

12) remote medical observation for potential contact (call-down, in case of opportunity video call-down);

13) laboratory inspection on COVID-19 according to appendix 10 to this resolution;

14) the organization of safe selection of material from patients with suspicion on COVID-19 for laboratory inspection according to appendix 11;

15) observance of requirements of the anti-epidemic mode in infectious, quarantine, provisional and other hospitals;

16) exception of crossing of flow contact of different flights, the house centers, contact on place of employment (study) in provisional, quarantine and infectious hospitals;

17) if necessary execution of sheets of temporary disability (sick leave note) without visit of the medical organizations for persons which are in quarantine at home;

18) the organization of online issue or delivery of recipes to the house to patients within free out-patient provision of medicines;

19) transfer of planned acceptance of doctors of PHC and planned consultations of doctors of the out-patient and polyclinic organizations in format of remote services;

20) if necessary decision making on cancellation/restriction of planned medical services (planned hospitalization, routine inspections, screenings, rehabilitation);

21) increase in quantity of crews of emergency medical service of the out-patient and polyclinic organizations;

22) requirement of the organizations of health care for the medicines and medical products necessary for treatment of patients with COVID-19;

23) introduction of quarantine in the stationary organizations of health care;

24) infectious safety of medical personnel according to appendix 12 to this resolution;

25) suspension of carrying out preventive inoculations until further notice, except for preventive inoculations:

the newborn in the organizations of obstetric aid (BTsZh and VGV);

to the population living and working in the natural centers of infectious diseases (spring and summer tick-borne encephalitis, anthrax, tularemia, plague);

to persons which underwent to sting or oslyuneniye any animal (rage);

to persons who were traumatized wounds with violation of integrity of integuments and mucous (tetanus);

contact in the infection centers according to epidemiological indications;

To assign 26) to each post of average health workers taking into account the round-the-clock working schedule;

27) in the organizations performing activities in the field of pathoanatomical service, forensic medical examination when opening corpses (autopsy) observance of anti-epidemic measures - use of individual protection equipment, with further control of the state of health of employees, including measurement of body temperature in case of appearance at work, without self-isolation;

28) the organization in all organizations of health care of locks with providing with thermal imagers for measurement of body temperature of all flow of patients;

29) employees of lock individual protection equipment (scrub, mask, glove, filter, hat);

30) allocation in all organizations of health care of rooms and ensuring equipping for carrying out the express of testing for COVID - 19;

31) providing crew of emergency medical service with equipment for the express - testings for COVID - 19;

31) in department of urgent medicine of multi-profile hospitals distribution of daily flow of patients separately on surgical and therapeutic profiles;

32) distribution of daily flow of patients separately with temperature increase of body, without temperature increase;

33) distribution of daily flow of patients separately with temperature increase of body and positive result the express - testings, with temperature increase of body and negative result the express - testings;

35) continuous training of dispatchers of the station of emergency medical service in COVID in remote triazh on the check - to the sheet, rules of epidemiological and biological safety, accomplishment of the standardized operational procedures (SOP), use the check - leaf of survey of the patient with suspicion on COVID - 19.

10. To heads of Department on transport, territorial departments of Committee of quality control of safety of goods and services to provide:

1) execution of procedure for purpose of type of quarantine for persons which had the increased risk of infection of COVID-19, according to appendix 5 to this resolution;

2) control of carrying out isolation contact, and also observance of the anti-epidemic mode in the conditions of quarantine;

3) the notification under list contact, being on house quarantine, and also persons living together with them about need of observance of Rules of isolation at home (house quarantine) according to appendix 9 to this resolution;

4) epidemiological investigation of each case of COVID-19 with determination of circle contact (close, potential contacts), assessment of conformity of the dwelling to requirements for the organization of house quarantine and amount of anti-epidemic actions, within 24 hours, and also questioning of persons with the confirmed (probable) diagnosis of COVID-19 and contact according to appendices 13 and 14 to this resolution;

5) provision of information on each new case of COVID-19 in the Republican state company on the right of economic maintaining "The national center of public health care of MZ RK" (NTsOZ) within 12 hours from the moment of receipt of laboratory confirmation;

6) control of observance of the anti-epidemic mode in infectious, provisional, quarantine hospitals and other organizations of health care;

7) informing the population on the current epidemiological situation on distribution of COVID-19 and the taken measures in regions;

8) daily monitoring and representation in information NTsOZ for last days till 02-00 o'clock the next day about persons crossing RK border with breakdown on citizens of RK, total quantity of foreign citizens, with separate accounting of the foreign citizens who arrived from the countries of COVID-19, unsuccessful on incidence;

9) in case of identification of the confirmed KVI cases among staff (including civil personnel) the Ministries of Defence of the Republic of Kazakhstan, the Ministry of Internal Affairs of the Republic of Kazakhstan, Committee of homeland security (including. The border service of KNB) and Services of the state protection of the Republic of Kazakhstan to notify the populations of the specified departments performing activities in the field of sanitary and epidemiologic wellbeing within 2 watch of division.

11. To provide to heads of territorial departments of Committee of quality control of safety of goods and services:

1) control of work of subjects to water supply with acceptance of necessary measures for providing the population with drinking water of guaranteed quality;

2) sanitary and epidemiologic monitoring of quality of the water pumped to the population of water without acceptance of administrative measures;

3) supervision of the grocery stores and the organizations of public catering performing delivery of food within control of observance of the mode of quarantine.

12. To heads of managements of health care of areas, cities of Almaty, Nour-Sultan, Shymkent, territorial departments of Committee of quality control of safety of goods and services to involve the organizations of science and education of the Ministry of Health of the Republic of Kazakhstan (medical schools, medical colleges, national, scientific centers) in assistance in actions for localization of koronavirusny infection.

13. To provide "The national center of public health care of MZ RK" to the republican state company on the right of economic maintaining:

1) the round-the-clock monitoring of epidemiological situation on COVID-19 in the countries of the world;

2) submission daily till 19-00 o'clock to Committee of quality control and safety of goods and services, managements of health care and Inspection departments of quality of safety of goods and services of areas, cities of Almaty, Nur-Sultan, Shymkent of the list of the countries, unsuccessful on incidence of COVID-19, by categories;

3) daily placement on the website the list of the countries with registration of COVID-19;

4) provision in the Ministry of Health and Committee of quality control of safety of goods and services weekly on Fridays the updated forecast of development of epidemiological situation in RK, daily each 3 hours - information on identification and monitoring of contact persons with sick COVID-19 (close and potential contact);

5) monitoring of number of persons crossing border of RK, the confirmed cases of COVID-19 and contact persons with informing on each registered case within hour of the Minister of Health both Committee of quality control and safety of goods, and provision of data of monitoring daily at least 2 times;

6) visualization of epidemiological situation in the territory of the republic with indication of "hot spots" and dislocation of contact persons;

7) carrying out retestirovaniye of 10% of positive samples and 5% of negative samples for the expired month according to algorithm of laboratory researches;

8) rendering the methodological help to specialists of laboratories of NTsE branch by methods of diagnostics COVID-19 according to the international recommendations (WHO, CDC);

9) round-the-clock operation of the Call-center for number 8(7172)768043;

10) regular interaction with the World Health Organization (24 hours 7 days a week) through contact Item of WHO.

14. To provide "The national center of examination" (further - NTsE) to the republican state company on the right of economic maintaining:

1) laboratory inspection sick and contact on COVID-19, and also the other persons determined by the Chief state health officer of the corresponding territory in the following priority: 1 - patients with suspicion on COVID-19, 2 - contact with sick COVID-19, 3 - persons which arrived from abroad to the Republic of Kazakhstan flights, 4 - other persons;

2) disinfection processing of the centers of COVID-19;

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