Dr. Ilona Butova almost looks out of place in her neatly pressed lavender scrubs as she walks through a door frame that hangs from a crumbled wall into what used to be an administrative office of her hospital in Zolochiv.
Not one building in the facility in the northeastern Ukrainian town near the Russian border has escaped getting hit by artillery shells.
Since Russia’s invasion on Feb. 24, space to treat patients at the hospital has shrunk constantly because of damage. Her staff has dwindled to 47 from 120. And the number of people seeking treatment in the small town 18 kilometers (11 miles) from the border is often higher now than before the fighting began.
Ukraine’s health care system struggled for years because of corruption, mismanagement and the COVID-19 pandemic. But the war has only made things worse, with facilities damaged or destroyed, medical staff relocating to safer places and many drugs unavailable or in short supply. Care is being provided in the hardest-hit areas by doctors who have refused to evacuate or have rushed in as volunteers, putting themselves at great risk.
“It’s very hard, but people need us. We have to stay and help,” said Butova, a neurologist who also is the administrator of the hospital in the town near Kharkiv, Ukraine’s second-largest city. She added that she has had to do more with fewer resources.
The World Health Organization declared its highest level of emergency in Ukraine the day after the invasion, coordinating a major relief effort there and in neighboring countries whose medical systems also are under strain.
About 6.4 million people have fled to other European countries, and a slightly higher number are internally displaced, according to U.N. estimates. That presents a major challenge to a health care system built on family doctor referrals and regionally separate administrations.
Across Ukraine, 900 hospitals have been damaged and another 123 have been destroyed, said Health Minister Viktor Liashko, noting: “Those 123 are gone, and we’re having to find new sites to build replacements.”
In addition, scores of pharmacies and ambulances have been destroyed or are seriously damaged, and at least 18 civilian medical staff have been killed and 59 others seriously wounded, he said.
“In occupied areas, the referral system has totally broken down,” Liashko told The Associated Press. “People’s health and their lives are in danger.”
Kyiv’s economy was drained by the conflict with Moscow-backed separatists in eastern Ukraine that began in 2014. When he came to power five years later, President Volodymyr Zelenskyy inherited a health care system that was undermined by reforms launched under his predecessor that had slashed government subsidies and closed many small-town hospitals. During the pandemic, people in those communities had to seek care in large cities — sometimes waiting as long as eight hours for an ambulance in severe cases of COVID-19.
As Russia has expanded the territory it controls in eastern and southern Ukraine, the supply of drugs in those areas has dwindled, along with medical staff to administer them. In the southern front-line town of Mykolaiv, “things have been very difficult,” volunteer Andrii Skorokhod said.
“Pharmacies have not been working, and shortages have become increasingly acute: Hospital staff were among those evacuated, including specialists. We just need more staff,” said Skorokhod, who heads a Red Cross initiative to provide residents with free medications.
Volunteers like Skorokhod saved the life of 79-year-old Vanda Banderovska, whose home near Mykolaiv was destroyed by Russian artillery. Her 53-year-old son, Roman, was killed, and she was brought to the hospital badly bruised and barely conscious.
“My son went out to the car to get his mobile phone when the Russians started shelling. He was hit in the head,” she said at a recovery ward, her voice trembling with emotion. “They’ve destroyed everything and I have nothing left.”
Banderovska said she was deeply grateful to the people who saved her life but also overcome by grief and anger.
“The pain I feel is so great. When doctors took me to the hospital I was bruised black and blue but I slowly recovered,” she said.
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Derek Gatopoulos reported from Kyiv. Vasilisa Stepanenko and Hanna Arhirova contributed to this report from Kyiv.
Total Doses Distributed = 803,252,035. Total Doses Administered = 607,588,353. Number of People Receiving 1 or More Doses = 262,323,837. Number of People Fully Vaccinated = 223,684,995.
New coronavirus cases reported globally dropped nearly a quarter in the last week while deaths fell 6% but were still higher in parts of Asia, according to a report Thursday on the pandemic by the World Health Organization.
The U.N. health agency said there were 5.4 million new COVID-19 cases reported last week, a decline of 24% from the previous week. Infections fell everywhere in the world, including by nearly 40% in Africa and Europe and by a third in the Middle East. COVID deaths rose in the Western Pacific and Southeast Asia by 31% and 12% respectively, but fell or remained stable everywhere else.
At a press briefing Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus said reported coronavirus deaths over the past month have surged 35%, and noted there had been 15,000 deaths in the past week.
“15,000 deaths a week is completely unacceptable, when we have all the tools to prevent infections and save lives,” Tedros said. He said the number of virus sequences shared every week has plummeted 90%, making it extremely difficult for scientists to monitor how COVID-19 might be mutating.
“But none of us is helpless,” Tedros said. “Please get vaccinated if you are not, and if you need a booster, get one.”
On Thursday, WHO’s vaccine advisory group recommended for the first time that people most vulnerable to COVID-19, including older people, those with underlying health conditions and health workers, get a second booster shot. Numerous other health agencies and countries made the same recommendation months ago.
The expert group also said it had evaluated data from the Pfizer-BioNTech and Moderna vaccines for younger people and said children and teenagers were in the lowest priority group for vaccination, since they are far less likely to get severe disease.
Joachim Hombach, who sits on WHO’s vaccine expert group, said it was also uncertain whether the experts would endorse widespread boosters for the general population or new combination vaccines that target the omicron variant.
“We need to see what the data will tell us and we need to see actually (what) will be the advantage of these vaccines that comprise an (omicron) strain,” he said.
Dr. Alejandro Cravioto, the expert group’s chair, said that unless vaccines were proven to stop transmission, their widespread use would be “a waste of the vaccine and a waste of time.”
Earlier this week, British authorities authorized an updated version of Moderna’s COVID-19 vaccine that targets omicron and the U.K. government announced it would be offered to people over 50 beginning next month.
The head of the nation’s top public health agency on Wednesday announced a shake-up of the organization, saying it fell short responding to COVID-19 and needs to become more nimble.
The planned changes at the Centers for Disease Control and Prevention — CDC leaders call it a “reset”— come amid criticism of the agency’s response to COVID-19, monkeypox and other public health threats. The changes include internal staffing moves and steps to speed up data releases.
The CDC’s director, Dr. Rochelle Walensky, told the agency’s staff about the changes on Wednesday. It’s a CDC initiative, and was not directed by the White House or other administration officials, she said.
“I feel like it’s my my responsibility to lead this agency to a better place after a really challenging three years,” Walensky told The Associated Press.
The Atlanta-based agency, with a $12 billion budget and more than 11,000 employees, is charged with protecting Americans from disease outbreaks and other public health threats. It’s customary for each CDC director to do some reorganizing, but Walensky’s action comes amid a wider demand for change.
The agency has long been criticized as too ponderous, focusing on collection and analysis of data but not acting quickly against new health threats. Public unhappiness with the agency grew dramatically during the COVID-19 pandemic. Experts said the CDC was slow to recognize how much virus was entering the U.S. from Europe, to recommend people wear masks, to say the virus can spread through the air, and to ramp up systematic testing for new variants.
“We saw during COVID that CDC’s structures, frankly, weren’t designed to take in information, digest it and disseminate it to the public at the speed necessary,” said Jason Schwartz, a health policy researcher at the Yale School of Public Health.
Walensky, who became director in January 2021, has long said the agency has to move faster and communicate better, but stumbles have continued during her tenure. In April, she called for an in-depth review of the agency, which resulted in the announced changes.
“It’s not lost on me that we fell short in many ways” responding to the coronavirus, Walensky said. “We had some pretty public mistakes, and so much of this effort was to hold up the mirror … to understand where and how we could do better.”
Her reorganization proposal must be approved by the Department of Health and Human Services secretary. CDC officials say they hope to have a full package of changes finalized, approved and underway by early next year.
Some changes still are being formulated, but steps announced Wednesday include:
—Increasing use of preprint scientific reports to get out actionable data, instead of waiting for research to go through peer review and publication by the CDC journal Morbidity and Mortality Weekly Report.
—Restructuring the agency’s communications office and further revamping CDC websites to make the agency’s guidance for the public more clear and easier to find.
—Altering the length of time agency leaders are devoted to outbreak responses to a minimum of six months — an effort to address a turnover problem that at times caused knowledge gaps and affected the agency’s communications.
—Creation of a new executive council to help Walensky set strategy and priorities.
—Appointing Mary Wakefield as senior counselor to implement the changes. Wakefield headed the Health Resources and Services Administration during the Obama administration and also served as the No. 2 administrator at HHS. Wakefield, 68, started Monday.
—Altering the agency’s organization chart to undo some changes made during the Trump administration.
—Establishing an office of intergovernmental affairs to smooth partnerships with other agencies, as well as a higher-level office on health equity.
Walensky also said she intends to “get rid of some of the reporting layers that exist, and I’d like to work to break down some of the silos.” She did not say exactly what that may entail, but emphasized that the overall changes are less about redrawing the organization chart than rethinking how the CDC does business and motivates staff.
“This will not be simply moving boxes” on the organization chart, she said.
Schwartz said flaws in the federal response go beyond the CDC, because the White House and other agencies were heavily involved.
A CDC reorganization is a positive step but “I hope it’s not the end of the story,” Schwartz said. He would like to see “a broader accounting” of how the federal government handles health crises.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
First lady Jill Biden tested positive for COVID-19 and was experiencing “mild symptoms,” the White House announced Tuesday. President Joe Biden continues to test negative after recently recovering from the virus but will wear a mask indoors for 10 days as a precaution.
The Bidens have been vacationing in South Carolina since Aug. 10, and the 71-year-old first lady began experiencing symptoms on Monday. Jill Biden, like her husband, has been twice-vaccinated and twice-boosted with the Pfizer COVID-19 vaccine. She has been prescribed the antiviral drug Paxlovid and will isolate at the vacation home for at least five days.
“Close contacts of the First Lady have been notified,” her communications director, Elizabeth Alexander, said in a statement “She is currently staying at a private residence in South Carolina and will return home after she receives two consecutive negative COVID tests.”
The president tested negative for the virus on Tuesday morning, the White House said, but would be wearing a mask indoors for 10 days. He plans to return to Washington on Tuesday to sign Democrats’ landmark climate change and health care bill in the afternoon, before continuing to his home in Wilmington, Delaware.
He recovered from a rebound case of the virus on Aug. 7.
“Consistent with CDC guidance because he is a close contact of the First Lady, he will mask for 10 days when indoors and in close proximity to others,” the White House said. It said it would increase the president’s testing cadence and report those results.
Bill Gates on Tuesday called for South Korea to further step up in international efforts to prevent infectious diseases like COVID-19 as he stressed the need for the world to be better prepared for the next pandemic.
Speaking to South Korean lawmakers in Seoul, Gates called for stronger international cooperation, including efforts to develop vaccines that would be effective for a broader range of coronaviruses, to navigate what he described as a “crisis moment” in global health.
He said the Bill and Melinda Gates Foundation and South Korea’s government have committed to a partnership aimed at addressing health disparities between countries and supporting efforts to eradicate infectious diseases in the developing world.
He noted South Korea’s strength in public health tools, research and vaccine manufacturing and praised the country’s pledge to donate $200 million to the U.N.-backed COVAX distribution program that provides COVID-19 vaccines to lower-income nations.
“There’s a lot we need to do together –- we need to reach deep, we need to build more partnership, we need to encourage the scientists,” Gates said in his speech at the National Assembly. “But I am confident that with these steps we can continue to radically improve global health, to cut the number of children dying in half again, to eradicate diseases like polio, measles and malaria, and improve the lives of all humans.”
Gates later met South Korean President Yoon Suk Yeol, who described government plans to promote the country’s bio-health industry and expressed a willingness to further cooperate with the Gates foundation to “improve the health of global citizens.” Gates said South Korea has been a “good partner” in his foundation’s health projects, including development of more accessible COVID-19 vaccines and work on HIV, malaria and tuberculosis.
“We hope we can do more together,” Gates said, according to Yoon’s office.
Gates also met leaders of the SK business group to discuss cooperation on health projects. SK’s pharmaceutical arm, SK Bioscience, produces COVID-19 vaccines and has received funds from the Gates foundation to develop nasal sprays designed to help prevent coronavirus infections.
