At the time of writing, Worldometer reports, per million population, 8325 COVID-19 cases and 172 deaths in Kyrgyzstan, 5841 cases and 95 deaths in Kazakhstan, 1923 cases and 16 deaths in Uzbekistan, and 1109 cases and 8 deaths in Tajikistan.
In March, 2020, when the pandemic hit central Asia, countries in the region were unprepared for it and responded differently. Kazakhstan, Kyrgyzstan, and Uzbekistan readily acknowledged the pandemic and implemented various combinations of measures between March and May, including announcing states of emergency, imposing strict regional or national quarantine or lockdown measures, and closing borders. Kazakhstan and Uzbekistan also re-introduced restrictions in July.
Tajikistan and Turkmenistan, instead, did not initially acknowledge the existence of COVID-19 cases within their borders. Tajikistan only started reporting cases when WHO officials visited the country in May, but did not impose strong measures to curb the spread of the virus. Turkmenistan, instead, has yet to report a single COVID-19 case or death, although it appears to have adopted some of WHO's recommendations. Luca Anceschi, a researcher of central Asian studies in Glasgow (UK), told The Diplomat that “Government advice on masks, social distancing, and pneumonia infection are telling us that Turkmenistan is acting ‘as if’ it has COVID-19 cases, but without reporting those cases”.
Regardless of central Asian countries' responses to the first wave of the pandemic, their health-care systems were overwhelmed, with insufficient hospital beds, personal protective equipment for health-care workers, ventilators, and supportive-care medications. Thousands of people with COVID-19 symptoms were cared for at home due to shortage of health-care workers and services. Assel Terlikbayeva, a global health researcher in Almaty (Kazakhstan) reported that “[in Kazakhstan] ambulances did not answer the calls and primary-care clinics were closed. […] People were left alone with the deadly virus fearful for lives of their own and their loved ones”.
Preparedness for a new surge in cases in the region is also proving difficult, particularly because of the unavailability of affordable testing. In Kazakhstan, for example, the cost of PCR testing for COVID-19 is US$42, although the Government plans to reduce it to US$20. The country is also building new laboratories and hospitals focused on the management of infectious diseases, and is training its medical workforce on the use of national clinical protocols for COVID-19 management. A contact-tracing strategy is in place but on a small scale, due to the scarce capacities of local public health services and legislative restrictions for personal data protection on the use of digital technologies such as mobile applications. Furthermore, efforts to digitise and electronically manage health data encountered major problems with the integration of various electronic databases, undermining data reliability, such as numbers of COVID-19 cases and deaths. “Lockdown and quarantine remain [the] main strategies to control the pandemic across the central Asia”, Terlikbayeva said.
Another issue in central Asia is the high prevalence of other infectious diseases—notably, HIV, hepatitis, and tuberculosis—and of substance misuse. Re-allocation of health-care services to COVID-19 has impaired access to care for these infections and services for harm reduction from substance misuse. For example, upscaling of pre-exposure prophylaxis availability for HIV prevention and access to care for tuberculosis and multi-drug resistant (MDR) tuberculosis have been affected. “As a result, substantial decreases in tuberculosis case notification have been observed starting April, 2020, compared to the same period of 2019, reaching the highest decline in May (–48%), as well as decline in the enrolment of patients to MDR-tuberculosis treatment (–45%)”, according to Askar Yedilbayev (WHO Regional Office for Europe, Copenhagen, Denmark). The management of chronic diseases such as cancer and of lifestyle risk factors such as obesity has also been sidelined, and suicide rates have increased.
Against this backdrop, some hope lies in the access of the central Asian population to at least one COVID-19 vaccine, once it has been developed. Uzbekistan, Kyrgyzstan, and Tajikistan are eligible to join the COVAX Facility. “WHO has called on all countries to join the COVAX Facility, to ensure eventual COVID-19 vaccines are available to all countries equitably”, wrote a spokesperson for the WHO Regional Office for Europe to The Lancet Microbe. And China has offered to provide Uzbekistan with a vaccine, although the Uzbek Ministry of Health has not responded yet. Kazakhstan, instead, has signed a deal with Russia for the procurement of doses of the Sputnik V COVID-19 candidate vaccine, upon completion of phase 2–3 clinical trials. “The vaccine should be available to at-risk Kazakh citizen[s] free of charge”, Terlikbayeva said. In addition, phase 1–2 trials of QazCovid-in, a Kazakh candidate vaccine against COVID-19, are starting this month. “Should QazCovid-in prove effective, Kazakhstan will be able to provide the vaccine to the entirety of Central Asia”, she added.
“Overall, the situation with the pandemic brought to light the major problems in health-care systems in central Asia: financing, capacity building, data integration, medical statistics, and case reporting”, concluded Terlikbayeva.