Bulgaria’s caretaker Health Minister slams previous government’s handling of Covid-19 crisis

Bulgaria’s caretaker Health Minister Stoicho Katsarov unleashed on June 15 a searing indictment of the previous government’s handling of the Covid-19 crisis, pointing to poor indicators, inefficiencies and wasteful spending.

Katsarov was speaking at a news conference to mark the first month in office of the caretaker administration.

He portrayed a grim picture of the state of public health in Bulgaria, saying that the country’s life expectancy was the lowest in the European Union while infant mortality was highest.

Patients were paying almost half of the cost of their medical care out of their own pockets, while the country had the second-smallest number of nurses.

There are severe regional disparities in the provision of medical care and unfair distribution of funds between different medical specialities, he said.

“We finished 2019 in first place in the world in terms of mortality with a total mortality rate – 15.5,” Katsarov said.

“For 2020 this coefficient is 17.8, and for the first five months of 2021 it exceeded 21. The lethality from COVID-19 in our country is twice higher than the EU average. We are the last in the EU in terms of the number of vaccines given,” he said.

He said that from January 1 until May 11 (the day before the caretaker administration took office) doctors had to travel, some more than 100km, to receive vaccines for their patients. During that period, 960 000 doses of vaccines had been administered.

“We have ensured the delivery of vaccines to every municipality and logistics centre in the country. Since May 11, 600 000 vaccines have been administered.”

Until May 11, the elderly and people with serious illnesses were not a priority in the vaccination plan. This was one of the reasons for the high mortality rate registered since the beginning of the year, Katsarov said.

Even only half of the people in old-age homes had been vaccinated, he said.

“We have given priority to immunisation of the elderly and those with severe chronic diseases,” Katsarov said.

Mobile teams had been formed to immunise people with limited mobility and residents of remote and inaccessible settlements.

He said that between May 11 and June 10, vaccines had been administered to 427 816 people over 60 years of age.

Between January 1 and May 11, a total of 454 352 people over 60 had been vaccinated.

“The scandals surrounding the purchase of vaccines, the chaotic decisions on crisis management, including vaccinations, have allowed the country to create a negative attitude against vaccinations,” Katsarov said.

He said that the caretaker government had launched an information campaign to promote the benefits of vaccination against coronavirus infection.

“We found more than 5000 people with incorrectly issued certificates. There was not even an operative procedure to fix them. The certificate could only be obtained only by people with an electronic signature,” Katsarov said.

“We have created a procedure for debugging already issued certificates,” he said.

Katsarov said that the caretaker government had organised the issuance of the EU digital certificate of vaccination, having been tested or having had Covid-19. Bulgaria had been one of the first EU countries to achieve this, and since June 1, Bulgarian citizens who had been vaccinated could use the digital certificate to travel without restrictions, he said.

“We have created an opportunity to download the green certificate without the need for citizens to have a QES (qualified electronic signature) or to visit a vaccination centre.”

He said that the caretaker government had updated the anti-epidemic measures in line with the indicators about the spread of the disease in the country.

“We have created flexible procedures for entering the country, as well as facilitated procedures on a reciprocal basis with other countries – Romania.”

The caretaker government had removed the restrictions on the in-person training of pupils and students, he said. It had reduced the restrictions on attending sports event, and had removed the requirement for PCR testing of children up to six years of age on entering the country.

“We are in the process of introducing a single national call centre, to which citizens will be able to direct their inquiries about vaccination, anti-epidemic measures, and so on.”

He said that medical statistical information was “not collected systematically and there are large gaps”.

“We do not even have an approximate estimate of the number of Bulgarians who have already encountered the virus. In terms of the number of tests performed for Covid-19, we are last in the EU, and the lethality is twice as high as the EU average.”

He said that the government was analysing the data on the number of people in Bulgaria who had already encountered Covid-19 in order to have an accurate forecast of when Bulgaria could achieve collective immunity.

“Until now, our country did not have a unified protocol for behaviour in case of SARS-CoV-2 infection, which is also one of the reasons for the high mortality,” Katsarov said.

“We established a working group with representatives of 17 expert medical councils for the preparation of a Unified National Protocol for diagnosis, outpatient and inpatient treatment of patients with Covid-19. The basis of the protocol is ready and will be published by the end of June.”

Bulgaria had applied for participation in the pan-European procedure for providing vaccines against Covid-19 for the next two years – 2022 and 2023, he said.

“We have also launched a procedure for obtaining the consent of the EC and the manufacturers of vaccines for donation of certain quantities of them to countries in the Western Balkans and Eastern Europe, if the needs of our country are met”

Katsarov said that the caretaker government had inherited a Recovery and Sustainability Plan, in which more than half of the funds were directed to the installation of thermal insulation and construction activities.

“In the extremely short time remaining for the submission of the plan to the European Commission, we wrote an entirely new plan for recovery and sustainability in the field of healthcare.”

He said that an inspection was being carried out of the manner of conducting the procedures for purchasing personal protective equipment, respirators and medicines for the period of the epidemic emergency situation from May 13 2020 until now.

“Preliminary results show that most of the procedures were conducted in a non-transparent manner, with offers from Bulgarian and foreign companies being received in an unclear manner,” Katsarov said.

“There are no approval signatures from the directorates in the Ministry of Health, as well as data about the preparation of specifications with requirements for the purchased products. The reports were submitted to the Cabinet, with a decision on concluding contracts with specific companies, after which they were concluded, again without the necessary coordination procedures.”

Katsarov said that as a result, some of the purchased respirators and medicines, some such as hydroxychloroquine – purchased at a price more than twice the market price – had remained unusable and may be scrapped.

“An unnecessarily large number of respirators were purchased without a public procurement at prices exceeding the market prices, some of which were delivered incomplete and without a warranty for use.”

He said that the Health Ministry’s budget and available finance had been analysed.

According to Katsarov, money from the budget for the epidemic emergency had been paid so far without a direct link to the quantity and quality of work done on the diagnosis and treatment of patients with Covid-19.

He said that there were many reports about people who had nothing to do with treatment who had received funds.

“The current government is faced with a fait accompli – without budget funds to pay first-line workers in regional health inspectorates, emergency services and medical facilities.

“We have developed several options for changing the methodology for paying doctors who are actually at the forefront.”

The specific model will be applied after coordination with the Bulgarian Medical Association and the National Health Insurance Fund, Katsarov said.

(Photo of Katsarov: Ministry of Health)

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