1. Myanmar Response to Covid-19
Outbreak
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Dr Zaw Wai Soe
COVID-19 Clinical Management Team Leader
Rector, University of Medicine 1
Yangon, Myanmar
2. COVID 19
⢠31/12/2019 1st COVID-19 in Wuhan
⢠11/1/2020 1st Death in Wuhan
⢠13/1/2020 1st Case Outside China
⢠30/1/2020 Public Health Emergency of International Concern
⢠11/2/2020 WHO announced a name of COVID-19
⢠11/3/2020 Global Pandemic
⢠22/5/2020 5.29 M Confirmed
341 K Deaths
3. ⢠54.4 million population
⢠Health Care Rankings
⢠Human Development Index
⢠GDP
⢠Developing/Emerging Country
⢠135 Ethnic Groups
⢠100 Dialects
⢠Conflicts in Myanmar
⢠Border Length (miles)
China 1323
Thailand 1501
India 912
Bangladesh 168
Laos 148
4. Command Control Centre/CCC
⢠16/3/2020
COVID-19 Prevention Control & Treatment
Central/Regional Committees
⢠31/3/2020
COVID-19 Control & Emergency Response
Central/Regional Committee
6. Myanmar
⢠2 millions migrant workers abroad
⢠70% in Thailand
⢠Malaysia, China, Korea and Singapore
⢠UK, US, UAE, Japan, Qatar, and Macao
⢠Long Summer Holidays and Water Festival
⢠Family Gathering
⢠Buddhism
⢠Meditation and Meditation Centers
7. Myanmar 30/3/2020
⢠Health Expenditure 5.09 % of GDP
⢠Shortage of Health Work Force 1.33/1000
⢠400 Anesthetists in Myanmar
⢠Ventilators 400 ventilators
⢠PPE 300,000
⢠N95 100,000
⢠Surgical Mask >1,500,000
8. Hospital Care for COVID-19 Myanmar
⢠Hospitals
⢠2000 to 25 bedded Hospitals
1000 for PUI
⢠100, 200, 500, >1000 bedded
100 for confirmed
⢠3 dedicated Hospitals about 100 beds each
COVID-19 Hospitals with 50/300 ICU beds
9. Why Separate Centre (27/3/2020)
⢠The biggest mistake we made was to admit
patients infected with COVID-19 into hospitals
throughout the region.
⢠We should have immediately set up separate
structures exclusively for people sick with
coronavirus.
⢠I recommend the rest of the world , not to
send COVID patients into health-care facilities
that are still uninfected.
11. COVID19 Medical Centre, Yangon
⢠20 ICU Beds
⢠240 HDU Beds and
⢠240 Regular Beds
⢠Liquid Oxygen
⢠Laboratory
⢠Imaging Unit CT, Xray,
Portable DR
⢠Medical Store
⢠Office with IT facility
⢠96 rooms for Doctors
⢠112 rooms for Nurses &
Technicians
⢠Free Wi-Fi
14. We are together to fight COVID 19.
⢠Government
⢠Ministries
⢠Myanmar Defense Services Medical Corps
⢠Private Hospitals
⢠Construction Companies
⢠Pharmaceutical Companies
⢠NGOs
⢠Donors
⢠All the citizens
15. Manpower For COVID 19 Medical Center
⢠Ministry of Health and Sport 50%
Mainly from Medical and Related Universities
(Medical, Nursing, Medical Technology,
Pharmacy)
⢠Defense Services Medical Corps 25%
⢠Private Hospitals 25%
⢠Red Cross, Fire brigade and Volunteers
⢠Training programs were started in February
16. COVID19 Medical Centre, Yangon
⢠Phase 1 500 Beds (20+240+240)
⢠Phase 2 1000 Beds (40+480+480)
⢠Phase 3 2000 Beds
Phase 1 Started on 21st April
Accordingly with WHO guideline
17. Quarantine >210,000(21/5/2020)
⢠Facility Quarantine
⢠Home Quarantine
⢠Lock Down
⢠Universities and Schools
⢠Meditation Centers
⢠Donated Hospitals
⢠Donated Foods and Materials
18. Testing Up to 21/5/2020
⢠RT PCR Started on 2nd Feburary
⢠Started on NHL 20th Feb
⢠Started on DMR 23rd Apr
⢠Total 15838
⢠Total PUI 4459
⢠Confirmed 199
⢠Death 6
⢠Recovered 108
⢠Cobas 6800 to increase testing capacity
19. Regular Zoom Meetings
⢠State Counsellor and Publics
⢠Ministry and Regional Head Quarters
⢠Clinical Management Committee Meeting
⢠Inter-hospital Meeting
⢠Inter-Departmental Meeting
Dynamic Strategy and Guideline from CCC
20. Preparation Phase
------------------------
Since January 2020, the principle
aim was a containment strategy .
Fever check started at Yangon &
Mandalay International Airports.
Myanmar-China border was closed for one month from 31/3.
Myanmar-Thailand border was closed for one month.
But International Flights were continued up to 9th April,
especially Europe , UK, USA, Italy.
Hospital preparations were late.
21. Preparation Phase
------------------------
People coming back from abroad
were sent to Facility Quarantine
( dedicated building or hotel) for
14 D. ( No Home Quarantine)
Promote and increase public
education on Hand âwashing,
mask, social distancing.
Plan for lockdown but only partial
lockdown in cities.
22. Response Phase
----------------------
Hospital preparedness (WHO)
All general hospitals received PUI
patients, swab taken.
Elective surgeries stopped
OPD number reduced.
More space for Covid patients.
Designated hospitals were set up.
In Yangon, Waibargi Hospital ,South
Okkalapa Hospital and Phaung gyi
Covid medical center.
In Mandalay , Kandaw nadi Hospital.
23. Hospital Issues
----------------------
⢠Creating space for PUI patients.
⢠No enough respiratory
resuscitation devices.
⢠PPE and other infection control
⢠Hot weather and PPE
⢠Confirmed patient transport
⢠Health care staffs affairs
⢠Changing clinical guidelines
⢠Level of care greatly reduced in
non-Covid cases.
Fortunately patient care is still under control
24. We still donât know
--------------------------
Number of confirmed cases are small compared with other
regional countries.
⢠Less number of testing ?
⢠Less international flights?
⢠Geography and weather?
⢠Participation of public?
⢠Hard immunity?
Still hospitals are attended not much respiratory illness.
But screening may be more difficult problem when raining
season comes. ( Local influenza outbreak, Dengue fever
outbreak soon.)
25. We would like to know
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⢠Re-opening of ordinary routine health care together
with Covid management
⢠Principles of elective surgeries during Covid and post-
Covid era.
⢠Possibility of Covid vaccine and availability to
developing countries.
⢠The role of rapid test kits and reliability
⢠How a health care system withstand against Covid
attack for long period.
