Ministry of Health on the Use of Hydroxychloroquine
According to Armenia’s Ministry of Health, hydroxychloroquine is included in the guidelines for the treatment of COVID-19 in many countries: Spain, Italy, Belgium, France, Switzerland, Russia, and more than 26 clinical trials are being conducted worldwide. Seventy years of experience in the use of hydroxychloroquine, including in the field of rheumatology, shows that the drug has a good safety profile.
According to the guidelines for treatment in Armenia, hydroxychloroquine is being prescribed to high-risk patients and those with pneumonia, including severe cases. It is not prescribed to patients who are being monitored at home, who are asymptomatic or have mild symptoms (without respiratory disorders). Hydroxychloroquine is used only in a hospital setting if there are no contraindications.
Before starting the treatment, and everyday thereafter, an electrocardiogram is performed. Special monitoring is performed on patients with diabetes, glucose levels are measured daily. Biochemical (including in the case of potassium hypokalemia) research is monitored for concomitant disease. According to the current guidelines, the interaction of the drug is checked. The drug is prescribed with caution in case of kidney disease or insufficiency; a decision is made collegially.
One case of arrhythmia was reported during the treatment of COVID-19 with hydroxychloroquine; the drug was immediately discontinued. The effectiveness of the drug in the treatment of COVID-19 has not yet been summarized, but according to preliminary data, most of it is positive.
NOTE: The World Health Organization has announced it is temporarily stopping its clinical trials of hydroxychloroquine: “In light of recent publications of evidence on the safety and efficacy of hydroxychloroquine as a treatment for COVID-19 patients, the Executive Group of the Solidarity Trial decided to implement a temporary pause of the hydroxychloroquine arm within the trial as a precaution while the safety data is being reviewed.”
Health Ministry Spokesperson Calls Out Misinformation
Health Ministry spokesperson Alina Nikoghosyan wrote on her Facebook page about an article published by the Hraparak news outlet. The article alleged that doctors did not provide the necessary medication for a 56-year-old man who died of COVID-19 and went on to say that the drugs for the virus are being set aside for younger patients. Nikoghosyan wrote: “A question arises as to why the news outlet did not try to contact the hospital or the relevant authorized body to receive information. Instead, they have disseminated a one-sided fictional piece. If, of course, the characters are not fictional, we invite the attention of law enforcement agencies, because the article in fact reports a crime has taken place. It should be noted that there is no medication to cure coronavirus in the world, and each patient is treated individually.”
Situation in Artsakh
The Health Ministry of the Republic of Artsakh reports four new COVID-19 cases. All four were contacts of a previously confirmed patient from the Shahumyan region. To date, there are 38 confirmed cases in Artsakh, 14 recoveries, 80 people have been quarantined, 789 people tested. There are no COVID-19 related deaths.
During the government session, Prime Minister Nikol Pashinyan spoke about the COVID-19 situation in the country. He noted that Armenia is in a serious condition and that the country is dealing with the second wave of the virus. Pashinyan stressed that the government knows how to eliminate the transmission of the virus and that the Special Commission has outlined rules of conduct for different spheres. From those specific guidelines, three simple rules have been singled out, which according to experts is critical for limiting the spread of the virus. The rules are the following: wear a face mask, maintain social distancing and regularly wash/disinfect hands. The Government’s strategy is to change public behavior and ensure that people follow the safety rules.
The PM reinforced the importance of wearing face masks to halt the spread of the virus. He explained that Armenia has more than 7,000 confirmed cases of COVID-19 and that it is very likely that there are thousands of undetected and asymptomatic cases (close to 14,000, most of whom do not know that they are infected). The PM went on to say that 90% of asymptomatic cases are detected during the contact tracing of those patients who exhibit symptoms of the virus, are in serious condition and hospitalized. Following the three simple rules will minimize the risk of intensifying the spread of the virus. Pashinyan also warned that, if people do not follow the rules, the government’s next step will be to require everyone to wear masks, with no exceptions.
Pashinyan reminded that the government has published its strategy for fighting the virus and that we need to learn to live with the pandemic for the foreseeable future; at least for the coming one year, we will have to deal with the virus. He went on to say that the number of confirmed cases shows that people have not yet learned how to live with the virus. Pashinyan clarified that the government is still trying to help Armenian citizens abroad to return to Armenia, if they wish to. It is very likely that some of them will be infected with COVID-19 and, if public behavior does not change, we will continue to register more cases of the virus in the coming months. Pashinyan noted that the Government will be using two main methods to avoid such a scenario and compliance with the set rules. The first is the use of public communication to increase general knowledge among the population about methods to avoid being infected and the second is the use of administrative resources to ensure that regulations are strictly enforced and citizens comply with the rules.
Artur Asoyan, the Head of Inspection Bodies’ Coordination Bureau, provided updates about the sanctions and administrative fines imposed on businesses. Asoyan explained that there are four bodies conducting regular monitoring and that particular attention is paid to those sectors/businesses where crowds of people are expected and where the virus can easily spread, such as factories, cafes and banks. During the past week, over 87 restaurants closed down and an additional 12 most likely will close today, by the decision of the Special Commission. To date, the Food Safety Inspectorate consulted over 9,561 cafes and restaurants. Within the past week, the operation of over 290 business entities was suspended for 24 hours by the decision of the Health Inspection Body and Food Safety Inspectorate. Asoyan noted that the inspection bodies also conduct monitoring in kindergartens and, according to their records, the attendance at over 120 inspected kindergartens is very low (less than 10%).
Arman Sargsyan, the Chief of Police, provided updates regarding police activities. He noted that police officers are strictly enforcing the latest decisions of the Special Commission. To date, over 966 reports on administrative violations have been filed (240 were because citizens did not have a face mask, 657 were violations registered on public transportation and taxis). Sargsyan also said that checkpoints have been installed on inter-regional roads to ensure that drivers are following the requirement to wear face masks. If they don’t, administrative violations will be filed. Pashinyan added that every day monitoring, without prior notice, will also be conducted in various administrative districts of Yerevan.
Arayik Harutyunyan, the Minister of Education, Science, Culture and Sport, warned that the upcoming four non-working days will be critical for the spread of the virus. The Minister said that they have concerns that graduating students will use those days to organize celebrations, which were postponed indefinitely because of COVID-19. Although educational institutions have been notified to be careful, the Minister once again urged students, parents and teachers to avoid such celebrations and strictly follow the rules and guidelines set by the Special Commission and the Ministry of Health. The Chief of Police noted that they have issued a statement three days ago urging citizens to avoid public gatherings, celebrations, hiking and pilgrimages.
During the session, the government also discussed and approved the nineteenth assistance package aimed at mitigating the consequences of COVID-19. Tigran Khachatryan, the Minister of Economy, said that the package is aimed at providing assistance to startup entrepreneurs who have a business idea. He explained that they will have an opportunity to participate in a course and gain important business skills. After the successful completion of the course, participants will be eligible for a loan and a grant to implement their business idea. The beneficiaries of the program are those individuals and organizations that meet the standards of small and medium enterprises, work in the regions and have a good tax and credit history for the past year. 75% of the allocated funds will be in the form of a loan, while the remaining 25% will be in the form of a grant. Loans in the maximum amount of 10 million AMD will be provided, which the beneficiaries can repay over eight years.
The Government also approved the proposal of the Ministry of Territorial Administration and Infrastructure, to allocate 50 million AMD to the ten regions of Armenia (5 million AMD to each). The allocated resources will be used to provide food and other essential items to socially vulnerable groups who are required to self-isolate.
Update on the Number of Cases
The Ministry of Health reported 372 new cases of COVID-19 and 35 recoveries, bringing the total number of cases to 7,774, of which 4,377 are active cases and 3,255 have already recovered. Seven patients, ages 56, 60, 66, 69, 76, 78, and 85, who all had pre-existing health conditions, except the 56-year-old, died bringing the total number of deaths to 98. Five COVID-19 patients also died but the virus was not the cause of death; 44 such cases have been reported. Over the last 24 hours, 1,124 tests were conducted; to date, a total of 53,678 tests have been conducted.