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Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.

According to him, now there are 5.5 thousand patients in hospitals who have been diagnosed with coronavirus disease. Of these, 2,300 are on beds with oxygen therapy, and most of them receive it. To prevent logistical problems, at the end of last year, state funding was allocated through several mechanisms: one in the form of centralized purchases, one in the form of subventions provided to the regions in order to purchase autonomous sources of oxygen supply. On September 15, the Ministry of Health sent 124,608 packages of the Paxclovid drug for coronavirus disease to the regions. The medicine is prescribed primarily to patients at risk to prevent the complex course of coronavirus disease.

Moreover, low vitamin D levels common in patients with CVD may increase the risk and severity of COVID-19. This is because vitamin D increases levels of anti-inflammatory cytokines and reduces viral replication, which in turn can reduce pro-inflammatory cytokines that contribute to lung damage. Despite the lack of evidence demonstrating increased susceptibility to COVID-19, drugs used in the treatment of COPD increase the risk of respiratory tract infections to varying degrees. However, theoretically, some immunosuppressive drugs may have beneficial effects, given that the cause of death in COVID-19 is a cytokine storm leading to acute respiratory failure.

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Responding to such epidemic challenges is very difficult both organizationally and financially. The result is evaluated over time with well-organized epidemiological surveillance. According to the approved polio outbreak response plan, which arose in early October 2021, it was only possible to start the 1st round of the campaign on February 1, 2022. It was supposed to last 3 weeks and was aimed at vaccinating 140,000 children from 6 months of age with IPV. up to 6 years who missed vaccination according to the Calendar. Almost by the end of the 3rd week of the 1st round, as of February 18, 2022, only 28% of the planned number of children were vaccinated. Therefore, we decided to extend the 1st round for an additional 2 weeks, which again was not performed due to the outbreak of war. Thus, there was no actual response to polio outbreaks.


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