Subject: RE:ფრიად სასწრაფო!!!FW:Georgia COVID Medical Capacity Question
From: Ketevan Goginashvili <[email-masked]>
To: Maia Nikoleishvili <[email-masked]>, Ekaterine Adamia <[email-masked]>
Date: Wed, 30 Sep 2020 09:03:04 +0000

გთხოვთ, დამეხმაროთ ამერიკის საელჩოსთვის ამ ინფორმაციის მიწოდებაში.

What percentage of patients are currently asymptomatic (72% )  and in a COVID center (28%)

How full the hospitals are at this time?  What percentage capacity?  (33% of Mobilized hospital beds are occupied)

How many trained doctors are able to assist with COVID management (4126 Doctors are trained during February-September)

მადლობა წინასწარ.

მაიკო

From: Cummings, Sarah R (Tbilisi) <[email-masked]>
Sent: Friday, September 25, 2020 10:13 AM
To: Maia Nikoleishvili <[email-masked]>
Subject: Re: Georgia COVID Medical Capacity Question

Maia,

Good morning and Happy Friday!

Do you have any information on:

What percentage of patients are currently asymptomatic and in a COVID center

How full the hospitals are at this time?  What percentage capacity?

How many trained doctors are able to assist with COVID management

Many thanks!
-Sarah

From: Maia Nikoleishvili <[email-masked]>
Sent: Wednesday, September 23, 2020 13:32
To: Cummings, Sarah R (Tbilisi) <[email-masked]>
Subject: FW: Georgia COVID Medical Capacity Question

Dear Sarah,

1040 intensive care beds are included in inpatient beds.

As for the pediatric COVID facilities, please be informed that  as of today below listed  health facilities provide pediatric service to COVID positive patients.

1.       LTD Tbilisi Children's Infectious Clinical Hospital, Tbilisi

2.       LTD Vakhtang Bochorishvili Clinic, Tbilisi

3.       JSC Georgian AIDS and Clinical Immunology Research Centre, Tbilisi

4.       JSC National Center for Tuberculosis and Lung Disease (NCTBLD) - Kutaisi

Best regards,

Maia

From: Cummings, Sarah R (Tbilisi) <[email-masked]>
Sent: Wednesday, September 23, 2020 10:26 AM
To: Maia Nikoleishvili <[email-masked]>
Subject: Re: Georgia COVID Medical Capacity Question

Maia,

Thank you for the clarification.

One question:  Are the 1,040 intensive care beds separate from the 2,522 inpatient beds?

Have a great day!

Best,

Sarah

From: Maia Nikoleishvili <[email-masked]>
Sent: Tuesday, September 22, 2020 17:48
To: Cummings, Sarah R (Tbilisi) <[email-masked]>
Subject: FW: Georgia COVID Medical Capacity Question

Dear Sarah,

Please, kindly note that instead of 36 inpatient facilities there are 35 approved. Attachment is revised.

·         In total, 297 inpatient facilities operate across the country with 17,514 beds, out of which 35 inpatient facilities with 2522 beds are used for Covid cases.

·         2,290 beds are available in intensive care units around the country, out of which 1,040 intensive care beds are reserved for Covid cases.

·         1763 ventilators are available for the management of respiratory distress syndrome.

·         101 hotels with around 8000 rooms are used as a quarantine space.

·         Considering current epidemiological situation, 8 hotels (5 in Batumi, 1 – Tbilisi, 1 – Kutaisi,  1 - Anaklia) are accepting COVID positive patients with mild symptoms or asymptomatic. In case of necessity, the number of hotels will be increased.

Sorry for technical error.

Best regards,

Maia

From: Maia Nikoleishvili
Sent: Monday, September 21, 2020 5:07 PM
To: 'Cummings, Sarah R (Tbilisi)' <[email-masked]>
Cc: Gvantsa Gasviani <[email-masked]>
Subject: RE: Georgia COVID Medical Capacity Question

Dear Sarah,

Upon you request we would like to provide you with the following updated information:

·         In total, 297 inpatient facilities operate across the country with 17,514 beds, out of which 36 inpatient facilities (please, see  the attached list) with 2522 beds are used for Covid cases.

·         2,290 beds are available in intensive care units around the country, out of which 1,040 beds are reserved for Covid cases.

·         1763 ventilators are available for the management of respiratory distress syndrome.

·         101 hotels with around 8000 rooms are used as a quarantine space.

·         Considering current epidemiological situation, 8 hotels (5 in Batumi, 1 – Tbilisi, 1 – Kutaisi,  1 - Anaklia) are accepting COVID positive patients with mild symptoms or asymptomatic. In case of necessity, the number of hotels will be increased.

Best regards,

Maia

From: Cummings, Sarah R (Tbilisi) <[email-masked]>
Sent: Friday, September 18, 2020 10:57 AM
To: Maia Nikoleishvili <[email-masked]>
Cc: Gvantsa Gasviani <[email-masked]>
Subject: Re: Georgia COVID Medical Capacity Question

Maia,

Thank you for your assistance!  I very much appreciate it and look forward to your update.

Right now, we only have the figures from March which I believe are outdated:

·         9 hospitals, with 550 hospital beds total, are mobilized for COVID patients across country:

o   Tbilisi Infectious Diseases Hospital

o   Bochorishvili Clinic (Tbilisi)

o   Tbilisi Republican Hospital

o   First University Clinic (former 8th Hospital, Tbilisi)

o   Gori Military Hospital

o   Sachkhere Hospital

o   Kutaisi Infectious Diseases Hospital

o   Batumi Infectious Diseases Hospital

o   Zugdidi Infectious Diseases Hospital

·         While selecting hospitals, MOH assessed ventilation systems in each of those to reduce risk of hospital-acquired infection.

·         At this stage, majority of the allocated beds are used for quarantining.

·         GOG is considering various scenarios of virus spread.  At this stage, even the worst-case scenario should not necessitate organization of a field hospitals (e.g. special tents), since existing number of beds (~15,000) in country should meet the demand.

·         There are up to 2,000 ventilators in country. 50-60% of those are used for non-COVID patients.

·         Right now, 40 ventilators are ready / on stand-by for COVID patients’ needs in Republican Hospital, First University Clinic, and Gori Military Hospital;

·         According to Gabunia, the existing capacity of ventilators should be sufficient to meet the demand.

·         As per WHO recommendations. A country shall have a Extra-Corporeal Membrane Oxygenation (ECMO, “artificial lung”) for the most severe patients. Georgia has three of those now, currently used in cardiac surgery.  According to Gabunia, there should not be the need in more.  Plus, modern advanced ventilators fulfill some of the functions of ECMOs.

·         There are 150 licensed infectious diseases physicians in Georgia.   In case of epidemy other licensed physicians will also be involved in response. In total, there are 20,000 licensed MDs in Georgia (this figure probably includes Tamara and me). Infectious Disease specialists are being used as trainers and consultants to train their non -ID specialist colleagues in COVID management.

·         There is a shortage of nurses. If needed, MoH will mobilize those nurses who are licensed but currently are not in the system.

·         At this stage there is no need to postpone any planned non-COVID surgeries.

·         On March 11 MOH has started training (online) of General Practitioners / Family Doctors in COVID management. In case if number of infected increases dramatically, MOH may consider home management of mild cases, while only severe cases will be hospitalized.

Best,
Sarah

From: Maia Nikoleishvili <[email-masked]>
Sent: Wednesday, September 16, 2020 19:12
To: Cummings, Sarah R (Tbilisi) <[email-masked]>
Cc: Gvantsa Gasviani <[email-masked]>
Subject: RE: Georgia COVID Medical Capacity Question

Dear Sarah,

I will coordinate this issue and get back to you as soon as possible with requested information.

Thank you for continued cooperation.

Best regards,

Maia

From: Cummings, Sarah R (Tbilisi) <[email-masked]>
Sent: Wednesday, September 16, 2020 3:32 PM
To: Gvantsa Gasviani <[email-masked]>; Maia Nikoleishvili <[email-masked]>
Subject: Georgia COVID Medical Capacity Question

Good afternoon Maia and Gvantsa,

Thank you for all your assistance over the summer in working with the US Embassy medical team during this unique time.

I know this is a busy time for everyone.  When you have a moment, do you have any information you could share on health facilities/capabilities for managing COVID?

Specifically, I'm interested in the current capacity (facilities, providers, beds) and how many beds are already in use.   How do you expect it to be impacted with the new surge in cases?

Thank you in advance.  We very much appreciate all your support so we can keep everyone safe.  Please let me know if there is a better point of contact for this inquiry.

Have a wonderful Wednesday.

Best,

Sarah Cummings

Medical Attache

US Embassy Tbilisi

From: Kiknadze, Natalia P (Tbilisi) <[email-masked]>
Sent: Friday, September 4, 2020 17:04
To: Maia Nikoleishvili <[email-masked]>; Gvantsa Gasviani <[email-masked]>
Cc: Cummings, Sarah R (Tbilisi) <[email-masked]>
Subject: Return of Embassy Medical Provider

Good day Maia and Gvantsa!

Once again thank you very much for your assistance and help especially while I was calling you on week-ends and after hours. Your help is very much appreciated.

Our Medical Provider Sarah Cummings is back, so starting from next week she will be in touch with you.

Take care!

Regards

Natalia

Natalia Kiknadze MD

Physician

US Embassy Tbilisi

Phone +995 322 2277665

Fax: +995 322 277198

Mob: +995 591949373

Email: [email-masked]

SENSITIVE BUT UNCLASSIFIED