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ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of July 5, 2020 No. KR DSM-78/2020

About some questions of the organization and holding sanitary and anti-epidemic and sanitary and preventive actions

(as amended on 10-10-2020)

According to Item 6 of Article 144 and the subitem 26) Item 2 of article 145 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system", PRIKAZYVAYU:

1. Approve:

1) Health regulations "Sanitary and epidemiologic requirements to the organization and holding sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of spread of koronavirusny infection" according to appendix 1 to this order;

2) the list of some orders of the Ministry of Health of the Republic of Kazakhstan and the Ministry of national economy of the Republic of Kazakhstan to which changes and additions, according to appendix 2 to this order are made.

2. To provide to committee of quality control and safety of goods and services of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan.

3. To impose control of execution of this order on the supervising vice-Minister of Health of the Republic of Kazakhstan.

4. This order becomes effective from the date of its first official publication.

Minister of Health of the Republic of Kazakhstan

A. Tsoi

Appendix 1

to the Order of the Minister of Health of the Republic of Kazakhstan of July 5, 2020 No. KR DSM-78/2020

Health regulations "Sanitary and epidemiologic requirements to the organization and holding sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of spread of koronavirusny infection"

Chapter 1. General provisions

1. These Health regulations "Sanitary and epidemiologic requirements to the organization and holding sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of spread of koronavirusny infection" (further - Health regulations) are developed according to Item 6 of Article 144 and the subitem 26) of Item 2 of article 145 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" (further - the Code) and establish requirements to the organization and holding sanitary and anti-epidemic, sanitary and preventive actions in cases of origin and threat of spread of koronavirusny infection.

2. In these Health regulations the following terms and determinations are applied:

1) koronavirusny infection of COVID-19 (further - COVID-19) - the infectious disease caused by new type of virus from family of coronaviruses;

2) occupation percent of bed fund (further - PZKF) - percentage ratio to quantity of busy beds sick COVID-19 to total number of the beds provided for patients with COVID-19;

3) reproductive number R - number of contact persons which on average infects with one sick koronavirusny infection;

4) social distance - the distance between people at the meter 1,5 level providing protection against COVID-19;

5) mass action - spectacular, sports, religious and family (banquets, weddings, anniversaries, commemoration and any similar, including carried out at home) actions, exhibitions, forums, conferences and other forms of actions with participation more than 10 people, except for numbers of persons jointly living;

6) the chief state health officers - the chief state health officer of the Republic of Kazakhstan and his deputies, the chief state health officers in the corresponding territories and transport, their deputies determined by the head of state body in the sphere of sanitary and epidemiologic wellbeing of the population according to Item 11 of article 21 of the Code.

Chapter 2. Sanitary and epidemiologic requirements to the organization of sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of distribution of COVID-19

3. For non-admission of distribution of COVID-19 on the corresponding administrative and territorial unit by the chief state health officers take measures according to the order of the Minister of national economy of the Republic of Kazakhstan of March 20, 2015 No. 239 "About approval of Rules of implementation of restrictive actions, including quarantine, in the territory of the Republic of Kazakhstan" (it is registered in the Register of state registration of regulatory legal acts at No. 10826) and the sanitary and anti-epidemic, sanitary and preventive actions obligatory for execution by the relevant state bodies, local executive bodies, physical persons and legal entities are organized.

4. For the purpose of the organization of sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of distribution of COVID-19 the chief state health officers perform:

1) regulation of aviamessages between regions, rail haulings, other passenger traffic, and also regulation of movement on personal vehicles;

2) regulation of holding spectacular, sporting events, exhibitions, forums, conferences and other actions with mass accumulation of people;

3) regulation of holding religious, family, commemorative events (banquets, weddings, anniversaries, commemoration), including at home, except for actions in which the living persons participate only jointly;

4) regulation of activities of objects;

5) regulation of movement of the population;

6) regulation of activities of state bodies (organizations), national campaigns, other physical persons and legal entities with establishment of sanitary and epidemiologic requirements to their activities during quarantine;

7) regulation of carrying out sanitary and disinfection processing of public places, industrial territories, airports, domestic playgrounds and other residential objects;

8) ensuring control of observance of quarantine measures, the sanitary and disinfection mode on objects which activities are resolved also acceptances of the adequate administrative measures according to the Code of Administrative Offences.

5. For the purpose of the organization of sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of distribution of COVID-19 the chief state health officer of the Republic of Kazakhstan determines indicators of criteria of PZKF and average in 7 days of value of reproductive number R (further - R) which calculation for each region is carried out by the republican state company on the right of economic maintaining "The national center of public health care of the Ministry of Health of the Republic of Kazakhstan" (further - NTsOZ) with daily placement on the website.

Chapter 3. Sanitary and epidemiologic requirements to holding sanitary and anti-epidemic, sanitary and preventive actions for the prevention of emergence of threat of distribution of COVID-19

6. For non-admission of distribution of COVID-19 in areas and (or) objects where sanitary and anti-epidemic, sanitary and preventive events are held, it is performed:

1) determination of groups of persons, with the increased risk of infection of COVID-19;

2) use of individual protection equipment and anti-septic tanks, including wearing medical masks in the open air (on the street, outdoors);

3) use of means for contactless thermometry;

4) social distancing of people;

5) airing and disinfection of rooms;

6) functioning of hospitals;

7) specific mode of work according to these Health regulations and requirements established by the chief state health officers;

8) allocation in the organizations of health care of placements for isolation on case of identification of the patient with the clinical signs which are not excluding COVID-19;

9) distribution in the organizations of health care of daily flow of patients (on other nosological diseases) with exception of their crossing with patients with suspicion of COVID-19 disease.

7. In case persons are determined, with the increased risk of infection of COVID-19 their isolation on quarantine is performed.

8. For non-admission of distribution of COVID-19 the objects which are subject to the state sanitary and epidemiologic control and supervision are provided:

1) installations (devices) for control of body temperature of workers, visitors on entrance;

2) sanitayzer with skin anti-septic tank at entrance, in halls, at entrance to elevators, bathrooms;

3) disinfecting, washing and antiseptics;

4) personal hygiene means (liquid soap, antiseptics) in bathrooms;

5) antiseptics on workplaces;

6) magazines of monitoring with marks of exit of employees for work, absence reasons;

7) marking of places by means of designations on floor or by means of restrictive racks for observance of social distance in places of the greatest accumulation of people where intensity of movement is observed;

8) bactericidal lamps or retserkulyator.

9. For the purpose of the correct use of individual protection equipment of mask and glove are subject to timely change (masks each 2 hours, gloves in case of damage).

10. For measurement of temperature, airing, distancing of people and use of individual protection equipment the following security measures are provided:

1) in case of visit of grocery stores the distance at least two meters between the visitor and the worker, and fillability of the trade markets by visitors for 30% of total capacity at the rate of possibility of observance of social distance is observed;

2) visit of places on rendering works and services is performed by appointment;

3) in Items of public catering tables are placed at least two meters from each other;

4) on services industry objects workplaces are placed with observance of distance at least two meters from each other;

5) employees in one room are located at distance at least two meters from each other;

6) in shopping centers operational work of ventilating systems and air conditioning systems with ensuring compliance with the mode of airing is carried out;

7) in the public places, rooms intended for visit, servicing and rest of the population in public transport, wearing medical or fabric masks is obligatory, except for children under five years, and also meal cases in places of public catering in case of observance of social distance;

8) availability at drivers and conductors of public transport, including office transport, anti-septic tanks for processing of hands and individual protection equipment;

9) wearing medical or fabric masks in public places is obligatory, except for the children under five years and persons who are engaged in individual, group sports activities no more than 5 people in case of observance of social distance in the open air;

10) sales of products of food is enabled in the packed-up type (except for not cut vegetables and fruit);

11) on entrances to railway, air, water and bus stations the contactless thermometry is provided.

11. In areas and (or) objects where restrictive actions are entered, including quarantine are not performed:

1) holding collective, mass and spectacular actions;

2) movement of persons is more senior than 65 years;

3) stay and movement (movement) of persons in the open air (on the street, outdoors) groups more than three people (except for family members).

12. For localization of infection on the corresponding administrative and territorial units and (or) objects where sanitary and anti-epidemic, sanitary and preventive events are organized and held by law-enforcement bodies of the Republic of Kazakhstan protection of places of karantinization and provisional hospitalization contact on COVID-19, search and the placement on quarantine of persons, contact on COVID-19,, with positive result of laboratory inspection on COVID-19, which arrived to the Republic of Kazakhstan through check points through Frontier of the Republic of Kazakhstan on rail, sea, river transport and autotransitions is performed and also carried out the anti-epidemic actions including laboratory inspection, treatment, medical observation for contact, persons among convicts and their isolation.

13. For localization of infection by local executive bodies functioning of provisional hospitals for patients with the symptoms which are not excluding disease of COVID-19 and quarantine hospitals for persons contacting to sick COVID-19, of multi-profile hospitals for hospitalization according to the emergency indications, transportation of persons contacting to sick COVID-19 is provided.

14. In case of placement of quarantine hospitals in the organizations of not medical appointment (hotel, hostels, sanatoria, etc.) work of the round-the-clock posts of observation of observance of requirements of quarantine with observance of anti-epidemic operating mode is carried out.

15. Under the organization and holding sanitary and anti-epidemic, sanitary and preventive actions for localization of infection in the organizations of health care zoning and operating mode according to requirements of health regulations is observed.

16. Hospitals are provided with necessary amount of medicines, products of medical appointment, resuscitation and consumable materials, test systems, diagnostikuma, disinfecting medicines, separate beds.

17. In the organizations of health care rooms for isolation are allocated for case of identification of the patient with the clinical signs which are not excluding COVID-19, taking into account specifics of the provided medical care and also to be performed distribution of daily flow of patients (on other nosological diseases) with exception of their crossing with patients with suspicion of disease of COVID-19, and also thermal imagers for measurement of temperature are used.

18. In case of confirmation at the patient of the diagnosis of COVID-19, the employee of the organization of health care contacting to the patient is isolated on house quarantine and there takes place laboratory inspection on COVID-19. In case of positive result it is discharged of work and goes for treatment, in case of negative result continues to fulfill the job responsibilities and is subject to medical observation within 14 days.

19. When filling infectious and provisional hospitals of the medical organizations more than 70% of bed capacity rendering planned medical services is subject to suspension, except for services of hemodialysis and delivery of health care by the cancer patient, and also patient with surgical diseases transfer of treatment of which poses threat for the patient's life.

20. In the accident ward of multi-profile hospitals patients are distributed separately on surgical and therapeutic profiles.

21. Under the organization and to holding sanitary and anti-epidemic, sanitary and preventive actions for localization of infection by department of state body in the sphere of sanitary and epidemiologic wellbeing of the population it is performed:

1) poll of sick COVID-19 within 3 hours from the moment of receipt of the notice on registration of case of COVID-19;

2) epidemiological investigation of cases of COVID-19 with design of the card of epidemiological investigation within 24 hours from the moment of receipt of the notice on registration of case of COVID-19 except for the centers of asymptomatic virus carriers in which there are no persons from risk group (people are more senior than 60 years with chronic diseases of cardiovascular system, diabetes, metabolic syndrome, chronic diseases of kidneys, pregnant women);

3) questioning of persons with the confirmed (probable) diagnosis of COVID-19 and relatives contact with sick COVID-19 according to requirements of Health regulations;

4) data processing by system of recognition of questionnaires with their transfer to authorized body in the field of health care within two hours after arrival of flight according to requirements of Health regulations;

5) control of carrying out isolation contact, and also observance of the anti-epidemic mode in the conditions of quarantine;

6) the notification contact, being on house quarantine, and also persons living together with them about need of observance of isolation at home (house quarantine) according to requirements of Health regulations;

7) informing on each new case of COVID-19 in NTsOZ within 12 hours from the moment of receipt of laboratory confirmation;

8) control of observance of the anti-epidemic mode in infectious, provisional, quarantine hospitals and other organizations of health care;

9) informing the population on the current epidemiological situation on distribution of COVID-19 and the taken measures;

10) daily monitoring and submission to NTsOZ of information for last days till 02-00 o'clock the next day about persons crossing border of the Republic of Kazakhstan with breakdown on citizens of the Republic of Kazakhstan, total quantity of foreign citizens, with separate accounting of the foreign citizens who arrived from the countries of COVID-19, unsuccessful on incidence;

11) in case of identification of the confirmed COVID-19 cases among staff and civil personnel to notify within 2 watch of division of state bodies, the populations performing activities in the sphere of sanitary and epidemiologic wellbeing;

12) control of work of subjects to water supply with acceptance of necessary measures for providing the population with drinking water of guaranteed quality;

13) sanitary and epidemiologic monitoring of quality of the water pumped to the population without acceptance of administrative measures;

14) supervision of the grocery stores and the organizations of public catering performing delivery of food within control of observance of the mode of quarantine.

22. The notification about cases with positive result of laboratory inspection of PTsR is carried out according to requirements of Health regulations.

23. For the period of situation complication on incidence on COVID19 are attracted:

1) the organizations of science and education in the field of health care to assistance in actions for localization of COVID19;

2) laboratories of the medical organizations to performing diagnostics of COVID-19 after receipt of the temporary work permit with microorganisms of the II group of pathogenicity (in case of its absence).

24. In case of violation and not observance of the requirements established by these Health regulations the responsibility established by the legislation of the Republic of Kazakhstan is provided.

25. Subjects of health care based on information of the mobile (monitoring) groups created according to the Law of the Republic of Kazakhstan "About local public administration and self-government in the Republic of Kazakhstan" on the corresponding administrative and territorial units send to territorial subdivision of department of state body in the sphere of sanitary and epidemiologic wellbeing of the population in the corresponding territory, information (the emergency notice) on cases of origin or threat of emergence of distribution of epidemic, the centers of quarantine objects and especially dangerous harmful organisms, infectious, parasitic diseases, poisonings, radiation accidents according to appendix to these health regulations.

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