In her doctoral dissertation, Dilyara Nabirova, MD, MPH, investigated the public health response to COVID-19 in Kazakhstan. In four studies, she analysed both nonpharmaceutical and pharmaceutical interventions implemented during the first two years of the pandemic. Her studies highlight key factors that influenced SARS-CoV-2 transmission in occupational settings, adherence to national COVID-19 treatment guidelines, COVID-19 vaccine effectiveness, and primary healthcare providers’ confidence in the COVID-19 vaccine.
The dissertation consists of four studies on the public health response
In 2020, a COVID-19 outbreak among oilfield workers in Kazakhstan revealed key factors contributing to SARS-CoV-2 transmission in a setting where the workforce had been reduced to one-thirds of its original size and rigorous nonpharmaceutical environmental interventions were implemented. Nabirova’s study showed that after-hour socialising in shift camps, the limited use of sanitizers and working in enclosed air-conditioned spaces significantly contributed to the outbreak. Even with robust preventive measures, individual adherence to safety guidelines remains essential for the effective control of viruses at the workplace.
In the second study, Nabirova examined clinical care given to patients hospitalised with COVID-19 at a large infectious disease hospital. The results showed that treatment practices during the pandemic were often not consistent with the national guidelines issued in Kazakhstan in 2020–2021. This discrepancy underscores the need for a better training of health providers to improve the adoption of updated treatment guidelines, particularly in the administration of life-saving treatments, such as anticoagulants and antibiotics for bacterial complications.
In the third study, Nabirova evaluated the effectiveness of four COVID-19 vaccines — QazVac, Sputnik V, Hayat-Vax, and CoronaVac — in preventing the SARS-CoV-2 infection in Almaty, Kazakhstan from February to September 2021. All four vaccines were found to be protective, potentially averting 100,000 severe COVID-19 cases and emphasising the need for continued vaccination efforts, particularly among older populations and during variant surges to mitigate breakthrough infections.
The fourth study addressed primary care providers’ confidence in the COVID-19 vaccine before vaccination became mandatory for providers. The results revealed that only 30% of providers were confident about the vaccine whereas many were hesitant or refused because of concerns about the safety and effectiveness of the vaccine. COVID-19 vaccine confidence was positively associated with adequate knowledge and attitudes toward routine vaccines. This highlights the importance of fostering knowledge, trust and confidence in vaccination and strengthening healthcare provider training related to vaccine-preventable diseases.
“This dissertation examined the gaps, strengths, and challenges of Kazakhstan’s public health response to the COVID-19 pandemic from multiple perspectives. The findings are critical for shaping future public health policies and preparedness plans against emerging infectious diseases. It highlights the importance of using multifaceted approaches that include public health and social (nonpharmaceutical) measures and pharmaceutical interventions to mitigate outbreaks before they spread and to prevent larger epidemics.” Nabirova says.