Amid the Ukraine war crisis, Ukraine very likely faces a dual threat of both Russian aggression as well as a potential health crisis led by the COVID-19 pandemic and also likely exacerbated by other likely epidemiological constraints as a consequential cost of the ongoing violence. 

The COVID-19 situation in Ukraine is sensitive as the highest number of daily infections since the start of the pandemic was recorded on 4th February 2022 (43,778 cases in a day), just 20 days before Russia began it’s incursion into Ukrainian territory. Cases have decreased since the invasion, however this is most likely due to reduced testing. As reported by BBC on 28th February, There are around 1,700 COVID patients coupled with a range of other patients in hospitals across the country who will most likely require oxygen treatment. The WHO issued a warning on 27the February that the oxygen supply in Ukraine is “nearing a very dangerous point” and “can run out in the next 24 hours”. Furthermore, Ukraine is the least-vaccinated country in Europe (34.07% as of 25th February) rendering the majority of the population at higher risk of infections. The social setting in the context of war has also disrupted COVID guidelines. Large volumes of people in bomb shelters, border posts and traffic jams will aggravate risk to infections. Attacking infrastructure is a common tactic in conflict to impede transportation and supplies in order to weaken a country into submission, and medical supplies in Ukraine will likely be adversely affected as a result. Access to healthcare and other emergency services will be hampered for both civilian and military populations due to a damaged and overwhelmed infrastructure. 

The essential health services (EHS) have already been disrupted and are likely to further collapse in prolonged circumstances of war. According to a Flash Alert issued by Humanitarian Programme Cycle (March-May 2022), treatments of chronic/non-communicable diseases (NCDs) (e.g., diabetes, cancer, cardiovascular disease), sexual, reproductive, and maternal health care (SRMHC), ante-natal care (ANC), child health, and support to individuals with disabilities are all likely to be affected by such disruptions. Hygiene is difficult to maintain in shelters due to crowding, population displacement, and infrastructure damage, which increases the danger of communicable diseases other than COVID-19 (polio and measles) as well as respiratory and diarrheal infections, which could have a rapid impact on the people's health.

To help with accessibility of essential healthcare services as well as resources, multiple civil service organisations (CSOs) are working on ground or in neighbouring borders. Information on some of the major CSOs can be found below:

• Global Giving Ukraine Crisis Relief Fund : Donations are directed towards "affected communities in Ukraine, with a focus on the most vulnerable, including children, who need access to food, medical services, and psychosocial support."

• Save the Children : Through donations, Save the Children is working towards helping families meet their basic needs such as food, medicine and shelter.

• The International Committee of the Red Cross : "The security situation permitting, our teams now in Ukraine will continue their work to repair vital infrastructure, support health facilities with medicines and equipment, and support families with food and hygiene items." - ICRC president Peter Maurer

• International Medical Corps : The organisation has been providing medical, mental health, and protection services in conflict-affected areas since 2014. (tbernhardt@InternationalMedicalCorps.org)

• Project HOPE : Project HOPE has teams in Poland, Romania, and Moldova, and is now transporting two tonnes of crucial medicines and medical supplies to refugees affected by the Ukraine crisis. These Interagency Emergency Health Kits (IEHKs) are intended to fulfil the immediate primary healthcare needs of displaced people in places where medical facilities are unavailable. The resources in these packages are enough to feed 20,000 people for three months. (Cinira Baldi, cbaldi@projecthope.org)

• Keystone Moldova :  Keystone Moldova offers a crucial service for people with disability within the country—a national hotline support service for people with disability in need of protection, support, and information.  The hotline has been successfully used during the COVID-19 pandemic to connect people with disability to resources and help ensure equitable access to health services. The service is available by calling 0 8001 0808 (Kris Weaver, kweaver@khs.org).

• Voices of Children : The Ukrainian organisation's Charitable Foundation helps provide psychological and psychosocial support to children affected by the armed conflict, according to its website.