Features of the epidemic process and epidemic risks of COVID-19 in the subjects of the Northern Caucasus

Relevance. The peculiarities of the course of the COVID-19 epidemic process in the regions of the world, as a rule, are determined by the epidemic risks characteristic of them. Identification and evaluation of the latter is necessary to improve measures to counter infection in a particular area. Aim. To study the features of the COVID-19 epidemic process in the regions of the North Caucasus, to identify and assess the impact of epidemic risk factors on the epidemic situation. Materials and methods. The data of the Departments of Rospotrebnadzor for the subjects of the North Caucasus, Internet resources: stopkoronavirus were used Russia, Johns Hopkins University and Our World in Data project. Statistical processing was carried out using methods of variation statistics and MS Excel software package (2016, USA). Correlation analysis was performed using Spearman's coefficient. Results. As of 01.12.2021, the incidence of COVID-19 in the Caucasus was lower than the Russian average (3890.0 and 65921.8 per 100 thousand population), and the mortality rate was higher (4.8 and 1.9%, respectively). The dynamics of the epidemic process as a whole repeated the situation in the Russian Federation, but with a delay of each phase by 2–3 weeks and had 4 periods of rising morbidity (waves), with the exception of the Stavropol Territory, the Republics of Adygea and Ingushetia, where three waves of morbidity were observed. In the Republics of Dagestan, Chechen and Adygea, a high proportion of community-acquired pneumonia was noted - 58.8, 47.0 and 34.1%, respectively. The mortality rate from a new coronavirus infection was higher than the national average in Dagestan (in the period of the 1st wave – 4.7%), Krasnodar Krai (in the period of the 2nd wave – 5.0%; 3 – 12.6%, in 4 – 9.9%), Karachay-Cherkess Republic (in the 3rd period of the rise – 9.0%) and in Stavropol Krai (in 4 – 7.6%). The lowest mortality from COVID-19 in the 3rd and 4th periods of the rise in morbidity in the North Caucasus was registered in Ingushetia – 2.2 and 2.1%, respectively. The exceptional situation in the Republic of Dagestan is due not only to a large proportion of community acquired pneumonia and high mortality from COVID-19, compared with other regions of the North Caucasus and Russia as a whole, but also to an increase in excess mortality in the republic. The excess of the average annual (over the previous 5 years) number of deaths in the Caucasus in 2020 was +19.8%, in 2021 +32.7%, in the Russian Federation as a whole 14.8 and 31.4%, respectively. Conclusion. The general epidemic risks of COVID-19 for the North Caucasus region have been identified – the level of vaccination, the implementation of non–specific prevention measures, as well as local risks for specific regions: in Dagestan – adherence to local mass ceremonies, as well as insufficient control over the implementation of restrictive measures, in Ingushetia – relatively high population density.