The lost summer: Central and Eastern Europe pay the price for slow Covid vaccination

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While Western Europe celebrates the results of successful vaccination campaigns, a very different picture emerges in Central and Eastern Europe, as a wave of coronavirus cases and deaths threatens to overwhelm already overwhelmed health systems.

A summer of sluggish vaccinations, the easing of most restrictions and, in some countries, political upheaval have given the highly contagious Delta variant a perfect storm. And unlike in previous waves, there is no appetite for further restrictions, leading some experts to warn that some countries are headed for Lombard scenes.

Romania and Latvia both took drastic measures last week to free up space in hospitals that are being flooded with cases. Last Monday, Romania suspended all non-emergency surgeries and hospital admissions, while Latvia declared a medical emergency on Thursday and diverted resources to focus on COVID-19 patients.

“The whole summer was wasted,” said Răzvan Cherecheș, Executive Director of the Center for Health Policy and Public Health at Babeș Bolyai University in Romania. “The government didn’t prepare for the fourth wave – they thought the wave would be minimal.”

Ramunė Kalėdienė, dean of the Faculty of Public Health of the Lithuanian University of Health Sciences, agrees. “Summer was wasted time,” she said. “That was a mistake, because we had to be very, very proactive from the spring and were kind of relaxed.”

The figures paint a stark picture. The average weekly coronavirus cases and deaths in Romania have surpassed their previous highs. On the other side of the border, Bulgaria has the highest two-week death notification rate per million inhabitants in the EU. In Latvia, the average weekly cases are higher than ever and deaths are on the rise. And in Lithuania, death rates for the year have hit new highs and are not showing any signs of flattening.

Hesitation fueled by suspicion

The connection with vaccination rates cannot be denied. In Bulgaria only 23 percent of the adult population are vaccinated, in Romania it is 34 percent. Other countries in the region that are seeing an increase in deaths have better coverage, but it’s not enough to contain the highly contagious Delta variant. Latvia is 52 percent of adults and Lithuania 69 percent.

Those numbers pale in comparison to the rates in the UK, Ireland, Portugal and France, all of which cover over 80 percent of adults. The rise in cases in these countries had a minimal impact on death rates.

“The best preparation for the fourth wave would have been an effective vaccination campaign,” said Ioana Mihăilă, who served as Romania’s health minister until September, when her party pulled out of government and supported a motion of censure that led to its collapse earlier this week.

Despite believing that Romania managed the vaccine campaign well, she told POLITICO that popular vaccine skepticism was partly responsible, as was the government, including itself, for “being too quick to loosen our messages on the need to take the vaccine” .

Several experts cite a deep distrust of the government as a main reason for the low acceptance of vaccinations. A Eurofound 2021 survey found that citizens of Romania, Bulgaria and Latvia all had levels of trust in their governments that were below the EU average.

Karlis Racenis works in the Latvian hospital and the coronavirus patients he sees are mostly unvaccinated. One reason is that they do not trust politicians, said Racenis, doctor and representative of the Latvian Medical Association. He attributes this to the “post-Soviet understanding of our political situation, in which you always claimed that politicians lie”. In Bulgaria, Vanya Rangelova, senior assistant professor of epidemiology at Plovdiv Medical University, believes that this distrust is “the main driving force behind people not wanting to receive vaccines”.

Hotspots are also flaring up across the border in northern Greece. The region has one of the lowest vaccination rates in the country and more than 90 percent of the intensive care beds are occupied. Nevertheless, the government has announced an end to the mini-lockdowns. “This is not the time for such freedoms, this is not the time to send a message that we are going back to normal,” said Nikolaos Kapravelos, director of a hospital intensive care unit in Thessaloniki. “The hospitals are at a turning point. What is done is a risky move. “

Appeasement of voters

Another factor also plays a role – political disruption: Romania’s government collapsed last Tuesday; Bulgaria has an interim administration and Latvia faces parliamentary elections next year.

Racenis sees the Latvian approach as a reassurance as politicians are reluctant to introduce further restrictions that could deter voters. The situation is similar in Romania, where Cherecheş believes that the rejection of new restrictions in the summer months is due to upcoming internal party elections. The government also implemented vaccination targets related to the lifting of restrictions. But when it looked like it wasn’t going to achieve those goals, it did corrected downwards. The collapse of the Romanian coalition has drawn attention to politics rather than the worsening pandemic.

Bulgaria will hold its third parliamentary election of the year in November after failing to form a government in previous votes. Rangelova said the politicians “don’t want to take harsh measures” because they want the people to be positive towards them and vote them for power.

Lithuania does not face a choice, but it simply lacks an appetite for further restrictions. In September, Thousands protested in Vilnius against the current restrictions. Kalėdienė said that if new measures were adopted there would be “very strong opposition” to it.

Fears are also growing that the region could repeat scenes from the dark days of the Italian Lombardy crisis in spring 2020 as the world watched in horror as patients die in hospital corridors.

In Latvia, COVID-19 bed occupancy has reached around 80 percent, with some hospitals reporting that more than 90 percent of beds are occupied. “If no severe restrictions are accepted, according to [limiting physical] If we have contacts, we will have something similar to what we saw in Europe in northern Italy, ”warned Racenis.

Mihăilă, the former Romanian health minister, is also concerned and warns that the health system is already overwhelmed: “We already do not have the capacity to treat both COVID and non-COVID patients, and that doesn’t just mean physical rooms and furniture but also medical care professionals. “

Additional reporting from Matei Rosca and Nektaria Stamouli.

This article is part of POLITICS‘s Premium Policy Service: Pro Health Care. Our specialist journalists keep you up to date on health policy topics from drug prices, EMA, vaccines, pharmaceuticals and more. E-mail [email protected] for a free trial.

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