From Baltic to Balkans, Covid crisis engulfs central and eastern Europe

As ambulances carrying coronavirus patients queue outside Romania’s emergency units, hospitals are running out of beds, morgues are overflowing and doctors are becoming exasperated as well as exhausted. Most of the sick are unvaccinated, medics say. Some die waiting to be seen.

“The situation is critical,” Radu Tincu, an intensive care specialist at Floreasca hospital in Bucharest, Romania’s largest emergency facility, told the Financial Times. “We’re frustrated . . . They refuse to be vaccinated,” he said. “[Even after] we tell them of the risk of severe Covid, they still refuse.”

Romania is at the heart of a relentless wave of Covid-19 sweeping across eastern Europe and the Balkans that threatens to overwhelm health services. The country’s daily toll of 19 deaths per million as of October 20 is the highest in the world, just ahead of neighbouring Bulgaria and Moldova. Romania’s death rate is higher than at any point during the pandemic.

Eastern and central Europe along with Russia account for the world’s 12 highest Covid-19 death rates. The figures contrast starkly with western Europe, where death rates are about a tenth of those in the east and stand at less than one per million in several countries.

Infections have also soared to unprecedented levels, particularly in the Baltic states. Latvia’s 115 daily new cases per 100,000 people are 30 times higher than Spain’s, and Lithuania’s rate of 94 is 24 times higher.

Health experts say widespread mistrust of government and officials dating back to the Soviet era, and resulting vaccine hesitancy and unwillingness to accept state-mandated coronavirus curbs, lie behind the surge.

“People distrust the authorities,” said Octavian Jurma, a Romanian physician and health statistician. “Nobody cares about the rules.”

Critics also blame corruption and political instability, notably in Romania and Bulgaria. The latter is heading into its third election of 2021, while Romania’s government is regrouping after a failed no-confidence vote last month.

Andrei Baciu, the top official responsible for Romania’s pandemic response, denied turbulent politics was to blame. Curbs introduced on Wednesday should help bring infections under control, he insisted.

Maria Ganczak, an epidemiology and infectious diseases specialist at Poland’s Zielona Gora University, cited mistrust in state institutions, lax enforcement of restrictions, inadequate testing and tracking, and low vaccine take-up as driving forces.

“It’s obvious we’re accelerating in this wave,” she said. “We’ll put a huge burden on the healthcare system.”

Romania has fully vaccinated just under a third of its total population, the second-lowest in the EU, behind Bulgaria at 20 per cent. This rises to half in Latvia and Lithuania but few central and eastern European countries reach the EU average of 64 per cent. Bosnia & Herzegovina, which is not in the EU, has fully vaccinated just 15 per cent of its population.

The differences in coverage have a marked effect on the link between virus cases and deaths.

In countries such as Bosnia & Herzegovina and Bulgaria, more than 4 per cent of people who test positive die from Covid-19. In Latvia and Lithuania, the case fatality rate drops to just over 1 per cent, and in countries such as the UK, France and Spain, where some 70 per cent have received two doses of a vaccine, the figure is about 0.5 per cent.

Low inoculation rates in some member states have triggered alarm in Brussels, with leaders discussing rising infections at the EU summit on Thursday. “In order to further increase vaccination rates . . . efforts to overcome vaccine hesitancy should be stepped up, including by tackling disinformation, notably on social media platforms,” they said in a statement.

The crisis has led to restrictions being reintroduced, ranging from mask mandates to full lockdowns, in several countries. Latvia this week became the first EU nation to bring back an almost full lockdown, switching to online education, closing all but essential shops and imposing a month-long curfew. Estonia has said it may impose a lockdown if the situation worsens.

Romania also announced new measures including a two-week school shutdown, mandatory mask-wearing in public and restrictions on night-time movement for the vaccinated.

Also this week, Adam Niedzielski, Poland’s health minister, warned of potential “drastic action” in the face of rising numbers, while Slovakia has closed restaurants and bars in five counties.

Serbia has restricted access to nightclubs and bars to vaccinated people while Bulgaria has made vaccine passports mandatory for restaurants — provoking a protest with several hundred people in Sofia that highlighted continued scepticism about the jabs and other preventive measures in the EU’s least-vaccinated nation.

Case and mortality figures will probably rise in Romania before they begin to fall again, health experts warn. Adrian Marinescu, medical director at Bucharest’s Matei Bals hospital, said reported cases were likely to be an underestimate because test rates were low. He estimated the probable level of daily new cases to be about 70,000-80,000 per day, or close to one in every 250 Romanians.

Inoculation centres have had increased traffic since Romania’s restrictions were announced. On Thursday first vaccinations reached a daily record of 62,500, the government said. Over the summer the rate was consistently in four figures.

At one Bucharest clinic, 47-year-old Camelia, who declined to give her surname, finally came for a first dose.

“I’m sorry I didn’t get the vaccine before. I was afraid of side effects,” she said. “But as my daughter and my husband got vaccinated I decided I should do it too. Enough people have died.”

Additional reporting by James Shotter in Warsaw, Richard Milne in Oslo and Sam Fleming in Brussels