Central Europe’s deadly pandemic blunders
The third wave has been especially deadly in the Visegrad countries.www.politico.eu/article/eastern-europe-visegrad-four-deadly-pandemic-blunders/BY SIEGFRIED MORTKOWITZ, WOJCIECH KOŚĆ, LILI BAYER AND CARLO MARTUSCELLI
May 5, 2021 7:27 pm
The per-capita mortality rate in the Czech Republic is almost twice the EU average | Martin Divisek/EFE via EPATHE Visegrad Four share something tragic in common: They have among the worst cumulative death rates from COVID-19 in Europe, far above the EU average and above most Western European countries.
While infections and deaths have been falling in recent weeks, these Central European nations can't mask the grim reality that their third wave has been exceptionally deadly, especially since January, when Europe reeled from a post-Christmas case surge and the U.K. variant tore across the Continent.
The legacy of this surge means that the per-capita mortality rate in the Czech Republic and Hungary is almost twice the EU average, taking into account all deaths since the pandemic's start. Slovakia's is about 40 percent higher, and Poland's is almost 20 percent above the EU average.
In human cost, these statistics mean that the four countries have lost about 140,000 lives to the pandemic.
One factor may be that health systems tend to be more under-funded in Central and Eastern Europe. All four countries spend a smaller share of their GDP on health care than the EU average — although the Czech Republic's standing fares well under broader health metrics.
But the main reason is political: Their recent pandemic response was shaped by a strong preference among policymakers to opt for populist quick fixes rather than make tough calls based on science. In many cases, leaders have picked fights with public health experts for perceived political gain and cut corners when enacting pandemic regulations — all of which has made their citizens less willing to follow the rules.
It's a far cry from the first wave, when these countries quickly locked down, closing borders and imposing draconian measures, for fear they could become another Italy. At the time, such measures helped keep infections in check.
It's my way or the highway
As the pandemic worsened over the fall and winter, a common response was to sideline scientists and public health experts, with politicians dictating the coronavirus response instead.
Slovak Prime Minister Igor Matovič was one such case in point. He resisted experts' calls over the autumn for a hard lockdown, instead backing widespread antigen tests as the answer to allow public life to reopen. He stuck with that view even as EU countries began rolling out jabs in January. When public health officials complained, he denounced them as "fools."
Matovič took an even more controversial step in March, when he unilaterally purchased 2 million doses of Russia's Sputnik V vaccine without consulting his government partners or the country’s drugs regulator, ŠUKL. That made Slovakia one of just two countries in the EU, along with Hungary, to order the jab, which the European Medicines Agency has yet to approve.
But when ŠUKL published a negative evaluation, pointing out that the samples sent to Slovakia differed from those sent to other countries, the Russian manufacturer rescinded the order. Matovič promptly took to Facebook, accusing ŠUKL head Zuzana Baťová of committing "the greatest shame Slovak science could perpetrate in the world." The resulting political uproar forced him to step down in late March and settle for the role of finance minister. (Last Friday, the country's health minister said the jab was finally approved, according to local media.)
Czech Prime Minister Andrej Babiš fought a similar battle with experts — cycling through no fewer than four health ministers over the past year. It got to the point where very few wanted to sit on the government’s crisis management team, according to Rastislav Maďar, head of the Institute of Epidemiology and Public Health at the Faculty of Medicine, University of Ostrava.
Maďar should know. Last year, he led a group of experts advising the government, only to resign in August after Babiš rejected the group's advice — and that of his own health minister — to mandate the wearing of masks indoors. Even though infection rates were beginning to spike at the time, Babiš insisted people had had enough of masks — only to backtrack later by denying all involvement in the decision and blaming Maďar for the confusion.
Another scientist who fell out of favor with Babiš was former national vaccination coordinator Zdeněk Blahuta. In late January, Blahuta quit to protest what he described as Babiš' micromanagement of the vaccine rollout. “He decided who would get how much vaccine ... and he really justified it all by saying that it's all politics," Blahuta said at the time.
Poland saw similar tensions between politicians and scientists. But in this case, they often revolved around holidays — namely, whether to loosen pandemic restrictions on family gatherings, shopping, travel and religious services.
Just ahead of Christmas, against scientists' advice, the government eased lockdown rules and issued only loose guidance to discourage travel and social gatherings — which many families ignored. Ahead of Easter, the government took a similar tack, declining to confront the Catholic Church and instead allowing holiday services to proceed with few restrictions.
Poland has also made its response worse by the quality of its health data. When a teenage data nerd proved that the country's reporting system, resting on the network of underfunded epidemiological stations, “lost” some 22,000 cases in November, the authorities responded by simply prohibiting regions from reporting.
That move undercut the credibility of government numbers, which was further damaged by the low number of daily tests and the very high positive rates. In contrast to the World Health Organization recommendation of a positive-test rate of 3 percent, Poland's is far higher, which means that the government doesn't have accurate, real-time infection data to control the pandemic.
In Hungary, meanwhile, the government's relationship with experts has been similarly fraught. The Hungarian Medical Chamber, a nonpartisan body representing the country’s doctors, raised concerns in early April about the government's decision to begin relaxing some restrictions. In a recent interview, one of the organization's leaders warned of a possible fourth wave as a result of a premature reopening.
The medical chamber has also taken aim at the government's curbs preventing independent media from accessing hospitals. If Hungarians could see the extent of the problem, the medical body argued, they'd be more willing to stick to social-distancing rules and get vaccinated. “It is our common responsibility to defeat the epidemic, but only by acknowledging the difficulties, recognizing and correcting any mistakes, learning from them, working together can it be achieved,” the chamber said in a statement.
Not giving process its due
In some cases, governments tried to push through pandemic measures without following the usual legal or legislative process. The problem: Sometimes these orders were later overturned by judges, undermining the consistent implementation of policy, or were rebuked by angry lawmakers.
In Poland, the nationalist government led by PiS avoided getting parliamentary backing for pandemic measures, instead using press conferences and late-night executive decrees to impose restrictions. The country also dodged imposing a state of emergency, worried about having to pay compensation to shuttered businesses.
As a result, Polish courts have been voiding fines imposed on people for taking part in "illegal" activities like protest marches, and on businesses like restaurants, gyms and hotels for staying open despite the restrictions.
In the Czech Republic, meanwhile, an uproar ensued in February when Babiš circumvented the parliament to impose a two-week state of emergency, despite the measure being voted down by MPs. The measure led to a constitutional standoff, raising questions about whether Babiš had such authority. It also prompted MPs to draft a pandemic law that would reduce his influence over any future lockdown restrictions.
Finding scapegoats
Some politicians have opted to play the populist card, escalating culture wars rather than focusing on details of policy.
In last summer's election in Poland, for example, the government spent far more time bashing “LGBT ideology” than talking about the pandemic. Critics who questioned why churches were open while shopping malls and gyms were shut were denounced as anti-Polish leftists.
More recently, Hungarian Prime Minister Viktor Orbán, who faces a tough parliamentary election next year, has turned his fire on his political opponents — who are skeptical of the Chinese and Russian vaccines that have been widely distributed in the country without EMA approval. Orbán has accused them of peddling vaccine skepticism.
"The Left is anti-vaccination," he told state-owned Kossuth Rádió recently. "They have anti-vaccination campaigns, [and] those who pay attention to them understand what they’re being told, and they’re less willing to have themselves vaccinated."
Paths of least resistance
But perhaps the most common failure, aside from sidelining scientists, was that leaders often declined to take tough decisions on lockdowns and other pandemic measures for fear of a political backlash — even if their hold on power was firm.
In the Czech Republic, for example, Babiš switched from supporting masks indoors to opposing them ahead of the country's elections in October. After the elections, as cases further spiraled, he pushed for shops to reopen ahead of Christmas amid rising pressure from business groups.
In the case of Poland, the government sought to do the popular thing by opening schools early and quickly last September, without a fully formed containment plan. This decision was a turning point for the worse, according to Robert Flisiak, head of the department of infectious disease and pathology at the Medical University of Białystok and president of the Polish Association of Epidemiologists and Infectiologists.
The spike of cases then repeated itself after the winter break in mid-January, he noted.
"Once again schools were opened," he said. "And it was at the time when the British variant became dominant."
The governing coalition was similarly fearful of anti-lockdown backlash around the issue of holiday gatherings. Most notably, it let Polish nationals living in Britain fly home for Christmas as the U.K. variant was starting its surge — with no quarantine or testing requirements.
"There would have been ... outrage if we had tested Poles returning to the country from the U.K. for Christmas," Stanisław Karczyński, a prominent senator in the co-ruling Law and Justice (PiS) party, told the private broadcaster TVN24 in late March.
A few weeks later, the U.K. variant was rampant in Poland.
As the situation grew even worse in the spring, the government stayed cautious, trying a hodge-podge of different lockdown rules depending on regional and local conditions. When that didn't work, it was forced to cave in, ordering a chaotic nationwide lockdown in late March whose effects were blunted by the relaxation of rules over Easter.
In the ensuing month, more than 14,000 Poles lost their lives to the pandemic.
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