As winter approaches, Central Europe is once again one of the regions worst affected by the global coronavirus (COVID-19) pandemic, as its underfunded health systems struggle to cope with the impact of the fourth wave of the coronavirus on the large numbers of their citizens who are still unvaccinated.
After tightening restrictions during the third wave in the spring, governments are being forced to contemplate imposing yet another lockdown, amid widespread loss of patience with the restrictions and growing opposition.
On November 22, Slovakia and Czechia imposed a de facto lockdown for the unvaccinated. The Slovak government is expected to announce a full formal lockdown on Wednesday, while the outgoing Czech government on Monday decided for the moment against declaring another state of emergency to help it fight the pandemic.
But the radical right-wing governments of Poland and Hungary are so far resisting further controls, which are opposed by many of their voters, as well as by a vocal libertarian lobby.
Both Slovakia and Czechia are currently openly discussing whether to make vaccinations mandatory – as neighbouring Austria will do from February – though this would be very controversial, because many would see this as reminiscent of Communist-era dictatorship, even if it is only mandated for old people.
Many citizens have fallen under the sway of conspiracy theories spread by disinformation websites, keeping vaccination rates low and sparking opposition to restrictions, though the region has yet to see the significant mass protests experienced in Western Europe. Vaccination rates are also beginning to pick up as infection rates soar and governments tighten restrictions on the unvaccinated.
As well as being unpopular, lockdowns could also halt the region’s fast recovery from last year’s recessions caused by the pandemic.
Certain features of CEE’s social and economic structure are being blamed for the region’s high infection rate, particularly its higher proportion of multi-generation households and the large share of jobs in big factories compared to Western Europe.
Another cause, however, is that the prolonged pandemic has severely tested state structures and found them wanting.
Health systems had often long been underfunded and short of staff, with many doctors and nurses having emigrated for better paid jobs in Western Europe. Healthcare staff have now been put under immense stress and hospitals have had to make tough decisions on whether to cancel other operations to make space for COVID-19 patients.
Below bne IntelliNews correspondents report on the latest situation in their countries.
The Slovak government has tightened the anti-coronavirus measures in all regions as of November 22 for the next three weeks, introducing a lockdown for unvaccinated individuals.
"Exhausted health personnel are entreating us to intervene because they no longer want to have to choose between who to connect to lung ventilation and who to let die. We've already had a request for a walk-in refrigerator for the dead," said Prime Minister Eduard Heger, as quoted by the Slovak News Agency.
"The problem in hospitals has gone so far that there is a risk that medical care won't be provided to both COVID patients and [other] patients, whose planned surgeries are being postponed," he stressed.
Unvaccinated individuals will be allowed to enter only essential shops and will have to be tested for COVID-19 twice per week to enter their workplaces. Only vaccinated people and those who suffered from COVID-19 in the last 180 days will be able to attend mass events.
"These two groups will see many benefits. They won't have to get tested twice a week in order to get to work and will be allowed to visit shops freely, not only the essential stores but also shopping centres," Heger noted, calling on unvaccinated people to get inoculated without delay, as vaccination is the only way out of the pandemic.
As of November 20, the number of new daily positive COVID-19 tests in Slovakia exceeded 9,000. Almost 3,000 people are hospitalised (2,997), with 259 of them in intensive care and 256 on extracorporeal membrane oxygenation (ECMO). 18.44% of these patients are vaccinated, while 81.56% are not.
Heger also floated the idea of making vaccination mandatory for older people.
“For me, mandatory vaccination for people over 65 or 60 would be ideal. It depends on the experts. I think that even 50+ would make sense, but let us wait what the experts say,” said Heger, who said he was discussing such an option with constitutional lawyers.
“I am convinced today that there is no other way than vaccines if we do not want to have repeated waves and lockdowns. This devours the economy, people’s health and people’s lives. If we don’t want to experience this agony for years, we clearly need to be protected by the vaccine,” said Heger.
However, former prime minister Robert Fico and his Smer-Social Democracy party have already said they would challenge mandatory vaccination in the constitutional court.
The total number of fully vaccinated Slovaks reached 2.5mn, which is around 47% of the total population, the EU’s third-lowest rate. Some 70% of new positive patients being hospitalised are unvaccinated.
Vaccination has been hampered by widespread scepticism, fuelled by online misinformation. According to a survey last month, around 40% of respondents believed in most widespread conspiracy theories, with the most popular being the theory that the Slovak government makes up the number of deaths to exaggerate the seriousness of the epidemic (43.3% of people).
42.4% of respondents believe that COVID-19 has been artificially made in the laboratory, while 39.7% think the authorities came up with the coronavirus to control people. Slightly above 20% (22.5%) are convinced that coronavirus does not exist.
From November 22, the outgoing government of Andrej Babis implemented the so-called “Bavarian” model of restrictive measures, which means that negative tests will no longer be accepted at public places, such as restaurants, hotels, pubs, as well as public mass events such as sports games. Only those vaccinated and those who recovered from COVID-19 in the past six months will be let in.
The government has also approved mandatory testing at schools of unvaccinated students until February 2022. It plans to introduce mandatory testing at the workplace until February 2022, covered partly by the state.
The government has for the moment decided against declaring a state of emergency in the Czech Republic once again, but it is mulling mandatory vaccinations for senior citizens.
The incoming government of Petr Fiala has yet to reveal its thinking on how to deal with the pandemic but has spoken against lockdowns, especially of schools.
Infection rates are breaking all records. On Sunday, tests revealed 8,244 cases, the highest number on a Sunday. In a week-on-week comparison, the number of people infected rose by almost 2,600.
The incidence number rose to a new record: There were 1,002 newly detected cases per 100,000 inhabitants in the last seven days, 284 more than a week ago.
The Czech Republic, which as a population of 10.7mn, has seen 2,003,561 confirmed COVID-19 cases since the epidemic broke out.
The number of deaths with COVID-19 in the Czech Republic has reached 32,173, with 562 of them dying last week, an average of about 80 a day. Since the beginning of November, there have been 1,310 deaths in the statistics so far, more than in the previous six months.
In the week-on-week comparison, the number of hospitalised rose by 816 and the number of serious conditions increased by 100. There are currently 4,885 occupied hospital beds for COVID-19 patients, out of which 715 are in critical condition. Soldiers are currently helping out in 24 hospitals and there are plans for them to help in another 15 this week.
The medical chamber has recommended a full lockdown and the Czech Republic’s Chief Hygienist Pavla Svrčinová said she would support mandatory vaccination. “Vaccination is the only option, personally I would go for mandatory vaccination,” she told Czech Radio-Radiožurnál on Monday.
So far, 6.25mn of the country’s 10.7mn inhabitants have received a full inoculation against COVID-19, giving a vaccination rate of 58.4%. About 624,461 people in the Czech Republic have received the booster shot so far.
The Hungarian government imposed mandatory mask wearing in closed spaces last week and said it would make COVID shots mandatory for all healthcare workers.
The government has allowed companies to require vaccination against COVID-19 as a precondition of employment in order to ensure workers’ safety. Vaccines will be compulsory in state administration and state-owned companies.
However, the government is resisting tougher restrictions as it approaches what could be a knife-edge election in the spring.
Hungary "is deep in the fourth wave and the hard part still to come", Prime Minister Viktor Orban said in his regular weekly interview on public radio on Friday.
He warned that restrictive measures could not provide protection against the virus, just slow down its spread. "The only thing that ensures protection is the jab. Those that are not inoculated are in mortal danger," he warned.
Despite people lining up for shots, Hungary's vaccination rate lags the EU average, with about 5.8mn people out of a population of 9.75mn having had the two shots, giving a vaccination rate of around 60%.
Hungary on Monday reported 27,209 new cases for Friday to Sunday, bringing the total number to just below 1mn since the start of the epidemic. Daily infection rates are breaking all records.
The official government portal reported on Friday that more than 6,100 people were hospitalised, with 613 of them on ventilators, which marks a weekly increase of over 20% and a 50% growth in three weeks.
Hungary also recorded 392 deaths, bringing the death toll to 33,172.
The exponential growth in infections is already making a significant impact on the healthcare system. The Hungarian Medical Chamber (MOK) warned last week that intensive care units are filling up fast. Due to the chronic shortage of nurses and doctors, a very high percentage of ventilated patients will die.
The chamber urged the government to implement new restriction measures, alerting the public that without these, hospitals will eventually find themselves under wartime conditions.
Janos Szlavik, of Budapest's main COVID-19 hospital, told commercial television ATV that further measures could soon be necessary to curb infections. He was cited as saying that 80%-90% of COVID-19 patients requiring intensive care were unvaccinated, and the intensive care unit in his hospital was full.
The number of new coronavirus (COVID-19) cases in Poland reached 24,239 as of November 17, the highest daily toll since early April, the health ministry said in its daily report.
Weekly growth in new cases came in at 30.6%. The number of fatal cases shot up 72% week-on-week to 463.
The figures renewed criticism of the administration for not planning to introduce any safety measures on top of the ones currently in place. Poland still requires masks in indoor public spaces and on public transit, but there is next to no enforcement.
Poland’s vaccination campaign has stalled too, with little over 52% of the population of 38mn fully vaccinated. Poland has not made vaccination mandatory, nor is it going to introduce so-called COVID-19 passports to make the hesitant get a jab, the government has long said.
The general public’s view of pandemic restrictions may be guiding the government in its course of inaction. Only 1.5% of Poles would welcome a new nationwide lockdown, a poll by IBRiS for the newspaper Rzeczpospolita showed on November 7.
Just over 42% said the restrictions should be in place locally where the number of infections is the highest. As many as 43% said no restrictions bar the ones currently in force are needed.
Over 3.25mn people in Poland have been infected with coronavirus since the pandemic began in March 2020. Over 79,600 people have died.
Pandemic modelling experts say that the fourth wave could peak at 30,000 cases a day by December. The government says that it is confident that even such a high number will not overwhelm the healthcare system because of the vaccinations and natural immunity of people who have recovered.
Heat map of COVID-19 infections (14-day notification rate per 100,000 population), updated November 18. Source ECDC.