ATHENS — As thousands of patients flooded hospitals in Italy in early March, its poorer southern neighbor Greece moved swiftly into coronavirus containment mode. The policy seems to have worked.
As of April 27, Greece, with a population of close to 11 million, has recorded 2,534 cases of the virus, with the loss of 136 lives.
But rather than resting on its laurels, the Greek government is racing to prepare for what it anticipates could be a second wave of the virus later this year.
“It will be a tiring summer for us, full of work, but this will be a legacy for the country,” Health Minister Vassilis Kikilias told POLITICO in a phone interview last week. “Countries that protected their citizens and didnt have a dramatic impact in the first wave may face more difficulties in the second.”
Watching the mounting tide of infections in Italy, Greece was quick to impose a full lockdown, sealing its borders with several countries and shutting down its economic activity to the absolute minimum, in an attempt to protect an under-staffed health system that had been run down during a decade of austerity and recession.
“The importance of a public health system, which has been prioritized years ago in other advanced countries, was lagging in our country” — Vassilis Kikilias, Greek health minister
Adding to the mix: Greeces population is the second oldest in the European Union.
“We all know that after 10 years of crisis, the national health system is wounded,” Kikilias said. “The importance of a public health system, which has been prioritized years ago in other advanced countries, was lagging in our country.”
He acknowledges that Greece, and others in Europe, have to reevaluate and “prioritize differently” the national health systems. “There must be emergency infrastructure in the country, and part of its national security should also be its health security,” he said.
Where Greece differs from the rest of Europe is its legacy of extreme economic turmoil. As it was battered by a debt crisis — with three international bailouts and successive waves of austerity measures that wiped out around 40 percent of its GDP — national health spending fell sharply.
Greeks spend €1,623 a year per head on their health care, little more than half the EU average of €2,884, and a third less than they spent before the debt crisis, according to the Organization for Economic Cooperation and Development. Furthermore, over a third of total national health expenditure is out-of-pocket spending by households, one of the highest rates in the EU.
At the beginning of the coronavirus crisis, Greece had just 560 intensive care unit beds, or 5.2 beds per 100,000 people, compared with Germanys ratio of 29.2 per 100,000.
A migrant wearing a face mask at a makeshift camp next to the Moria camp on the Greek island of Lesbos | Manolis Lagoutaris/AFP via Getty Images
The government is now racing to plug that gap. It has already increased that number by 70 percent through upgrading and repurposing wards in public hospitals and leasing capacity from private hospitals. By the fall, the ministry aims to raise the number of ICU beds further, to around 1,200.
To prepare for any second coronavirus wave, its also hiring 4,200 doctors, nurses and paramedics on two-year contracts.
“The whole Western society was caught by surprise,” Kikilias said, adding that Greece had to fight against “unbelievable aggressiveness” among EU countries just for supplies of protective equipment.
“The neediness of the system was apparent,” he said. “Even the EU common procurement mechanism has not progressed.”
“The word solidarity has been heard many times, but it hasnt been able to transform into a common European policy,” he added.
The governments crisis measures have been helped by a compliant populace, for whom health is hardwired into the national mentality. The same fears that make Greeks the highest users of antibiotics in Europe also led them to stay home when told to, experts say.
On the debit side, though, Greece has a poor record on testing for the virus, with one of the lowest rates in Europe. Testing is focused on high-risk groups, medical workers and symptomatic patients.
“Its obvious there are asymptomatic cases missed,” Kikilias said. “But theres a hardcore number that cannot be ignored, and this is unfortunately the number of deaths and those hospitalized.”
“If the real picture was different, we would have had many more deaths or people [put on a ventilator],” he argued.
As Greece, like others, looks ahead to its exit strategy, ensuring a large-scale testing capacity will be a key challenge. Diagnostic capacity is being expanded, with mobile testing units and antibody testing, but there are no plans for mass testing as yet.
Real test lies ahead
Doctors on the coronavirus front line warn that the Greek health care system has not yet been seriously tested, and the real examination lies ahead.
“The damage done is so deep that some interventions cannot fix it anymore. It needs a full restart with large-scale interventions that nobody wants to go ahead with,” said Giota Lourida, an infectious disease specialist at Athens Sotiria hospital, the main facility handling the coronavirus outbreak.
She noted that her department, which normally should have been operating with nine doctors, has just four. Two of those are aged over 60 and have had to be assigned to jobs like administration or contacting relatives to avoid exposure to the virus.
“For the third month in a row, Im on call day after day,” Lourida said.
Since the countrys debt crisis, more than 18,000 doctors have left Greece, and that exodus continues, according to the Athens Medical Association.
That outflow means that almost a quarter of the workforce has left — so hiring a few thousand staff on short-term contracts wont do much, said Ilias Sioras, a cardiologist and head of the employees union at the Evangelismos hospital in Athens.
“Our system is not in place to cope with the needs when we are at peace, let alone now,” Sioras said. “Were particularly worried about our regular patients, with cancer, heart issues or other issues, who can no longer visit us. Its important for them to create a proper primary health care system.”
Greek doctors dismiss the powers they were recently given by both government and the public as superficial.
“I dont want to be a hero, I want to be a proper professional,” said Lourida. “Heroes are sent to war without weapons and ammunition and Im afraid that this will happen soon in this war.”
Pockets of high risk
Greece must also keep a wary eye on its overcrowded migrant camps, where asylum seekers are more exposed than the rest of the population.
Aid groups have urged the Greek governRead More – Source
ATHENS — As thousands of patients flooded hospitals in Italy in early March, its poorer southern neighbor Greece moved swiftly into coronavirus containment mode. The policy seems to have worked.
As of April 27, Greece, with a population of close to 11 million, has recorded 2,534 cases of the virus, with the loss of 136 lives.
But rather than resting on its laurels, the Greek government is racing to prepare for what it anticipates could be a second wave of the virus later this year.
“It will be a tiring summer for us, full of work, but this will be a legacy for the country,” Health Minister Vassilis Kikilias told POLITICO in a phone interview last week. “Countries that protected their citizens and didnt have a dramatic impact in the first wave may face more difficulties in the second.”
Watching the mounting tide of infections in Italy, Greece was quick to impose a full lockdown, sealing its borders with several countries and shutting down its economic activity to the absolute minimum, in an attempt to protect an under-staffed health system that had been run down during a decade of austerity and recession.
“The importance of a public health system, which has been prioritized years ago in other advanced countries, was lagging in our country” — Vassilis Kikilias, Greek health minister
Adding to the mix: Greeces population is the second oldest in the European Union.
“We all know that after 10 years of crisis, the national health system is wounded,” Kikilias said. “The importance of a public health system, which has been prioritized years ago in other advanced countries, was lagging in our country.”
He acknowledges that Greece, and others in Europe, have to reevaluate and “prioritize differently” the national health systems. “There must be emergency infrastructure in the country, and part of its national security should also be its health security,” he said.
Where Greece differs from the rest of Europe is its legacy of extreme economic turmoil. As it was battered by a debt crisis — with three international bailouts and successive waves of austerity measures that wiped out around 40 percent of its GDP — national health spending fell sharply.
Greeks spend €1,623 a year per head on their health care, little more than half the EU average of €2,884, and a third less than they spent before the debt crisis, according to the Organization for Economic Cooperation and Development. Furthermore, over a third of total national health expenditure is out-of-pocket spending by households, one of the highest rates in the EU.
At the beginning of the coronavirus crisis, Greece had just 560 intensive care unit beds, or 5.2 beds per 100,000 people, compared with Germanys ratio of 29.2 per 100,000.
A migrant wearing a face mask at a makeshift camp next to the Moria camp on the Greek island of Lesbos | Manolis Lagoutaris/AFP via Getty Images
The government is now racing to plug that gap. It has already increased that number by 70 percent through upgrading and repurposing wards in public hospitals and leasing capacity from private hospitals. By the fall, the ministry aims to raise the number of ICU beds further, to around 1,200.
To prepare for any second coronavirus wave, its also hiring 4,200 doctors, nurses and paramedics on two-year contracts.
“The whole Western society was caught by surprise,” Kikilias said, adding that Greece had to fight against “unbelievable aggressiveness” among EU countries just for supplies of protective equipment.
“The neediness of the system was apparent,” he said. “Even the EU common procurement mechanism has not progressed.”
“The word solidarity has been heard many times, but it hasnt been able to transform into a common European policy,” he added.
The governments crisis measures have been helped by a compliant populace, for whom health is hardwired into the national mentality. The same fears that make Greeks the highest users of antibiotics in Europe also led them to stay home when told to, experts say.
On the debit side, though, Greece has a poor record on testing for the virus, with one of the lowest rates in Europe. Testing is focused on high-risk groups, medical workers and symptomatic patients.
“Its obvious there are asymptomatic cases missed,” Kikilias said. “But theres a hardcore number that cannot be ignored, and this is unfortunately the number of deaths and those hospitalized.”
“If the real picture was different, we would have had many more deaths or people [put on a ventilator],” he argued.
As Greece, like others, looks ahead to its exit strategy, ensuring a large-scale testing capacity will be a key challenge. Diagnostic capacity is being expanded, with mobile testing units and antibody testing, but there are no plans for mass testing as yet.
Real test lies ahead
Doctors on the coronavirus front line warn that the Greek health care system has not yet been seriously tested, and the real examination lies ahead.
“The damage done is so deep that some interventions cannot fix it anymore. It needs a full restart with large-scale interventions that nobody wants to go ahead with,” said Giota Lourida, an infectious disease specialist at Athens Sotiria hospital, the main facility handling the coronavirus outbreak.
She noted that her department, which normally should have been operating with nine doctors, has just four. Two of those are aged over 60 and have had to be assigned to jobs like administration or contacting relatives to avoid exposure to the virus.
“For the third month in a row, Im on call day after day,” Lourida said.
Since the countrys debt crisis, more than 18,000 doctors have left Greece, and that exodus continues, according to the Athens Medical Association.
That outflow means that almost a quarter of the workforce has left — so hiring a few thousand staff on short-term contracts wont do much, said Ilias Sioras, a cardiologist and head of the employees union at the Evangelismos hospital in Athens.
“Our system is not in place to cope with the needs when we are at peace, let alone now,” Sioras said. “Were particularly worried about our regular patients, with cancer, heart issues or other issues, who can no longer visit us. Its important for them to create a proper primary health care system.”
Greek doctors dismiss the powers they were recently given by both government and the public as superficial.
“I dont want to be a hero, I want to be a proper professional,” said Lourida. “Heroes are sent to war without weapons and ammunition and Im afraid that this will happen soon in this war.”
Pockets of high risk
Greece must also keep a wary eye on its overcrowded migrant camps, where asylum seekers are more exposed than the rest of the population.
Aid groups have urged the Greek governRead More – Source