Country’s hospitals bore brunt of cuts but its efforts to contain Covid-19 appear to be paying off
Helena Smith in Athens – The Guardian
Health workers gather outside a hospital in Thessaloniki on World Health Day last week to watch a show of support by firefighters. Photograph: Giannis Papanikos/Zuma Wire/Rex/Shutterstock
Every day at 6pm Greeks turn on their TV sets and tune into a broadcast that at other times they might have missed. Like most rituals, there are no surprises: each time they encounter the same scene, two men, seated several meters apart, behind a long table in a brightly lit room.
The health ministry’s daily coronavirus briefing then begins with Sotiris Tsiodras, a soft-spoken Harvard-trained professor of infectious diseases, delivering the latest facts and figures with the occasional emotional plea. Nikos Hardalias, the civil defence minister, invariably follows, invoking the gravity of the situation with warnings that Greeks “must stay at home”.
The bookish professor and no-nonsense former mayor are the faces who have come to be associated with the government’s drive to contain the spread of Covid-19. Their efforts at keeping the country virus-safe appear to be paying off: in a population of just over 11 million, there were, as of Monday, 2,145 confirmed cases of coronavirus and 99 deaths, far lower than elsewhere in Europe. Italy to date has registered 20,465 deaths.
Greece, it is generally agreed, is having a better crisis than may have been expected. Tsiodras recently allowed himself to speak of “a flattening of the curve” even if authorities accept that the prospect of Orthodox Easter, on 19 April, is unlikely to be without challenge. Traditionally, Greeks flock to ancestral villages in the countryside to celebrate the biggest festival in their religious calendar.
The country’s ability to cope with a public health emergency of such proportions was not a given. After almost a decade embroiled in debt crisis – years in which its economy contracted by 26% – Greece’s health system has far from recovered.
State hospitals bore the brunt of cuts demanded in return for rescue loans from international lenders to keep the nation afloat and in the eurozone. With the epidemic’s arrival in Europe, officials were forced to acknowledge, 18 months after the country exited its third bailout, that it had only 560 intensive care unit (ICU) beds.
It was a stark reality that left no room for mitigation strategy, or contemplating policies of achieving “herd immunity”.
Greece, like Italy, also has a large elderly population, with about a quarter of pensionable age. “There were realities, weaknesses, that we were very aware of,” said Dr Andreas Mentis who heads the Hellenic Pasteur Institute. “Before the first case was diagnosed, we had started examining people and isolating them. Incoming flights, especially from China, were monitored. Later, when others began to be repatriated from Spain, for example, we made sure they were quarantined in hotels.”
What is increasingly being seen as textbook crisis management, even by political foes, has been attributed as much to prioritising science over politics as to a managerial approach that focused on what the 51-year-old prime minister, Kyriakos Mitsotakis, has described as “state-sensitivity, co-ordination, resolve and swiftness”.
Alex Patelis, Mitsotakis’ economics adviser, said: “There are problems you can solve through spin and others that require truth and transparency. It was very clear we needed experts and we needed to listen to them. That said, Greeks have been through crisis; they know what it is. I think that also enabled them to adapt and be stoic.”
From the outset the 25-strong committee pushed for the socially disruptive choice of lockdown, a devastating option for a country that had only just begun to show signs of economic rejuvenation.
In late February, before Greece had recorded its first death, carnival parades were cancelled. On 10 March, several weeks before the rest of Europe, schools were ordered closed. Within days, bars, cafes, restaurants, nightclubs, gyms, malls, cinemas, retail stores, museums and archaeological sites were also shuttered.
Traumatic scenes in Italy, across the Adriatic, shocked Greeks as much as anyone else and were highlighted by Tsiodras and Hardalias as they tried to ram home the message of the dangers posed by the disease.
The measures were not immediately accepted and in quick succession the government was forced to shut down beaches and ski resorts, ban public gatherings of more than 10 people, prohibit travel to islands to all but permanent residents and – as argument raged over the power of faith and science – take on the influential Greek Orthodox church, whose clergy refused to give up services and the rite of Holy Communion. Air links with the worst-affected countries were suspended.
But the pandemic was also a catalyst for an administration elected to power last July on an agenda of reform and as Greece went into lockdown, the government announced it was harnessing the crisis to enact long overdue digital reforms aimed at both protecting citizens’ health and modernising the state.
“When the pandemic broke, the need to simplify government processes became paramount,” Greece’s minister of digital governance, Kyriakos Pierrakakis, told the Guardian. “One of the first things we did to limit the incentives for people to exit their homes was to enable them to receive prescriptions on their phones. That, alone, has saved 250,000 citizens from making visits to the doctor in the space of 20 days. It has dramatically helped reduce the number of people exiting their home, which can only be a good thing.”
Documents that once required appearances at government offices and dealing with a labyrinthine bureaucracy were made available online, likewise saving thousands of trips daily. “By changing the nature of the interaction of citizens with the state, our hope is that ultimately public trust in institutions will be further regained,” said Pierrakakis.
Meanwhile, Greece has managed to almost double the number of ICUs. But doctors say testing, limited with rare exception to hospitals, will need to be much more widespread for confidence to prevail. With two refugee camps quarantined after detainees tested positive for coronavirus, concerns abound over facilities described as “ticking health bombs” by the government.
The costs to an economy so dependent on tourism are already high – and that is before emergency funding worth €14.5bn (£12.6bn) in state benefits and tax deferrals is taken into account.
For now, however, the government is basking in the limelight of unexpected praise for having flattened the curve.
“If we pull through this, if we show that we are competent and can deliver, the rest will come,” said Patelis, adding that Athens’ objective was to regain some of the credibility that had been shattered during its bailout years. “The faster you deal with a health crisis, the greater the short-term economic costs, but then the greater the long-term benefits too.”