In-depth | COVID-19

New Year’s Resolution: Fighting Omicron

By - 22.12.2021

The new year looks grim for Kosovo’s battle with the pandemic. 

Kosovo is going through a relatively calm phase of the COVID-19 pandemic after the Delta wave in mid-August, which caused 238 deaths and nearly 27,000 positive cases in just one month. 

Every day at 3 p.m. the Ministry of Health publishes its daily report, which in recent times has consistently shown less than 10 new positive cases. As a result, people have let their guard down just as the world is facing a new wave of infections from the new variant Omicron, which is “spreading at lighting speed.”

Before the new variant emerged in late November, other countries in the region were facing a new wave of infections. In the last 28 days, Serbia recorded nearly 47,000 cases and 1,120 deaths; North Macedonia, about 9,000 cases and 376 deaths; Bosnia and Herzegovina, about 15,000 cases and 870 deaths; Albania, about 9,000 cases and 123 deaths. Meanwhile, in the same period, only 249 cases and 7 deaths were recorded in Kosovo.

Following the appearance of the Omicron variant, on December 1, the Government of Kosovo imposed new measures. Until now, it was necessary to have at least one dose of the vaccine or a recent negative PCR test to enter Kosovo, but from January 3, only those who are fully vaccinated will be allowed to enter Kosovo. In the meantime, according to the latest decision, nationals and residents can no longer enter the country without at least one dose, unless they take it on the spot, for which mobile teams will be stationed at entry points.

However, this announcement has done little to clear up the uncertainty surrounding travel rules. Recent notices issued by the National Center for Border Management (QKMK) signal that the older rules are still being applied at the borders. Although the QKMK echoed the announcement of the most recent measures on December 6, they followed this up on December 17 with a notice contradicting themselves. 

In their post, they reminded travellers that Kosovo citizens can enter the country without a single vaccine dose, provided that they show a negative PCR test or agree to quarantine for 7 days, something that is only allowed under the older rules. 

This contradicts the information appearing on the website of the Ministry and the latest decision published by the Office of the Prime Minister, creating confusion at a time when thousands of diaspora members are to come home.

The experience of past waves tells us that they come along with the diaspora; the August wave coincided with their summer vacations, during which measures against COVID-19 were disregarded by both individuals and public institutions. 

On the eve of the end-of-year holidays, when as many as 1 million Kosovars living abroad could be traveling from all over the world, Kosovo is threatened by a new wave. Is there a plan to avoid repeating history? It does not seem so.

Omicron, the challenge for 2022

The newest variant of the SARS-COV2 virus — named Omicron — was detected in South Africa in late November, prompting many countries to close their borders to African countries only to discover later that it was already present even before South African scientists raised the alarm. So far, the new variant has been detected in 89 countries around the world, while Kosovo is still waiting for the results of sample testing to return from Germany, which are expected by the end of the week, according to the health ministry.

Omicron invades immunity

In a briefing on December 20, the World Health Organization (WHO) announced that active cases of Omicron double every 1.5-3 days, infecting even those who are vaccinated or have recovered from the disease. The WHO said that there is now consistent evidence that Omicron is spreading significantly faster than the Delta variant. A study found that Omicron replicates 70 times faster than older variants in the bronchial tubes, but is less likely to infect the lungs.

The head of the WHO warned that holiday festivities would in many places lead to “increased cases, overwhelmed health systems and more deaths” and urged people to postpone gatherings. “An event cancelled is better than a life cancelled.”

The concern with which the new variant was met is mainly due to the extremely high number of mutations — more than 30 in the main spike protein, the structure that the virus uses to enter cells. For comparison, Delta only had 18 mutations.

This difference has scientists worried about how effective the vaccines will be. Recent studies show that to defeat this variant, a third dose is necessary. The studies suggest that it offers 80-86% protection against the need for hospitalization, while the normal two doses are only 30-40% effective.

Redoubling vaccination efforts might be the best defense against the new variant, as preliminary studies show promising results for booster and third doses compared to the baseline double jab. However, the process had a slow start in Kosovo. 

As the rest of the world progressed in vaccinating their populations, the first doses only arrived by the end of March, when health workers were the first to receive the jab. Mass vaccination only began in June. Since then the country caught up with the region and even surpassed most of its neighbors, but by the beginning of December only 60.5% of the population over the age of 18 had been vaccinated with two doses.

During the peak of the summer wave, vaccination was done even on weekends. When interest fell with the decline of cases, the Ministry of Health tried to open vaccination points in city squares, while now travellers can even be vaccinated at Prishtina’s airport and other border crossings. As of November, they also started administering vaccines in high schools.

Despite these efforts, fewer and fewer people are getting vaccinated since September. For comparison, about 21,000 people were vaccinated on September 10, while October 10 saw that number halved to about 10,200 and on November 10 the number dropped further to 2,134. There has been some recovery. On December 10 about 4,000 jabs were administered, yet those numbers remain at almost half the October rate and about a fifth of the rate in September.

To date, the most vaccinated age group is 21-40 years old, followed by the 41-60 age group. Conversely, the least vaccinated age group is under 20, which is to be expected taking into account the fact that the administration of vaccines for minors started only a month ago. According to the available data, the most vaccinated are housewives and retirees, while nurses are the least vaccinated.

Pandemic management has been met with criticism since its first steps in early 2020. During peaks in the wave, the country’s overwhelmed health system made evident the two decades of institutional neglect of the sector. Since the beginning of the pandemic, one national and another local elections have been held, all of which featured campaigns that disregarded the measures in place. In between, Kosovo has seen four changes of leadership at the Ministry of Health. 

The potential new wave does not seem to alarm anyone. When K2.0 asked the ministry for the measures being taken regarding entries in Kosovo around the New Year holidays, they replied that if people are not vaccinated, they can get vaccinated in Kosovo.

“[Keep in mind] that most diaspora come from countries that started vaccination before we started and we call for them to come vaccinated,” the ministry representative wrote. If they have not done this where they live and work, they can do it anywhere in Kosovo, from border crossings to vaccination centers.”

The Ministry of Health struck a note of optimism regarding its booster vaccination campaign. K2.0 asked if the country will be able to achieve a desirable vaccination rate with a third dose or booster, considering that only 60% of the population has been vaccinated with two doses. The ministry responded that the decision shows that Kosovo has always made “pretty quick” decisions.

“Within a few days from the beginning of the booster and the third dose provision, about 4,000 doses have been given and interest is expected to increase,” the ministry said by email.

According to the data available on their website, to date, 1,712 third doses and 3,539 boosters have been given.   

The booster & third dose

The booster dose is given to people who have already received two doses of the COVID-19 vaccine, but whose immunity is declining over time. It is administered six months after taking the second dose.
The third dose is given on the recommendation of their doctor to people who received two doses of the vaccine, but who have not developed the desired immunity as a result of a weak immune system or concomitant diseases. The third dose is given no earlier than eight weeks and not later than six months after receiving the second dose.

The planned response to a potential new wave from the Omicron variant does not appear to include any tailored strategy other than doubling down on tried and tested practices.

The plan, according to a health ministry representative is: “To keep resources ready, improve the supply of medicines, keeping current resources mobilized and, if necessary, increasing them, continuing vaccination with third and booster doses and conducting an active research and case tracing. Also, strengthening the oversight of the measures in force through the responsible institutions.”

However, according to them, the relatively calm situation may quickly change if vaccination does not continue with a greater speed and if measures are not followed.

The current measures — adopted on December 1 this year — are a continuation of previous measures. Everyones is required to wear a mask at all times except when driving alone or in the presence of close family members, during physical activity or while eating or drinking. But few people are seen with masks.

To access cafes, restaurants and public transport, and other public settings, customers are supposed to provide one of the following: proof of full vaccination; or a single dose, not older than four weeks, along with a negative COVID-19 test no older than 48 hours; or a single-dose immunization certificate together with evidence, no older than 180 days, that the individual has recovered from COVID-19. Almost nowhere are these rules respected.

Although similar measures were in place when the last elections were held in October and November this year, the political parties themselves — including the ruling one — held campaign events where hundreds of people could be seen without masks. 

While a lot of questions regarding the Omicron variant remain unanswered and uncertainty swirls, every countries’ efforts aim at a common goal: preventing their health systems from becoming overwhelmed. In the United Kingdom and in the United States, the Omicron variant has become dominant. Other countries have begun to change their measures and reinstate movement restrictions. The Netherlands is the first country to implement a full lockdown lasting four weeks. Meanwhile, in the Balkans, Montenegro is the first country to have confirmed five cases of the Omicron variant. 

Will little to no preparations in place and the measures against the spread of COVID-19 not being implemented, will history in Kosovo repeat itself? Upcoming numbers will show. Every day at 3 p.m.

Feature image: Atdhe Mulla /K2.0

This publication is part of the Human Rightivism project, which is funded by the Swedish International Development Cooperation Agency (SIDA), implemented by Community Development Fund through its Human Rightivism Program. The author’s views expressed in this publication do not necessarily reflect the views of the Swedish International Development Cooperation Agency (SIDA).