Perspectives | COVID-19

The Delta variant is coming for Kosovo

By - 02.09.2021

Without proper measures, the most deadly part of the pandemic may lie in the future.

While it may not feel like it, Kosovo’s experience of the pandemic has been far milder than much of the rest of Europe and the U.S. With its younger population, which can fight off the virus easier, and loose lackadaisical restrictions, Kosovo has been floating along, at least until recently. While other European nations have imposed harsh and lengthy lockdowns and seen record death rates, Kosovo’s relatively lower viral prevalence over the summer months has instilled a false sense of security, relaxing people’s already blasé attitude towards the pandemic even further.

The relaxed attitudes on the pandemic coincided with the less virulent strains of COVID-19: the original Wuhan strain and then the Alpha variant first identified in the UK. But now with the Delta variant as the dominant strain in a poorly vaccinated population, Kosovo is unlikely to get off so lightly. A study last week from The Lancet found that the Delta variant more than doubles chances of hospitalization in unvaccinated individuals compared to the Alpha variant, which had been the dominant strain in Kosovo until Delta displaced it. The ultimate question is: How will Kosovo respond to what could become, without the proper measures, the most deadly phase of the pandemic so far? 

According to the World Health Organisation, the pandemic is considered to be out of control and expanding if the daily positivity rate is greater than 5%. During the last week of August, Kosovo reported a concerning positivity rate of 13.4% to 20.1%. These statistics speak volumes about the mismanagement of the pandemic by the government, a complete disregard of public health by citizens and a triumph of vaccine skepticism over scientific pragmatism. Alongside the surge in positive tests has come a surge in deaths. On average 15 Kosovars are dying from coronavirus each day.

We can expect to see a surge in deaths over the next few weeks.

Sadly, this is only the start. The recent record highs of daily infections will likely translate into harrowing death statistics unseen during the course of the pandemic in Kosovo. By now, we know that acting by imposing restrictions when the infection numbers have skyrocketed is already too little too late. The most recent restrictive measures imposed in Kosovo are too late, and will not be able to prevent an upcoming surge in deaths which we can expect to see over the next few weeks.

The Kosovo government is well aware that this pandemic hits in waves. It is a failure of leadership that measures were not brought earlier in anticipation of an end-of-summer surge. The newly imposed restrictions are welcome, but their effects will be limited if they are not sustained for at least three weeks with strict measures for indoor masking and social distancing. Kosovo has to understand that it is not immune to COVID-19 and the laws of epidemiology apply just as strongly in Kosovo as elsewhere.

As a scientist, I find it absolutely indefensible that Kosovo continues with a sluggish vaccination program. Vaccine skepticism and supply issues are not unique to Kosovo. What makes Kosovo unique is its inability to proportionally respond to a low vaccine uptake and educate its citizens on social distancing.

Faced with the current crisis, there are urgent tasks Kosovo’s leadership must undertake.

First, impose a two to three week circuit-breaker lockdown to suppress the exponential growth of the pandemic. In the midst of such high community transmission, it is irresponsible to just impose curfews from 10 p.m. to 5 a.m. when during the day mask wearing and social distancing are alien concepts. A lockdown could have been avoided, but now it is far too late.

Second, decentralize the vaccination program to improve community access at the local level. It no longer works to have a centralized system when Delta is battering the country. People need to be able to access vaccinations in the communities where they live.

Third, make it strictly mandatory to show a certificate of full vaccination to attend leisure events, restaurants and cafes. Those who choose not to get vaccinated must be asked to show a negative PCR test in the last 24 hours prior to attending live public events including restaurants and shopping centers. I am aware this suggestion is unpopular and restrictive, but Kosovo cannot afford to go into repetitive lockdowns in the future as a result of unvaccinated citizens’ decision to endanger their own communities. We must act now to maximize chances of more normality in the future.

Inaction will lead to many otherwise preventable deaths.

Finally, fight misinformation and increase trust in vaccines. The government needs to run a public information campaign to convince people that the vaccines are safe for all pregnant and breastfeeding women, those with allergies to penicillin and those who were previously infected with coronavirus. A common belief is that vaccines cause infertility, but this is not true and scientifically, there is no mechanism which links vaccination to loss of fertility. Data emerging from the UK consistently prove vaccine effectiveness. A recent report published by Public Health England shows that vaccines in use in the UK have prevented over 100,000 deaths and over 24 million infections as of August 20.

Pandemic management requires measures that can proportionally, effectively and measurably combat it, not some cosmetic fiddling to generate the perception of management, which I fear is precisely what is happening right now. Delta, as a more highly transmissible and deadly variant, is going to change the equation this winter. It is therefore incumbent on the government to take on board the above recommendations aimed at stabilizing the situation.

Failure to act now, both in terms of imposing restrictions and speeding up the vaccination campaign, will only guarantee the need for future lockdowns. Sadly, these ones will have to be extremely restrictive and far more draconian in order to suppress transmission and high deaths that are likely to occur in a poorly vaccinated and Delta-ridden Kosovo. Not all is lost yet, but inaction and dithering will lead to many otherwise preventable deaths.

Feature image: Atdhe Mulla / K2.0.