Why the COVID-19 problem in Ukraine is everyone’s problem

Ukraine struggled to bring the COVID-19 pandemic under control even before Russian troops entered the country. It was slower to launch its COVID-19 vaccination campaigns than other European countries, and while the government encouraged citizens to get vaccinated, most people struggled to find a way to get the shot, didn’t feel the need to get it. need to get vaccinated, or they didn’t. do not trust the safety and efficacy of the vaccine.

Just before the invasion on February 24, only 35% of the Ukrainian population had been vaccinated. That puts it in line with most of its neighboring countries, although some, including Poland and Hungary, have achieved higher vaccination rates. While different health systems and differing views on vaccination in those countries contribute to those contrasting rates, Ukraine’s relatively low vaccination coverage may have implications for the large increase in the number of cases, both in the country and in the region, as a result of the war. † Like many other countries, Ukraine experienced an increase in the number of cases due to the Omicron variant in November and a new peak in the first week of February – most likely due to the low vaccination level. In mid-February, 60% of the COVID-19 tests conducted in the country were positive.
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Such a low vaccination rate is not enough to control a highly transmissible virus like SARS-CoV-2, public health experts say. Add to that a war — with the political and social unrest it’s causing — and not only are spikes in infections inevitable, but there’s the potential for new variants to put the whole world at risk.

Vaccination and restrictive measures such as mask-wearing, social distancing and basic hygiene are critical to contain the spread of SARS-CoV-2, but are impossible to enforce when a country is under siege. The MSF humanitarian group has distributed trauma kits and trained health care providers in Mariupol, Ukraine – a target of the Russian attack – and provides shelter and basic health needs to those crossing the border into other countries such as Poland. But it’s not enough.

“War is an infectious disease’s best friend,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It challenges any public health program you can possibly have. It limits the medical care available to those who may be seriously ill, and often promotes transmission when so many people are crammed into bomb shelters and on trains. This becomes the perfect storm of one serious challenge after another.”

Read more: They called Ukraine home. But they faced violence and racism when they tried to flee

A decade and a half ago, researchers at the World Health Organization found that 65% of the major infectious disease outbreaks that occurred in the 1990s occurred among refugees or in conflict zones. Les Roberts, professor emeritus of Columbia University’s Mailman School of Public Health who has spent time in war zones dealing with outbreaks, notes that these populations are particularly vulnerable to viral diseases such as COVID-19. “It turns out that when you’re under stress, your immune system doesn’t work as well. You don’t eat very well and you can’t fight against disease,” he says. “And in times of conflict, you move around a lot and end up in air raid shelters or basements or on trucks that are much busier than usual and have poor air circulation. I don’t think people fully understand how war is the breeding ground for disease.”

More than 670,000 people have left Ukraine since the start of the war, and this increased travel will almost certainly lead to a spike in cases in the country and neighboring countries – such as Poland, Hungary, Slovakia, Romania and Moldova – as their health care systems come under strain. to stand. According to the UN High Commissioner for Refugees, health experts are particularly concerned about the situation in Poland, where nearly half of Ukrainians have fled. “SARS-CoV-2 is currently spreading like lightning,” said Jeffrey Shaman, a professor of epidemiology at the Columbia University Mailman School of Public Health. “For places like Poland and places in western Ukraine where people are fleeing, there is a huge opportunity for this virus to cause damage that it wouldn’t have done otherwise.” Prior to the influx, nearly 60% of Poland’s population was vaccinated, which will help protect it from a wave of flooding, but new infections are also likely to increase there, raising the demand for healthcare.

“We’ve been warning for years about the potential convergence of conflict and epidemiology — bad things happen when those things coincide,” said Dr. Eric Toner, senior scientist at the Johns Hopkins Center for Health Security. “Certainly, in the appalling conditions the population is currently in, wearing masks, distancing and quarantine will not be possible. While people are fleeing the affected parts of the country, crowding buses, trains and cars and ending up in hotels or with relatives or in refugee camps, these are not prerequisites for good control of a communicable disease such as COVID-19.

Hospitals are likely to be hardest hit by the influx of refugees during the pandemic, public health experts say. War-related injuries take precedence over COVID-19 care, which only makes it easier for the virus to spread. That disruption, in turn, will lead to more health workers becoming infected and unable to perform their duties.

“There will be runs on hospitals and facilities and resources because of injuries related to the conflict,” Shaman said. “In the longer term, I can imagine that this will lead to a deterioration in the ability to deliver health care to the level that people in Ukraine are used to have.” And if peaks also occur in neighboring countries, this will put extra pressure on healthcare throughout the region. “The world community would be advised to provide supplies and facilities to protect the displaced Ukrainians and Polish populations from those impacts.”

Shaman and other public health experts are also concerned about the long-term effects of the conflict on COVID-19 containment. Studies consistently show that vaccine-based immunity begins to wane after about five to six months. Booster shots are essential to maintain protection against a disease so severe it requires hospital care; if the conflict in Ukraine continues, it would mean that even vaccinated civilians won’t be able to get a boost, as trauma care and war-related injuries will be prioritized over vaccination efforts.

Read more: Europe’s illusion of peace is irrevocably shattered

The situation exposes the weaknesses in the global biodefense network against threats such as highly contagious coronaviruses. Even without a military conflict, wide disparities in health resources have led to wide disparities in countries’ ability to control COVID-19; developed countries have been able to buy and distribute vaccines, while poorer countries, mainly in Africa and parts of Asia, still struggle to contain the virus because they don’t have access to the injections. Now, when such a conflict arises in Ukraine during a pandemic, the lack of global coordination of public health resources becomes more tragically apparent. “I can’t tell you where the solution is,” Shaman says. “The World Health Organization does not have the authority or the funds in terms of money to address this. This is a very big issue that relates to development, nation sovereignty and the ability of nation states to get along and support each other in a familiar way, rather than in the way we have seen the world evolve over the past 20 years. .”

What’s really needed is a global public health coordinating body, Toner says, which isn’t likely given the challenges posed by national sovereignty. But the principles behind global coordination can still be implemented in more limited ways.

The COVAX global vaccine distribution program, through which developed countries buy vaccines to drive down prices for developing countries, represented such an effort, but failed to deliver on its promise. It failed to deliver the 2 billion doses it had guaranteed by the end of 2021, and the group estimates it will take well into 2023 to deliver enough vaccines to immunize the world. “After the pandemic is over, I think we need to take a closer look at COVAX and why it didn’t work as well as we hoped, and what we could have done to make it better,” Toner says.

Some public health experts have suggested alternatives, such as supporting vaccine makers to set up manufacturing facilities in countries that have historically struggled to get the latest vaccines, and encouraging more shared intellectual property to allow poorer countries access. give them the technology they need to take shots independently.

Roberts points out that there are also ways to control and reduce the chances of viral spread when Ukrainians gather in shelters and flee to other countries. Vaccinating and encouraging people entering these communal settings, especially those who are particularly vulnerable, such as the elderly or those with underlying health conditions, is an important start.

However, that is still largely out of reach. The World Health Organization does not have enough resources to quickly send vaccine supplies and personnel to crisis areas such as Ukraine, and has no political authority to address issues of national sovereignty. Organizations such as MSF and other humanitarian groups also play a vital role, but are equally limited to more local aid efforts. “If we continue to react reactively in crisis after crisis, we will not get to the systemic, underlying problems that need to be solved,” Shaman says.



This post Why the COVID-19 problem in Ukraine is everyone’s problem

was original published at “https://time.com/6153254/ukraine-russia-war-covid-19/”