August turned out to be a very difficult month for Greece, which is ironic given that’s it is normally a month of rest and relaxation. The rapid rise of new coronavirus infections per day from 100 on August 1 to 200 a couple of days later and then to 293 – just below the psychologically important threshold of 300 – caused widespread and intense concern. With over 5,000 new cases, the month of August alone accounted for roughly half of all of Greece’s infections since the start of the pandemic in the country, raising serious questions like what will happen with schools? Can the National Health System (ESY) handle more pressure? How tough will the autumn be?
The experts are calm but they are also being vigilant, keeping a close eye on the numbers as any fluctuation, however small, could be significant. How did they interpret the latest spike in new cases?
“We have observed a slight flattening of the curve, with new cases steady at between 200 and 300, which may indicate that measures adopted in early August are taking effect,” Nikos Sipsas, an infectious diseases professor at the Athens School of Medicine and a member of the government’s expert committee, told Kathimerini. He adds that this week will give us a better picture of the evolution of the virus since the mid-August peak of the holiday season (due to the two-week incubation period).
Athanasios Tsakris, the director of microbiology at the Athens School of Medicine and vice rector of Athens University, says that he started worrying before August. “We saw the rise begin in July. Today, in fact, we’re at a plateau,” he adds, saying that while we should expect a spike in the next few days, the number of new cases alone is not indicative of any one thing. “The number of tests being carried out in the country is also important. The ratio of positive tests right now indicates that the situation is controllable. We are, of course, in a crucial phase, when systematic checks need to be carried out in the community and measures need to be introduced, but mainly implemented properly.”
While the caseload so far has been manageable, recent reports suggest that the health system would struggle to cope with a rise of 500 or so new cases a day. As far as Sipsas is concerned, it is not the specific number that should cause alarm. “If we’re talking about 500 young people who were partying on Mykonos, we wouldn’t be so worried. We would be particularly worried, though, if we had a doubling of cases every day pointing to an aggressive phase of the pandemic. This is not something we’re seeing right now,” he told Kathimerini.
One of the indices that is very important is the number of patients who are in intensive care. According to the 12th report of the government’s Covid-19 observatory, that number came to 31 in the August 20-26 period, from an average of 23.4 on August 5-20.
“The situation, as it stands, is manageable, but if the numbers keep rising it will get very tough,” warns Matina Pagoni, the president of the Athens and Piraeus Hospital Doctors’ Association (EINAP), stressing that ESY will have to have access to 1,300 ICU beds by the end of December. “We have to prepare for a difficult winter. Let’s not forget that, come October, we will also have the H1N1 flu virus, for which everyone should be vaccinated this year, but also a lot of other diseases that need to be treated in hospitals. We tend to forget this with Covid-19,” she says.
Personal responsibility, Pagoni adds, is also instrumental. “If each and every one of us applies the measures, we can bring the three-figure number down to two and then to one.”
For London School of Economics Health Policy Professor Elias Mosialos, who is also Greece’s international coronavirus spokesperson, a purely medical approach to the pandemic is not sufficient during this phase. “We need a multidisciplinary approach, with contributions from sociology, behavioral science and big data. The number of new cases is not enough. We need to know their characteristics, and not just on a broad geographical level – like, for example if they are concentrated in a particular area or spread across the country – and on the level of family structure. Who are the new patients living with? Their parents? With people who have underlying illnesses or elderly individuals?”
Mosialos has recommended the creation of a special task force comprising experts from those fields, which would work in tandem with the team of health experts already appointed by the government. “Controlling the epidemic right now is not a medical matter. It would be if we had medicines and vaccinations. But we don’t have a cure. Therefore, the weapons we do have are mainly a matter of behavior – how Greek citizens will behave and what measures will be taken by the state to facilitate the behavior of citizens,” he says.
Mosialos explains that such measures could include increasing bus services to avert crowding and bolstering working from home. “We need a national understanding between the government, the opposition, local authorities, employers and workers. This, after all, is the definition of public health,” says Mosialos.