John Vassilopoulos
Greece announced 130 COVID-19 deaths on December 14—the highest death toll recorded in a single day since the beginning of the pandemic. The death toll has been consistently high in recent weeks with over 1,400 deaths recorded since the start of December. November was the deadliest month of the pandemic so far with nearly 200,000 cases and 2,157 deaths.
The toll of the pandemic in Greece this year was underscored in a recent press release by the Greek Statistical Service ELSTAT, which stated that there were 11,185 additional deaths in the first 43 weeks of 2021 compared with the same period in 2020. Compared with the average number of deaths between 2015 and 2020, the death toll in 2021 was 14.27 percent higher.
The 32,327 COVID cases recorded in the last week took overall infections to over 1 million (1,026,902). This is among a population of just 10.3 million.
The latest upsurge is part of a wider trend in Europe with infections and deaths rising across the continent as governments reject any public health measures that cut across the profit interests of the financial elite.
Greece has been hit particularly hard by the latest wave of infections and now has one of the highest COVID death rates in Europe. According to figures compiled by Our World in Data, Greece’s COVID mortality rate currently stands at 8.98 per million, which is the second highest rate in the eurozone after Slovakia (19.23 per million) and almost double the average death rate across Europe (5.86 per million).
The disproportionate devastation wrought by the virus in Greece is the direct result of the brutal austerity imposed by successive conservative, social-democratic and pseudo-left governments at the behest of the European Union and International Monetary Fund over the previous decade. Total healthcare spending decreased from 9.52 percent of GDP in 2010, when the first austerity package was signed, to 7.72 percent in 2018. According to a 2020 OECD report, Greece had 5.3 intensive care unit (ICU) beds per 100,000 population in 2019 just before the pandemic began, well below the EU average of 12.9 ICU beds per 100,000 population.
Despite claims by the government that ICU beds have been doubled in response to the crisis, the pandemic has brought Greece’s public health system to near collapse. The number of people on ventilators throughout December has been around the 700 mark. Figures published by the Ministry of Health on December 12 reported that 104 patients on ventilators were hospitalised outside of ICU due to a lack of beds in intensive care. One 62-year-old COVID patient recently died on a hospital trolley at the Ippokrateion Hospital of Thessaloniki after an eight-hour wait to be admitted into intensive care.
In an interview to medical news website iatronet.gr at the end of last month, ICU doctor Apostolos Tsapas painted a devastating picture of the current situation at the Papageorgiou Hospital in Thessaloniki where he works.
Speaking about patients on ventilators outside his ICU he said, “as a rule these people are monitored not by ICU specialists at the Papageorgiou hospital, but by anaesthetists, while in other hospitals I have heard it’s general practitioners.” He added, “If required they will ask for our help. And then we split ourselves in two and go and help. On the other hand, if ICU departments are full and woefully understaffed by doctors and nurses this means that we can’t practically cover our own patients in ICU let alone those on ventilators outside ICUs. And for seriously ill patients on ventilators there are situations where time is not a luxury. Interventions need to be immediate, within 60 seconds.”
As for the government’s refusal to address the staffing crisis in ICU departments. he said, “It takes two years to specialise in ICU medicine. If incentives had been given from the start [of the pandemic] today we would have nearly fully-fledged ICU doctors and the system would be better staffed. This shows which needs were prioritised.” Referring to the €3 billion defence deal that Greece signed with France in September he said, “We gave ample money for Rafale [fighter jets] and frigates. But for health we chose not to give anything.”
Another ICU doctor, Michalis Rizos, who works at Attikon Hospital in Athens, told online news site tvxs.gr, “If a COVID patient with additional problems can’t find an ICU bed how is it possible for them to live? This is so-called hospitalisation, which is why I call it mass murder.”
During a December 1 debate in parliament Prime Minister Kyriakos Mitsotakis of the ruling New Democracy sought to downplay the issue of patients being on ventilators outside intensive care, stating, “Do we have indications [that patients on ventilators outside intensive care] have a higher mortality than those in ICU? I don’t have such an indication, do you? If so bring it to me.”
Just such a study was published this week in the Scandinavian Journal of Public Health authored by epidemiologist Theodoros Lytras and Sotiris Tsiodras. Tsiodras is the infectious disease specialist in charge of the government’s Committee of Public Health Experts (EEDY). Analysing the mortality of patients on ventilators in Greek hospitals between September 2020 and May 2021, the study concluded that the mortality of patients on ventilators outside intensive care was 87 percent higher than those within an ICU.
Regional disparities were also exposed with mortality being significantly higher outside of the Attica prefecture which contains the capital Athens. Mortality was 35 percent higher in Thessaloniki, Greece’s second largest city, and 40 percent higher across the rest of Greece. The report also concluded that mortality of ventilated patients increased by 25 percent if there were more than 400 patients hospitalised in ICUs, rising to 57 percent if the number of patients exceeded 800.
In a December 14 tweet, Lytras made clear that the study’s findings were made immediately available to the government in May, exposing Mitsotakis’ claims in parliament as lies. Lytras also tweeted that out of the nearly 4,000 deaths included in the study, around 1,500 of these would not have occurred “had they been hospitalised in a health service that was not under pressure (meaning less than 200 patients on ventilators), in hospitals within Attica and within intensive care”.
Health Minister Thanos Plevris tried to present the record number of deaths recorded on December 14 as a peak, pointing to the fact that daily cases have been consistently dropping in the past two weeks while claiming, “we are vigilant about the new variant Omicron, which has not yet hit us”. Just a couple of days later this was belied after the total number of confirmed Omicron cases jumped to 17 on December 16—up from five at the beginning of the week, prompting the government to require a negative test from all travelers coming into Greece.
However, with no additional measures to suppress community transmission it is only a matter of time before Omicron spreads further. With hospitalisations at an already high level the impact will be catastrophic.
Speaking to state broadcaster ERT earlier in the week, Yiannis Prassas, a molecular biologist at Toronto University in Canada, predicted that Omicron will hit Greece in about a month and will produce “a very grim situation for the National Health Service.” He warned, “Under the threat of a huge wave of cases with everyone becoming infected at the same time, hospitals will receive unprecedented pressure with no scope for leeway when you have 700 patients on ventilators. Health workers will also become infected, which will result in huge staffing gaps when maximum coverage will be required.”
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