Weekly Briefing, Vol. 27, No. 3 (Al), March 2020
COVID-19 in Albania: a country in curfew and lockdown
On March 9th the first two cases of COVID-19 were confirmed in Albania. It was somehow expected, due to the nonstop expansion of the virus in the neighboring Italy – a country intensively connected to Albania by land, sea and air, and with an extremely large population of Albanian nationals living in Italian there. Even though the a drastic majority of citizens received with concern the initial news, there was not evident sign of true fear or panicking, which led to the most of the daily activates being held as normal. Since the number of confirmed cases was increasing, the Government decided on implementing on total curfew for the entire country giving so the chance to specific authorities to better monitor the suspected cases.
Awareness and impact
For weeks, the only headline in Albania is COVID-19, and it is expected to be so for the foreseeable future. The Ministry of Health confirmed the first two cases of COVID- 19 in Albania in the early hours of Monday March 9th. The two patients, father and son, who returned from Florence to Tirana in February 26th did not display any severe symptoms for days, until they were tested. The Ministry called on citizens to maintain calm and practice good hygiene, in accordance with the latest announcements, as well as urging everyone to refer only to official sources of information.
On March 10th other 4 cases were confirmed; on March 11th the total was 15; on March 15th the cases increased at 42, and as of March 19th the number of total positive to COVID-19 was 64. With the capital being hit most (70% of total cases), other areas also started to have their first positive lab tests such as Durres, Fier, Lushje, Elbasan, Rrogozhine.
Unfortunately, in the first days of the outbreak, there were hundreds of citizens who disobeyed the new regulations and kept on gathering in groups by so not respecting the quarantine rules imposed. This created a divide in the country with one side being extremely careful and the other disregarding the severity of the situation.
As the careful ones started being the majority, self-quarantine became the new rule. The immediate reaction was the race to supermarkets and drugstores in order to store food and medicament supplies. The panic was palpable in the third day after the first confirmed case; however, the awareness was higher in the capital, while in other cities, news coming from Tirana (being it the hub of the first patient) seemed overestimated and most of other big cities went on with life as usual. In view of this reaction, the Government enforced the same regulation to other areas where all bars, restaurants and recreational spaces where people gathered in large numbers, closed by order. Even if there was low awareness of the seriousness of the situation, this was imposed and actually proved effective.
For Albania, a number of valuable lessons on coping with this pandemic were taken from the sour experience of the neighboring Italy. Indeed, the first precautionary voices came from Albanians living in Italy, where private messages, news, daily information and more were taken at face value because the fellow compatriots living on the other side of the Adriatic made their statements loud and clear.
While in the entire country social distancing became the new normal, there were instances, especially amidst the elderly (who are at the same time the most vulnerable stratum of the society to the COVID-19), that did not take at face value the new rules and considered them as mere recommendations. To this end, the Government had to intervene again and impose now regulations as a proper quarantine should work.
Actions and reactions
Days before the first case confirmed, Albanian experts feared the increasing potential of the virus spread in the country. On February 25th, by expecting for a potential outbreak of COVID-19, the National Medical Emergency Center hands out coronavirus instructions and increased hospital budget and announced protocols in case of spread to Albania, explaining that citizens suspect they have contracted the virus should call the designated National Emergency Number (127).
The first measures implemented immediately after the confirmed cases included the suspension of flights and ferried from and to northern Italy. To contain and mitigate the spread of COVID-19 in the country enhanced screening was implemented and quarantine measures followed. With a special decree the Government ordered the closure of all educational institutions (be this public or private) for two weeks, all sporting, cultural events and other large public gatherings were cancelled for a period of three weeks.
Country’s lockdown became effective from March 10th – the use of private cars and intercity transport vehicles was banned in Tirana and Durres, and all private and public transport was banned in Shkoder, Lezha, Elbasani, Lushnja, Fieri and Vlora, with the only vehicles allowed being ambulances and vehicles for delivering essentials food and health needs.
On March 12th, Prime Minister Edi Rama declared “War” on COVID-19 and warned all Albanians that if they did not conform to the new regulations, drastic measures would be taken addressing the violators.
From March 13th , it was the same lockdown in other major cities across the country and from March 15th, Albania closed all of its land borders until further notice. On March 16th, another wide-ranging “emergency legislation” was adopted, specifying various fines for violations of protocol, to be effective immediately. Social, cultural, and political gatherings, whether in enclosed or open-air spaces, were banned, and violators could be fined up to five million Lek (or 40,000 euros). The legislation, called a “Normative Act”, is an emergency law taking effect without prior approval by parliament. Furthermore, a national curfew was imposed: each day, all citizens were required to return and to stay in their homes from 18:00 onward, as well as a ban on sitting in public places.
Due to this new Normative Acts, daily life changed drastically for the entire country. Most of the population is in self-quarantine due to the restrictions, and concerns are multiplying at the same pace as the confirmed positive cases of COVID-19.
In the initial days of total lockdown, there were voices and comments against these measures taken by the Government – and of course these voices generated from the party lines of the opposition, nevertheless, they did not have any considerable impact in the Albanian society. For the first time in decades, even for the most sceptics, quieting down controversies for the sake of public health became the priority with only sporadic claims of discontent.
COVID-19 and Albanian healthcare system
The Albanian healthcare system is by all standards unequipped to handle the outburst of the COVID-19 in the country, the entire society is aware of it and all Government entities are aware of the situation. The fact that the two first patients infected went to a public hospital before being quarantined into the National Hospital for Infectious Diseases indicates the low confidence in public healthcare structures.
However, in times of pandemic and highly contagious diseases all patient confiremed positive and with symptoms are hospitalized in one single center. As the core structure of this center was having in the first patients, flaws of the same were made public: first, it was the limited number of beds for a potential increase of number of infected; than the low equipment for severe cases; than the lack of proper medicament and the initial scandal – the stock of surgical masks in store were expired since 2011.
Ten days into this national emergency – there are not enough coronavirus test swabs to actually test the suspected cases, especially the ones who have been in contact with the patients now positive.
Other shortages such as facemasks, gloves, hands sanitizers have made their price go to the roof, some times as much as 100 folds more expensive than before the outbreak.
As many more developed countries in Europe, Albania is not ready to face this public health emergency – it is only hoped that the number of positive case will be contained and some support will be granted from other countries.
Meanwhile, the crippling for decades of the national healthcare system has produced an emergency within the emergency – there is not enough specialized medical staff, be this doctor or nurses, to assist in these times of intense demand for them. The Government is asking retired doctors and nurses to help as they can, but this is not a solution. The medical brain drain intensified in the last years and now it is having its immediate impact on Albania.
Conclusions
For most of Albanians, life as they know it is interrupted. Either some like it or not, accept it or not, these are extraordinary times, which need extraordinary measures, attitude and self-containment.
Albanian Prime Minster declared: we are at war! For the first time since 1997, the army took the streets in order to implement the new regulations and safeguard the most vulnerable of the society and mostly to impose a curfew and quarantine that in many have taken as a suggestion not as the new rule.
The response from the Government was swift and alarmist, but ultimately it is up the entire society to behave diligently and responsibly. The daily life of Albanians is turning into a severe challenge to the people and authorities, and it is testing its capabilities and limits.
As to the present, the main concern is health and survival, and with regards to the future, it is feared for a catastrophic scenario especially in economic terms.