Weekly Briefing, Vol. 38, No. 3 (Al), March 2021
Some notes on recent demographic trends in Albania
By the end of February 2021, the National Institute of Statistics released the official demographic data for the pandemic year, and the cost in human lives of the virus were made public. In terms of deaths out of the total, 2020 was one of Albania’s darkest years, placing Covid-19 the fourth cause of deaths in the year left behind.[i] Prior to the release of these data there was much intense public debate on whether the official data released on daily bases for Covid-19 fatalities were accurate or not. The delay of this official yearly statistics made suspicions even deepen with regards to the pandemic related loss of lives.
The pandemic out of control
According to official reports of the Ministry of Health, as of December 31st, 2020, there were 1,181 citizens who lost their lives due to coronavirus in the “Covid hospitals” facilities. On the other hand, the National Institute of Statistics (INSTAT) data the claims that total number of deaths, in 2020 was 27,605 people, marking an increase by 25.8 % compared to the previous year. During the year 2020, all prefectures of the country recorded increase in the number of deaths compared to the same period of the year 2019. The lowest number of deaths is registered in Kukes prefecture, with 627 deaths, while the highest is registered in Tirana prefecture, with 7,129 deaths, for the year 2020. The most tragic was the fourth quarter of last year when Covid-19 cases increased exponentially. During that time all prefectures of the country recorded increase in the number of deaths compared to one year prior. [ii] The table below indicates the natural population increase, and in the fourth quarter of 2020 registers 2,386 deaths more than births.
Albanian Natural Population Increase
Source: INSTAT
Data that don’t match
According to some experts there is something that does not match in these figures released: there are 5,665 deaths in total more than one year prior, out of which declared as Covid-19 fatalities are 1,181 people, thus there are about 4500 loss of lives unaccounted for, or extra deaths “without” definite reason. There might be an increase naturally from year to year, but not in these levels. Most of them attribute this mismatch in figures to the Covid-19 fatalities not declared as such, but if they are correct, it means that only one out of five Covid-related deaths are reported as such.
Historically, the first quarter of the year has brought more fatalities in Albania, due to respiratory diseases and declining immunity during the winter, but the Covid-19 overturned this order. The highest mortality rates are not observed at the beginning of the year, but at the end of it where, in addition to severe respiratory infections, they coincide with the first deadly peak of the pandemic in the country. With the end of quarantine, in the second half of the year, the figures have deteriorated significantly marking the record number of loss of lives for 2020. Since 2009, the average life loss in the country has fluctuated between 21-22 thousand per year, with peaks that had been reached so far in 2015 and 2017, coinciding with more severe flu periods. [iii] Aside from patient receiving home-treatment, people who lost their lives after being neglected or others who die in foreign hospitals are not classified as Covid-19 death. But, the worst seems to have not come yet. This dark balance refers only to the first peak of the pandemic, in November-December, when there were about 800 daily infections. The first quarter of 2021 had more 1000 new infections daily, which could bring the balances at even more catastrophic levels. The main question remains, why do Albanians in the majority of the cases chose home-treatment for Covid-19 infections? It is clear that something is wrong with the healthcare system, and mostly because of some gruesome bribery cases, videos, accounts of patients and more, the trust in those “Covid hospitals” is less then granted. Furthermore, private hospitals are by all considerations taking advantage of the situation by charging for example for one day of treatment (for Covid-19 patients) more than the average monthly salary of Albanians.
Lowest birth rates in a century
Recent official data from show that the gap between births and deaths of the population in Albania is narrowing at an alarming rate. During the last year in Albania 28,561 babies were born. This is the lowest natural increase of the population recorded in one century, since the time when Albania as a nation started to keep a demographic register (1923). Historical data show that in 2014, the natural increase of the population in Albania was over 15 thousand people. But this indicator has been steadily declining from year to year, falling for the previous year to only 6624 people or 2.3 times less than in 2014. The decline in natural population growth is directly related to the decline in fertility. Although Albania continues to have a positive natural increase of the population, so the number of births registered in a year continues to remain higher than that of deaths, the population is shrinking. Another major reason is also emigration, which continues at a high rate (there is an estimation of an average of 40 thousand Albanians leaving the country each year) at times higher than the natural increase of the population, which makes the total values go deeper into shrinking mode. [iv]
Potential future scenarios on demographic trends
According to a revised projection from INSTAT, the population of Albania in 2031 is estimated to be 2,745,996 inhabitants. This number is about 36 thousand inhabitants less than the population number given by previous studies and estimations. This projection argues that the change of this number is a direct consequence of lower fertility rates and the gender distribution of migrants.
Population projections according to 3 scenarios 2019-2031
Source: INSTAT
As time goes by, it is visible that the low scenario of the above chart will occur to the country’s demographic. In 2011, Albania was a country with more men than women. This has already changed in 2020, as in Albania the gender ratio stands at 99.8 men per 100 women. According to the updated population projections, the gender ratio is expected to deepen with higher rates for women reaching 89.1 men per 100 women. Albania’s population will continue the aging process and its median age is expected to reach 42.1 years in 2031. And it is expected that this aging process is associated with the rapid growth of the old dependency ratio from about 20.5 elderly people for 100 people in working age in 2020, to about 35 elderly people for every 100 working age people. During this period the youth dependency ratio will remain at constant levels of about 25 young people per 100 working age people. The demographic changes expected to happen to the population of Albania by 2031 will also have an impact on its distribution among the regions of the country. Until 2031, only the population of the prefecture of Tirana is expected to be higher than that of 2020, reaching about 954 thousand inhabitants. In 2031, around 35% of Albania’s population is expected to live in the prefecture of Tirana.
Another report released in mid-March 2021 from Eurostat states that the aging of the population in the European Union (EU) has started almost half a century ago, but in Albania it is happening at a much faster pace in the last decade. Data show that in 2020 about 20.6% of the EU population was over the age of 65 or older. Compared to 2010, the population over the age of 65 increased by 0.3%, while in Albania this process is happening much faster. From 2016 to 2020 the population over 65 years old in Albania increased by 2%. [v] Albania still has a young population in relation to Europe, as people over 65 were as much as 14.7 % of the total population, however if the trend of the last decade continues, the future seems less than promising.
Conclusions
January and February 2021, had an exponential rise in new cases as well as fatalities due to Covid-19 infections, what stands beyond reason is the fact that almost no restrictions are placed (besides the after 8pm curfew, which is too little, too late). The economy cannot stop, this was made clear by the policy makers of Albania, however there is another social element that is endangering citizens’ lives, namely the electoral campaign. Inconceivable as it may be, large group of people are following the leaders of all political parties and it seems that they are not going to stop anytime soon.
Unlike most European countries, Albania did not close during the winter wave of Covid-19, which is dragging its effects with disturbing figures of new cases even in March 2021. It is obvious that economy was placed before people’s lives in terms of priorities. And if another lockdown, even partial, would have been devastating for the economy, the death toll is tragic to say the least. At the end, a country can recover from economic losses, but it can never recover the lost lives.
[i] E. Gjediku. COVID-19 shkaktari i 4-t i vdekjeve. https://shqiptarja.com/lajm/tetornentordhjetor-muajit-e-erret-per-humbjet-e-jetes-instat-rriten-vdekjet-me-258-krahasuar-me-2019
[ii] INSTAT. Press release February 2021. Retrieved from: http://www.instat.gov.al/media/8018/demographic-indicators-q4-2020_final.pdf
[iii] Panorama. Virusi jashte kontrollit. Retrieved from: http://www.panorama.com.al/virusi-del-jashte-kontrollit-pese-mije-te-vdekur-shtese-u-dyfishuan-gjate-dimrit-raporti-i-instat-zbulon-se-numri-real-i-vdekjeve-ishte/
[iv] Top Channel. Shqiptarët lindin më pak/ Lindjet dhe vdekjet në një vit po shkojnë drejt barazimit. Retrieved from: https://top-channel.tv/2020/02/13/shqiptaret-lindin-me-pak-lindjet-dhe-vdekjet-ne-nje-vit-po-shkojne-drejt-barazimit/
[v] Albanews. Shqipëria po plaket me ritme më të shpejta. Retrieved from: https://albanews.al/shqiperia-po-plaket-me-ritme-me-te-shpejta-europa-po-i-afrohet-moshes-se-trete/