Where did it go wrong for Poland’s pandemic response?

By Wojciech Kość

During the first phase of the coronavirus pandemic, Poland succeeded in keeping infections low. But the second wave has hit the country hard, with its COVID-19 death rate now among the highest in the EU. While much of the world is also suffering, the situation in Poland has been exacerbated by key mistakes made by the government, say experts.

“A critical week is ahead of us,” Poland’s health minister Adam Niedzielski said ten days ago, while announcing a new round of restrictions aimed at containing the rapid spread of the pandemic.

“We could soon be at 20,000-25,000 new coronavirus infections a day. That is a scenario worse than the worst,” Niedzielski warned.

Less than a week later, Poland passed the 20,000 threshold for the first time, at the same time recording 301 coronavirus-related deaths, also a new record daily figure.

In late September, the Chief Sanitary Inspectorate (GIS) had predicted that by mid-October there would be around 1,000-1,500 new cases a day, after which the figure would go into decline.

Amid the dramatic spike in cases, hospitals have been left struggling to cope, with reports of patients in ambulances being turned away. On Sunday, one of Poland’s 16 provinces announced that all of its ventilators designated for COVID-19 patients were now occupied.

If the number of cases continues to rise, the United Right coalition government – led by the Law and Justice (PiS) party – will have little choice but to do what it has long insisted is a no-go: impose the second full lockdown this year.

The price to stop the spread of the virus will be high. A new freeze would strangle the economy, push up joblessness, strain parents juggling working at home with looking after children, and leave kids to return to the remote learning that proved an unsatisfactory replacement in the spring.

But, say experts, things could have been very different had the government made better use of the time it won itself by successfully keeping cases low during the first wave.

The good old days

Only two months ago, the pandemic appeared but a nuisance and the government oozed confidence.

“I’ve prepared all the plans for the autumn,” Niedzielski’s predecessor, Łukasz Szumowski, boasted in a radio interview shortly after his resignation in August. Szumowski’s unexpected decision to step down seemed like the biggest coronavirus-related problem for the government at the time.

New cases were trickling in at around 600 a day throughout summer, with the daily death figure no higher than 20. The pandemic was no longer on people’s radar. Poles enjoyed the summer heat vacationing countrywide.

Their holiday spending was aided by the government’s “tourist voucher“, worth 500 zloty (€115) per child, covering costs such as accommodation. The move, designed to both help families and boost the domestic tourism industry, was part of the government’s sizeable fiscal package worth 13% of GDP.

Such policies helped cushion the impact of the pandemic on the economy, for example by limiting growth in the unemployment rate to just around 1 percentage point by September, when it reached 6.1%. In July, the European Commission forecast Poland to have the smallest relative GDP decline (-4.6%) in the EU this year.

The government basked in the glory of being one of Europe’s few to have responded decisively right at the start of the pandemic, when it introduced one of the continent’s earliest and toughest lockdowns.

Politics over pandemic

Yet that early mobilisation to combat the virus began eroding as Poland’s presidential election campaign went into full swing in June and July.

PiS had sought, for political reasons, to hold the election as early as possible. It initially pushed for the constitutionally scheduled date in May. When that proved unfeasible amid lockdown, it delayed the two rounds of voting as little as possible, scheduling them for the end of June and start of July.

With PiS keen to boost turnout – especially among the elderly, who were on average more likely to favour its candidate – and to promote its success in handling the first wave of the pandemic, it was keen to play down the threat on the campaign trail.

“I am glad that we are less and less afraid of this virus,” Prime Minister Mateusz Morawiecki (in)famously told a rally in the south-eastern town of Tomaszów Lubelski.

“This is a good approach, because [the epidemic] is in retreat. You do not need to be afraid of it now. You should go to vote in large numbers. Everyone, especially seniors, do not be afraid. Let’s go to vote,” Morawiecki said.

Although at the time Poland still had a number of coronavirus restrictions in place, they were hardly adhered to. Morawiecki himself was speaking to a closely packed crowd, most of whom were not wearing masks, in contravention of the government’s sanitary guidelines for public gatherings. Such scenes were typical at the rallies of all the election candidates.

Inconsistent messaging

It was this complacency that paved the way for the current explosion in infections, say experts. The government’s critical mistake was inconsistent messaging and lack of information on the continued dangers of the coronavirus.

“In the spring, the government did well by introducing lockdown. But as time went on, it slipped into inconsistent messaging that made people become less disciplined about wearing masks and social distancing,” says Tomasz Dzieciątkowski, a virologist at the Warsaw Medical University.

“What happened between May and September was not surprising – weaker transmission because of higher temperatures and humidity as good weather made us all spend more time outside,” notes Krzysztof Pyrć, a professor of molecular virology at the Jagiellonian University in Krakow.

“That contributed first to a relaxation of people’s behaviour in terms of safety and then simply made them ignore the danger,” Pyrć told Notes from Poland.

“That there would a surge in the coronavirus cases in the cold season was clear all along. We knew that it would come, we knew that it would be more difficult to deal with and we also knew that there would be the seasonal flu to deal with on top of the pandemic,” adds Dzieciątkowski.

Another contributing factor to the surge in cases has been reopening of schools as normal at the start of September, after the first wave of infections had left them closed since March.

Although experts had warned that schools could become hot spots for outbreaks, the government insisted that, with sanitary measures in place, things would be safe.

“The buildings have been standing empty for several months, so the buildings themselves are not infectious,” said the then education minister, Dariusz Piontkowski.

In fact, five million pupils returning to schools in September has been one of the drivers of the currently surging infection numbers. In late October, the health minister, Niedzielski, admitted as much, saying that schools have become “a seedbed of the epidemic”.

Over the last two weeks, all pupils other than reception class and the first three years of primary school have been moved to remote learning.

“Domino effect”

Yet experts warn that the tougher measures being introduced now have come too late, as infections have already passed the point at which acceleration would be easy to reverse. There also remain significant organisational problems.

“Now we’re at a point where it’s very difficult to counteract and the entire healthcare system is on the line, not least because many of the infected are people from, or linked to, medical professions – that has a domino effect of non-COVID-19 patients not getting treatment,” Dzieciątkowski says.

That is the reality that Grażyna Cholewińska-Szymańska, a doctor working in the Provincial Infectious Diseases Hospital in Warsaw, is currently afraid of.

“There will be more beds to treat COVID-19 patients in my hospital and others in the Warsaw province. But it is all being done ad hoc instead of in a strategic manner, which should have been drafted in June and July, when the pandemic was ‘quiet’,” Cholewińska-Szymańska says.

“So what if we’re going to get 2,500 beds pulled from, say, cardiological or other wards, to treat COVID-19 patients if there’s no strategy what to do with non-COVID-19 patients that we’re just about to rid of beds?” she asks.

Faced with the exponential growth in new infections, the government is hastily setting up temporary hospitals countrywide. But it is soon going to hit another problem, Dzieciątkowski says.

“Beds and ventilators won’t cure anyone if there is no staff – which is the problem we have as a country right now,” Dzieciątkowski said.

Indeed, there only are 479 infectious diseases specialists working in infectious disease wards nationwide, October data from the Polish Association of Epidemiologists and Doctors of Infectious Diseases show.

Other data, compiled by the Supreme Chamber of Physicians and Dentists (NIL), the self-governing body for doctors, says there are just over 1,100 such doctors. That is still just over one per 40,000 people in Poland.

Media reports have suggested that medical staff at Warsaw’s hospitals are receiving calls offering them pay rises to transfer to the government’s new temporary emergency hospital in the National Stadium.

This is “disrupting the entire health system”, says the city’s opposition mayor, Rafał Trzaskowski, who has accused the government of “not preparing a strategy for the second wave”.

“Time was wasted”

Cholewińska-Szymańska is also livid. “What should have been done in late June through to early July was drafting various scenarios for the second wave of the pandemic, which we knew would come,” she says.

“We would have had strategies to rely on, covering various scenarios in growth of COVID-19 cases from the most optimistic to the most bleak. Instead, decisions are being made on the go and they’re often difficult to implement or the implementation requires time, which we don’t have,” she adds.

“That time was wasted,” agrees Jacek Drobnik, chief epidemiologist at the Wrocław University Hospital. “When some of the restrictions were still in place and people were more disciplined, schools should have been reopened to test their impact on how the virus spread and what procedures should be implemented for after the summer holidays.”

But that was only one of several mistakes, he adds. “The government failed to communicate to people that the virus was not gone and it was still dangerous. Instead, it told the people what they wanted to hear in fact: the lockdown is over, there’s nothing to worry about, the pandemic is in retreat. All because of the presidential election, of course.”

There were also failings with the testing and quarantine systems, says Drobnik. People would get tested only if they showed all four main symptoms of COVID-19, which meant those with fewer symptoms would just go on with their daily routines and spread the virus.

Shortening the quarantine from 14 to just 10 days, as the government did in September, was also an error, he believes. “The incubation period of the virus is between 1 to 14 days, so that left a number of people spreading the virus while they should have been quarantined,” Drobnik says.

Drobnik also points to the systemic shortcomings in Sanepid, Poland’s sanitary services that is in charge of testing but has struggled to keep up with the explosion in case numbers. “The current reality is that only people with symptoms are being tested, while those who are asymptomatic keep spreading the virus.”

Drobnik says that in order to try and curb the spread of the virus, key areas will be consistent enforcement of mandatory wearing of face masks and maintaining social distance, strengthening Sanepid, and limiting social interactions.

The government should consider closing all schools again, advises Drobnik, who also suggested ending the Sunday trading ban that it introduced two years ago. Opening retailers for seven days a week and round the clock would disperse shoppers over longer opening times.

Meanwhile, the government continues to make incremental and often last-minute moves that suggest a lack of strategy. The most recent example was closing cemeteries from 31 October to 2 November, when millions of Poles visit graves around All Saints’ Day.

The decision was announced in the late afternoon of 30 October.

Wojciech Kość is a journalist covering Poland and the Baltic states for bne IntelliNews. He also reports for Politico Europe and OKO.press, with a particular focus on energy and climate issues.

Main image credit: Adam Guz/KPRM (under CC BY-NC-ND 2.0)