Medical emergency workers decontaminate themselves after attending to a COVID patient in Romania.
Foto:Petrut Calinescu / DER SPIEGEL
COVID-19 in Romania From Vaccine Champion to the World's Highest Death Rate
Mr. Florescu must have celebrated a birthday recently. Balloons printed with "Happy Birthday" are stashed in a corner of a room in his central Bucharest apartment. It’s uncluttered, with an icon of the Virgin Mary and photos of his granddaughter arranged on a shelf. Florescu is lying on the sofa when the paramedics arrive, wearing protective suits and visors. Eleven days ago, Florescu tested positive for COVID-19.
The article you are reading originally appeared in German in issue 45/2021 (November 6th, 2021) of DER SPIEGEL.
He is unresponsive and his face is sallow. The two paramedics lift him to the floor. While one begins cardiopulmonary resuscitation, the other pumps oxygen from a bag into the man’s lungs. To protect 86-year-old Florescu’s privacy, we have only used his surname here. He is diabetic, a high-risk COVID patient. He also hasn’t been vaccinated.
Paramedics and the reporter at the patient's home: Emergency workers in white protective suits are a common sight these days.
Foto: Petrut Calinescu / DER SPIEGELThe pensioner is one of the approximately 65 percent of Romanians who haven’t been vaccinated yet - which is why the country’s hospitals have been overflowing for the past several weeks. Paramedics report that they sometimes have to travel to three hospitals before they find a bed available for COVID-19 patients – or they have to spend hours caring for them in ambulances. Most of the sick are unvaccinated.
"Most of Them Get To the Hospital Far Too Late"
At the beginning of the year, things were looking good in the country. When the first vaccines hit the market, Romania quickly emerged as an immunization leader. For several weeks, the country vaccinated its citizens at a faster rate than most other European Union member states. As Germany became embroiled in an argument about prioritizations for different age groups, Romania vaccinated its homeless population with little discussion.
Since this autumn, however, the country has been experiencing its worst wave of the coronavirus since the start of the pandemic. Poland, Hungary and other countries have taken in patients from Romania. As of early November, COVID-19 is killing one person every three minutes in Romania. No other country in the world currently has a higher per capita death rate.
Genoveva Cadar, 56, is the leader of the "red zone" at a pulmonology clinic in Bucharest. The hospital’s COVID ward accommodates more than 100 patients, 15 of whom are in intensive care. A sign at the entrance to Marius Nasta Hospital reads: "We breathe together.” Cadar, who is wearing a lab coat over a colorful dress, has worked here for 30 years, but says this crisis can’t be compared to anything she has seen before.
Cadar’s hospital even set up additional intensive care beds in a large red truck because there were no longer enough in the clinic. Eight people are connected to breathing tubes in the windowless vehicle. A photo of one patient’s family is lying on her pillow. A nurse holds the hand of the man next to her. The machines beep without pause or any rhythm.
"Most of them get to the hospital far too late," says Cadar. She says they don’t trust the doctors. "They don’t trust anyone, not even each other."
First responders on their way to a COVID call: Mr. Florescu, says a neighbor, had been faring badly for days. But it took a long time before anyone called the paramedics.
Foto: Petrut Calinescu / DER SPIEGELIndeed, the country’s vaccination rate has become a measure of skepticism toward the state. In addition to Romania, the situation has also deteriorated in other Eastern European countries like Bulgaria, Latvia and Lithuania. In many of these countries, less than half of the population is vaccinated, and the number of deaths is rising dramatically.
Romania’s recent plight is a symptom of the crises the country has been struggling with for years. With the pandemic, an ailing health care system collided with distrust of a state that many perceive to be corrupt and indifferent. The situation has been aggravated by fake news about vaccination, which is also spread by priests from the Orthodox Church and established television channels.
As Genoveva Cadar describes her daily routine at the hospital, a fire engine drives past. In recent months, more than 20 people have died in fires in intensive care units in Romania.
"We’re also afraid of fires," Cadar says. The large quantities of stored oxygen increase the risk of fire if there is a short circuit in the hospital electrical system. Romania spends less than 6 percent of its gross domestic product on its health care system, lowest in the EU. Many hospitals badly need to be renovated, and there is also a shortage of medical staff, doctors, nurses and other hospital workers.
An Exodus of Medical Workers
Cadar says she needs three times more staff for her ward. Since the country joined the EU, thousands of Romanian doctors have emigrated to countries where they earn more. Some 5,000 Romanian doctors are working Germany alone. Medical students are now stepping up to help fill the biggest gaps at hospitals and vaccination centers.
In its moment of crisis, Romania is being led by a caretaker government following the September collapse of the governing coalition in September. Vlad Voiculescu, of the liberal USR-Plus party, has twice served as health minister, most recently from December 2020 to this April. He looks exhausted as he joins a Zoom interview from an unfurnished study. He says Romania is currently experiencing "a humanitarian catastrophe.”
Voiculescu was once seen as a beacon of hope for young and progressive Romanians. It was a fire that first brought him into office six years ago. At the end of October 2015, a conflagration broke out inside the Club Colectiv nightclub in Bucharest, killing 65 people. Reporting later uncovered that some of the injured died from infections they contracted in the hospital because disinfectants had been diluted to the point of ineffectiveness. The disaster became a symbol of a broken health-care sector.
Health Minister Voiculescu blames Romanian President Klaus Iohannis and current Prime Minister Florin Cîțu for the current coronavirus disaster. "They wanted to be the champions of easing" restrictive measures to contain the coronavirus, Voiculescu says. In May, Romania relaxed its pandemic-related rules, and the pace of vaccinations decreased at around the same time. This summer, the government announced that the pandemic had been defeated. "If countries like Germany are continuing to impose measures, how can anyone believe that our weak health-care system could cushion this without measures?" Voiculescu asks.
In an effort to stop the rapid rise in infections, the government re-imposed restrictions in late October. Large parties are prohibited and those entering shops or government offices are required to present a Green Pass, showing that they have been vaccinated, tested or have recovered from COVID-19. Those who don't have such a pass must remain at home from 10 p.m. to 5 a.m. Marathon vaccination campaigns on weekends are also intended to help - and vaccination rates have, in fact, risen significantly in recent days.
"I'm Not an Anti-Vaxxer, But ..."
To further increase the rate of immunizations, caretaker Prime Minister Cîțu recently visited two vaccination centers. The press and the head of the vaccination campaign, a military doctor, accompanied him. Around 70 percent of Romanians trust the military, but not even one in five trusts their own government. So far, it has largely been politicians who are promoting vaccination in the country.
But Romanian health expert Vlad Mixich believes that was a big mistake. He argues that international stars like tennis player Simona Halep could do more for the vaccination campaign than any politician. Under socialism, he says, it was safer not to trust politics, and many have internalized that to this day. Mixich attributes the recent boost in vaccination rates to the high number of deaths and new restrictions. However, the lack of trust toward vaccination persists.
More than one in two people in Romania even believe that governments develop viruses in the laboratory to restrict people’s freedom. That thinking is fueled by conspiracy theories that are disseminated on social media platforms, but also through major television channels.
A paramedic rushes to a patient: Most COVID patients didn't trust the vaccine or vaccination. It has only been since the death toll started to rise that many Romanians have decided to get the jab.
Foto: Petrut Calinescu / DER SPIEGELOne self-proclaimed sage is Dan Dobre, a 24-year-old with more than 40,000 followers on Facebook. The platform has attached a warning to one of his recent posts about COVID-19. In it, Dobre pokes fun at the government’s coronavirus containment measures and advises healthy eating as a weapon against the virus. Dobre says he used to be a fan of Health Minister Voiculescu. Today he begins his speeches against vaccines with words like, "I’m not an anti-vaxxer, but …”. He then goes on to compare the Green Pass to the beginnings of the Holocaust.
Priests and Bishops also Advising against Vaccination
The young marketing consultant claims he gets some of his information from "journalists” belonging to an NGO and agrees to a meeting in their office in downtown Bucharest. Wearing a turtleneck and hipster glasses, Dobre is surrounded by podcast mics and cameras.
Dobre and two of his fellow campaigners who have joined the meeting claim that the figures of around 48,000 COVID-19 deaths in Romania have been falsified. As alleged evidence, he cites two autopsy reports on coronavirus victims. They reference hospitals that they claim were empty at the time - and say they even have video footage of their own from April to prove it. Unfortunately, though, these videos can't be seen because, you see, nobody has yet found the time to put them online. Follow-up questions are met with counter-questions, and then they change the subject.
Members of parliament, like right-wing extremist politician Diana Șoșoacă, also regularly rail against vaccinations, claiming they make people infertile. But television stations like România TV and Antena 3 still regularly provide her with a platform. Both are among Romania’s largest broadcasters and have repeatedly participated in smear campaigns in recent years. Even bishops with the Orthodox Church have advised their followers not to get vaccinated. Archbishop Teodosie, who uses radio stations and YouTube to spread his messages, recently even claimed that the EU had halted vaccinations.
Doctor Genoveva Cadar believes these campaigns are largely to blame for the fact that many patients aren’t getting vaccinated, and the help explain why they arrive at the hospital too late once they do get infected. For years, the government has invested too little in education. "Now people have opinions about health issues rather than facts," she says, adding that most of her patients express regret at not having been vaccinated once they get to the hospital.
Cadar doesn’t expect the situation in Romania to ease until December. She says it will take time before the vaccination campaign and the lockdown takes effect. Besides, there are significant exceptions to the rules: Orthodox Church services have barely been restricted at all.
At the exact moment that paramedics are doing all they can to revive Mr. Florescu in his apartment, the Orthodox Church is celebrating Saint Dumitru. TV reports show several hundred people attending the service at the Patriarchal Cathedral in Bucharest, though at least it is outdoors. At the same time, a few hundred of Dan Dobre's followers are protesting against the coronavirus measures.
At 8:21 p.m., Mr. Florescu is pronounced dead. The paramedics rush out to attend to the next emergency. Later, an undertaker who specializes in COVID-19 deaths will come to the small apartment in Bucharest. Until then, the pensioner lies alone on his carpet.
Local support provided by Alexandra Nistoroiu
