Armenia’s unique experience with COVID-19

An ambulance has deployed a mobile vaccination point against COVID-19 on the streets of Yerevan. May 2021. Photo: frantic00 / Shutterstock

The Armenian government’s pandemic management was influenced by economic concerns right from the beginning. This was quite understandable, as the country’s fast growing tourism and hospitality sector had been badly hit. This has recently been considered a key area for economic development. As political scientist Ivan Krastev noted in March 2020, “at a certain point, governments will be forced to choose between containing the spread of the pandemic at the cost of destroying the economy, or tolerating a higher human cost to save the economy.” Around the same time, economic forecasts varied for the country, with the Asian Development Bank’s rather optimistic expectation of 2.2 per cent growth contrasting with the 11 per cent decline considered possible by Armenia’s former Minister of Economy Vahram Avanesyan. Eventually, the pandemic and the country’s disastrous military confrontation in the autumn resulted in a decline of 7.4 per cent.

The only lockdown imposed by the Armenian government lasted from late March to May 2020 at the latest. This involved the closure of all businesses apart from medical institutions, infrastructure facilities, banks, pharmacies, supermarkets and food shops. The country also decided to suspend all public transportation. Later, only educational institutions were closed a few times for several weeks. It should also be remembered that the country’s social structure, which involves many low-income, rural and traditional households with multigenerational families, was also an additional risk factor. There was also a clear lack of discipline and control as many people kept gathering outside their apartment blocks to meet up and play board games.

Neighbouring experiences

In comparison with neighbouring Georgia, Yerevan seemingly failed to properly tackle the pandemic. Tbilisi imposed longer restrictions earlier and a mask mandate was more strictly observed by the country’s population. Georgia also introduced various additional measures, such as a curfew and a nationwide ban on the use of personal cars and motorcycles. In the last days of April 2020, Armenia experienced a considerable growth in active case numbers. By May 11th, the country’s death rate (15.9 per million) was much higher than that in Georgia (3.0 per million). The government’s approach was heavily criticised by the political opposition and civic groups. A clear unwillingness to adopt zero tolerance policies similar to those in Georgia and amend some regulations were some of the main reasons behind the public outrage. Whilst it was particularly clear that the police were unwilling to enforce restrictions, the courts tended to overrule fines for violations of the mask mandate.

However, the situation changed radically in a few months. The infection rate and number of deaths in Georgia grew sharply during September 2020. By November, it was clear that the situation in Armenia was improving despite fewer restrictions. It should also be noted that the possibility of visiting cultural events, cafes, restaurants, beauty parlours and gyms had an important therapeutic effect on the population. This was especially true following the psychological impact of the war. The author’s brief interviews with 28 persons of different sex and occupation, age 24 to 52, suggest that another lockdown similar to those experienced in several European countries would cause depression and other psychological disorders among a large segment of the population.

By summer 2021, before the spread of the delta variant, the situation in Armenia was essentially not of particular concern. Armenia even found itself on the EU’s safe country list. Wizzair flights from Vienna, which commenced in July, were full with many visitors, especially those from the Czech Republic and Slovakia. While in Georgia, there were a number of new cases, with many resulting in death between June and August. While Armenia experienced its highest number of cases and deaths per capita soon after the spread of the delta variant, the situation has stabilised in recent weeks. This is despite the fact that only 22 per cent of the population have been fully vaccinated. The majority of people have not been wearing masks or paying attention to social distancing (even in closed areas, such as shops or public transport). At the same time, very few obeyed the requirement to wear masks in the open air as demanded by governmental decree imposed between November 1st and December 17th. However, the daily number of new cases has dropped from over 2000 in the period between October 20th and November 6th, to below 200 by December 16th. Meanwhile, in Georgia, where the population is about one third larger, the number of daily cases is still counted in the thousands, with a death rate surpassing that found in Armenia. At the same time, the smaller number of diagnosed cases in Armenia should not be attributed to the smaller number of tests. After all, unvaccinated employees of all public and private institutions have been obliged to take PCR tests every second week since October 15th and weekly since December 1st.

Social attitudes

When the infection rate and number of deaths reached its peak in late October and early November, there were suggestions that unvaccinated patients might be required to pay for treatment. It was also suggested that “green passes” might be required to enter shops, restaurants and other business premises after the new year. Still, the government reiterated that no new lockdowns were planned. In an interview on December 23rd, Minister of Health Anahit Avanesyan said that the omicron variant had not yet been found in the country. She also stated that green passes might be required from mid-January and that paid treatment might be introduced from February. The feasibility of such measures is not clear, as paid treatment might encourage some people to avoid testing and hospitalisation until the last possible moment.

Few people in Armenia still worry about the presence of an unmasked person. In the spring and summer of 2020, such situations often resulted in altercations. There was even a stabbing on April 14th 2020, when two men brawled on a bus. Few people are also willing to discriminate against the unvaccinated. This attitude is essentially limited to a handful of activists on social media, who are also likely to continue restricting their own social interactions. Asking about others’ vaccination status is not popular either in the country. It is even quite surprising that the antagonism between vaccine enthusiasts and sceptics is so negligible, given the extreme political polarisation that Armenia has experienced over the last year. The war with Azerbaijan and the resulting disagreements over normalisation and border delimitation have contributed greatly to divides in Armenian society.

Armenia’s low vaccination rate still seems troublesome. The AstraZeneca (acquired with the EU’s support via the COVAX programme), Sinovac and Sputnik V vaccines have all been available since April 2020. Sputnik V is generally preferred by those planning to travel to Russia for work and other reasons, as Russia keeps refusing to recognise the other vaccines. Some increase in the pace of vaccinations could be observed in the autumn, as several hundred thousand doses of Moderna were donated by Lithuania, Norway and Slovakia. In December, the country’s first Pfizer vaccine doses were donated by Portugal. The government has also allocated 1.2 billion Armenian dram (about 2.22 million euros) for procurement of additional supplies from Pfizer. In November, the government also procured 400,000 doses of the Sinopharm vaccine.

Some good luck?

It is also important to mention that, perhaps surprisingly, a number of richer countries with far better healthcare systems have registered higher death rates than Armenia. This was the case last winter and spring and now as well. For example, as of December 26th 2021, Armenia had experienced 2673 deaths per million. This is in comparison to Georgia (3397), the Czech Republic (3329), Slovakia (3001), Bulgaria (4443) and Hungary (3980). Meanwhile, in Bosnia and Herzegovina, which has the same vaccination rate as Armenia, the death rate is 4082. This situation is also reflected in the figures available for the last seven days, with even some Western European countries experiencing higher weekly death rates despite new lockdowns.

It is subsequently possible to hypothesise that a considerably higher proportion of Armenians have achieved natural immunity. In order to examine such a hypothesis and to determine the country’s progress towards herd immunity, a representative sampling of people who have neither been vaccinated nor had a positive PCR test would be needed. This investigation would have to involve people of different sex, age, occupation, health condition and lifestyle.

At the same time, several publications already show that lockdowns and other restrictive policies are clearly having negative middle and long-term effects on public health. In October 2021, a group of Hungarian scholars published research showing that about 5000 fewer malign tumour cases had been diagnosed in the 15 months since the beginning of the pandemic in comparison to previous periods. This means that more complicated treatment will be needed in the future. The number of people waiting for surgery in Hungary has doubled since the start of the pandemic. This is clearly having a negative effect on the population’s quality of life, as most of the postponed operations concern cataracts and knee and hip replacements. The number of children treated for mental health problems has grown by 40 per cent. There has also been a general growth in mental health problems, with the consumption of tobacco, alcohol and drugs increasing during this time. A notable increase in domestic violence and other violent crime is also evident within the data.

In most countries, the working class and small businesses have been the most affected by the economic consequences of repeated lockdowns, with disruption to education also ensuring that social divides will remain in the future. Notably, the director of the Motol University Hospital in Prague, Miloslav Ludvík, has suggested that lockdowns are simply postponing the end of the pandemic while harming countries’ economies and societies.

The number of COVID-related deaths in Armenia still could and should have been lower. However, this would have probably required selective protection targeting the elderly and other risk groups, rather than lockdowns and other restrictive measures.

Armen Grigoryan is co-founder and vice president of the Yerevan-based Centre for Policy Studies, and a member of the advisory board of the project Resilience in the South Caucasus: Prospects and Challenges of a New EU Foreign Policy Concept, implemented by the Institute of Slavic Languages and Caucasus Studies, University of Jena.

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Armenia, COVID-19, pandemic, South Caucasus