Coronavirus in the Balkans: As cases rise, preparation and panic

From restricting travel to creating hospital space for patients, region neighbouring Italy prepares for further cases.

CROATIA-VIRUS-HEALTH A picture taken on March 6, 2020 in Zagreb, shows a poster bearing warning against the new covid-19 coronavirus in a tram.
A sign in a tram in Zagreb warns against the novel coronavirus [Denis Lovrovic/AFP]

Although the Balkans have considerably fewer coronavirus cases compared with Western Europe, infection is spreading in the region, much of which is separated from the continent’s COVID-19 epicentre, Italy, by a stretch of the Adriatic Sea.

Thousands of citizens from across the Balkans are residents of Italy and many fly or drive back and forth regularly for work and personal travel.

In total, there are now more than 100 cases in the region.

Greece is home to most, with 66 patients, while Slovenia has 19 and Croatia has 12 confirmed cases.

Croatian Health Minister Vili Beros has declared the epidemic a danger, explaining the move was “an administrative measure that enables the ministry to mobilise workers”.

Albania over the weekend reported its first cases – a father and son who returned from neighbouring Italy, where 400,000 Albanians live. The country has called on people returning from Italy to quarantine themselves at home for 14 days and call a doctor if they feel unwell.

While officials across the region have urged citizens to cancel all trips to Italy, the borders in the Balkans, as in the rest of Europe, remain open.

“We won’t close the border if it hasn’t been agreed upon [in the EU], but I think that we will have to decrease the number of entry points in Croatia so we can surveil [the situation] in the best way possible,” Beros said last month.

Measures taken

The region is preparing for more cases and is taking steps to prevent the infection’s spread.

Over the past week, Bosnia detected three cases after a citizen returned home to Banja Luka from Italy, where he works.

Bosnian authorities have prepared hospital space, carried out dozens of tests and tasked more than 400 people to work on the health emergency and track developments

Serbia, which has confirmed one case, installed a thermal camera at Belgrade airport in late January to detect fever among travellers, adopting a technique first introduced at airports, train and bus stations in Wuhan, China – where the coronavirus originated.

There is no need to spread the panic.

by Sead Karakas, head of the public health department in central Bosnia

But infection-control expert Marylouise McLaws, a professor at the University of South Wales, told Al Jazeera that measuring body temperature was not the most effective way to contain the virus as not every patient will have a temperature.

“Just relying on temperature is not as sensitive as one would think,” McLaws said. “Not everybody in the early stages [of the infection] will develop a temperature.

“It’s not the most sensitive test. Important questions [asked] at the border, such as where they have been or where they’ve come from is potentially more helpful. And then, of course, asking and giving out information to travellers about what to do when they develop classic signs and symptoms.”

Should borders be closed?

China is by far the most affected country in terms of infections and deaths, followed by Italy, Iran and South Korea.

At least 80 World Health Organization (WHO) member states, including Italy, have imposed travel restrictions on China due to the coronavirus outbreak, according to the Think Global Health website.

Countries including the US, Indonesia and Australia have banned entry to foreign visitors who have recently visited China.

India, Jordan and Lebanon, meanwhile, are among a group of countries which deny entry to people who have recently visited Italy – all in this list also ban those who recently visited China.

In February, Montenegro suspended all tourist arrangements with China until further notice to prevent the spread.

On Sunday, Romania, which has 15 cases, halted flights to and from Italy, where more than a million Romanians work.

Franka Vican, Bosnia border police spokesperson, told Al Jazeera that those wishing to enter Bosnia from China, Italy, Iran and South Korea must fill in a questionnaire stating the number of days they plan to stay and information on their current health condition, as well as provide contact details.

According to Vican, more than 15,000 people have entered Bosnia from the four countries between January 1 and March 5.

But McLaws said it was “very difficult” to contain the virus if borders remain open.

“One would close the borders to try to fulfil the basic requirement of outbreak containment, and that is quarantine. However, the borders may not be closed because economic or political decisions are being made instead,” McLaws said.

“[Closing borders] may not be very well received by some neighbours, or countries where they rely on tourism, but it’s a very important, simple and effective method of reducing infections.”

Panic buying

In late February, Bosnian media reported a shortage of face masks and disinfectants because of panic buying at pharmacies in the capital Sarajevo; these items had already been in demand before the arrival of coronavirus due to hazardous pollution during the winter season.

Like in the rest of the world, crowds of shoppers across the country have been buying oil, flour and boxes of pasta in bulk, to prepare for a worst-case scenario.

Sead Karakas, head of the public health department in central Bosnia, told Al Jazeera: “There is no need to spread the panic.”

McLaws also urged calm and said stocking up on food and medicine only “fulfils the prophecy of shortage”.

“Protective masks can become in short supply for healthcare workers who are at the frontline of very great risk of acquiring COVID-19,” she warned.

She added that the situation was different in cities such as Wuhan, which has an “enormous” number of cases and where residents are required to wear masks to stem transmission, but that the measures were not necessary for those living in Australia, Europe and North America.

“Don’t walk around with a mask on because you’re wasting a really important resource,” McLaws said, adding that maintaining hand hygiene using soap and water is key.

Source: Al Jazeera