Lessons learned from the Baltic countries’ response to the first wave of COVID-19

Abstract

The Baltic countries of Estonia, Latvia, and Lithuania shared a similar response to the first wave of the COVID-19 pandemic. Using the information available on the COVID-19 Health System Response Monitor platform, this article analyzed measures taken to prevent transmission, ensure capacity, provide essential services, finance the health system, and coordinate their governance approaches. All three countries used a highly centralized approach and implemented restrictive measures relatively early, with a state of emergency declared with fewer than 30 reported cases in each country. Due to initially low COVID-19 incidence, the countries built up their capacities for testing, contact tracing, and infrastructure, without a major stress test to the health system throughout the spring and summer of 2020, yet issues with accessing routine health care services had already started manifesting themselves. The countries in the Baltic region entered the pandemic with a precarious starting point, particularly due to smaller operational budgets and health workforce shortages, which may have contributed to their escalated response aiming to prevent transmission during the first wave. Subsequent waves, however, were much more damaging. This article focuses on early responses to the pandemic in the Baltic states highlighting measures taken to prevent virus transmission in the face of major uncertainties.

Lessons learned and lessons missed: impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination

“…At the other extreme, many countries in Central and Eastern Europe, which had put strict measures in place and had experienced no detectable excess mortality during the first half of 2020, removed restrictions on travel and social contact in summer of 2020, at times to a greater extent or at a faster pace than their Western European counterparts 58 , 62 , 70 , 71 . With virtually the entire population still susceptible to infection, this set into motion community transmission, which coincided with the introduction of more transmittable variants of SARS-CoV-2 which were not controlled as fast and as strictly as earlier in 2020, leading to their true ‘first wave’ in Autumn 2020 which was equivalent to or worse than those in their Western European counterparts in magnitude and duration ( Figure 6 and Figure 7 ).…”

Travel measures in the SARS-CoV-2 variant era need clear objectives

“…In 2020, this was successfully used to permit less restrictive travel between countries with low SARS-CoV-2 prevalence, such as in the Western Pacific or Baltic regions. 17 However, use of reported cases as a measure of equivalency is fraught with difficulty: routine case data do not account for the limited reporting capacity in many countries or variation in actual testing strategy from country to country. Given the extensive SARS-CoV-2 testing for travel that is being used globally, it is a missed opportunity that test data have not been better used to improve understanding of global SARS-CoV-2 dynamics.…”

Riding the Pandemic Waves—Lessons to Be Learned from the COVID-19 Crisis Management in Romania

“…The HSRM examines a country’s health policy responses to the COVID-19 pandemic along with the following five areas: preventing local transmission, ensuring sufficient physical infrastructure and workforce capacity, providing health services effectively, paying for services, governance, and measures in other sectors. Similar to several previous analyses evaluating the health policy responses of the COVID-19 pandemic in countries, we adapted the structure of HSRM for our analysis [ 18 , 19 , 20 ]. The HSRM framework was chosen because it focuses on critical areas of pandemic response, uses a broad set of criteria, and allows for the systematic organization of relevant information and data.…”