Prolonged conflict in the Ukraine will make it more difficult for people to access needed healthcare.
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Less than 35% of the country’s population is fully vaccinated, and Covid treatments will be harder to access in the middle of a war zone.
History tells us that war is often a handmaiden of disease. During World War I, the influenza epidemic that spread around the world had its likely origins in a military training base in Kansas. That disease killed more American soldiers than died on the battlefield.
Russia’s invasion of Ukraine comes in the middle of another pandemic, and while both countries have experienced a decline in cases from winter’s peak, the virus is still transmitting at high levels. Prolonged conflict in the region threatens a humanitarian crisis, public health experts say.
World Health Organization Director-General Tedros Ghebreyesus said Thursday that he authorized $3.5 million from the agency’s contingency fund to purchase and deliver medical supplies to Ukraine. “Maximum care must be taken by all parties to ensure that health facilities, workers, patients, transport and supplies are not targeted,” Ghebreyesus said in a statement.
According to data from Johns Hopkins University, there were 26,819 new cases of Covid-19 in Ukraine on Wednesday, down from a record high earlier in February, but still a high amount in a country of about 44 million people. Over 1,700 people died in Ukraine from Covid-19 during the past week. Less than 35% of the population is fully vaccinated, leaving many vulnerable to severe symptoms.
“As people flee or take cover, that could also be problematic in terms of transmission because they’re going to confined spaces” like bunkers or basements, says Paul Spiegel, director of International Health at the Johns Hopkins Bloomberg School of Public Health.
More exposure to the disease could strain hospitals, Spiegel warns, and patients may have difficulty getting the treatment they need. He says that some doctors have left regions near the conflict, and notes that the country already doesn’t have enough oxygen for patients. “There’s going to be limited ICU to begin with, and on top of that, you’re going to have a lot more trauma patients, so the actual treatment may be severely hampered,” Spiegel says.
Even for cases that are less severe and don’t require admission to an intensive care unit, treatment options may be harder to come by during a conflict. Covid-19 medicines such as monoclonal antibodies or remdesivir, for example, require an intravenous hookup, which may be harder to manage in the middle of war.
WHO’s regional office in Europe said in a statement Thursday that it plans “to rapidly scale up readiness to respond to the expected health emergency triggered by the conflict” and will aim to “minimize disruptions to the delivery of critical health-care services.” But the hostilities in eastern Ukraine preceding the invasion prompted the International Red Cross to urge both parties last week to spare infrastructure.
“The ICRC calls on all sides to spare infrastructure that is essential for the survival of the population and to respect principles of distinction, proportionality and precaution,” Florence Gillette, the Red Cross’ head of delegation in Ukraine, said in the statement.
It’s a warning that may do little good. Ukrainian officials have already reported that at least one hospital in the eastern Donetsk region has been shelled by Russians. Ukraine’s foreign minister condemned the attack on Twitter. “Putin has launched a massive war of aggression in Europe during a still-raging pandemic,” he wrote. “On top of that, Russians bomb Ukrainian hospitals now. This is beyond evil.”
If the invasion of Ukraine is prolonged, however, Spiegel warns that destruction of healthcare infrastructure will be unavoidable. If there’s a lot of serious fighting, all diseases will be tougher to tackle, including Covid-19, he says. Spiegel has also visited other areas torn by armed conflict during the pandemic, including Yemen and Afghanistan, and notes that in those places, fighting Covid becomes de-emphasized.
“That may not be their priority if they’re worried about getting food or getting access to immediate care,” he says. “That sometimes means they won’t take precautions. In relative terms, masks and handwashing may not be their priority.”
