From: Alice Taylor
Exit Explains: Albania’s COVID-19 Transparency Issue

A combination of recently published data and surveys has cast doubt over the Albanian government’s level of transparency while dealing with the COVID-19 pandemic in the country.

Concerns relate to the possible under-reporting of COVID-19 deaths and positive cases since the start of the pandemic.

The news led Albanian President Ilir Meta to call for a full inquiry, stating that the situation is concerning. “I call on the Technical Committee of Experts and the authorities to responsibly analyze the data, review all protocols and measures for prevention and treatment of the pandemic, transparently and cooperatively with citizens.”

In January 2021, INSTAT, the country’s official statistics publisher, said that deaths increased by 25.8% in 2020 compared to the previous year. Data from previous years put deaths at around 22,000. But in 2020, 27,605 people died, demonstrating a sharp increase in mortality.

The primary variable between 2019 and 2020 was the COVID-19 pandemic. The problem is that the government publicly recorded just 1,315 deaths from COVID-19 during the year. This leaves some 4,700 “excess deaths”, over what would be expected.

Furthermore, the trend continued into 2021. During the first three months of the year, there were 9,657 deaths reported. This increased 35% compared to the average number of deaths over the four years before the pandemic- 6,414.

The government reported 1,810 COVID-19 deaths, leaving 1,433 excess deaths.

Even when you account for a gradual increase in deaths which is around 1% due to an aging population, the number of excess deaths is significantly higher.

According to data from the EU, there were almost 300,000 more deaths between March and October 2020 than in the same periods during the years 2016-2019. The EU found that the increase in fatalities was between 8% and 25% during the year.

A recent report from the International Monetary Fund highlighted the issue when their report on the economic outlook in Europe demonstrated Albania has the highest excess death rate on the continent. Their figures put the excess death rate at 20%.

The Ministry of Health has remained silent on the reports circulating in the media since January. They also did not respond to questions from Exit by the time of publication.

Concerns over positive test figures

Another concern is that of the incidence of positive tests. So far, the Ministry of Health has reported that roughly 180,000 people had been diagnosed with COVID-19 since the pandemic began.

A survey conducted by Euronews found that 37.8% of participants reported having passed COVID-19, totaling around 830,000 people. Almost 43% of the population said they had tested positive in the capital alone, with 17% saying they experienced severe symptoms.

During the early days of the pandemic, some citizens reported they could not get tested by the state. This included those with moderate symptoms and those who had been in contact with confirmed cases.

Earlier this month, the Albanian State Supreme Audit (KLSH)  found that delays in testing and contact tracing and a lack of resources led to a rapid spread of the virus throughout the country.

KLSH audited several institutions, including the ministry of health, finance, and the Institute of Public Health. They found delays and mismanagement in several areas. One of these was testing issues, as many reported they had to call the designated number or their family doctor multiple times before getting a test.

Delays were caused due to small testing teams, a lack of lab staff, and few resources in regional hospitals.

Ultimately, these delays meant that patients did not receive the appropriate care at the right time and continued to spread the virus, overwhelming the health care system.

According to KLSH, the COVID-19 pandemic brought to light more significant infrastructural problems with the Albanian healthcare system, especially the lack of qualified staff and material resources at regional hospitals.

The World Health Organisation has asked that both probable and confirmed deaths be categorized as COVID-19 related “unless there is a clear alternative cause of death that cannot be related” to the disease.

However, the Albanian government has not been transparent in the way that they categorize and report COVID-19 deaths.

Stagnating vaccination

Meanwhile, attempts at vaccinating the population are struggling. Vaccination started in January 2021 with a small number of Pfizer and AstraZeneca, and larger numbers of Sinovac and Sputnik. The elderly were first to be vaccinated, along with health workers, journalists, and teachers.

Nine months later and vaccines are available widely at clinics and walk-in centers, yet the vaccination rate is one of the lowest in the region, somewhere below 40%. In an effort to encourage uptake, the government-mandated vaccines for healthcare workers, teachers, students over 18, police, public administration workers and pharmacists. Despite this, no real increase has been observed.

A recent survey conducted by an independent student organization, the National Student Board, found that 74% were against mandatory vaccination and would prefer to learn online than take the vaccine and attend university in person.