Why Does Greece Have Such a High Death Rate from Covid?

Greece has recorded unprecedented high death rates from Covid in recent months. With 136 deaths per 1 million population, it had almost three times the death rate of the European average as of January 29, 2022 (see table).

As seen in the Johns Hopkins University graph, other nations, notably the United Kingdom, had enormous spikes in the number of coronavirus infections, far surpassing Greece in overall cases per capita.

This was partially due to UK premier Boris Johnson’s decision to go for “herd immunity,” in the expectation that there would be a huge drop in infections after nearly everyone in the country had the disease and then became immune to it. However, things didn’t work out that way, leading the Prime Minister to make a policy U-turn as British hospitals grappled with untenable numbers of patients.

Meanwhile, Greece was shut down nearly completely for months in 2020, with almost no economic or social activities allowed outside shopping for food and going to the doctor. Was it all worth it? It appears that this was not a strategy that worked out for Greece in the long run.

Greece death rate from Covid attributed to low vaccination rates in elderly by Greek government

Experts analyzing the data have identified several factors that contribute to the high fatality rate in the country.

In the multiple questions they have received about the extremely high mortality rate in Greece, both scientists of the Committee of Experts of the Ministry of Health, as well as state officials, attribute the phenomenon primarily to the low vaccination rates among our most vulnerable fellow citizens, who are at risk of developing serious disease and dying from the virus.

These are the unvaccinated people over the age of 60 — mainly the elderly — as well as the people with serious underlying diseases. However, as everyone admits, this is not the only reason. Another contributing factor is the over-consumption of antibiotics that do not “work” when doctors need them, as well as the great pressure placed on the National Health System.

Recently responding to the opposition, Minister of Health Thanos Plevris attributed the problem of deaths to the aging population of our country, which to a large extent remains unvaccinated, he said. He made his remarks during the debate in Parliament on the motion of no confidence in the government regarding, among other things, the management of the Covid-19 pandemic.

“The issue of mortality is directly linked to vaccination,” Plevris declared.

“Unfortunately, 89% of the deaths are our fellow citizens over 60 years old. It is the critical age group that should have been vaccinated. And if we consider that our country is third in the European average in the age of over 50 and second after Italy, 7.2% of our population is over 80 years with an average of 5.5% in the European Union. Therefore, there are many people who were in this vulnerable category.”

Measures taken in Greece were “very inefficient, even detrimental”

Dr. John Ioannidis, the Athens Medical School graduate who is a medical professor at Stanford University in California, focused on many problems in the Greek health care system itself in remarks made to Greek Reporter this week about the nation’s sky-high death rate.

Major cuts dating back to the financial crisis, coupled with a lack of primary care doctors and an ill-conceived coronavirus fighting strategy on the part of the Greek government worked with other negative factors to create a “very inefficient, even detrimental” situation which has led to Greece having the highest death rate from Covid-19 in the entire European Union, he charges.

“The cumulative number of COVID-19 deaths per million people as of February 4, 2022 places Greece among the 30 countries with the highest COVID-19 fatalities among a total of 225 countries in the world. Given the current trajectory, it is possible that within a few months Greece will be in the top 25, if not even higher in that macabre list of deaths, and it is very likely it will have the highest fatalities per population compared to all western European countries,” Ioannidis states.

“There are many reasons for this sad performance record. Greece lacks primary care and this means that hospitals take all the burden of handling the pandemic. The public healthcare system has suffered from a long crisis for over a decade with major cuts and these were further exacerbated by lay-offs of personnel during the pandemic.

“National health system personnel has fought valiantly but against the odds,” the medical professor opined. “Additional ICU care was built hastily, but even if one gets ventilators and assigns beds, it is not easy to train people to become efficient ICU experts so quickly. Thus fatality rates remain exceptionally high compared with other countries and in some newly-built ICU units the rates are sobering.

“Greek hospitals also have chronic problems with nosocomial (hospital-derived) infections that increase the death rate for vulnerable, sick individuals. A chronically stressed system produces very poor outcomes both for COVID-19 and for other diseases and its performance deteriorates, the longer the stress is continued,” Ioannidis tells Greek Reporter.

“The measures taken to stop the spread were very inefficient, even detrimental,” he charges.

Very foolish lockdown approach” led to high Greece death rate from Covid

“It is likely that the true number of infections at the moment is in the range of 8-10 million since the beginning of the pandemic (versus 2 million documented ones). Many people have been infected two times (or even more) and probably 50-70% of the population have been infected at least once,” Ioannidis says.

Currently, the population of Greece is counted at 10.34 million, meaning most people in Greece have been infected with the coronavirus.

“Greece adopted a very foolish lockdown approach in early 2020, focused on police patrolling and fines and this exhausted and confused the population, given the overt incoherence against subsequent management,” the medial professor charges in the Greek Reporter interview.

“It is as if someone has to run a marathon and he starts with full sprint for the first 2000 yards in the beginning of the race to show off when the photographers are taking photos – but then he has no energy to finish the race.

“Very little testing was done for a long time and thus viral spread happened undetected. Even when in the last year testing was accelerated, it still continued to be available for a fee (with some exceptions of free testing). This means that poor and disadvantaged people (typically those who are also more vulnerable to COVID-19) had fewer opportunities to get tested and thus infection probably spread more among them,” the professor explains.

“There was hardly any serious intervention to improve mass transportation, work conditions, and school infrastructure. Whatever interventions were adopted focused on mandates, fines, passes, micro-management of shops and restaurants and the police force, which had nothing to do with serious epidemic containment,” Ioannidis points out.

Many measures of the lockdown “against common sense,” leading to lack of public trust

“Many of the measures related to lockdown were so obviously against common sense that many people lost their trust in the public health effort. Television-based experts, many of them with few or no credentials in epidemiology and with lack of skills in science communication, added more aggressive (and often controversial or outright wrong) statements to the mix and this sadly fueled a more recalcitrant anti-vax movement.

“It is not possible to convince people to become vaccinated by insulting them,” Ioannidis declares.

“As a result, a sizeable proportion of elderly, vulnerable Greeks have sadly remained unvaccinated and they see their stance as defiance to a suppressive irrational regime. No one has apologized unfortunately for this mess. Many of the vulnerable, unvaccinated people have also other problems such as smoking and obesity that further enhances their risk of bad outcomes with COVID-19.

“Moreover, when they are marginalized by the measures taken, including mandates and fines, they become even more vulnerable.

“This is a vicious circle,” the Stanford professor stated. “It can only be broken if there is an effort focusing on empowerment rather than humiliation, offering support to the weak segments of the population, building primary care, making testing available for free (especially for the poor population strata), and improving infrastructure in areas where there is high chance of congestion and crowding, in particular mass transportation and work environments.

Asked by Greek Reporter about the high rate of deaths in the elderly, who many times live in small villages in Greece, Ioannidis states “I have been unable to find out detailed data on what has happened to nursing homes in Greece in terms of infection rates and outcomes, but this is an area where fatality rates are extremely high worldwide and I suspect that not enough has been done in Greece and their personnel is understaffed.

“Moreover, many small villages in Greece are equivalent to nursing home communities, given their very elderly populations, and I am afraid that these villages and their populations have been mostly unprotected.”

Patras pulmonolgy professor deplores hundreds of thousands of unvaccinated over-60s in Greece

Argyris Tzouvelekis, a professor of pulmonology at the University Hospital of Patras, says much of the high death rate in Greece is due to the vaccine hesitancy of the over-60 population — which is the opposite of the trend in most other countries, where older citizens are more likely to become vaccinated.

“What we are seeing in Greece is that deaths and intubations do not follow the de-escalation of infections. This has partly to do with the fact that there are hundreds of thousands of people over 60 that are not fully vaccinated,” he told interviewers from Greek state television channel ERT.

“To be fully vaccinated all three doses of the vaccine must be administered. In Greece, 50 percent of the over-60s are not fully vaccinated,” Tzouvelekis notes.

“Side losses contribute to the high death rates in Greece,” he continued. “There is a percentage of 20-25% of patients in Covid clinics with a positive molecular test but are not ill because of Covid-19. They simply came in for another reason (heart attack, bleeding) and tested positive for the coronavirus.

“Or they are immunosuppressed with serious illnesses who were admitted to the Covid clinic because they tested positive. These patients do not die from coronavirus, they die with coronavirus,” he says.

“It is a minority of 20-25% of deaths in Covid clinics, but they contribute to the fact that this hard index does not fall,” Tzouvelekis explains.