War in Ukraine: is a rebound in the epidemic possible?

I’epidemic marked time for several weeks all over the world. In Ukraine, too, the indicators were quite good, just before the start of the war. The number of new cases each day was less than 25,000 cases on February 24, 2022 for 44 million inhabitants. By comparison, in France, there are currently about 45,000 new cases per day for 67 million inhabitants.

However, the latest events are likely to change the situation in this country. The humanitarian situation is “catastrophic” according to Doctors Without Borders. In Mariupol in particular, “ there is no water, electricity or heating “. Public infrastructure, including hospitals, suffered heavy shelling. For those who are still standing, stocks of medical equipment are “exhausted”. In this context, should we fear a rebound in the Covid-19 epidemic in Ukraine?

A favorable context for the spread of the virus

First, Ukraine has vaccination coverage against SARS-CoV-2 rather weak, about 35%. By comparison, in France, 79.4% of the population, all age groups included, has a complete vaccination schedule.

Secondly, the war that is currently raging forces people to crowd into subways or public transport. Places that are poorly ventilated and not designed to receive so many people at the same time. Needless to say, lack of both water and hygiene favor the spread of diseases, including that linked to SARS-CoV-2.

Third, SARS-CoV-2 is known to spread best in cold weather. The weather forecast announce freezing air over eastern Europe, including Ukraine, for the next few days. Temperatures between -10 and -18°C are expected.

The impossible care of patients

Hospitals have been damaged by the bombardments and medical equipment is lacking. Those still functional are overwhelmed by war wounded. On February 27, 2022, the director general of WHO warned about the lack of medical oxygen in Ukraine. Also, oxygen is a gas highly flammable and transporting it to war zones is dangerous. In this context, the correct care of people with a severe form of Covid-19 disease is more than compromised.

Finally, as the government has other priorities, counting cases and monitoring the spread of the virus seem illusory. If it is almost certain that the current context favors the spread of the virus, we will never be able to quantify it precisely. Moreover, the vaccination people at risk who have not yet been vaccinated or respect for barrier gestures take second place in view of the ongoing war.