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Estonia has the lowest coronavirus infection rate in Europe since last week. University of Tartu professor of medical microbiology and virology Irja Lutsar and Minister of Social Affairs Tanel Kiik find that the reason is the sum of systematic efforts, the fact that Estonia is small, as well as a good dose of luck.
Lutsar described the situation as fragile and said that the fact infection rates remain low does not mean that will be the case in the future. “We are walking on a knife-edge today with poisonous snakes on either side and must take care not to fall,” Lutsar said.
The professor explained that getting to a good place can be easier than staying there. “It seems that the strategy we have opted for is working. The pandemic is new for everyone and every country is trying to find a good fit for itself. What works in Estonia might not work in the Czech Republic and vice versa,” she said.
Lutsar said that the government’s night-time alcohol sales restrictions are working, especially as concerns young adults. “We are seeing working people between the ages of 30 and 56 come down with the virus and not many younger people who usually make up the clientele of night clubs. That said, while a night-time ban on the sale of alcohol worked after an outbreak that started in a night club in Tartu, similar effect cannot be observed elsewhere in the country. But I at least hope there are fewer night parties,” the professor said.
Tanel Kiik agreed that alcohol sale restrictions have delivered a notable effect. “People are spending less time in close contact and cramped conditions. People realize we are not in an ordinary situation. While we have not declared an emergency situation, what we have is a healthcare challenge that requires people to contribute to the solution,” the minister said.
Lutsar said that it is easy to keep one’s distance in Estonia as the country is very sparsely populated compared to the rest of Europe. Even if smaller villages get COVID-19 patients, the infection usually doesn’t leave the village and the outbreak is limited to a few cases.
Tanel Kiik agreed with Lutsar and added that while Belgium has a smaller area than Estonia, it has 12 times the people, meaning that social dispersion is that much harder to achieve, for example, in shops or on public transport.
“Information moves quickly in a small country, with the Ministry of Social Affairs and Stenbock House often up to speed on what is happening in all 79 local governments, whether problems concern care homes, workplaces or night clubs. This makes it possible to react quickly. People have been feeling responsible for the local situation since spring and promptly reported problems. They can call the social minister or the PM directly if need be. This effect cannot be achieved in a larger country that has tens or hundreds of millions of people. Or in China or India that have over a billion people. Rapid exchange of information is unthinkable on that scale,” the social minister said.
However, Kiik admitted that when it comes to small countries, chance has a much bigger role to play when it comes to the infection rate. “A few major events or delayed reactions is all it takes for the infection rate to explode. We saw individual events blow up to become major outbreaks in spring. We have managed to avoid that in autumn so far.”
Lutsar pointed out that the infection rate also depends on the situation in neighboring countries. She said that while the coronavirus infection rate has grown in Latvia and Lithuania, the rate in the latter remains ten times lower than the Czech Republic’s. “Finland, Sweden and Norway also sport relatively low infection rates. Russia doesn’t, while its rate is not catastrophic either. It is a complicated situation with several factors playing a part, including neighbors’ infection rates,” she explained.
Kiik emphasized that the situation in nearby Norway and Finland is similar to that in Estonia that undoubtedly has an effect. “We could say the same about the other Baltic countries until recently, but infection rates have spiked now. We are trying to prevent that from happening,” the social minister said.
While most European countries have made wearing masks on public transport and indoor public spaces mandatory, it remains a recommendation in Estonia, yet the infection rate has not grown.
Lutsar said that a mask is no silver bullet to solve the problem but rather a piece in the puzzle. “It would seem peculiar to wear a mask walking in the Nigula bog, while it can be an additional safety precaution indoors and when keeping one’s distance from others is problematic. Wearing a mask also does not mean other precautions should go out the window. A mask is an aid in the right place and at the right time. It makes no sense to wear a mask walking down a deserted street or shopping in an empty supermarket. That said, because there are a lot of outbreaks in Sillamäe, for example, wearing a mask to visit the shop or when taking public transport is justified. People need to think for themselves and gauge the risks. One should definitely wear a mask when visiting their grandmother in a nursing home,” Lutsar said.
The professor explained that a mask cannot stop the virus itself as a filter that strong would make it impossible to breathe, while it can help limit its spread by stopping droplets of saliva from flying around.
Minister of Social Affairs Tanel Kiik said it is clear that a bigger case rate would come with additional measures. “Were we to see hidden spread of the virus, the obligation to wear masks would follow. Today, wearing a mask remains a recommendation.”
Tanel Kiik said that while European countries have largely approached combating the virus similarly, there are aspects where Estonia stands out.
“One very important thing we’ve done concerns random sample surveys that have given us a clearer picture of the number of asymptomatic carriers and of the spread of COVID-19 in different counties. We also have wastewater surveys that help us map out the spread of the virus in major settlements. These surveys have allowed us to organize additional testing and for local leaders to take precautions.”
Irja Lutsar does not believe strict flight restrictions that Estonia has laid down have contributed to slowing down the viral spread.
“I do not believe flight restrictions are having an effect. People who want to fly will find a way. But it is good that everyone who arrives in Estonia can get tested at the airport. Airport testing has surely had an effect on containing the spread. We know of a lot of people who have been tested at the airport, have tested positive and self-isolated. I’m sure we have managed to get more than a few people to stop spreading the virus this way,” she said.
Both Lutsar and Kiik remain cautious when asked whether Estonia could succeed in keeping the virus in check.
“I would refrain from making forecasts or jinxing it but looking around us, at what is happening in Europe, we see that case rates are growing not falling. I do not hold it realistic that the rate will start falling rapidly. We need to keep in mind that we are entering the flu season. These are all negative factors. No one dares say what will come next. But if the situation gets bad in Estonia, measures will be taken. We cannot afford to let this thing run away from us. We need to keep following the rules: keep our distance, refrain from going to work sick, download the HOIA mobile application, get tested when prompted and isolate upon testing positive for COVID-19. If everyone can follow those rules, I believe we can hold on until we get a vaccine. That said, no one is naive enough to believe vaccines are 100 percent effective. We need to coexist with this virus for a while,” Lutsar said.
Tanel Kiik said that a major wave of infection can be avoided if Estonian people, agencies and companies keep acting responsibly.
“There will be certain fluctuations, spikes and slumps – it is inevitable. People move around and the virus moves with them. It will not remain hidden or abroad. However, by acting responsibly, actively testing new arrivals, complying with self-isolation requirements, staying home when sick, keeping in touch with doctors and an eye on information, it is possible for Estonia to retain a low level of COVID-19 infections compared to the rest of Europe. We have the necessary preconditions,” Tanel Kiik said.
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