COVID-19 and Romania’s healthcare brain drain could be a ‘perfect storm’

Eastern European countries have so far escaped the worst of the coronavirus pandemic, but many believe it’s only a matter of time before the number of cases and the number of deaths go down. are increasing significantly in the region.

If and when it hits, the ability of health systems to withstand the onslaught is highly questioned, especially given the experiences of wealthier and better-equipped countries like Spain and Italy. Beyond the availability of health and safety equipment, one concern is the effect of years of brain drain as doctors and nurses left for better-paying jobs in Western Europe.

In countries like Romania and Bulgaria, which joined the European Union in 2007, as well as Poland, which joined a few years earlier, the effects of free movement on their healthcare systems have been particularly pronounced.

“If we talk about Romania, there are certain specialties that are specifically affected by the brain drain, and one of the biggest areas is intensive care,” said Vlad Mixich, a Romanian doctor and health analyst. , who is also an independent expert on the Management Board of the European Agency for Safety and Health at Work.

“I think it can be described as a perfect storm because there is a lack of doctors trained in resuscitation, because many of them have gone abroad, while at the same time there is a huge need for resuscitation specialists in the context of the coronavirus epidemic,” he added.

According to Solidaritatea Sanitara, one of Romania’s largest healthcare federations, the country’s public healthcare system today has a deficit of almost 40,000 healthcare workers, which is equivalent to 17.46% of staffing needs of public hospitals.

It’s a similar problem in neighboring Bulgaria, where, according to some estimates, between 250 and 300 doctors leave the country every year to work abroad. Poland lost at least 7% of its nurses and doctors to migration between 2004 and 2014, and other countries in the region have suffered similar losses, often exacerbated by the latest financial crisis.

“Due to the previous medical brain drain from Latvia, we are very afraid of the situation in the future,” said Jevgenijs Kalejs, president of the Association of Latvian Hospitals, who added that Latvian hospitals had closed all the planned activities to focus on the fight against the virus. . The country has yet to see its first coronavirus-related death.

At the same time, the doctors who stay are generally older and therefore more exposed to the virus.

According to Mixich, the average age of a family doctor in Romania is between 50 and 60, and many of them are older, putting them at higher risk. “One in five people infected with the coronavirus in Romania right now is a healthcare professional,” he added.

The brain drain is not the only source of concern. Eastern Europe’s healthcare systems are, on the whole, less well-funded than those in wealthier parts of Europe, meaning resources could quickly be stretched and overwhelmed if the virus spreads further. widely in the days and weeks to come.

“It’s not just the brain drain but more generally,” said Pascal Garel, chief executive of the Brussels-based European Hospital and Healthcare Federation, which has members in 30 countries across Europe. Europe. “Compared to the Western part of Europe, they generally spend much less on healthcare from their GDP than other countries. The situation in Romania is dramatic in terms of percentage,” he added.

Romania has the lowest health spending as a percentage of GDP in the EU, according to the latest figures available from Eurostat, with countries like Latvia, Poland and Slovakia also bringing up the rear.

The fact that many people have returned to the region after working abroad due to the economic impact of the coronavirus will also likely have adverse consequences, particularly in more rural areas, which have often struggled to attract doctors and nurses.

In Romania, “we are talking about tens of thousands of people, and many of them have returned to the villages where they were born and where their old parents live,” Mixich said. “If the epidemic hits a village, or a small town, it will be a real problem to ensure enough medical personnel to take care of the people there.”

Helen D. Jessen