Experts say COVID-19 is only one of a number of healthcare concerns for refugees fleeing Ukraine. Omar Marques/Getty Images
- Some experts say they’re concerned about a potential spike in COVID-19 cases in Europe as refugees flee Ukraine.
- They note Ukraine has a relatively low vaccination rate and refugees are clustered together in train stations and other places.
- Most experts don’t expect the Ukraine refugee exodus to cause a worldwide increase in COVID-19 cases.
- They add that wars like the one in Ukraine cause a multitude of healthcare issues, from a resurgence of polio cases to crowded conditions at medical facilities.
COVID-19 case rates are falling across Europe and have been for weeks, but some experts say the war in Ukraine and the ensuing flood of refugees to other countries could spur another surge.
“The refugee crisis could increase infection numbers in Europe,” Sharona Hoffman, JD, a professor of bioethics and law at Case Western Reserve University in Cleveland, told Healthline.
“In Ukraine, only about 35 percent of people got two vaccine shots and very few got a booster,” Hoffman said. “Therefore, many are still very vulnerable to infection, especially if they find themselves in crowded conditions on trains and shelters.”
That circumstance is exacerbated by the fact that many countries in Europe are easing pandemic restrictions. That includes nearby Poland as well as the United Kingdom.
“When people are fleeing for their lives, they are understandably not prioritizing COVID precautions. I am not seeing a lot of footage of refugees with masks, for example,” Hoffman said. “If they are entering other countries, they could spread infection, especially if those countries are easing restrictions.”
“The good news is that Poland has a much higher vaccination rate (about 58 percent with two shots and 30 percent boosted), so its population has a greater degree of protection. The same is true for Hungary and other countries,” she added.
In Ukraine itself, COVID-19 cases have continued to fall, but deaths have spiked in the past week, perhaps due to strain on hospital systems under a state of war.
“War suddenly and dramatically changes the pandemic landscape as forced migration from armed conflict prioritizes safety, shelter, food, water, and basic healthcare needs,” Dr. Jan K. Carney, MPH, an associate dean for public health and health policy at the Larner College of Medicine at the University of Vermont, told Healthline.
“This leaves people from Ukraine not only vulnerable to infection, but to its complications, as individuals and families are separated from social supports, their environment, and access to healthcare,” she said.
“The WHO says — to date — this humanitarian crisis has impacted 4.4 million people, displaced 1.6 million, and created health and social needs for over 3 million people to date,” she added. “This is the tip of the iceberg. It is also why public health organizations, such as the American Public Health Association, condemn Ukraine’s invasion and its consequences for health.”
War is a public health crisis
Many experts say a surge in COVID-19 cases due to the war in Ukraine is unlikely to affect the overall trajectory of the pandemic with the Omicron variant.
“We are currently experiencing a point in the pandemic where COVID cases, hospitalizations, and death rates are decreasing, people are starting to feel more relaxed, and officials are starting to loosen restrictions,” Dr. Ilan Shapiro, the chief health correspondent and medical affairs officer at AltaMed Health Services, told Healthline.
“The movement of refugees from Ukraine could create some spikes throughout Europe, but if they move the way they’ve been moving at other points of the pandemic, then it is more unlikely this will cause a dramatic spike in cases compared to if this was happening during a surge,” Shapiro said.
The more significant issue is the holistic nature of war as a public health crisis. Not just for COVID-19, but other infectious and devastating diseases such as polio.
“I have been optimistic that the world will soon see the eradication of polio,” Oladele A. Ogunseitan, PhD, a professor of population health and disease prevention at the University of California Irvine, told Healthline. “But the last vestiges of the devastating disease has always been in the areas of conflict in Nigeria [and] Afghanistan. Now, there is evidence of a small but significant detection of polio in Ukraine and the current war will make it difficult to contain, and perhaps even spread to countries receiving large numbers of refugees such as Poland.”
And while cases and deaths from the Omicron variant may only rise slightly, a new, more vaccine-evasive variant of the disease could throw those predictions out the window.
“There is a long history of war and public health. There is evidence that in many cases, after the gun battle is over, public health impacts continue for years, perhaps decades,” Ogunseitan said. “This is particularly troublesome in the middle of a pandemic that has taken a toll of 2 years and millions of lives lost.”
“The war situation and population migration will make the emergence of new variants more likely, and that is a threat to global health, particularly if the existing vaccines are not effective against new strains or vaccinated people require a fourth booster vaccine to remain protected,” Ogunseitan added.
What the world needs, experts say, is an end to fighting as well as the support of healthcare systems in other countries that are taking in Ukrainian refugees.
“This is exactly the time to take care of refugees leaving Ukraine,” Ogunseitan said. “We cannot afford to leave it to them to find their way to healthcare in the receiving countries. Otherwise, dispersion into the host population will delay an end to the pandemic.”