From time to time, until the crisis has passed, the HEPL blog series authors will be given the opportunity to provide short updates on their country/region’s continuing response to this worldwide catastrophe and their further reflections on those responses. Each update will be labelled accordingly with the original response at the bottom of each post.

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HEPL blog series: Country Responses to the Covid19 Pandemic

 

Serbia’s response to the coronavirus pandemic – Update (May 2020)

Tamara Popic, European University Institute

Since mid-April Serbia has been experiencing a gradual flatting of the curve with respect to the daily new cases of COVID-19 infections and deaths. As of the 8th May, the COVID-19 record in Serbia is as follows: 128,805 tested individuals, 9,943 confirmed cases, 2,453 recoveries and 209 deaths.

Lockdown exit measures

In mid-April, the authorities announced that in accordance with the improvement of the epidemiological situation they would start easing the lockdown measures. On the 21st of April, shops offering services such as car repairs and dry cleaning were allowed to reopen. This measure also included some retails shops such as book stores and car dealers, as well as both open and closed markets. The next day, the 22nd of April, the authorities also reopened the country’s border with Hungary, allowing border crossing for those who live 50 km from the border, and work or have their relatives in Hungary.

On the 27th of April, the government made big step in the easing of the lockdown by allowing the reopening of the services involving close contact – e.g. hairdressers, gyms and beauty parlours. These services are supposed to operate under specific protocols, which involved, for example, a booking system for the use of gym fitness sessions. At the same date, individuals over 65 were also allowed to go for a 1 hour walk each day in the period from 6 pm to 1 am. The culmination of the exit measures took place on the 7th of May, when the parliament officially lifted the curfew introduced on the 15th of March. Among the measures that still remain in place are the following: use of masks and gloves in public spaces, social distancing, closure of schools, theatres and cinema, and a ban on public gatherings. Public transport started operating on the 11th of May and kindergartens reopened on the same day. Future easing includes permission to holding celebrations such as weddings, baptisms and birthdays from the 15th of June. The authorities also announced that the general elections will be held on the 21st of June. 

Testing

A new testing laboratory with a capacity of 2,000 tests daily was established at the Clinical Center in the capital Belgrade and another testing laboratory will open with the aim of increasing the country’s capacity to 6 – 7,000 daily tests. In early May, the government also announced a national study on the population’s development of COVID-19 antibodies.

Reflections

The Serbian authorities’ lockdown measures were under critical scrutiny both during and after the state of emergency, raising a number of legal and political issues. According to the Association of Independent Journalists of Serbia, the state of emergency worsened the situation of non-aligned media. These media were often discredited by the authorities, labeled as “spies” and “traitors” and their freedom was limited through the authorities’ attempts to formally introduce censorship. The constitutionality of the state of emergency itself continued as a disputed issue,  with legal experts agreeing that declaring a state of emergency was a violation of the constitutional principle of the rule of law. During the state of emergency the parliament was not permitted to hold sessions and all decisions were made by the president, the prime minister and the head of the parliament. Another hot issue were human rights. The Belgrade Center for Human Rights filled an initiative with the Constitutional Court of Serbia to review the constitutionality and conformity of the restrictions on individual movement with the European Convention on Human Rights. 21 members of the European Parliament have also warned the European Commissioner for Neighborhood and Enlargement Várhelyi of the “extremely serious” situation in Serbia regarding human rights, pointing to the  “severe and disproportionate” measure to tackle the pandemic, which impeded freedom of expression and free movement.

In addition, the last weeks of the state of emergency witnessed growing public opposition to the authorities’ decision to keep the rigorous lockdown measures in place, also in light of the above mentioned issues. Similar to the 1990s protest against the authoritarian regime of Slobodan Milosevic, in Belgrade people were banging pots on the terraces to express their disapproval. 57 people were fined for this protest activity. The most recent analysis suggests that the country’s president, the right-wing populist Vučić, used the crisis to concentrate power and use it for his and his allies’ political aims. The president’s currently increased approval ratings, but also future risk of declining popularity, has also been suggested as an explanation of the rather fast lockdown exit and the authorities decision to hold elections as early as the 21st of June.

 

Serbia’s response to the coronavirus pandemic – Original post (April 2020)

Tamara Popic, European University Institute

 

The corona virus pandemic officially started in Serbia on the 5th of March when the Ministry of Health announced the country’s first case – a 43 year-old man who travelled to Serbia from Hungary. As of the 17th April, the COVID-19 record in Serbia is as follows: 29,472 tested individuals, 5,318 confirmed cases, 443 recoveries and 103 deaths. It is worth mentioning that the country has a relatively high number of infected healthcare staff, which amounts to 12% (616) of the total number of the infected. With a relatively low mortality per absolute number of cases (1.9%) Serbia’s record is good, even though the country has still not seen the much expected ‘flattening of the curve’.

Since 2012 the country has been led by the right-wing populist Serbian Progressive Party. The government at first played down the danger of the virus but started to take it seriously with the increase in the number of cases, and on the 16th of March decided to postpone the country’s parliamentary elections (scheduled for the 26th of April). The country’s political leadership perceived Serbian migrant workers from countries such as Germany, Austria and Switzerland as the biggest threat for the exacerbation of the virus. It was estimated that around 315,000 of these workers returned to country in the first weeks of March after losing their jobs due to the lockdown in their employment countries. In terms of crisis management, there is a special coronavirus expert team lead by epidemiologists that consults the government. However, given the highly restrictive measures put in place, the country’s crisis management is clearly in the hands of the political leadership. The government and the president have also been relying on the opinion of Chinese and Russian experts, who arrived in Serbia as part of the two countries’ support to fight the virus.

Timeline of measures  

On the 11th and the 13th of March, respectively, Serbia banned indoor public gatherings for more than 100 people and visits to nursing homes. On the 15th of March, when the country’s virus record stood at 48 infected and no deaths, a state of emergency was declared (which implied the closure of schools, universities and businesses) and the country closed its land borders. A few days later international air and national public transport were suspended. More restrictive measures followed when on the 20th of March the government introduced a curfew for all residents (with few exceptions) from 8 pm to 5 am. The mandatory period of self-isolation for all citizens returning from abroad was set at 14 days (on 28 of March this was extended to 28 days). Citizens over 65 in urban areas and 70 in rural areas were banned from leaving their homes. Subsequently, the curfew period was extended  from 5 pm to 5 am (from the 22nd of March). This excluded citizens over the age of 65, who were allowed to leave their homes from 3 am to 8 am on Sundays to buy groceries. On the 1st of April the ban on public gatherings was restricted to no more than 2 people. Over time, there has been an increase in the duration of the curfew over the weekend, with the latest – an 84 hours curfew (from Friday 5 pm to Tuesday 5 am) –  introduced for the weekend of the Orthodox Easter (19 April) due to the expectation of increased movement during the celebration period.

Health system response

At first, testing for the virus was slow and chaotic, marked by a significant delay between testing and results, but then the country witnessed gradual improvements. The latest announcement by the government is the construction of two testing laboratories (enabled by Chinese donations) which will be capable of testing 3,000 cases daily, which is three times more than Serbia’s current capacity. At the start of the outbreak, many hospitals in Serbia lacked basic safety gear, but the government has since been able to supply equipment, mainly due to the aid which has arrived from China and the European Union (EU). Some of the measures introduced to support health system responsiveness include VAT exemptions for protective masks delivered by the Republic’s Health Insurance Fund to wholesalers, abolition of user fees for medical prescriptions, and a 10 per cent increase in salaries of medical workers (but with nurses receiving an average monthly salary of 440 euros, this could be seen as merely symbolic). On the 24th of March the government also set up a makeshift hospital at the Belgrade Fair with a capacity of 3,000 beds. On the 1st of April, the government announced an online system for the reporting of COVID-19 symptoms, which will be made available to all the insured with the aim of reducing waiting times for testing and the speeding up of treatment.

Financial and other support

The main support in the context of the country’s COVID-19 crisis came from abroad. China was the first to send a large shipment of medical aid, including medical devices, security equipment, and Chinese medical experts who stayed in the country to help government officials monitor the crisis. Russia also sent help through its military teams which provided support to disinfect facilities and public spaces. Norway provided medical assistance to the country that was worth 5.5 million euros. UNICEF donated dozens of ventilators, protective gear, and sanitizing supplies. However, the biggest support from abroad came from the EU and the World Bank (WB). Initially providing support worth 7.5 million euros, the EU extended its support with another 93 million euros (originally allocated to different projects under the Instrument for Pre-Accession Assistance and then repurposed to fight the virus spread), while the WB contributing 29 million euros.

The government’s main economic measures included a financial support package to help the local economy. Other measures included deferment of tax payments and social security contributions for private businesses, introduction of a loan guarantee scheme which will give private business access to cheaper loans, and support to farmers including financial assistance and facilitation of loans eligibility criteria. 

Reflections

Overall, Serbia’s approach to the COVID-19 crisis has been based on the conviction that implementing the strict, Chinese-style measures early on would help the country avoid a large-scale epidemic as seen in some European countries. This highly restrictive response seems also to have been motivated by the intention to prevent significant added pressures on the country’s already weak healthcare system. At the same time, as already recognized by some media outlets, there have been important geopolitical considerations at play in the context of the Serbia’s fight against the COVID-19 pandemic. The initial lack of the EU’s support – demonstrated by the Brussels’s announcement of the export ban on some medical protective equipment – left non-EU countries, including candidate countries such as Serbia, out in the cold. This led the country’s political leadership to immediately turn to its alternative partners – China and Russia. The EU’s significant financial support that followed was characterized by Serbian government officials as ‘too little and too late’. In addition, there are a few important political issues in the context of the country’s COVID-19 crisis. There has been a cracking down on the media and a limiting of citizens’ access to information, demonstrated through the government’s decision that the information related to the virus outbreak could only come from the Prime Minister (PM), and the detainment of a journalist who published an article on the coronavirus crisis in a medical center in the north of the country. The Organization for Security and Cooperation in Europe (OSCE) watchdog and local media associations have criticized these moves, and the Council of the European Commissioner for Human Rights issued a written statement stressing the need for the preservation of the country’s media freedom. Due to pressures, the decision on centralized information from the PM was lifted on the 2nd of April, just a day after its introduction. Another disputed issue is the constitutionality of the procedure used to introduce a state of emergency, which was declared without the involvement of parliament and set to an unlimited period of time, which has been questioned by the Serbian Bar Association.

 

 

Health Economics, Policy and Law serves as a forum for scholarship on health and social care policy issues from these perspectives, and is of use to academics, policy makers and practitioners. HEPL is international in scope and publishes both theoretical and applied work.

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