“The sickness… it is finally here.”
My brother Georgios’s proclamation down the phone line stopped me in my tracks. He was calling me in Australia from Florina, my family’s ancestral home in Greece, deep and isolated in the northern mountains. The borders with North Macedonia and Albania are only 20 and 50 kilometres away, respectively. And the nearest major city with hospitals and fully-equipped intensive care units (ICUs) is 200 kilometres away in Thessaloniki.
It was from that perspective that I worried deeply about my brothers, Georgios and Vasilios (Billy). Both in their late fifties, they live together in the house that our grandfather built in 1930 when he fled to northern Greece as a refugee from Turkey. I was born in Florina before being adopted as a baby by a family in Australia. I knew that if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) somehow made it to Florina, healthcare was not readily available should my brothers get sick with COVID-19 and require respirators. And they had been heavy smokers for their entire adult lives.
Part of me wished I could have brought my brothers out to Australia for the duration of the crisis, but that option quickly closed. Another part also hoped that coronavirus might not actually reach Florina given its isolation. But like so many remote regions of the world – from Pacific Island nations to small African republics – the virus was eventually brought in by a single traveller. The devastation that COVID-19 could wreak in such poor, outlying regions is significant. It is why remote and regional communities in parts of outback Australia have sought to be protected, and particularly those with large communities of Aboriginal Australians.
“Fortunately, Greece went into lockdown early,” Georgios said. “The streets have been deserted for a long time, everything’s closed, it is like the whole town is mourning. Billy is especially bored, he used to stay out all night in cafés and bars talking with friends. At least it’s now snowing, which means he’s less likely to want to go outside.”
He was referring to our mentally impaired older brother. Billy’s condition – which seemed to freeze his brain in time – related to a sickness that swept through Florina when he was a young child. I never managed to find out the precise details; chasing down 1960s medical records from a remote Greek town was mission impossible. But from what Georgios described, it sounded like something similar to meningitis. He said that some children died from the illness, while others lost limbs and senses (vision, hearing). In Billy’s case, his brain didn’t develop. Georgios was now his carer. The history behind Billy’s condition left me feeling acutely sensitive to what might happen if coronavirus made it to Florina.
But my brother’s words were also reassuring. Greece’s response to the threat of coronavirus was swift and decisive. Up to now, the country has ridden the wave of viral infections and effectively flattened the curve.
With the tragic number of coronavirus deaths in Italy and Spain – 18,851 and 15,843, respectively, at the middle of April according to the World Health Organization (WHO) – the attention of global media has somewhat overlooked their Mediterranean neighbour in Greece. There has been understandable focus on the appalling conditions within the overcrowded Greek migrant camps on eastern Aegean islands such as Lesbos and Samos; should a cluster of coronavirus cases break out amongst the refugees, it would be profoundly calamitous. But the impact on mainland Greece has been largely missed.
When Greece recorded its first COVID-19 case in late February, it promptly cancelled its Apokries carnival festivities. By contrast, the New Orleans Mardi Gras went ahead a month after the US’s first case. Within two weeks, Greek schools and universities closed. Public commercial venues soon followed, along with tourist hubs like hotels and museums, and churches (ahead of Orthodox Easter, the busiest time of year). International flights from certain countries stopped, including European Union (EU) nations hard hit by coronavirus. And during the first week of April, swimming and water sports in the sea were banned. For a Mediterranean nation coming into spring and summer, the last move by the government seemed especially harsh. But it was necessary for a country forced by economic circumstances to initiate a lockdown long before many of its European cousins.
“Our schools closed before we had the first fatality,” Greek Prime Minister Kyriakos Mitsotakis recently told parliament. “Most countries followed a week or two later, after they had mourned the loss of dozens.”
Greece’s early lockdown was necessitated by its economic fragility. A decade of austerity measures following a financial meltdown in 2009 saw its national healthcare expenses slashed by 75 per cent. And like Italy and Spain, Greece has a large elderly population, which is particularly at risk of developing COVID-19.
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Put simply – Greece couldn’t afford a large virus outbreak. In some respects, it is in a similar situation to a country like India, which has gone into heavy lockdown.
“Greeks are generally very distrustful of their government, they think all politicians are corrupt,” my brother Georgios told me. “Given what happened with the economy, you can see why. But this new crisis is different. It’s about health, which Greeks prize above all other aspects of life.”
What my brother described, in my experience, was true. It comes as no coincidence that when Greeks make a toast, they say “stin ygeia mas!” which literally means “to our health!”
“I think the economic crisis meant it was easier for people to make another sacrifice,” Georgios said. “We’re used to hardship, we know what it means, but we’re resilient.”
From that perspective, the Greek economic crisis appears to have served the same mental purpose as the 2003 SARS crisis for Hong Kong residents and 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea – it put people on alert. When COVID-19 rolled around, all these countries were ready. Hong Kong and South Korea appear to have handled COVID-19 effectively so far, and so has Greece, with only 2,011 confirmed infections and 90 deaths.
When adjusted for population difference, Greece has a fatality rate of about 35 times less than Italy. And when compared with other EU members, Greece has also fared better – its fatalities are far lower than Belgium (3,019) or the Netherlands (2,511), which have similar populations but much higher gross domestic product (GDP). The end result is that Greece is today using a mere 10 per cent of its ICU beds, of which it only has about 900.
Greece’s exit strategy will be key. A long, drawn out shutdown appears likely, although getting the public health response right may allow for reactivation of the economy sooner and ahead of other nations, ultimately creating a form of relative advantage. Either way, it fills me with immense hope to hear that the country’s aggressive line of defence against coronavirus has so far paid off. I already picture the day when the borders reopen and I can board an international flight and again embrace my brothers.
Peter Papathanasiou is author of Little One (Allen & Unwin) and Son of Mine (Salt Publishing). He has is a former research scientist who completed his PhD in immunology and genetics at The Australian National University (ANU) and has worked at Stanford University and New York University.