Martin Kadai: General restrictions do not solve crisis

Former Health Board chief of emergency medicine Martin Kadai.
Former Health Board chief of emergency medicine Martin Kadai. Source: Priit Mürk/ERR

Implementing a curfew for the whole country does not solve the issue of hospitals being overburdened, but instead extends the crisis, former Health Board emergency medical department head Martin Kadai told ERR about Latvia's decision to implement strict restrictions against the coronavirus. He said the solution is increasing risk group vaccination rates.

Kadai spoke about Latvia's decision to implement a month-long "lockdown" from Thursday and said the main question for Estonia's southern neighbor is what they hope to achieve with a curfew. "A curfew will likely not bring a solution to the problem," the former Health Board official said, calling general restrictions an indirect solution.

"An indirect path to resolving a situation is long, difficult and may not lead to a solution. You take a risk making this decision of extending the crisis. Every country should keep this logic in mind nowadays," Kadai said. "A direct path is for people to get vaccinated - people in risk groups, before all."

He said general restrictions were necessary a year ago, when there was no direct solution - vaccines. With vaccines widely available now, the attention should go toward reaching the highest vaccination rate possible and not toying with restrictions.

"The most direct path would be to vaccinate risk groups. If this does not work and infections are still out of control, there is no other solution to avoid overburdening the healthcare system than good old restrictions, but we must understand that they come with a risk of extending the situation. This can bring the hospital network temporary relief, but is not a solution," Kadai emphasized.

He added that the virus itself has changed from a year ago, which is also an important aspect. "The Delta variant is significantly more infectious. The effectiveness of restrictions might not be the same as we have seen due to higher infection rates," Kadai said, adding that people may not be as willing to cooperate because many have been vaccinated or have recovered and consider restrictions to be too excessive. These are some of the risks that must be taken into account when implementing general restrictions, the former Health Board official said.

Therefore, the Estonian government should opt to base restrictions on choices that promote vaccinations for the people who will likely require hospitalization the most - the elderly and other people with serious illnesses. In other words, there is no need to close night clubs and schools because that will not do much in stopping the coronavirus from reaching unvaccinated older people. Measures must be directed at increasing vaccination rates.

Kadai doubts the need for restrictions. "If we just implement restrictions, we will scatter the problem and extend the crisis. These restrictions only have a goal if they actually lead to a solution - the issue we are trying to solve is that there would not be a deep healthcare crisis. That should be the country's main objective, that is where attention should be turned to," the healthcare expert said.

So the main priority of a country should be to try and increase risk group vaccination rates, helping avoid overburdening in hospitals and not thinking of new restrictions. But how can people in risk groups be directed to vaccinations?

"Since we have an unusual situation, the solutions should also be 'out of the box'. I do think that the government and society are both not prepared to discuss changing this principle in Estonia, where vaccinations have been voluntary so far," Kadai said, adding that solutions must be justified, fair and ethical.

Different groups of people also require different approaches, although the state still does not have any knowledge of why people are refusing vaccinations or motivators to promote it because it just has not been researched, the former Health Board official said.

"Today, in the middle of the crisis, is not the time to conduct public opinion polls of the population, but there should be some understanding. Some patterns have to pop out in age groups or other socio-economic factors, where vaccination rates are lower. You can draw initial conclusions from there," he said.


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Editor: Kristjan Kallaste

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