Study: Coronavirus hit the Estonian Health Board like a tidal wave

Health Board.
Health Board. Source: Ken Mürk/ERR

Like the rest of the world, Estonia was not prepared for the coronavirus pandemic, the crisis hit the Health Board like a tidal wave and cooperation with other agencies was very bumpy at first, a recent study by pollster Kantar Emor reveals. But Estonia is also considered to have handled the crisis rather well in general terms.

Kantar Emor interviewed 20 persons who were instrumental in managing the coronavirus crisis in Estonia, ranging from doctors and experts to government ministers, in an effort to map out the lessons learned. All interviews revealed that neither Estonia nor the wider world were ready for the pandemic.

Such a widespread pandemic seemed so unlikely that the coronavirus reaching Estonia was deemed unlikely even when the virus arrived in Europe. Readiness was created offhand.

"If someone had told me before that we would see something like this in Europe, America or the rest of the civilized world in our lifetime, I would never have believed them," a representative of Estonia's family doctors who participated in the study said.

Merje Klopets, leading expert at pollster Kantar Emor, said that the crisis concerned the whole of society and decisions had to be made based on very limited information which was constantly changing. While all agencies had crisis plans for various scenarios, none had foreseen or put in place measures for what the coronavirus pandemic turned out to be.

"There was chaos and anxiety when the crisis first hit. Responsibility was bounced from one state agency to another," the doctor said.

But the interviewers also said that the extraordinary nature of the pandemic meant that it would have been impossible to plan for it as no one knew to foresee anything of the sort.

"Yes, we had a concept on paper, we also had a reserve of people we could use, on paper, plus a few other things, but it was virtually untested /.../ So we cannot say we simply kicked a comprehensive and well-oiled machine into gear when it began /.../ We started building the plane midair, as the saying goes," a Government Office employee said.

While the Health Board was put in charge of managing the crisis, its structure, prior level of funding, staff and crisis management experience just weren't up to the task. A representative of the board said in their interview that while the Health Board had told the Ministry of Social Affairs it was not prepared to handle major pandemics before Covid hit, its funding was not increased.

"The Health Board was too small for this crisis, that much was clear from the first," a former minister told Kantar Emor. "They were hit by a tidal wave kind of."

A family doctor was more direct in their criticism: "They were simply made the scapegoat," she said, referring to the Social Ministry's decision to delegate crisis management to the Health Board.

The board did not manage to resist the tidal wave, while great expectations were placed on it, which created a lot of doubt and distrust. Klopets said that the board was also embroiled in an in-house crisis as there had been tensions and conflict between members of the staff even before the pandemic landed. But despite a very difficult situation, the agency gradually managed to make changes, replace and gain staff members and render cooperation more successful.

"Changes have been considerable, and the board's crisis readiness is on a very different level today, compared to three years ago," Klopets remarked.

The interviewees said that the eventual decision of also putting the Government Office in charge was key as a society-wide crisis cannot be resolved by a single agency.

The crisis had been going on for a year by the time the Health Board got its house in order. A Government Office employee said that once the board figured out what it needed to do, they were quite busy and successful – it simply took them a very long time from when the crisis started.

One key aspect of the crisis was communication, which was not helped by available information changing all the time and causing spokespeople to send conflicting messages and at times compete at who could rely information faster.

"Lessons the participants highlighted included more effort to explain various restrictions and displaying more empathy and less top-down attitude toward the population," Klopets said.

The interviewees were also asked about failures one among which was saddling the Health Board with too much responsibility. Planned treatments were also suspended too soon, which caused hospitals to be on standby for too long while not treating patients with other problems, with efforts to address the consequences continuing to this day, experts suggested.

Other failures mentioned were partial restrictions that favored coronavirus tourism, with restrictions coming too late in March 2021 highlighted as the biggest blunder.

Kantar Emor leading expert Kristiina Saks said that the latter was considered to be the toughest moment in the crisis. Restrictions came three weeks too late, which put hospitals under heavy strain and there were serious concerns of whether they would be able to hold out.

In summary, the study concludes that Estonia handled the crisis relatively successfully and managed to strike a good balance between restrictions and keeping society open. The healthcare system was put under very serious pressure but still held out, and no dark scenario manifested in full.

Klopets said that Estonia is better prepared today should another medical crisis hit. However, she pointed to what a member of the scientific council had said about soldiers always preparing for the last war also being true in terms of other crises. This means that a different type of crisis, for example, a radiation disaster, would see the agency in charge also start to learn pretty much from scratch.


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Editor: Marcus Turovski

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