No. 46




Three Years with COVID-19: Which Way Forward?

14 December 2022


RiTo No. 46, 2022

  • Toivo Maimets

    Toivo Maimets

    Professor of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu

  • Mait Altmets

    Mait Altmets

    Senior Doctor, Head of the Infection Control Department, North Estonia Medical Centre

  • Jaanus Harro

    Jaanus Harro

    Head of Chair of Neuropsychopharmacology, Professor of Psychophysiology, Institute of Chemistry, University of Tartu

  • Ruth Kalda

    Ruth Kalda

    Professor of Family Medicine, Institute of Family Medicine and Public Health, University of Tartu

  • Pärt Peterson

    Pärt Peterson

    Professor of Molecular Immunology, Institute of Biomedicine and Translational Medicine, University of Tartu

  • Margus Varjak

    Margus Varjak

    Associate Professor in Medical Virology, Institute of Technology, University of Tartu

  • Triin Vihalemm

    Triin Vihalemm

    Professor of Communication Studies, Institute of Social Studies, University of Tartu

The authors have studied the analyses published so far in international research literature as well as the Estonian research data to present the key conclusions on the success achieved in responding to the three-year long COVID-19 pandemic as well as the possible lessons to be learned in preparation of potential future pandemics.

Global cooperation in scientific research, which has resulted in relatively efficient vaccines being developed with unprecedented speed, has proven successful during the COVID-19 pandemic. COVID-19 posed a medical challenge only during the first year, until the vaccines were fully developed. During the second and third year of the pandemic, the key focus shifted to social distrust, opposition to masks and vaccines, and the conflict between the interests of the individual and the society. Countries with higher levels of prosociality fared better during the pandemic. Prosocial behaviour must be systematically developed in the Estonian society in anticipation of future crises; however, this cannot be achieved by isolated campaigns but requires consistent daily dialogue with citizens and offering support to vulnerable groups.

The COVID-19 pandemic has strongly affected the state of public health in Estonia. Our life expectancy fell in 2020, and even more so in 2021 (21.5 months). The steady decrease in life expectancy during the second year of the pandemic can be explained by one of the lowest vaccination rates among the European nations (64%), particularly in the older age group (78%). By October 2022, 92% of Estonian adults have developed antibodies for the coronavirus. The high rate of antibodies among the Estonian population permits the assumption that most people would be protected by a certain degree of immunity should new virus strains emerge, which should keep the pressure on the Estonian hospital system within its current capabilities. However, COVID-19 affects the general state of public health in a negative way because severe symptoms (as shown by hospitalisation) cause new afflictions or aggravate the existing chronic illnesses in around 40.3% of the patients. This in turn will increase the need to treat these conditions or offer care services, which is something we need to prepare for. In addition, COVID-19 causes long-term health problems to around 22% of Estonian adults, regardless of the severity of their coronavirus symptoms. Post-COVID-19 health care would benefit from a broader exchange of experiences between GPs, school physicians, and occupational health doctors. Vaccination of risk groups against SARS-CoV-2 should be included in the national immunisation plan. Sequencing of the coronavirus and research into the changes to the immune response must be continued.

Any plans for public health and communication measures should recognise that there is a noticeable trend towards increased social opposition to pandemic control measures, especially concerning vaccines.