Structure Polish Academy of Sciences

The virus knows no borders. The COVID-19 pandemic has highlighted the need to take action for the sake of the health and common safety of neighboring countries. Herein we consider the observed similarities and differences in how the pandemic has played out in Poland and Ukraine, and what kinds of conclusions might be drawn from them.  

Nowadays, it takes just half a day to travel from Asia to Europe by plane, or from Warsaw to Kyiv by car. Traveling is conducive to interpersonal contacts, but it also creates excellent opportunities for a virus to spread. This is especially significant for countries that neighbor one another.

Poland and Ukraine have a great deal in common. For instance, Poland is Ukraine’s largest international partner. Therefore, what happens in Ukraine is important to Poland, and what happens in Poland affects many activities in Ukraine. The COVID-19 pandemic has highlighted the need to take joint action for the sake of the safety and health of neighboring countries. Let us take a closer look, therefore, at the history of the COVID-19 epidemic in Poland and Ukraine.

The course of the COVID-19 epidemic in Poland

The first 50 officially recorded cases of COVID-19 in Poland occurred between 4 March and 11 March 2020. Those individuals had been infected with the virus chiefly outside Poland’s borders, in particular in Italy, Germany, the United Kingdom, Spain, and Norway. They had been in those countries for job-related reasons or had spent time at holiday resorts during the school winter break. The first death caused by SARS-CoV-2 in Poland was reported on 12 March 2020. In the second half of March 2020 infections had already been reported throughout Poland’s territory. That was also when new infections started to concentrate in areas characterized by high population density.

Poland was one of the first countries in Europe to introduce health screening on its land borders (9 March). On 13 March, Poland closed its borders, which also included the suspension of passenger air flights. At the same time, however, the #LOTdoDOMU (#FlyHome) campaign was initiated, during which LOT Polish Airlines made 400 flights from 70 destinations on five continents in just three weeks. In April, the epidemic situation in Poland was therefore fueled by the arrival of infected individuals into local communities, while the local transmission had been rather limited. 

By the end of April 2020, the epidemiological situation had stabilized. Stability was achieved three weeks after the introduction of isolation measures: professional activity shifted to the work-from-home model, schools, shopping malls, and large-format retail stores were closed, restrictions on social contacts were imposed, and staying in public places and traveling were banned. Further research showed that early interventions were the most effective in limiting the pandemic’s spread.

However, the epidemic situation changed drastically in the fall of 2020, with rapid growth in the epidemic being caused directly by the easing of restrictions (the partial opening of Poland’s airspace, the return to full social activity, including the opening of schools with no epidemic restrictions). In mid-September, the number of detected infections started to grow rapidly. Administrative restrictions on social activity (restrictions on the number of people at gatherings, remote education in schools and universities, telemedicine and  the cancellation of scheduled hospital admissions), introduced in late September, and lockdown measures, introduced on 24 October, were not able to stop the number of infections from growing rapidly. By the end of 2020, Poland had officially recorded a total of just under 1,300,000 infections and 28,524 deaths from COVID-19. Many of those victims were seniors, including nursing home residents.

Around mid-December 2020, the Alpha variant of SARS-CoV-2 appeared in Poland. This was related to the fact that people who worked abroad, in particular in the UK, arrived in Poland for the Christmas and New Year period. This led to a high number of new infections in early 2021 and a rapid rise in the number of cases in the spring wave. The wave of infections was also accompanied by a wave of deaths, whose course was delayed by about two weeks after infection detection.

The number of reported cases during the summer of 2021 did not exceed 300 infections per day. In mid-July, however, it began to rise again and exceeded 900 infections per day in the second half of September.

In December 2020, a voluntary and free COVID-19 vaccination program began, using the Pfizer/BioNTech, Moderna, AstraZeneca, and Johnson & Johnson vaccines. However, the program was progressing too slowly to attenuate the next wave of the pandemic, which was recorded in spring 2021. As of 25 September 2021, approximately 19 million Poles were fully vaccinated. However, incomplete vaccination among seniors and low vaccination rates among adolescents aged 12-18 continue to pose a major problem. Vaccination of adolescents has been possible in Poland since June 2021.

Projections of the course of the epidemic in Poland

In the conditions of a full return to normal life (the opening of schools and retail service providers, the return to in-person education at universities, and so on), with the infections being dominated by the Delta variant of SARS-CoV-2, the number of recorded cases started to grow exponentially in mid-July 2021, marking the next wave of cases. The number of infections is growing almost at the same rate as in the same period of 2020. Projections made by two research groups, ICM from the University of Warsaw and MOCOS from the Wroclaw University of Technology, show that in late October and early November 2021, the number of infections will reach 30,000 per day. Another wave of deaths is also projected, with the number of deaths being estimated at up to 40,000 in the pessimistic scenario. 

The course of the COVID-19 epidemic in Ukraine

The history of the beginning of the epidemic in Ukraine is very similar to the Polish case. The first 100 cases of infection with the novel COVID-19 disease were registered in Ukraine by 25 March 2020, with the majority of infected cases coming from abroad. The first COVID-19 related death was registered on 13 March: a 71-year-old woman who had recently returned to Ukraine from Poland. 

To stop the spread of the infection, Ukraine went into lockdown on 17 March 2020, with more strict restrictions being introduced on 6 April 2020, including the closure of schools, universities, shopping malls, and fitness facilities. Public transport was reduced to an absolute minimum across the country to minimize inter-regional transmissions, and face masks became obligatory in all public places. The early introduction of the lockdown stabilized the spread of the disease until late April / early May. From mid-May until late July, the numbers of newly registered cases fell in the range of 400 to 900 per day. 

In the spring of 2020, the system of testing and detection of COVID-19 cases was in the development stage, therefore it is hard to say what the true number of infected people was in that period. But analysis of excess mortality data showed that the early restrictions imposed in both Poland and Ukraine effectively stopped the spread of infection, with no increase in total deaths being observed in our countries, in contrast to some other European countries (like the UK, Spain, Italy). Stable growth in the infection rate started from August 2020, with a doubling period of around 4 weeks, and the epidemic reached its peak at the very beginning of December. Through the beginning of 2021, almost 20,000 COVID-19 related deaths were officially registered, but excess mortality analysis showed that this number was underestimated by at least a factor of 2. From February 2021, a new spring wave began in Ukraine, bigger in comparison with the autumn wave. The spring wave reached its maximum at the beginning of April 2021, with more than 400 registered COVID-19 related deaths per day.

The vaccination program began in late February 2021, with AstraZeneca, Sinovac (Coronavac), Pfizer/BioNTech and Moderna vaccines being used. Rates of vaccination were significantly lower than in Poland. By 21 October 2021, 6.7 million Ukrainians had been fully vaccinated.

Projections of the course of the epidemic in Ukraine

A new wave of COVID-19 spread, caused mainly by the new Delta variant of the virus and the lifting of quarantine restrictions, began in July and was enhanced with the start of the new school year. The rate of spread is higher compared to previous waves. In mid-October, Ukraine reached and exceeded the maximum seen during 2020’s autumn wave. By 21 October, almost all the epidemic parameters had reached the maximum values of the spring wave. The indicators for the coming wave maximum are expected to be much higher than for the whole previous history, due to the higher virus infectivity and low vaccination level.

The main methods and recommendations used against the pandemic in Poland and in Ukraine

In Poland, the basic recommendations aimed at curbing the epidemic currently include the following: vaccinations, social distancing, and if this is impossible – wearing face masks, ventilating indoor spaces, and disinfection. Travel restrictions apply to international travel only. COVID-19 certificates (issued to those who have been vaccinated or recovered from the disease) are not officially required in public places, workplaces, and schools, but they are sometimes required of people wishing to visit patients in hospitals.

In Ukraine, the key approaches to countering the SARS-CoV-2 pandemic are as follows: social distancing, the use of face masks, and vaccination, the coverage of which, however, remains one of the lowest in Europe. A color classification of the levels of epidemic threat is used at the regional and subregional level, implying different degrees of severity of quarantine measures. In practice, the movement of public transport – urban and suburban – is restricted. In addition, the government has recently established weaker restrictions for vaccinated people at some levels of epidemic threat, in order to minimize economic losses from closing businesses.

The impact of the pandemic on the cross-border traffic between Poland and Ukraine

Ukrainians make up the largest minority group in Poland (about 2 million people). In 2013–2018, the arrival of workers from Ukraine increased Poland’s Gross Domestic Product (GDP) by about 0.5 percentage points each year, and the influx of migrants from Ukraine is responsible for 13 percent of the growth in Poland’s economy during this period [1]. For Ukrainian society, this means private remittances to Ukraine, the total volume of which over the past five years has been estimated by the NBU at $15.6 billion. This is approximately 30% of all external receipts to Ukraine and 2-3% of Ukraine's GDP annually [2]. Effective provisions regulating cross-border traffic are in the interests of both societies.

However, the trajectory of the pandemic in both countries forced the closure of borders. Poland closed its borders on 15 March 2020, and Ukraine on the next day. It soon became apparent that without migrants, some sectors of the Polish economy would be threatened by costly downtime. Hence, as part of the “anti-crisis shield” measures, on 7 April 2020, exceptions were introduced in Polish law to allow for the legal stay of migrants for up to 30 days after the end of the declared state of epidemic [3]. Restrictions in cross-border travel resulted in long lines at the borders, which posed additional health risks. Moreover, Poles and Ukrainians crossing the border were subject to different rules, even if they were travelling in the same car or bus. For example, most Ukrainians crossing the Polish border had to undergo quarantine, whereas Poles were exempt from this requirement.

Under the visa-free regime, Ukrainian citizens may stay in Poland for up to 180 days and have the right to take up employment, provided that they have concluded a contract with an employer to perform a specific task. This forces them to cross the border quite frequently, which runs counter to epidemic safety requirements, and to remain tied to a single employer, which leads to labor market rigidity for both employees and employers.

It is important for the health of citizens that everyone, including migrants, should have easy access to clear, up-to-date, and reliable information in their native languages, even in countries of temporary stay. The pandemic has shown how important it is for neighboring countries to work together in this field.

Efforts and mutual information and education support are needed to promote vaccinations against COVID-19

In Poland, we can observe considerable skepticism about SARS-CoV-2 vaccines and ineffective measures taken by the government in response to this phenomenon. Such skepticism is fostered by disinformation on social media and aggressive actions taken by anti-vaccination movements.

On 1 February 2021, Ukraine’s Ministry of Health presented a SARS-CoV-2 vaccination plan for the population [4]. The plan consisted of five stages, with Ukraine’s medical professionals and armed forces being the first to receive vaccines. Ukraine received its first vaccine deliveries in February 2021. The European Union (EU) pledged to provide Ukraine with vaccines because Ukraine is a member of Gavi, the Vaccine Alliance. However, media reports in Ukraine claimed that the Ukrainian government would purchase COVID-19 vaccines at inflated prices, which led to public outrage and protests. A poll carried out by Rating Group Ukraine found that 55% of Ukrainians were willing to receive a SARS-CoV-2 vaccine if it were given for free. Currently, 16% of the population in Ukraine is fully vaccinated.

In Poland, 52% of the population is currently fully vaccinated against SARS-CoV-2. Poland benefits greatly from its membership in the EU. Just six months after the vaccine was developed, the EU made sure that it would be available to practically anyone who wanted to receive it. Vaccinations in Poland have slowed in recent months and, unlike in other EU member states, the vaccination rate has practically stopped at 50%, due to considerable skepticism about vaccinations, supported by disinformation on social media and a low level of trust in state institutions among citizens.

Ukrainian society is faced with similar phenomena. In October the pace of vaccination declined by nearly 25% from the level seen at the beginning of September, when two million doses of the Moderna vaccine were made widely available, remaining close to a hundred thousand administered doses daily. This meant it took approximately a week to fully vaccinate another one percent of the population. Moreover, skepticism about vaccines remains strong and stable. Recently, however, after the implementation of new quarantine restrictions for the unvaccinated, vaccination rates increased significantly and reached 250K doses per day.

This suggests that even after the resolution of initial problems with vaccine deliveries, the vaccination rate in the population may stagnate at around 55%. In this situation, in order to reduce the social and economic costs of the prolonged pandemic, both countries may need to consider mandatory vaccinations among certain occupational and age groups (PAS Position Statement No. 19, dated 2 September 2021). Ukraine, indeed, has already announced mandatory vaccinations for a list of jobs.

Fig. 1 [5] 

Similarities and differences in the epidemic situation in Poland and in Ukraine

The major problem that Ukraine and Poland face when analyzing the common traits is the availability of high-quality data. This includes information on the real number of cases and deaths, but also on patient follow-up. Excess mortality due to COVID-19 exceeded the official data in both countries, which suggests that the actual magnitude of the epidemic was underestimated, and many cases remained undiagnosed. Furthermore, both countries have only started sequencing programs. Mass sequencing would allow scientists to track the transmission of specific variants and strains and understand better the direction and routes of the virus transfer between the countries.

Consequently, mapping and understanding of SARS-CoV-2 transmission between Poland and Ukraine has been limited. Therefore, we will not venture to suggest here any interpretation of the differences in pandemic wave height and distribution. However, it does seem that the PAS COVID-19 Advisory Team’s Position Statement No. 21 on data availability would appropriately apply to both our countries. This includes more robust data collection but also data storage, sharing, processing, and integration.

Another conclusion that emerges from comparisons of the epidemic situation in Poland and in Ukraine is that there are distinctive concurrences of factors unifying and differentiating the dynamics of the epidemic. We see certain similarities, first of all the comparable period of the onset of the epidemic waves in both countries. Yet, we also see differences, for instance, a faster pace of epidemic development in Poland. We might initially hypothesize that the similarities are more closely connected to the “biology of the pathogen” itself, whereas the differences result to a larger extent from the “sociology of its penetration” in the specific populations. Here, the mobility patterns, demographic structure (including population density), and the structure of households play a role. This also overlaps with the accessibility and use of vaccines.

It is relatively easier to indicate the above unifying, “biological” factors, than to identify the role of differentiating, “sociological” factors. The latter task would require more research and data from the social sciences. Based on studies of the “biology of the pathogen”, we may assess how many persons would be infected by one person, if they converse in an unventilated room. However, we have to turn to the social sciences to answer such questions, for instance, as whether it is a social norm in a given society for rooms to be well ventilated. Therefore, even though the virus “knows no borders” between countries, social factors influence patterns of its penetration in populations. 

[1] Strzelecki P.,Growiec J., Wyszyński R. 2020. The contribution of immigration from Ukraine to economic growth in Poland. NBP Working Paper No. 322. Warsaw: Narodowy Bank Polski, https://www.nbp.pl/publikacje/materialy_i_studia/322_en.pdf

[2] Remittances, annual data. Balance of payments and other statistical information compiled on the basis of the BPM6. National Bank of Ukraine, https://bank.gov.ua/files/ES/Perekaz_y_en.pdf

[3] Cope B.,Keryk M. 2020. Nowa sytuacja, stare problemy. Legalizacja pobytu ukraińskich migrantów w Polsce w czasie pandemii COVID 19. Warsaw: Fundacja „Nasz Wybór”.

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242568/pdf/JMV-9999-0.pdf

[5] Source of data for the graph: Ritchie H., Mathieu E., Rodés-Guirao L., Appel C., Giattino Ch., Ortiz-Ospina E., Hasell J., Macdonald B., Beltekian D., Roser M. 2020. Coronavirus Pandemic (COVID-19). Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/coronavirus[Online Resource].

[6] Komisarenko S. V. 2020. Scientists’ pursuit for SARS-CoV-2 coronavirus: strategies against pandemic. Ukr. Biochem. J.; 92 (6): 5-52.

About the authors

The Polish team is chaired by Prof. Jerzy Duszyński, President of the PAS, with Prof. Krzysztof Pyrć (Jagiellonian University) as deputy chair and Dr. Anna Plater-Zyberk (Polish Academy of Sciences) as its secretary. Other members of the team are:

• Dr. Aneta Afelt (University of Warsaw)
• Prof. Małgorzata Kossowska (Jagiellonian University)
• Prof. Radosław Owczuk, MD (Medical University of Gdańsk)
• Dr. Anna Ochab-Marcinek (PAS Institute of Physical Chemistry)
• Dr. Wojciech Paczos (PAS Institute of Economics, Cardiff University)
• Dr. Magdalena Rosińska, MD (National Institute for Public Health – National Hygiene Institute, Warsaw)
• Prof. Andrzej Rychard (PAS Institute of Philosophy and Sociology)
• Dr. Tomasz Smiatacz, MD (Medical University of Gdańsk)

The Ukrainian team is chaired by Prof. Anatoly Zagorodny, President of the NASU. Other members of the team are:

• Prof. Serhiy Komisarenko (NASU Palladin Institute of Biochemistry)
• Prof. Mykhaylo Tukalo  (NASU Institute of Molecular Biology and Genetics)
• Prof. Mykola Spivak (NASU D.K. Zabolotny Institute of Microbiology and Virology)
• Prof. Andiy Sibirny (NASU Institute of Cell Biology)
• Dr. Igor Brovchenko (NASU Institute of Mathematical Machines and System Problems)
• Dr. Ihor Ivanov (NASU Institute of Mechanics)
• Prof. Vitalii Mokin (Vinnytsia National Technical University)