Omicron, the dominant strain of COVID-19 in Lithuania, has been on the rise again in recent weeks, but the Ministry of Health (MoH) reassures that the increase in the number of cases is modest, the cases are not severe, and the number of hospitalisations remains stable. However, the situation could change in the autumn, especially if a more severe strain of the coronavirus reaches Lithuania. Another risk during the autumn season is the co-infection of COVID-19 and influenza, i.e., the possibility of both infections occurring at the same time, potentially resulting in a more severe condition.
For this reason, the MoH urges people to start preparing for the autumn in case the situation worsens and recommends getting vaccinated if a person has not done so already.
‘We feel prepared and have learned the lessons of the pandemic. While we are calmer about the situation, we should not forget that COVID-19 is not going anywhere. The situation may worsen somewhat already in the autumn, as this season brings the additional risk of getting infected with COVID-19 and influenza at the same time, which is likely to make the cases more severe. We therefore already now urge residents and public institutions to be prepared. For those who have not yet been vaccinated, now is the time to do so’, says Arūnas Dulkys, Minister of Health.
According to the data by the European Centre for Disease Prevention and Control (ECDC) from 16 June 2022, 68% of the total population of Lithuania have completed the primary course of COVID-19 vaccination and 31.9% have received the booster dose. Among the persons over 18 years old in Lithuania, 79.2% have completed the primary course of COVID-19 vaccination, while 38.7% of adults have received the booster dose. Given that the majority of the Lithuanian population is now vaccinated or have been infected with COVID-19, the burden of the disease is expected to be lower than previously observed, unless a more severe strain of the virus starts to spread.
According to the Minister, vaccination programmes and capacities aimed at high-risk groups are to be upgraded in preparation for the expected new virus wave in autumn 2022. Strengthening the whole seasonal immunoprophylaxis system, focusing on close and continuous contact with high-risk groups, dissemination of information and motivational measures, are the priority areas to control the COVID-19 pandemic and other infectious diseases in the future.
It is likely that starting from the autumn–in line with the recommendations of the Lithuanian Society for Infectious Diseases–the aim will be to vaccinate people from influenza, pneumococcal infection, and COVID-19 at the same time.
When it comes to COVID-19, the most likely scenario is that the coronavirus will become a seasonal virus, and vaccination of high-risk groups will be crucial to be able to control it. In Lithuania, from August 1 this year, vaccination will be made available to people over 80 years old and those at higher risk.
As a reminder, the fourth dose of COVID-19 vaccine has been available since 30 May 2022 for adults with chronic immunocompromising diseases or those with severe immune deficiencies caused by other reasons as well as those receiving treatment with immunosuppressive agents.
Currently, vaccination with the selected COVID-19 vaccine is carried out in primary health care institutions. Mobile teams are also planned to be organised to ensure vaccination of persons unable to access a health facility. The vaccination will be carried out using the funds of the Compulsory Health Insurance Fund (CHIF).
Testing is currently carried out in personal health care institutions. Rapid antigen tests are carried out for symptomatic individuals, while PCR tests are carried out at a secondary level or in hospitals. The tests are paid for using the funds from the CHIF budget. Mobile testing may only be necessary in the event of an extremely high number of patients and if health-care facilities are no longer able to cope with testing volumes of symptomatic persons.
Currently, sequencing tests are not carried out due to low incidence and changes in the testing strategy when rapid antigen tests are used for diagnosis. If the incidence rate increases, sequencing could be resumed for monitoring purposes.
There will be no preventive testing of schoolchildren in autumn. Just like now, it will be possible for those with symptoms to take the self-test in the educational establishment. In the event of a municipal or national epidemic, a school could temporarily suspend education or organise it remotely. It would also be recommended to enhance the usual infection prevention measures, such as proper respiratory hygiene (sneeze and cough etiquette), hand hygiene, cleaning and disinfection of premises, and proper ventilation. Proper ventilation indoors can also help to control the spread of COVID-19 and other airborne infections.
When it comes to personal health-care facilities preparedness for the autumn, one may claim that the last two years of the pandemic have seen them adapting to the ever-changing demand for service provision. With the increase in hospital admissions, the usual pattern for health-care facilities has been to increase the number of beds for COVID-19 patients and reorganise their service provision.
When considering the control of the infection spread within the country, the procedure for declaring influenza epidemics is being reviewed by integrating COVID-19-related criteria and the recommendations on the use of measures during epidemics are being reconsidered. The plan is to be able to declare epidemics at both municipal and national levels once the set criteria have been reached, as in the case of influenza epidemics. If the situation in Lithuania becomes extremely severe due to high hospitalisation rates or deaths, quarantine could be considered again if the measures taken during epidemics would not have the required effect to control the situation.
There are currently no plans to impose restrictions on travellers. Additional restrictions could be imposed in the event of an emergence of a new dangerous strain that causes severe forms of the disease. As the experience has shown, travel restrictions can be useful for a very limited period of time only, at the very beginning of the spread of a new strain, to slow down the spread of the strain in the country, while getting prepared to control the strain. If the new strain does not require a reorganisation of capacities or application of specific measures, then travel restrictions would not be appropriate as it is not possible to prevent the introduction and spread of an airborne infection.