COVID-19 pandemic in Poland




The COVID-19 pandemic in Poland is part of the worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. In February and March 2020, health authorities in Poland carried out laboratory testing of suspected cases of infection by SARS-CoV-2, one of the seven known human coronaviruses, as well as home quarantining and monitoring. The first case of a laboratory confirmed SARS-CoV-2 infection in Poland was that of a man hospitalised in Zielona Góra, with confirmation announced officially on 4 March 2020. The local transmission phase of SARS-CoV-2 in Poland was declared to the World Health Organization on 10 March. The first death from coronavirus disease 2019 in Poland was that of a 56-year-old woman on 12 March. Polish authorities did not participate in the 28 February 2020 European Union tender procedure for purchasing COVID-19 pandemic related medical equipment, in which 20 other member states participated. Poland applied on 6 March for the 17 March tender for the purchase of gloves, goggles, face shields, surgical masks and protective clothing; the European Commission stated that all requests in the tender were satisfied by offers.
, there were 33,119 laboratory confirmed SARS-CoV-2 cases, 1,412 deaths, and 18,654 recoveries.
Lockdown-type control measures started on 10–12 March, closing schools and university classes and cancelling mass events, and were strengthened on 25 March, limiting non-family gatherings to two people and religious gatherings to six and forbidding non-essential travel. On 20 March, the Ministry of Health tried to prevent medical personnel from commenting on the pandemic. The Polish Ombudsman Adam Bodnar defended medical personnel's right to speak publicly about the epidemic on :s:Constitution of the Republic of Poland|constitutional grounds of freedom of speech and the right of the public to information. Doctors opposed the self-censorship orders. Fatality counts initially only included deaths from lab-confirmed SARS-CoV-2 infection. Starting on 1 April 2020, fatalities that were clinically or epidemiologically diagnosed as COVID-19 ) were also considered as COVID-19 deaths by NIPH–NIH., people in Poland who died in quarantine from suspected COVID-19 were not tested post mortem for SARS-CoV-2., there were 269,307 people under quarantine for suspected SARS-CoV-2 infection and 42,783 SARS-CoV-2 tests had been made since the beginning of testing. The lockdown restrictions were tightened starting on 31 March–1 April by a government regulation, requiring individuals walking in streets to be separated by two metres, closing parks, boulevards, beaches, hairdressers and beauty salons, and forbidding unaccompanied minors from exiting their homes. A followup regulation on 10 April loosened the restrictions on public gatherings starting from 20 April, allowing religious gatherings and funerals to be held for up to a maximum of 50 people.

Background

Predictions of a pandemic were made repeatedly in the early twenty-first century, prior to the 2019–20 COVID-19 pandemic. The World Health Organization and the World Bank warned about the risk of pandemics throughout the 2000s and the 2010s, especially after the 2002–2004 SARS outbreak. The WHO coined the term Disease X in 2018, so that preparations for the next, at-the-time unknown, pandemic could be undertaken. In 2005–2006, prior to the 2009 swine flu pandemic, and during the decade following the pandemic, governments in the United States and France prepared stocks of pandemic protective items and then depleted these stocks. In late December 2019 and early January 2020, an outbreak of infections from a virus, which was found to be closely related to the SARS virus, rapidly expanded in Wuhan in China, prior to spreading elsewhere around the world, with the first COVID-19 death being officially reported on 11 January 2020 in Wuhan.

Preparations

During January 2020, Warsaw Chopin Airport carried out special screening measures for passengers arriving from China.

Testing and monitoring

, four-member teams at the National Institute of Public Health – National Institute of Hygiene together with the Berlin hospital Charité had carried out 307 genetic tests of samples from suspected SARS-CoV-2 carriers, and 28 tests were waiting to be analysed. NIPH–NIH carried out the tests in its Warsaw laboratory and in the Wojewódzki Szpital Zakaźny in Warsaw. Diagnostic laboratories in eight other towns were being prepared for making similar analyses. The Ministry of Health refused to state how many test kits were available in Polish laboratories.
On 4 March, the Minister of Health claimed that nine laboratories were carrying out SARS-CoV-2 testing, while OKO.press claimed that only four laboratories were carrying out the testing. The Minister claimed that "sanitary–epidemiological stations" in Lublin, Łódź and Poznań would start SARS-CoV-2 tests the following day. On 6 March, the Minister stated that 13 laboratories were running SARS-CoV-2 tests.

New law: "specustawa"

A new law to manage a possible epidemic of COVID-19 or other infectious diseases in Poland via administrative, budgetary and epidemiological measures passed through a first reading by a parliamentary committee and through second and third readings by the Polish lower house of parliament, the Sejm, on 1 and 2 March, with 400 votes out of 418 in favour in the third reading. Konfederacja was the only parliamentary club which voted against the measure. Philosopher and law professor praised the discussion of the bill in the Sejm, in that the Speaker allowed members of parliament to discuss the bill under the principles of deliberative democracy, which he judged rare for the parliament dominated by PiS. Zajadło criticised the bill as establishing vague powers with little chance of checks and balances, which he saw as being in the spirit of the approach of the political party in power; he saw the bill as establishing a permanent state of emergency for COVID-19 and all other contagious diseases; he criticised the wide array of changes implied in the law as having consequences difficult to predict; and he judged the law to be unnecessary given that laws covering the situation already existed., a former judge in the Polish Constitutional Tribunal, also criticised the law as effectively creating a new, 180-day long state of emergency, in addition to the state of emergency rules defined in :s:Constitution of the Republic of Poland/Chapter 11|the Polish Constitution for a maximum of 90 days. She interpreted the law as giving the authorities arbitrary power without control by administrative courts.

Timeline

Pre-4 March 2020

On 19 February, twelve people remained hospitalised "in connection with the coronavirus", 13 were under home quarantine and 1000 were being monitored by health services. On 27 February 47 people remained hospitalised with suspicions of SARS-CoV-2 infection, 55 were under home quarantine and 1570 were being monitored by health services. Polish Minister of Health Łukasz Szumowski stated on 27 February that he expected positive SARS-CoV-2 laboratory confirmed cases in the following days.
On 3 March, a total of 559 SARS-CoV-2 tests had been run for people in Poland suspected of SARS-CoV-2 infection, all with negative results, while the numbers of people home quarantined and monitored increased and the number of hospitalised, suspected cases dropped.

4–9 March: imported cases only

The first lab-confirmed case of SARS-CoV-2 in Poland was announced on 4 March 2020, out of 584 tests in total. The patient, a 66-year-old man, returned from a visit to Westphalia in Germany by bus to Świecko and from there by private car to Cybinka. He telephoned a general practitioner. He was taken by ambulance to a hospital in Zielona Góra, where he arrived around midday 2 March. In the evening of 2 March, a sample from the patient was sent for analysis to Warsaw. The result was known to be positive during the night of 3 to 4 March, and announced by the Minister of Health at 8:00 local time on 4 March. OKO.press criticised the delay of 44 hours from the patient's arrival at the hospital to the announcement of the positive test result as excessive. Close contacts of the patient were home quarantined. The Minister of Health requested the media to respect the patient's privacy.
On 6 March, Polish Minister of Health Łukasz Szumowski announced the confirmation of four new cases: one hospitalised in Ostróda, linked to "patient zero" from Cybinka ; two patients in Szczecin who had returned by car from Italy; and one patient in Wrocław who had returned from the United Kingdom. On 7 March, another SARS-CoV-2 case, of another person who had travelled in the bus together with "patient-zero", was announced by the Minister of Health as lab-confirmed.
On 8 March, The Ministry of Health reported two new cases of SARS-CoV-2 infection. One person was hospitalised in Warsaw and another in Racibórz. Both were in good condition. In the evening, the Ministry confirmed another three positive test results, increasing the daily case count to five new cases. The patients were hospitalised in Warsaw, Wrocław and Racibórz: one elderly person, one middle-aged and one young. The elderly person was in serious condition.
On 9 March, in the morning, Polish Minister of Health Łukasz Szumowski announced the confirmation of five new cases. Three cases were confirmed in Racibórz, one in Kraków, one in Wrocław and one in Poznań, bringing the total number of confirmed SARS-CoV-2 cases in Poland to 17.

10 March–27 March: local transmission

On 10 March, the mode of SARS-CoV-2 transmission in Poland was officially declared to the World Health Organization as having shifted from imported cases only to local transmission.
The eighteenth confirmed SARS-CoV-2 infection was announced in the Masovian Voivodeship on 10 March. The two SARS-CoV-2 patients earlier announced in Warsaw were both seriously ill with COVID-19. Armed Forces General Commander gen. Jarosław Mika was diagnosed with the virus on 10 March.
On 16 March, the number of confirmed cases increased to 177 and the death toll to 4. One of those infected was Minister of the Environment.
On 17 March, "patient zero", at Zielona Góra hospital, tested negative for SARS-CoV-2 the second time, and was considered to have recovered.

28 March–1 April: nursing home and hospital clusters

On 17 March, a doctor at a hospital in Grójec, "Z.", had a dry cough and fever and had a sample taken for SARS-CoV-2 testing. While several members of staff did not want to work with him, the head of their group disagreed but decided after a long debate to isolate Z. The hospital continued to function for the rest of the day without disinfection of the places where Z. had been present. On 18 March Z. was confirmed to be SARS-CoV-2 positive, and the hospital took samples from close contacts of Z. from the previous five days. Some of the nurses were ordered back to work at the hospital while waiting for their test results. As of 24 March, 11 of the 59 patients of the hospital and seven medical personnel were found to be SARS-CoV-2 positive. Onet.pl and Gazeta Wyborcza described the situation as contagion by carelessness.
One of the Grójec hospital personnel also worked at a Niedabyl nursing home. On 28 March, 52 of the 66 residents and eight employees were found to be SARS-CoV-2 positive.
On 1 April, 38 hospitals and hospital sections around Poland, including twelve in the Masovian Voivodeship that includes the Polish capital of Warsaw, were temporarily closed due to the risk of SARS-CoV-2 contamination from a confirmed or likely SARS-CoV-2 infected patient.

Epidemic controls

Lockdown type measures

Polish authorities' initial COVID-19 limitation strategy of laboratory testing, contact tracing, quarantining and monitoring intensified in mid-March with "lockdown" type measures. On 10 March, authorities cancelled all mass events, defined as those allowing 1000 or more participants in the case of stadiums or other events outside of buildings, and those allowing 500 or more participants in the case of events in buildings. Cultural institutions, such as philharmonic orchestras, operas, theatres, museums, and cinemas, had their activities suspended beginning on 12 March 2020.
All schools in Poland were closed starting on 12 March, with a reopening initially scheduled for 25 March 2020. The closure was extended to 10 April, with schools being required to carry out online classes with their students. As of 20 March, the dates of final exams for eighth year of primary school and matura, the exam during the final year of secondary school, remained unchanged.
Universities cancelled classes for the same period, while typically keeping research and administrative staff at work and allowing exceptions for research purposes.
An official epidemic was declared in Poland on 20 March 2020 by the prime minister, Mateusz Morawiecki.
On 24 March, Poland's government announced further restrictions on people leaving their homes and on public gatherings to further limit the spread of SARS-CoV-2 infections. The new limits constrained gatherings by default to a maximum of two people ; an exception for religious gatherings, such as mass in the Catholic Church, funerals and marriages in which five participants and the person conducting the ceremony were allowed to gather; and an exception for work places. Non-essential travel was prohibited, with the exception of travelling to work or home, SARS-CoV-2 control related activities, or "necessary everyday activities". Everyday activities qualifying as "necessary" included shopping, buying medicines, visiting doctors, walking dogs, jogging, cycling and walking, provided that no more than two people participate and contact with others was avoided. The restrictions were initially defined for the period from 25 March to 11 April inclusive.
As of 12 March 2020, the National Bank of Poland, to which commercial banks in Poland send their bank notes to, carried out a two-week quarantine procedure and heating at for all bank notes, prior to returning the notes for circulation.
On 31 March, the prime minister announced that Poland would strengthen the restrictions starting from 31 March–1 April. Lawyers contacted by OKO.press expected the restrictions to be issued as a regulation , which they considered would be an unconstitutional method of introducing the rules. The regulation was published in Dziennik Ustaw on 31 March 2020 as a regulation issued by the government. According to the regulation, minors were prohibited from leaving their homes unaccompanied by a legal guardian. Parks, boulevards and beaches were closed, as well as all hairdressers, beauty parlours and tattoo and piercing salons. Hotels were allowed to operate only if they had residents in quarantine, in another form of isolation, on an obligatory work delegation for services such as building construction or medical purposes. Individuals walking in public were obliged to be separated by at least two metres, with the exception of guardians of children under 13 and disabled persons. No restrictions were applied to people travelling in private cars.
The 31 March regulation allowed religious and other gatherings of only five people plus a religious personnel or funeral employees from 1 to 11 April. The gatherings were allowed to be bigger, up to 50 people, inclusive of religious personnel, to start from 12 April 2020 until further notice. An updated regulation on 10 April retained the authorisation of religious/funeral gatherings of up to 50 people but shifted the start date to 20 April while other gatherings remained banned 1 person per 10 m2.
On 9 April, Mateusz Morawiecki announced that the closure of educational institutions and international transport would continue to 26 April, the borders would remain "closed" until 3 May, and people entering Poland would still be required to be quarantined for 14 days. Szumowski stated that the closure of cultural institutions and limits implemented in shops would continue to 19 April. A new control measure was planned to start from 16 April, making it obligatory to cover one's nose and mouth in public places. After being asked where people could obtain masks from, Szumowski clarified that any form of face covering, such as scarves, would be acceptable. A government website differed from the 31 March regulation, stating that religious gatherings were to be limited to at most five people until 19 April. Police stated that the 10 April gathering of the de facto leader of Poland Jarosław Kaczyński and nine other people, standing close together, commemorating the Smolensk air disaster by laying a wreath, did not constitute a gathering in the sense of big gatherings forbidden in relation to the COVID-19 pandemic. Former prime minister of Poland Leszek Miller described the gathering as showing contempt for ordinary people respecting the COVID-19 restrictions.

SARS-CoV-2 tests

, the number of SARS-CoV-2 tests per capita in Poland was lower than that of 22 other members of the European Union, the EFTA and the European Economic Area, and above that of Croatia and Hungary. Among 19 mostly European countries analysed by OKO.press using data from 20 March, the number of tests per positive detection was 30.8 tests per positive detection in Poland, higher than for any of the other European countries listed, including Germany and Norway, and lower than in South Korea at 36.6 and Russia at 721 tests per positive detection.

Medical supplies

On 26 March, the Minister of Health Łukasz Szumowski claimed that European solidarity in the provision of medical equipment to Poland had failed. OKO.press qualified the claim as "false" and accused the minister of deliberately misleading public opinion. OKO.press referred to the European Union tender process for masks and other protective equipment as a "success" that Poland applied for very late, and commented as context that the EU does not have the legal powers to impose health management policy, such as quarantine measures or closing schools, on member states. The EU tender process was announced on 28 February 2020, to which 20 member states, without Poland, responded. Poland joined the mechanism on 6 March, qualifying for a procedure opened on 17 March for the purchase of gloves, goggles, face protectors, surgical masks and clothing. The European Commission claimed that all the purchases were satisfied by offers, and should arrive within two weeks. Commissioner Thierry Breton described the procedure as illustrating the power of EU coordination. On 19 March, the EU announced the creation of the rescEU strategic stockpile of medical equipment, to be financed at the level of 90% by the commission, to deal with the COVID-19 pandemic.

Impact

Economy

The pandemic and the isolation measures in response to it had a serious influence on the Polish economy, especially commerce, tourism and the hospitality industries.

Anti-crisis Shield

The government prepared a plan of public assistance to businesses, called the "Anti-crisis Shield". The program was launched on 1 April 2020. The program consists primarily of the following five areas.
;Financial safety of employees and protection of jobs
;Finance of business
Business finance measures include:
;Healthcare
;Enhancing financial market soundness
;Public investment plan
Polish authorities and citizens took several solidarity actions to support people in other countries affected by the pandemic and to help in repatriations.
The Polish government sent medical supplies to Italy and San Marino, including 20,000 litres of disinfectants to Veneto and San Marino, produced by the state-owned Polfa Tarchomin, and a load of medical supplies on 7 April 2020. The Polish Centre for International Aid sent a team of 15 Polish doctors and paramedics to a field hospital in Brescia, Lombardy. Doctors from WIM Warszawa share their Italian COVID-19 experience with Armenian, Azeri and Moldovan colleagues. Polish farmers allocated some of their production to Italian doctors, nurses and other healthcare professionals. The Italian flag was shown as an illumination on many buildings in Poland. Polish authorities sent Spain 20,000 litres of Trisept Complex disinfectant liquid.
A medical mission from Warsaw's Military Institute of Medicine went to Chicago on 23 April 2020 to help in COVID-19 management. On 13 April 2020, the Representation of Solidarity Fund PL in Georgia provided spraying equipment, 500 visors and 800 reusable face masks to municipal authorities in Rustavi and Marneuli, Gori and to a clinic in Nikozi, near the demarcation line with South Ossetia. The Polish Ministry of Foreign Affairs allocated 1.2 million PLN to projects aimed at supporting emergency services in Georgia and Ukraine. A convoy of the Polish State Fire Service carrying humanitarian cargo for the National Medical Response Center arrived in Minsk in Belarus on 24 April, for medical institutions in Grodno Oblast, including 50,000 litres of disinfectant, 30,000 litres of antiseptic, 100,000 surgical masks and chloroquine.
The Polish company Wipasz donated 100,000 reusable protective masks to Kazakhstan, laptops for Kazakhstani schoolchildren. A team of Polish eight doctors, nurses and paramedics from Polish Center of International Aid participated in the World Health Organization support program, spending a ten-day mission training staff in Kyrgyz hospitals.
The Polish community participated in grassroots solidarity actions around the world. Volunteers of the Polish Catholic Mission in Freiburg, Breisgau, organized help and emergency counselling, teachers from Polish schools in the Czech Republic sewed masks and provided them to senior peoples' homes, the Polish community in Canada printed 3D protective materials and helped in shopping, the Polish Medical Association from Berdyansk in Ukraine organized telephone consultations, the Association of Poles in Spain nasz Dom – Nuetra casa provided legal and psychological support and sewed protective clothing for nursing homes.
The Polish airline LOT used Twitter to organise a "#LOTdoDomu" return program of 2,000 people to their countries of origin, including 18 other member states of the European Union. The programme was completed on 5 April 2020. LOT also organised 388 special charter flights over 22 days which brought 55,000 Polish citizens and workers to Poland. Polish authorities offered ferry and dedicated train services, and 18 convoys of 800 vehicles, escorted by police, to help Estonians, Latvians and Lithuanians to return to their countries.

Censorship of medical personnel

On 18 March 2020, an experienced midwife in a Lesser Poland Voivodeship hospital published a report on Facebook on the conditions of medical personnel and the situation of the hospital in relation to the COVID-19 pandemic. On 19 March, she was fired from the hospital by Marek Wierzba. He stated that medical staff should be responsible, reliable and should publish true information. He also stated that the dismissed midwife had been spreading panic. Polish Minister of Health Łukasz Szumowski stated that she shouldn't have been fired.
On 20 March, the secretary of state of the Ministry of Health,, sent a written statement ordering voivodeship medical consultants to not make statements about SARS-CoV-2, the epidemiological situation, the risks for medical staff or methods of protection from infection, unless they had first consulted with the Ministry of Health or. Szczurek-Żelazko motivated the order by the need to provide correct, unified information and to avoid unjustified unrest in the medical community.
A surgeons group, Porozumienie Chirurgów SKALPEL, described the order as blackmail and said that it risked catastrophe. The group stated that the COVID-19 pandemic showed Poland as "not at all prepared for crisis situations" with a "lack of equipment, basic personal protective gear and disinfectant materials and a lack of standards and procedures".
On 25 March 2020, the Polish Ombudsman Adam Bodnar sent a letter to the Minister of Health, Szumowski, stating that medical staff's freedom of speech and is guaranteed under :s:Constitution of the Republic of Poland/Chapter 1|Articles 2 and :s:Constitution of the Republic of Poland/Chapter 2|54 of the Polish Constitution and the right of the public to information is guaranteed under :s:Constitution of the Republic of Poland/Chapter 2|Article 61 of the constitution. Bodnar stated that firing or punishing doctors for informing the public during the pandemic could be a violation of the "obligatory standards". Bodnar asked if Szumowski was aware of the situation and requested a clarification of policy.

Spread of SARS-CoV-2 within and around Poland

After the first laboratory confirmed SARS-CoV-2 case in Poland on 4 March 2020, in Lubusz Voivodeship, bordering Germany, cases were confirmed in seven other voivodeships throughout Poland during 5–9 March 2020, covering eight of the sixteen voivodeships. On 17 March, all sixteen voivodeships had recorded SARS-CoV-2 positive cases, with the final two voivodeships being Kujawsko-Pomorskie and Podlaskie.
On 15 March, Poland closed its land borders for 10 days, and international airports for 14 days for passenger traffic, only allowing Polish residents, citizens and those with immediate Polish family to enter Poland. People entering Poland were required to be quarantined for 14 days.

Additional information

COVID-19 versus non-COVID-19 death classification

On 26 March 2020, the Polish health authorities' classification of COVID-19 deaths only included deaths of people with lab-confirmed SARS-CoV-2 infection, classified as under the ICD-10 international disease classification system. COVID-19 deaths under U07.2, which had been defined by WHO one day earlier to mean deaths when "COVID-19 is diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available", were not yet included in the NIPH–NIH instructions. Stefan Karczmarewicz, writing in Polityka, interpreted this as an attempt by authorities to lower the official COVID-19 death toll in Poland. He argued that there was a policy of limiting the number of SARS-CoV-2 tests, which together with the exclusion of the ICD-10 category U07.2 implied an underestimate of the true COVID-19 death toll. NIPH–NIH stated that the omission was unintentional due to the timing, and updated its instructions on 1 April, instructing doctors to also use the U07.2 definition of clinically or epidemiologically classified COVID-19 cases. NIPH–NIH stated that the WHO considered it "irrelevant" to distinguish between U07.1 and U07.2. On 6 April, Bartosz Fiałek, a Polish rheumatologist, claimed that the NIPH–NIH instructions were unclear, and that it appeared that U07.2 was not being used for COVID-19 deaths in hospital in which SARS-CoV-2 tests had not been carried out, nor for people dying of COVID-19 in quarantine.

Suspected COVID-19 deaths in quarantine

On 21 March 2020, a 45-year-old man who was quarantined in Głogów after returning from outside of Poland and who had shown COVID-19 symptoms was found dead by police. As of 26 March 2020, the prosecutor investigating his death had not decided whether or not to carry out a SARS-CoV-2 laboratory test on the corpse. The dead body of a 50-year-old woman who returned from Germany to Konin and felt ill was found by her family on 24 March. refused to test the corpse for SARS-CoV-2., GIS had not stated what procedures were in place for post mortem tests., it was not known if any laboratories in Poland were qualified to carry out post-mortem SARS-CoV-2 tests.

Unofficial deaths

There were several claims of COVID-19 deaths unreported by the Ministry of Health. In early April, Warsaw City Council stated that there had been 32 COVID-19 deaths in Warsaw, while official statistics only listed eight. The Minister of Health stated that the difference was that deaths were officially allocated according to the official places of residence of the deceased. The mayor of Warsaw, Rafał Trzaskowski, stated that the data were carefully checked, and that 18 of the 32 were registered as officially living in Warsaw, not eight.
OKO.press claimed that two COVID-19 deaths at a Ministry of Interior and Administration hospital in Warsaw, on 19 March 2020 of a man born in 1942 who had returned from Austria and on 24 March of a psychiatric patient, were not announced by the Ministry of Health. On 26 March, the family of the man born in 1942 claimed that his 19 March death had not been announced. On the same day, 26 March, the Ministry of Health announced the death of a 78-year-old man in Warsaw.
Disagreement between local media, the head of the Kuyavian-Pomeranian Voivodeship, and GIS continued for several days in early April in relation to the 4 April death in a Grudziądz hospital of a 64-year-old woman from Grudziądz who was SARS-CoV-2 positive. stated that the head of the voivodeship only accepted including the 64-year-old's death in official reports after the newspaper "intervened"., according to Gazeta Pomorska, the Ministry of Health still listed only one COVID-19 death from Grudziądz, while local branches of the health agency stated zero SARS-CoV-2 infections from Grudziądz in their reports.