By Mark Dovich
Does Armenia have enough hospital beds for patients infected with the coronavirus? The capacity of the country’s healthcare system has become a hot-button issue in recent days after a series of contradictory statements from government officials on the matter.
Although Health Minister Arsen Torosyan had been warning that Armenia was approaching the point of running out of available hospital beds for several days, the issue became a more popular topic of public discussion following a June 6 press conference by Prime Minister Nikol Pashinyan, who went on the record stating that three coronavirus patients in critical condition had died waiting for intensive care beds to become available.
In late April, Torosyan cautioned that the Armenian healthcare system currently has a maximum capacity of 3000-4000 patients. Case in point: Arman Hovakimyan, the director of the Surb Grigor Lusavorich Medical Center, a large medical facility in Yerevan, revealed in late May that upwards of 95 percent of the hospital’s intensive care beds were already occupied. As of June 8, Armenia reported about 9,000 active coronavirus cases, with nearly 500 patients in critical or extremely critical condition.
However, just two days after Pashinyan’s press conference, Torosyan announced that Armenia had added 350 new hospital beds, primarily by expanding rural hospital capacity across the country. According to Torosyan, medical facilities in the towns of Vedi, Spitak, Dilijan, and Martuni, as well as in Yerevan, had all increased their supplies of available hospital beds in recent days.
In other words, the Armenian government effectively switched tack, in just a matter of days, from warning that the country’s maximum hospital capacity had been reached to announcing that there are now “enough [hospital beds] to serve all patients, even if the [current] infection rate…is maintained.” This change in projection, announced without any clear or detailed explanation to the public on how the government achieved such a positive result, generated a widespread conspiracy theory on Armenian-language social networks, suggesting that now patients can or must pay a bribe to receive a hospital bed.
Although the ramifications for public health are certainly significant, it is no longer just a public health issue.
Armenia introduced strict coronavirus-related social restrictions in mid-March, but without strict enforcement. As economist Hrant Mikaelian has shown using data from the Russian search engine Yandex, Yerevan saw significantly higher levels of non-compliance with social restrictions than neighboring capitals Tbilisi and Baku during their respective lockdowns.
In early May, Armenia became the first country in the region to reopen virtually all sectors of the economy—despite not seeing a flattening of the infection curve. At the time, the Armenian government argued that maintaining restrictions on social activity had proven economically unsustainable. Nonetheless, since the reopening, the country’s infection rate has continued to climb, dwarfing coronavirus figures in neighboring Georgia.
Beyond the public health response, the confusion over Armenia’s hospital capacity also highlights ongoing issues within the government and between state institutions. The extent to which government bodies are successfully coordinating and collaborating with one another in crafting the state’s pandemic response and messaging remains unclear. If, at his press conference, Pashinyan failed to mention the expansion of rural hospital capacity simply because he was not briefed about the development by the Health Ministry—as some observers have speculated—then the entire hospital bed issue is the outcome of intra-governmental communication problems.
At the same time, the confusion over Armenia’s hospital capacity also highlights a deep historical distrust in state institutions among the general public that predates Armenia's independence from the Soviet Union in 1991. Polling data from the Caucasus Research Resource Center from 2017, a year before the Velvet Revolution, show that the majority of respondents reported trusting only two institutions: the Armed Forces and the Armenian Apostolic Church. As a point of contrast, less than 20 percent of respondents reported “fully trusting” or “rather trusting” the president, the National Assembly, and the court system.
Though these figures have changed following the Velvet Revolution—public trust in Pashinyan topped 80 percent late last year—Armenia still grapples with widespread public distrust in state institutions, particularly the police and the judiciary. This deeply-ingrained distrust contributed both to early dismissals of government announcements about the severity of the disease and, later on, the widespread flaunting of social restrictions during the lockdown.
The Armenian public’s lack of trust in state institutions is also reflected in the ease with which conspiracy theories and fake news, including coronavirus-related misinformation, spread throughout the country and on its vibrant social media networks. Many of these stories are pushed by media platforms and civil society organizations associated with figures from the pre-revolutionary government, who retain the knowledge and resources to conduct slick and clever disinformation campaigns against the current administration.
This latest misstep underscores the needs for a strategy to improve public communication and increase trust in state institutions—issues which, importantly, are deeply intertwined. In light of the ongoing coronavirus pandemic in the country, it is imperative that state institutions convince the general public to undertake and respect measures that may run counter to widespread cultural norms in a society that deeply values its traditions. As prominent Lebanese-Armenian health expert Tamar Kabakian-Khasholian has written, a “communication strategy that prioritizes the engagement of the public…is urgently needed to protect individuals and communities, as well as to save lives.”
Read more: Armenia’s Government Has a Public Communication Problem