Scientists have warned that some countries in eastern Europe risk facing repeated COVID-19 restrictions until vaccination rates improve.

Coronavirus infections have risen across the continent as restrictions were relaxed over the summer. But a recent surge in cases has led to the continent experiencing two very different pandemics.

In eastern Europe, Romania and Bulgaria have reported record numbers of daily coronavirus infections. Case rates have increased by more than tenfold in two months to the end of October, when some restrictions were reimposed.

Daily case rates in the UK have also risen to around 70 cases for every 100,000 people and has remained there for much of the summer.

But while the link between infections and hospital admissions appears to be broken in the UK – where two-thirds of the population has been fully vaccinated – this is not the case in many eastern European nations.

In the UK, the number of COVID-19 patients in intensive care has broadly remained flat since September.

However, in Bulgaria, the number of people in ICUs has doubled over the same period.

Hospitals in Romania are also struggling to deal with the inflow of coronavirus patients as ICU admission rates have risen fivefold since September to reach record highs.

Healthcare experts suggest the low vaccination uptake in both the eastern European countries might be to blame.

Less than a third of the population in Bulgaria and Romania have had two doses of a COVID-19 vaccine, which is half the average rate across Europe, according to an analysis of the data from the European Centre for Disease Prevention and Control.

Both countries have now reimposed some restrictions such as mandatory use of face masks in public spaces and restricting entry to large venues to fully vaccinated people.

Scientists suggest that governments will be forced to keep imposing restrictions to prevent hospitals and health care systems from being overwhelmed unless vaccination rates improve.

“The main issue is to get to the people who refused to get vaccinated,” said Dr Dimitri Diavatopoulos, an immunologist at the Radboud Centre for Infectious Diseases in the Netherlands.

Dr Diavatopoulos added that unless the situation with the vaccination rates improves, people will “have to live or deal with this [restrictions] for the foreseeable future”.

The low vaccination uptake has also led to an increase in deaths linked to COVID-19 as coronavirus infections rise.

Bulgaria, which has the lowest vaccination rate in the EU, saw its mortality rate from COVID-19 double in October to reach a record high.

Deaths linked to COVID-19 in Romania have decreased only after the government reimposed restrictions such as temporarily closing schools and mandating curfews on shops and restaurants.

“We are in a disaster situation,” said Dr Raed Arafat, an intensive care physician and government minister in Romania, while announcing the restrictions in October. “We are in this situation while having the vaccine because the majority of us refused to get inoculated. This situation could have been avoided.”

Meanwhile, Portugal – which has the highest vaccination coverage in Europe – continues to see a drop in its relatively low number of deaths.

Bulgaria and Romania are now seeing increased vaccination take-up after plans to make health passes mandatory for entry to most public venues were announced.

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