Observations About Armenia’s COVID-19 Response

No country in the world was ready to deal with a pandemic like COVID-19. The coronavirus outbreak left healthcare sectors in some countries on the brink of collapse. In fact, it viciously exposed existing inefficiencies and inequalities and, in some cases, the consequences of systemic corruption and decades of neglect. Some governments utilized lessons learned from previous epidemics but many failed to take necessary precautionary steps to prioritize and protect public health.

As with all countries, the pandemic left its mark on Armenia. Although it is still early to assess the effectiveness of the government’s COVID-19 response, it is useful to review some of the key measures that authorities introduced over the past five months to better understand how we got to where we are now.

Government’s Actions to Limit the Spread of the Virus

Armenia confirmed its first case of COVID-19 on March 1. The patient was a 29-year-old citizen of Armenia, who arrived from Tehran (one of the epicenters of the virus at the time) on a flight evacuating Armenian citizens after regular flights were canceled. Passengers on that flight were asked to self-isolate but were not quarantined.
But even before the virus started spreading in Armenia, the Government had taken a number of precautionary measures. Some of the key actions in January and February were the formation of a special Task Force to prevent the spread of the virus, temporary suspension of the visa-free regime with China, where the virus originated (just two weeks after a bilateral agreement between Armenia and China removing visa restrictions came into force) and closure of the border on February 23 with neighboring Iran. The messaging of the Government in early March, before a national lockdown and restrictions on freedom of movement were imposed, mainly focused on urging citizens to limit non-essential travel to countries where the virus was rapidly spreading. Prime Minister Nikol Pashinyan also pledged to be fully transparent and keep the public constantly updated about COVID-19 developments.

Also, the day Armenia confirmed its first coronavirus case, Armenia’s Minister of Education, Science, Culture and Sport Arayik Harutyunyan announced the Ministry’s decision to move Spring Break up as a precautionary measure and thus shut down all educational institutions for one week. The Ministry decided to reopen all schools on March 9, as no further cases of COVID-19 were confirmed. However, four days later, schools and universities across the country were shut down again as new cases were registered. Educational institutions transitioned to online learning until the end of the academic year and as the number of confirmed cases is not stabilizing, it remains to be seen if schools will reopen in September.

On March 12, eleven days after the first coronavirus case was reported, Prime Minister Nikol Pashinyan returned from a leave of absence he had taken to campaign for the constitutional referendum, which was scheduled for April 5. Following his return, the Prime Minister came under criticism for campaigning and not suspending flights from Italy, which had already reported over 5,800 confirmed cases and 230 deaths as of March 7. Back then, Pashinyan explained that suspending flights from Italy alone would be ineffective because there were no internal restrictions within the EU (at the time); potential virus carriers from Italy could still have entered Armenia by connecting through other countries, he argued.

On March 16, fifteen days after the first coronavirus case was reported, the Government declared a 30-day State of Emergency (SOE). When the SOE was declared, Armenia had 30 confirmed cases of COVID-19, 20 of which were traced back to the city of Etchmiadzin,[1] which at that point was the largest infection hub and had been placed under lockdown a day earlier. In declaring the SOE, the Government also changed the status of the initial Task Force for coronavirus prevention and formed the Special Commission of the State of Emergency, led by Deputy Prime Minister Tigran Avinyan, to coordinate the government response. According to the rules introduced by the SOE, Armenian citizens as well as foreign nationals were prohibited from exiting the country through land borders (except those carrying out cargo transportation). However, there was no government-imposed restriction on boarding flights to leave the country, as long as the airline ran the flight and the receiving country accepted the passenger. All citizens of Armenia and their family members (who are not citizens of Armenia) were allowed to return. Those with special residency permits, representatives of diplomatic missions based in Armenia and their family members, and representatives of foreign states who were in Armenia on official visits were also allowed to enter the country. Those, who, in the preceding 14 days were in highly affected countries (determined by the Special Commission) were not allowed to enter the country (except representatives of diplomatic missions and international organizations and their family members).

The most restrictive measures, however, pertained to the dissemination of information about the virus. Individuals posting on social media platforms as well as media organizations were required to reference only official sources when writing or reporting about COVID-19. If and when these requirements were not met, they were obliged to immediately remove the post. The restrictions, however, were lifted on April 13 (by the decision to extend the SOE for another 30 days) after concerns were raised that the government is overreacting and that the restrictions constitute media censorship.

While some world leaders tried to downplay the seriousness of the outbreak and others framed it as a war against an invisible enemy, Pashinyan’s messaging was more focused on coronavirus being an opportunity for Armenia to retool and expand its economy. His priority was not just effectively managing the crisis but also preparing the country for a post-coronavirus world. While presenting the Law on the SOE to the National Assembly, Pashinyan stressed that, according to some estimates, the world economy will lose about $2 trillion as a result of the crisis and new spaces will open for Armenia to step into. He went on to say that the government’s strategy is to increase Armenia’s presence in the newly-opened spaces and maximize economic activity in the country. Urging citizens to exercise social responsibility and discipline was another key element of government communications when the restrictions on movement were yet to be introduced. Seniors and citizens with pre-existing health conditions, who are particularly susceptible to the virus, were advised to limit their contact with other people and work from home, if possible.

By March 18, Armenia already had 84 confirmed cases of COVID-19 and over 70% of those cases could be traced back to two major infection hubs (the city of Echmiadzin and a factory based in Yerevan). At the time, PM Pashinyan explained that people who had arrived from affected countries but did not report their symptoms were the major reason for the spread of the virus. As a result, the government’s strategy henceforth was predicated on the assumption that people are often unwilling to self-quarantine at home. Testing, hospitalization, contact tracing and isolation were the four key elements of the prevention strategy. Armenia thus became one of the very few countries which hospitalized all confirmed patients, including those who did not exhibit symptoms, and isolated all citizens who had come in contact with an infected patient. However, this strategy was gradually modified as the ability of the healthcare system to expand its capacity met its limits.

Twenty-four days after Armenia registered its first coronavirus case, a national lockdown was imposed. In a Facebook Live, PM Nikol Pashinyan announced that the geographic transmission and the volume of new infections warranted additional restrictive measures to curb the spread of the virus. At this point, Armenia already had 235 confirmed cases of COVID-19. The new decision prohibited the operation of all cafes and restaurants, with the exception of deliveries. Supermarkets, pharmacies and banks remained open but citizens were encouraged to use online services as much as possible. All those leaving their homes were required to fill out a standardized form about their movement and have it along with their ID. Much tighter restrictions on movement were introduced from April 1 to April 13. According to the new decision, everyone was required to self-isolate in their place of residence in order to limit direct contact with others and prevent the transmission of the virus. Free movement of the population was also restricted between the regions of Armenia and the administrative borders of the capital Yerevan. Public transport did not operate, with the exception of trains. People were required to carry a form filled out by the employer if they were going to work.

Underestimating the Gravity of the Situation

Countries around the world were challenged to accurately communicate the seriousness of the disease and, at the same time, avoid panic among the public. It would be fair to say that people in Armenia underestimated the gravity of the situation. PM Pashinyan noted that the government was successful in preventing panic in the early stages of the outbreak, but that it was challenging later on to make sure people took the spread of the virus seriously. By early April, 16 hotels and guesthouses were being used to quarantine people, including patients who tested positive but had light or no symptoms and those who had come into contact with patients who had tested positive. Nine hospitals were fully dedicated to treating COVID-19 patients and the healthcare sector kept increasing its capacity.

Starting from April, Health Minister Arsen Torosyan warned that there is a possibility that the country will reach a point when it will be impossible to trace each new case. Torosyan also warned that the healthcare system will then be forced to only take care of patients with serious conditions and those with light cases will be told to stay home. Although the Government actions were aimed at avoiding such a scenario, two months later, Armenia is in a situation where patients with light symptoms are monitored at their homes and hospital beds are allocated to patients who exhibit more acute symptoms and need treatment.

Thirty days after the SOE was first declared, the Government voted to extend the SOE for another 30 days because the circumstances that were the basis for declaring a state of emergency had not been eliminated. At this point, the Government strategy was focused on ensuring that the number of infected stayed as low as possible and remained manageable for the healthcare system. While presenting the government decision to the National Assembly, Warden of the Special Commission Tigran Avinyan mentioned that Armenia’s demographic patterns showed that a significant number of people are at a greater risk of being infected with COVID-19. Over 12% of Armenia’s permanent population (more than 353,000 people) are at risk, based on their age alone. People with chronic diseases are also in the high-risk group: over 77,000 citizens of Armenia have diabetes, more than 71,000 people have coronary artery disease and over 145,000 people have hypertension.

The strategy also made intensive use of location tracking tools, stricter restrictions and increased testing capacity. The messaging was focused on the fact that people need to learn to live alongside the virus and change their behavior because the country cannot stay locked up forever. The responsibility of the individual in flattening the curve, avoiding unmanageable peaks and neutralizing infection cases among people in the high-risk groups became the focus of the government’s communication with the public. It was in April that the government started recommending citizens follow three simple rules in order to not get infected and spread the virus: maintain physical distancing, regularly wash/disinfect hands and wear a face mask.

After the SOE was extended, the restrictions on the freedom of movement that were introduced on March 31 remained in force until the end of April, public and inter-regional transportation remained shut down, the entrance of foreign nationals into Armenia remained prohibited. Restrictions on economic activity also remained in place, with certain exceptions. But as a number of restrictions were lifted, individual responsibility was increasingly prioritized.

On May 14, the Government decided to extend the SOE for another thirty days. At this point, Armenia already had 3,860 confirmed cases of COVID-19. All of the restrictions that were introduced after the SOE was initially announced on March 16 to ensure that the government had sufficient time to expand hospital capacity were lifted. Public transportation, restaurants and cafes resumed their normal operations, retail outlets re-opened, kindergartens and preschools began accepting children again. Moving forward, the government adopted a decentralized approach to fighting the virus, meaning that, in addition to official government action, each citizen should also take on individual responsibility.

Privacy vs. Pandemic: Government Tracking Mobile Phone Data

Everyone would agree that citizens are entitled to freedom from government intrusion. But in times of a public health crisis, they also have an obligation not to unnecessarily expose their fellow citizens to a deadly virus. The government’s decision to amend the Law on the State of Emergency and the Law on Electronic Communication was guided by this logic.

To strengthen its contact tracing efforts, the government introduced a bill which allowed authorities to track mobile phone data, access citizens’ telephone call and text message history and location data in order to stop the transmission of COVID-19. The government justified the decision by saying that, if a State of Emergency is declared because of the spread of a pandemic, then certain infringements on personal data protection, privacy rights and freedom of communication should be allowed. The bill authorized the government to gather information already available to mobile operators and consolidate it into a centralized database. That bulk-harvested data included the location of users’ mobile phones, the phone numbers of those they contacted through telecommunications, as well as the date, start time and end time of the communications.
The government explained that having all of this information in one place will allow it to take a more targeted approach to identifying the circle of contacts of those who test positive for COVID-19 and place them under quarantine. Armenia was not the first country to introduce such measures in order to increase the efficiency of its COVID-19 response. In fact, the government’s initiative was based on the successful examples of Israel, South Korea and China, which extensively relied on mobile surveillance for contact tracing.

Although the government clarified that the restrictions exclusively pertain to the SOE declared due to the pandemic and that the data harvesting will expire after the SOE is lifted, the bill raised many concerns among opposition political parties, human rights advocates and the public in general. Some of them focused on the issue of oversight over the body that is tasked with both collecting the information and destroying it after the SOE is lifted. Others raised concerns that the measure was disproportionate since calling or texting someone does not necessarily mean that the two came in close physical contact.

Conspiracy Theories and Politicization of Coronavirus

As the COVID-19 pandemic keeps unfolding, the world has found itself in what has been called an infodemic by the World Health Organization (WHO), an excessive amount of both accurate and inaccurate information. For the past four months, the world has been overwhelmed by a daily avalanche of information about the virus, regularly updated and often conflicting guidelines by international health organizations, politicization of the pandemic, a wave of conspiracy theories and much more. This has made it difficult for people to find trustworthy sources of information and has created an overall sense of confusion.

Arsen Torosyan, Armenia’s Health Minister, has reacted to the spread of disinformation and conspiracy theories on a number of occasions. Back in May, Torosyan warned in a Facebook post that, parallel to the increase in the number of infections, the number of conspiracy theorists was also growing. He said that the situation is concerning as many people are becoming complacent to the risks of the disease. “We will be fitted with microchips,” “There is no such disease,” “It will not happen to us,” “It is an international conspiracy,” “It is all a lie,” “It is all so that they can get financing from abroad,” are some of the most widespread conspiracy theories among Armenians. PM Nikol Pashinyan also reacted to lies about COVID-19 not being real and noted that such disinformation is accelerating the spread of the virus.

Interestingly, as the pandemic is evolving, the conspiracy theories and disinformation about it keep transforming along with it. When COVID-19 first began spreading in Armenia in March, the dominating topic in the public discourse was that coronavirus is just a hoax. As the number of confirmed cases started increasing, more people started to be cautious and follow the anti-epidemic guidelines but kept insisting that coronavirus is no more dangerous than the seasonal flu. It is especially dangerous when disinformation like this is spread by people in positions of authority and whose opinions are more likely to be adopted by the larger public. Dr. Hayk Manasyan is just one such example, whose Facebook Lives and interviews about coronavirus have thousands of views. He insists that coronavirus is not more dangerous than a seasonal flu, when, in fact, the World Health Organization (WHO) warned back in March that it definitely was. The WHO explained that people globally have built up immunity to seasonal flu strains, but because COVID-19 is a new virus, people haven’t managed to build up immunity and are more susceptible to infection.
Medmedia.am is an example of an online platform, run by well-known doctor Gevorg Grigoryan, which has been spreading disinformation about the pandemic. The website came under the spotlight of the Armenian public when, on May 28, British news website openDemocracy published an investigation revealing that US taxpayer dollars were funding the news website in Armenia while it spread “incredibly dangerous” COVID-19 misinformation. According to the investigation, the website was launched in 2019 by the Armenian Association of Young Doctors NGO and is led by Grigoryan, who is known for his anti-LGBT views and connections to local far-right activists. The website was established with a US State Department grant meant to promote democracy. Some of the most-read pieces on the site say that COVID-19 is a “fake pandemic” or that Armenia should refuse all potential COVID-19 vaccination programs. Another one claims that a morgue offered 100,000 AMD to relatives of a dead patient, in exchange for signing a document which says that COVID-19 was the cause of the death.

Grigoryan is also a member of the Board of Trustees of Hayrenik Development Fund, founded by the former Head of the National Security Service Artur Vanetsyan, who has been very critical of the government’s handling of COVID-19. Vanetsyan called on the two parliamentary opposition factions to form a special parliamentary committee to look into the Government’s COVID-19 strategy and actions. MPs of the two opposition factions did, in fact, send a request to Ararat Mirzoyan, the Speaker of Parliament to form a special parliamentary committee to determine whether the decisions of the Government and the Special Commission were timely and legal. Mirzoyan approved their request and Parliament will discuss the details regarding the composition of the committee in September.

During the past few months, the conversation about coronavirus has also become politicized. It is especially dangerous when healthcare workers, whose primary concern should be the protection of public health, get involved in such a discourse. Dr. Nune Nersisyan, who is the former director of Masis Medical Center, is one such example. In one of her interviews, Nersisyan stressed that coronavirus was an excuse for the government to cancel the constitutional referendum, scheduled for April 5, because the authorities realized that they no longer had the public support to implement the constitutional changes. Nersisyan is also among a group of doctors who have spoken out against COVID-19 vaccination. She claims that coronavirus is an artificially created virus and shares the unsubstantiated theories about Bill Gates’ involvement in the spread of the virus.

Oversight and constructive criticism (by civil society, opposition political forces, the public) is not only necessary but can be extremely effective during a public health crisis if it is meant to improve a government’s response to a situation such as the COVID-19 pandemic. In such fluid situations, governments need to focus their resources and energy on overcoming the crisis and not having to counter the dissemination of false information, an avalanche of conspiracy theories and come under relentless attack by political adversaries more interested in political dividends than healthcare outcomes. On the other hand, the Armenian government’s communication strategy, in the beginning especially, was at times contradictory and confusing. PM Nikol Pashinyan stayed committed to his earlier pledge to be transparent and from the beginning of the outbreak took on the role of communicating with the public, something that in hindsight should have been handled by medical professionals, epidemiologists, the Health Minister or experts from the National Center for Disease Control and Prevention. Additionally, after strict restrictions on movement were lifted, the main thrust of the government’s strategy was to ask people to exercise social responsibility by following the anti-epidemic regulations. The authorities did not take into consideration that large segments of society would not comply.

All of the latest developments have come to highlight the ever increasing need for better communication strategy by the authorities and media literacy among the general public. Although conspiracy theories are defenseless when confronted with factual scientific evidence, they are not going away and will continue expanding and thriving long after this pandemic is over. But all the efforts of government officials to refute or provide clarifications about every conspiracy theory that is spread online will be of little use if people do not start sharing and consuming information responsibly.

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1. The original case of the infection hub was a woman, who arrived from Italy and despite having a fever attended an engagement party in the town of Etchmiadzin.

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