Citizens of Bulgaria and Romania—the European Union's least vaccinated countries—are preparing for the next wave of COVID-19 as the Omicron variant rapidly spreads around the continent.
Health experts across Eastern Europe worry that holiday gatherings will only exacerbate the situation, with officials in both Romania and Bulgaria saying to expect big surges in the new year.
Bulgaria is the 27-nation EU's least vaccinated nation with only about 32 percent having received two doses and even less having received a booster shot. Mariya Sharkova, a public health law specialist based in Plovdiv, told the Associated Press the country can expect a fifth wave by early next year.
"Epidemiologists predict that wave five will hit Bulgaria at the end of January and probably harder in February," Sharkova said. "Holidays will bring Omicron to Bulgaria and probably will have a negative impact on the spread of COVID-19."
Romania is the second-least vaccinated EU nation, with about 40 percent of the population having two doses. About 75 percent of the vaccinated population has not yet gotten a booster, according to Adriana Pistol, director of Romania's National Center for Surveillance and Control of Communicable Diseases.
Pistol warned that during the upcoming fifth wave, Romania could see as many as 25,000 cases per day, as about 60 percent of Romanians who have chronic illnesses or are over the age of 65 are not vaccinated.
"Even if the Omicron strain does not have the same level of severity(,) ... the health system will be overloaded anyway and reach levels recorded this year in October," Pistol said.
Romania saw huge lines at borders before Christmas as hundreds of thousands of citizens flocked home, many from the West. The government started requiring travelers to complete passenger locator forms as of December 20 to help track infections, but Pistol said many have failed to fill them out.
Romania's underfunded public health system teetered on the brink of collapse a few months ago, during the country's last explosion of virus cases. Hospital morgues ran out of space for bodies, and some patients were transferred abroad for treatment because COVID-19 intensive care units were filled to capacity.
Exhausted medical personnel watched with dread as countries with high vaccination rates such as France, Italy and the U.K. reported record cases as Omicron spread in recent days.
"It's very clear that the fifth wave will probably hit us in January," Dragos Zaharia, a primary care doctor at the Marius Nasta Institute of Pneumology in Bucharest, said. "We just hope that there will be fewer deaths, fewer severe cases, and fewer hospital admissions."
In the Balkans region of Europe, Bosnia, Slovenia, Serbia, and Croatia have all confirmed Omicron cases but so far not tightened restrictions to control the variant's spread.
Serbian authorities decided this week to allow planned outdoor concerts to go ahead on New Year's Eve. Experts opposed the move and called for requiring COVID-19 status passes for 24 hours due to Omicron concerns.
"We are aware that a significant number of our nationals will return home from the European Union for holidays, as well as...foreign guests visiting our ski resorts," said Goran Cerkez, the assistant health minister in the larger of Bosnia's two highly autonomous regions. "But we hope that we will weather what is ahead of us."
The Czech Republic, which has a population of 10.7 million, is among the European countries hardest hit by the pandemic and is currently registering around 6,000 new cases a day. The country's Health Ministry on Wednesday estimated the Omicron variant currently accounts for about 10 percent of all new cases and by January 10 could be 25 percent.
Some experts are cautioning against taking comfort from preliminary studies that suggest the Omicron variant causes milder cases of COVID-19.
Mircea Iliescu, a Romanian doctor in human evolutionary genetics at the University of Cambridge, says that even if that is the case, Romania still "has a lot of people susceptible to hospitalization."
"We can only assume that many cases being transmitted now are Omicron, since it's transmitting so fast compared to Delta," he said. "If other countries are now getting towards it being the majority strain, we should be getting there in a couple of weeks."
Despite concerns over the variant, Romanian authorities eased some internal restrictions in early December and are allowing businesses to stay open all night on New Year's Eve.
Andrei Otelea, 31, who lives in the U.K. and is unvaccinated against COVID-19, arrived with his young family at Sibiu International Airport in central Romania on Tuesday, returning home for the first time since the pandemic started.
"We are a little bit scared (of visiting grandparents), but we're going to go and keep our distance for the moment," Otelea said.
The Associated Press contributed to this report.
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