Prime Minister Kyriakos Mitsotakis participates in the digital conference “Beyond the Pandemic: A Radical New Approach to Health Security”

(Γ.Τ. Πρωθυπουργού/ Δημήτρης Παπαμήτσος)

Prime Minister Kyriakos Mitsotakis participated in the digital conference “Beyond the Pandemic: A Radical New Approach to Health Security” organized by the Eurasia Group Institute of Geopolitical Analysis and the organization Flagship Pioneering.

The Prime Minister had a conversation with the moderator Meg Tirrell, CNBC journalist and Moderna CEO Noubar Afeyan and Eurasia Group President Ian Bremmer.

Meg Tirrell: Okay. First Mr. Prime minister. Back in April 2020, there was a New York Times article that said that Greece was defying the odds and managed to avoid the devastating scenarios playing out in Italy, Spain and later in the UK. To what do you attribute that early success with the pandemic? And then perhaps the surge that we saw later for Greece?

Kyriakos Mitsotakis: It was not rocket science. We listened to the scientists. We took decisions early. We shut down the country probably earlier than most other European countries. And one of the reasons I had to take that decision was the fact that, although we had a national health system, it was underfunded after 10 years of crisis. So I knew our capacity in terms of dealing with the pandemic was relatively limited. When we took over we essentially had 600 ICU beds for the entire country for a population of 10 million. We knew that was not enough. So we needed time. Essentially we avoided, we completely avoided the first wave. We were obviously not able to avoid the second or third way, but overall Greece, a country which was battered by the financial crisis has done better than most EU countries, certainly better than richer countries with better organized healthcare systems.

And of course, we also used that time window to strengthen the basic infrastructure of the system. We added ICU beds. We’re now close to 1,500 ICU beds through a very aggressive investment plan. We hired people. So essentially we were able to overcome chronic shortcomings of a national health system to make sure that we address the immediate emergency. Of course now, as you pointed out – the real challenge is how do you build a healthcare system for the next century? Our healthcare system essentially is four decades old. We saw its limitations, but we also saw tremendous determination and commitment by our healthcare professionals. So in that sense, on certain fronts, we exceeded expectations.On others it was very clear to me that there’s a lot of work to be done going forward. So I think I will very much take the point that Ian mentioned, you know, at some point I do agree the pandemic is going to be over at least for the richer countries.

And I think there is a general tendency to forget things that have been extremely painful. It is our obligation to make sure that we use the lessons of the pandemic to strengthen both our healthcare system, but also our public health policies. And that is certainly a task that my government takes very seriously. We have significant additional funding provided now by the European Union, through the Recovery and Resilience Fund. We also have the political commitment necessary to drive through change that sometimes is politically delicate or difficult. Frankly, having faced what we had to face, the horrible loss of life, for me there is no excuse whatsoever not to invest smartly -it’s not just about money. Invest smartly in our healthcare system, use the best available technology and make sure that whenever there’s going to be a next pandemic, we will be better prepared.

Meg Tirrell: Let’s talk about reopening. You know, of course, the pandemic was a blow economically for a nation that depends so deeply on tourism -roughly 20% of your economy. Your Tourism Minister declared in May that Greece is opening up to the world again, how do you plan to do that safely?

Kyriakos Mitsotakis: First of all, our plan is to open up safely. We will not compromise the safety of tourists, we will not compromise the safety of the local population. But we have additional tools at our disposal, which we didn’t have last year. Let me just give you an example. Last year, we received 25% of the annual number of visitors to Greece. And of course it was very, very painful economically. This year we are able to use what was a Greek proposal which was adopted by Europe, the digital COVID certificate as a tool to facilitate at least intra-European travel. So we need proof of vaccination or proof of illness or proof of a negative test. And we did manage to get the European Union to agree, which is not easy as you, as you know, in two months to develop this tool, which is incredibly valuable to us because it makes our lives much easier. So we have additional tools.

Even last year, we employed a very clever artificial intelligence algorithm that helped us with our testing capacity, in order to be more targeted in terms of our testing. And of course this year we also have an additional tool which we found in Greece -again, I’m always eager to share experiences and to listen to what other heads of state and government have to tell us- but we used self-tests very aggressively over the past two months. We distributed them for free to almost everyone; everyone who’s employed had to have one or two tests a week. We opened our schools using self-tests. We found lots of asymptomatic positives through our self-tests, which were later confirmed. I think one of the reasons why we’ve done very well over the past couple of months in bringing our numbers down also has to do with the fact that we have a much better understanding regarding the patterns of the pandemic.

So, we intend to open up safely. There’s a lot of interest. People want to travel, that’s the one thing we know. When we ask people “what’s the first thing you want to do after the pandemic” they tell us “I want to take a trip”. And so we want them to come to Greece, but we want them to be safe. We have all our healthcare protocols in place. We still do a lot of additional testing. And we’ve also done something which I think is interesting: we’ve accelerated vaccinations on our islands. So we said “let’s put our lives as the number one priority”. Especially our smaller islands are practically fully vaccinated. So that also gives people the comfort that they come to a place which is relatively safe. And I do expect the numbers to go down further as we increase vaccination. As you know, the EU is probably two to three months behind the US in terms of vaccination pace. But we in Greece today are vaccinating 100,000 people per day. That’s 1% of our population every single day. So every week it makes a difference, every month makes a huge difference. So we’re catching up very quickly and come July, August, September, the months when we really expect most of our tourists, I think we’ll be in an even better shape.

Meg Tirrell: You mentioned a proof of vaccination or a negative test. That has been a real hot button issue here in the United States. What is the kind of cultural acceptance of that over there? In political acceptance, has there been pushback or are we a little different here than the United States?

Kyriakos Mitsotakis: There’s a big debate as to whether vaccinated people -it’s starting now in Greece- should have special rights or special privileges; and how do we treat the vaccination skeptics from a political point of view but also from a legal point of view.

We are not there yet, because in order to have this discussion you need to give access to the entire population in terms of vaccines. And we’re probably going to be opening up all age groups, including the 18 to 25, within the next weeks.

Once we give everyone the right to get vaccinated we can start talking about facilitating those who are vaccinated, but it is essentially already happening: when we ask people to take, for example, a self-test before they travel or we ask for a proof of vaccination. If you’re vaccinated, you do it once you’re done, otherwise, it’s going to be constantly very complicated for people to prove that they are negative.

But I think the real challenge is not going to be during the summer, because in Greece everyone is outdoors during the summer. It is by definition much safer and the summer is a better period than the winter. Come winter, when we will start moving indoors, that’s going to be an interesting question.

And I think it is also a question that is going to be addressed by the market. I’m sure there will be many restaurants who tell us, and we will give them the right to do so, that “we only accept vaccinated clients”. And people will realize suddenly that if they’re not vaccinated, especially our youth, they don’t have the same level, the same freedom as the other vaccinated people in the same age group.

And of course the challenge is with those who are in the older age brackets. I was looking at the data now, we have approximately 360 people in ICU beds; all with the exception of five were not vaccinated. So it is very, very clear what is happening.

Those are people who had the chance to be vaccinated and didn’t choose to do so. It’s not just a question of social responsibility, people who are older need to get vaccinated because they can die, they can get sick and they can die. And I think we’re trying to make that argument in the most convincing manner, but at some point there is going to be a distinction between those who have been vaccinated and those who are not. And if it’s not going to be a regulatory distinction, I’m pretty sure the private sector is going to adapt to that reality.

Meg Tirrell: So you mentioned that the EU is a few months behind the US and the UK in terms of the pace of the vaccine rollout. You’ve been critical of the EU’s pace. Why do you think it lags behind the US and the UK?

Kyriakos Mitsotakis: I’m sure Noubar also has experience in the negotiations that took place between the EU and the big pharmaceutical companies. Yes, it’s a pity that we’re behind their pace. Having said that, representing a medium-sized European country, I am happy that the EU decided to purchase vaccines collectively and distribute them pro rata. I don’t want to be competing with Germany, France or Italy in a vaccine race.

So I think this was an important political decision taken by the EU. And the fact that we’re also thinking now regarding booster shots, purchasing vaccines for ‘22-‘23 and again distributing them pro rata, is an important demonstration of European solidarity. So, yes, there were problems in terms of delays, you know the EU is not always the fastest supranational institution, but we need to coordinate policies amongst 27 member states.

But the decision in itself was a very important decision and I certainly welcome it as the head of government from a medium-sized European country.

And I think there are also two other aspects, two other policy areas where the EU has done well. For example the digital certificate. Normally, in order to get a regulation approved, which is essentially legally binding in Europe -Ian knows- that needs two years on average to get a regulation approved, we did it in three months. So there was a sense of urgency.

And, and of course, the fact that we have mobilized significant resources at the EU level, through the Recovery and Resilience Fund, is tremendous. I mean, we essentially did what nobody thought could happen: we borrowed at the European level. I wrote a letter in March 2020 with eight other heads of state and government, to the President of the Council asking him at the time to consider such an instrument. It was inconceivable at the time that this could happen, and it did happen. So it is an important step towards European integration.

My country, Greece, will receive 32 billion euros, 19 billion in direct grants for investments and reforms. We submitted a good plan that focuses a lot on digital transformation and the green transition. This is really significant, it gives us a lot of comfort that it can also leverage private capital to really change the country in terms of driving through meaningful investments, including in healthcare and in digital health.

The one thing which a lot of people were surprised with was how quickly we drove through the digital transformation in Greece during Covid. Our vaccination campaign was fully digital. It was a big success and people are pleasantly surprised by the ability of the Greek state to deliver on such a complicated process. So, digital health and the digital transformation is a huge opportunity for a country such as Greece, we can actually leapfrog other countries if we do it cleverly and now we also have the funds to do so.
Noubar Afeyan: One question I have for the prime minister, and (then I’ll bring him in to have a question himself). We’re talking about leadership now and pandemic preparedness,of course, the G7 leaders are convening in UK later this week. Mr. Prime minister, what do you hope to hear from them about pandemic cooperation as they get together?
A: Well, there’s only –again- that much smaller countries can do in terms of global cooperation. And certainly we will be looking for leadership by the big players. And I think the observation that there was very little coordination at the beginning is correct.
I very well remember during the first days of the pandemic this scramble to get access to personal protective equipment. I mean, it was just like the Wild West. I mean, everyone was in there for themselves and I guess now and I think they’re important questions. I mean, we’ve all purchased more vaccines than we needed just to be on the safe side. So what do we do with the excess vaccines? When do we actually start distributing them? When do we feel safe to make a commitment to the rest of the world to help them? Because we know we’re not going to be completely safe until we have dealt with this disease- everyone. Because again -I’m not a doctor- but I guess the big fear is variants, mutations, what could happen somewhere, which would make us start again from scratch.
Do we, or don’t we vaccinate kids? Are these vaccines better use, are these vaccines more valuable if you look at global health, if they were given to Africa?
So these are important topics where we certainly will be looking for global leadership at the level of the G7. And again, at the European level, I think we played our part after some initial delays. I think we’ve done a good job in terms of allocating vaccines among member states and planning for the future. But these are some of the topics that certainly will be very interested in being addressed at the level of G7.
Ian Bremmer: His country has gone through a great depression that has been deeper and broader than a great depression in the United States. And his people knew, and he knew as Prime Minister that when this pandemic hit, there was no margin for error. So they actually learned the lesson from a completely different crisis that they had to respond immediately with expertise with science and without politics to effectively combat this crisis with a healthcare system that no way could handle that kind of hit that the Americans in principle should be able to handle.

Thank you Ian for your kind words. The Greek experience is sort of unique because we went through so much of the past decade, but I think it’s probably an interesting part of the story that we did come off strong. Our democracy I think is stronger now, it’s not sort of a written on the wall that economic crises inevitably lead to more authoritarian responses. It did not happen in Greece.

But I think there was certainly a moment where Europe, especially Northern Europe, in particular Germany, realized that mistakes were made during the economic crisis of the last decade and that they simply cannot be repeated. So that we really need to take the risk to spend more, the ECB got that immediately, and at the level of fiscal policy, we were willing to essentially say “Look, we cannot let countries such as Greece incur additional debt. Let’s take that debt on the European level. And let’s give these countries the ability to spend money, invest money, but do it wisely in order to make sure that they overcome the crisis, but they also drive the important changes that are at the core of the European agenda.

And I think the real challenge now is to make sure that we make good use of the money that is available. That I think will also determine at the European level, whether this is a one-off instrument or whether this is something which could be repeated in the future. So we have to prove not just to Europe, but also to Greek citizens that the money that was actually raised at the European level during the pandemic is used wisely, especially when it comes to the green transition, where we have a very bold agenda.

We decided to shut down more coal-fired electricity plants by 2023, which is very bold given how dependent we were on brown coal (lignite). But of course, we need funding to fund the transition to make sure it happens in a just manner. So I think what is at stake here is also the ability not just of Europe, but of member states to become at the national level, more competitive to stick to our targets.

We want to be the first continent to be climate neutral in 2050, but of course this is not only going to happen at the national level. And we have a big discussion ahead of us. We’re waiting for the recommendations of the Commission. How are we going to achieve that goal? And of course we need additional funding to do and we need to make sure we’re doing it in a way that does not shatter social cohesion.

So some of these challenges I think have been well-understood that I can tell you at the level of the Council, because we spent hours, days and days, you know, thinking through the unthinkable, I think we’ve all realized that that, you know, these black swan events are really not that unpredictable after all, a lot of people were talking about this and no one was listening.

So we cannot afford not to be better prepared to beat, you know, strategic issues of strategic autonomy investing in, as you said, not just in our healthcare, but also in our, in our public health. The one thing I always asked our ICU doctors was who are the ones who really get sick. And, you know, there was a clear correlation between obesity and, you know, really having a higher likelihood of getting really, really sick. It’s not just about, you know, the pandemic, it’s about the long-term diseases that have to do with our lifestyle.

Maybe, you know, Greece has something to teach the world in terms of moderation, you know, the Mediterranean, the greek diet and having a healthy lifestyle, surely this is a big part of our theme as we try to grow out of this crisis.

Meg Tirrell: I know when I have been in Greece I just eat a lot of your cheese, which is wonderful so I’m not sure I have learned the lessons of moderation.

Kyriakos Mitsotakis: Goat cheese is healthy and if you want to eat meat, prefer goat to beef. It certainly has a much lower environmental footprint.

Meg Tirrell: I’ll take that into consideration. Thank you so much. This wonderful conversation. We really appreciate you being with us.