The mortality rate in Bulgaria is among the highest in the world, despite the adequate resources and vaccines. This is presented in the audit report conducted by the National Court of Audit for the first two years of the pandemic.

The lack of an effective vaccination campaign contributes to this. Despite having sufficient quantities and the freedom to choose vaccines, the country is experiencing a slow vaccination process, with only around 30 percent vaccination coverage.

The report provides comprehensive information not only on the measures taken and their implementation but also on the impact of the pandemic on the entire healthcare system, as well as on the socio-economic life in our country.

At the onset of the COVID-19 pandemic, strict anti-epidemic measures resulted in significantly lower excess mortality in Bulgaria compared to the EU average. However, in 2021, an opposite trend is observed, with Bulgaria's average excess mortality significantly exceeding that of the EU.

According to data from the Ministry of Health's COVID registry, a total of 29,238 individuals have died from COVID-19 from the beginning of 2020 until the end of 2021, with 8,031 deaths occurring in 2020, including 100 healthcare workers, and 21,207 deaths occurring in 2021, including 78 healthcare workers. Among the deceased healthcare workers, the number of doctors exceeds that of nurses. The highest mortality from COVID-19 has been registered in the city of Sofia, while the lowest has been recorded in the Targovishte region. The highest mortality is among individuals aged 70-79 years – totaling 10,894 individuals, and among those aged 60-69 years – totaling 7,114 individuals. The lowest mortality is among individuals aged 0-19 years – 24 individuals, and those over 90 years old – 724 individuals.

In 2020, COVID-19-related deaths comprised 6.9% of the total fatalities in the country, whereas in 2021, this figure rose to 18.5%, according to statistics from the National Statistical Institute (NSI).

The number of laboratories conducting virus detection tests increases from three at the beginning of the pandemic to 123 by the end of 2021. However, the uneven geographical distribution of these laboratories in medical and healthcare facilities hinders access for a significant portion of the population in small towns and three provincial centers.

The emergency medical teams have served 670,244 emergency patients. A total of 634,627 COVID-19 patients have been served by general practitioners.

During the period 2020-2021, hospitals admitted 211,760 patients for treatment, accounting for 28% of the total confirmed cases. Among them, 17,783 were admitted to intensive care units, representing 8.4% of hospitalizations. These patients were treated in the absence of established medical standards for anesthesiology and intensive care in Bulgaria.

In 2021, the number of hospitalizations nearly triples compared to 2020. The highest number of hospitalizations is reported in the regions of Sofia City, Plovdiv, Varna, and Blagoevgrad.

By the end of 2021, there were enough vaccines delivered for the entire population and for those passing through the country. However, only 29.8% of people have completed their vaccination course. The highest number of completed vaccination courses is in the age group of 40 to 69 years.

Due to the low vaccination rate in the country, there is a risk of vaccines being discarded due to expiration before use. As a result of the conducted audit, 11 recommendations are sent to the Minister of Health. He is required to take measures for their implementation and to inform the Chairman of the National Audit Office in writing about it by October 31, 2024.