Hungary gov't to decide on lockdown measures in delicate situation

Portfolio has learned that the government expects the restriction measures implemented on 8 March to start showing convincingly in the number of the daily new confirmed COVID-19 cases in the following days. This means it needs to take a decision in a sensitive situation about the future of the lockdown measures to be in place until 29 March. The epidemiological data we have been seeing do not warrant the easing of restrictions. While there are some slightly reassuring numbers, the health care system is strained to the extreme which pressure should be lowered as urgently as possible. In the following, we take into consideration the factors the cabinet will likely discuss at today’s meeting and later when it makes a call on the lockdown measures.
Orban Viktor koronavirus jarvany kormanydontes szigoritas nyitas 210324

Symptoms of a person infected with the UK coronavirus variant generally show in four to six days (if they show at all). It takes weeks for these people to show up in the statistics. (They feel sick, they call the GP, the GP asks for a test, it takes days until a sample is taken and at least a few more days but usually more to get the results back.) This is why the impacts of the large-scale spread of the virus on the weekend before 8 March started to show in the statistics only a couple of days ago.

According to Portfolio’s information, the epidemiological experts of the government think the first impact of the lockdown measures implemented on 8 March (closure of kindergartens, schools, stores) should be reflected in the COVID-19 stats if the restrictions were stringent enough and if the population adhered to the new rules.

Given that the cabinet extended the stricter lockdown measures only by a week to 29 March, it will need to say something about what’s next in the coming days. And it is in a delicate position because the statistics up to Tuesday evening do not show a convincing improvement in the pandemic situation. Quite the contrary, in fact:

  • On the one hand, the Hungarian Medical Chamber (MOK) released statement on Monday evening, describing a dramatic situation in hospitals and urging the cabinet to tighten restriction measures at once. On Tuesday evening, the President of the MOK recommended a full lockdown of stores apart from grocery stores and pharmacies in a bid to break the transmission chains and give health care some breathing space. The Operational Corps also admitted yesterday that the pandemic is rampant in Hungary and 100% of the samples tested show the highly contagious UK variant.
  • On the other hand, the latest wastewater analyses indicated a stagnation or a decline in SARS-CoV concentration. Also, in four counties where new cases spiked before the upward trend in new daily cases stopped. These might be considered as positive developments, but they are extremely far from being reassuring or convincing. Contrary to what local authorities claim, the results of sewage testing most likely have no forecasting capability in respect of the epidemic curve.

Now that even the MOK urges an immediate stepping up of lockdown measures, we should take a look at the Oxford COVID-19 Government Response Tracker, or more precisely its Stringency Index in Hungary and other countries that are combating the challenges of the third wave in the pandemic.

What can we learn from other countries?

The lockdown measures implemented swiftly in the United Kingdom from early December pushed the Stringency Index up to 88 points (on a scale of 100) by early 2021. The first meaningful easing came in early March when schools were re-opened, when more than 30% of the UK population got at least their first COVID-19 jab.

Ireland was also quick at implementing restrictions, peaking at 88 points on the stringency index that was followed by some easing in early March when the number of new daily cases was convincingly low for weeks.

The Portuguese also responded quickly to the resurgence of COVID-19 cases, and their stringency index was around 82 points in the first two months of the year which helped curb the spread of the virus. (The country’s index was hovering between 76 and 86 points between end-January and mid-March, and 82 points is the average of these values.)

The third wave kicked off in Germany in the last few days, and Berlin decided on Tuesday that above a predetermined threshold in new daily confirmed COVID-19 cases they will automatically tighten measures and that the current lockdown will be extended to 18 April. The country dropped from 83 points in the stringency index and is now expected to return around that level. In retrospect, the end-February easing does not appear to be such a wise choice.

In Central and Eastern Europe, we see different pandemic management approaches, in Czechia and Slovakia, for example. The Czechs went up to 76 points the other day which could help tame the pandemic there.

The pandemic has been stagnating in Slovakia practically for two months, and it have just possibly started to recede at a stringency score of 71 points. The Czech and Slovak examples suggest that looser lockdown measures tend to elongate the hardships of the population because with these the spread of the virus cannot be curbed rapidly and effectively. The UK and Irish examples suggest that strict restrictions implemented with less hesitation are more effective at combating the pandemic, while large-scale vaccination campaigns also help, of course.

Hungary’s 72 points on the stringency index rose close to 80 points with the 8 March lockdown measures, and we should see in the coming days whether these helped achieve a meaningful improvement in coronavirus statistics or not. The extreme stress on hospitals would urgently require some positive changes, and in light of the above examples we can say that

Hungary’s current score on the stringency index may be regarded as ‘normal’, but international examples make it evident that it takes more rigorous lockdown measures to manage the pandemic more efficiently.

Prime Minister Viktor Orbán said last Friday that in his assessment the population would not be able to cope with another set of restrictions therefore a middle-ground solution might be used in the following weeks. The PM reminded that Easter is a particularly problematic period due to increased social interactions therefore it should be treated separately from an epidemiological point of view, given that a jump in mobility could quickly turn things for the worse.

However, more stringent restrictions for Easter could help boost the positive changes that will hopefully materialise by then.

Consequently, we have come up with a couple of scenarios and charts to show what trajectories in the pandemic we could be facing in the coming weeks.

Scenarios for illustration purposes

The scenarios below are just illustrations on what could be ahead depending on what epidemiological situations will materialise and what impacts potential new government measures will exert. The three scenarios show how drastically the interpretation of the situation changes the importance of anti-pandemic measures.

These potential trajectories are likely to be discussed at the government meeting to be held today and next week when politicians and epidemiological experts consult on the period around Easter.

With an admittedly extreme approach as to the potential outcomes, the 8 March lockdown measures are to show us the following results in the following days:

  1. Sharp downward correction

The current lockdown measures will live up to expectations (possibly a bit later than expected) and will dampen the spread of coronavirus rapidly in the following days, thus easing the strain on the health care system. The load on hospitals will quickly return to below capacity and the pandemic will start to retreat. This is an extremely optimistic scenario that would warrant no further restrictions (see the grey lines), because by the time they would start to make an impact, the spread of coronavirus would already be in check.

2. Insufficient first impact

Under the second extreme scenario the 8 March lockdown measures will prove so inefficient that the pandemic will show only a temporary loss of momentum in the following days and then the rapid spread of the virus will quickly become evident again. In this case, new restrictions would be necessary to stem the spread of coronavirus. This is not simply an extremely negative approach, this outcome would be downright tragic, as the number of new daily cases (and deaths) would keep going up for weeks, and the peak to be combated by the more stringent measures would be a lot higher. We don’t even want to imagine the degree of stress on the health care system under this scenario.

3. Wide plateau

In the (extremely wide) gap between the two extreme scenarios above we have the ‘wide plateau’ scenario, in which the spread of coronavirus stabilises in the following days or even starts to decelerate. Infections, however, would remain wide-spread and the load on hospitals would start to decrease only after a while. The wide plateau would lengthens the course of the pandemic, and thus lead to more deaths. Under this scenario, a package of new lockdown measures would not push the peak lower, but at least it would shorten the period when the health care system has to cope with the stream of (COVID-19 and other) patients beyond its capacities.

Critical two weeks ahead, re-opening may be far away

The following two weeks will be critical. For now we need to focus on the curve of new daily cases because the vaccination campaign has not reached a point where it can have a serious dampening impact on serious cases which would ease the load on hospitals.

Orbán said in a video posted on his Facebook page on Tuesday that Hungary cannot re-open until all citizens above 65 who have registered for a vaccine are vaccinated, because that would ‘bring woe to us’.

We estimate that 2.5 million people could be vaccinated (with first shot) by around 14 April, which is still three weeks from now.

In another video he suggested twice that the re-opening plan and its concrete steps need to be drafted over the next month

For a month we work on re-opening, that's our job.

This suggests that an actual, significant re-opening of the economy is not on the agenda and not within reach, and in order to start that there must be at least 2.5 million vaccinated people. (That's 25% of the population, however, and even adding those that officially recovered from the infection (some 600,000) we're still just about 30% while the lowest ratio of herd immunity is 60%. Not to mention that with the more contagious and more deadly UK variant it should be at least 70% or even higher.)

In view of the above, we can expect a protracted system of lockdown measures similar to those implemented in Czechia and Slovakia. This would result in something similar to our 'wide plateau' scenario that will leave the health care system strained for a long time.

In order to avoid that the cabinet might tighten measures by Easter. But, again, this is just an educated guess based on one of Orbán's remarks. Unfortunately, his wording is often vague and confusing and keeps people guessing as to what he could have meant.

Cover photo: Viktor Orbán's Facebook page, photo published on 5 March 2021

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