No epidemiological data suggest Hungary should re-open – virologist

Portfolio
The coronavirus pandemic can be stopped only if everyone is vaccinated against it, old and young alike, said virologist Ernő Duda, associate professor at the University of Szeged. He told daily Népszava on Saturday that in an extreme case the choice will be that either you get your COVID-19 shots, go live like a hermit in the woods, or die.
kórház egészségügy lélegeztetőgép koronavírus járvány

Duda’s key observations were:

  • There are about 2.5 to 3.0 million people in Hungary that are protected from coronavirus, via vaccination (a couple of weeks after their second dose) and infection.
  • It is evident that the pandemic will not end unless everyone is vaccinated. Elderly people and children alike.
  • If it does not work any other way, vaccination must be made compulsory.

Re-opening of the economy already underway

Hungary's Prime Minister Viktor Orbán announced last Tuesday that the re-opening of the economy was starting the next day, as a milestone of 2.5 million people vaccinated against coronavirus (SARS-CoV-2) was reached.

Experts agreed that easing the curbs was premature.

Whereas the herd immunity threshold (HIT) had been around 60% before (the ratio of the population protected from the virus via inoculation or infection), the more infectious and more deadly UK variant pushed HIT to 85 to 90%. And Hungary is still far from that level.

In a co-authored analysis (see link below), Portfolio estimated optimistically that 2.5-2.8 million people are now (temporarily) protected from coronavirus. This implies that the country needs three times as many protected people (preferably via vaccination) to reach the new HIT.

Re-opening not warranted by epidemiological data

When asked if it was the right call to start re-opening the economy in view of the current epidemiological statistics, Duda replied that it was not.

This is clearly a political decision

, and in that sense it was smart because if they do not open now, the popularity of the governing parties will decline. People are fed up with being locked in. Tens of thousands of are protesting against lockdown measures all across Europe. Will it [re-opening] be good? No, it won’t be," said Duda.

There is no epidemiological data that would warrant re-opening.

He stressed that "there should be intensive propaganda stressing the pandemic is not over, wear those masks. And those that do not, should be fined. We don’t need more stringent measures but the enforcement of the existing ones."

Asked if teachers can receive full protection by vaccination by the re-opening of nurseries and elementary schools on 19 April (only the re-opening of secondary schools was put off to 10 May) Duda gave a negative answer.

He stressed that it takes time to build protection against coronavirus, and only those are fully protected that received their second dose and wait for a week or two. He estimates that it could as little as a day to build full immunity after the second shot with Pfizer’s vaccine, and one week in the case of vector vaccines (Russian Gamaleya Institute’s Sputnik V and AstraZeneca’s Vaxzevria).

Duda estimates that besides the 1.1 million people who have received their second jab, there could be 1.5 to 2.0 million people that obtained protection via infection.

This means a total of 2.5 to 3.0 million people could actually be protected against COVID-19 in Hungary, which is 25 to 30% of the population.

He also reminded that the UK variant has the capacity to infect twice as many people under a given period as the previous strain.

Children need to be vaccinated too

Asked about the inoculation of children, he said Pfizer had started clinical trials in the 12-15 age group last October, and found that the vaccine was 100% effective, and that the Chinese are also running trials in the 3-17 age group. Pfizer/BioNTech and Moderna is also launching clinical trials with their SARS-CoV-2 vaccines in age groups spanning from six months to teenagers.  

He reminded that six months ago young people and children had not fallen seriously ill when they contracted coronavirus, but this has changed due to the UK variant.

It is evident that this [pandemic] will not end until we have vaccinated everyone; the children and the elderly too.

Duda noted that high school students will start the next semester vaccinated in the autumn of 2021 and that elementary school students could probably be vaccinated in the spring of 2022.

In a best-case scenario Hungary could also inoculate secondary school and college students by the autumn of 2021. He said there’s already scientific evidence that if teachers and the adults have received their COVID-19 doses, coronavirus prevalence among students also decreases.

This implies that once parents and teachers are vaccinated, elementary school students can also safely go to school in the autumn.

Go get your shot or go off the grid

He thinks the pandemic can end “if society can protect itself, and enforce possibly everyone to take up a vaccine.”

In order to enforce this interest, a drastic means may be deployed in an extreme case, for example, making vaccination mandatory.

"In a democratic country one can trust sensible people realise that it is their interest to be inoculated. If one is in capable of this [realisation] they must be forced. One way is that the police will detain them, and another way is to issue green cards granting special rights to those vaccinated. If one has one of these they can go to the cafeteria, the movies and board airplanes. And if one doesn’t they cannot do any of these things," said Duda.

The latter [group of people] will sooner or later need to make a choice: become hermits in the woods, die out or get vaccinated.

Health care is not the only consideration behind the new strategy

International spokesman for the Hungarian government Zoltán Kovács has just talked to Al Jazeera and has made a remark we have not yet heard before from any government official. Hungarian doctors' repeatedly warned about the rushed and untimely re-opening. Hungary has the highest number of COVID-19 deaths per population, while the cabinet chose the strategy of focusing on virtually random milestones reached in vaccination. When confronted with these factors, Kovács has admitted that epidemiological factors were not the only ones considered here.

He argued that many doctors are of this view "but not all", adding that "very definitely, when as strategy's being formulated,

it's not only the health care element actually which is taken into consideration.

"The Hungarian hospital system is prepared, can care with the burden it is carrying," he added.

We have to take of those actually who were about [to lose] or lost their jobs, so re-igniting or re-starting the economy is another must.

Kovács named another consideration, namely the

MENTAL HEALTH

of "Hungarians who have not been able to go to school or work because they have to take care of their children."

When asked why the government does not allow media to report from hospitals, Kovács replied that public media outlets are allowed and do report from hospitals, adding that

hospitals are there for treating the patients, not for media purposes.

Hungary on top of the world...

Meanwhile Hungary is way ahead of any other country in the world in terms of active COVID-19 cases per population with an index of 2.80%, followed by the United States (2.07%), Slovakia (1.92%), Estonia (1.39%), Lebanon (1.26%), Honduras (1.14%), Bosnia and Herzegovina (1.08), North Macedonia (1.03%), Bulgaria (1.03%), Serbia (0.96%), Czechia (0.94%), Poland (0.93%), and so on.

210411activepopul

In terms of COVID-19 deaths per closed cases (recovered+deceased), Hungary is ranked 10th in the world with an index of 5.21% and preceded only by Mexico (10.29%), Syria (8.96%), Sudan (7.85%), Papua New Guinea (7.44%), Egypt (7.23%), Lesotho (6.31%), Honduras (5.96%), Ecuador (5.62%) and Mali (5.40%). (The data are taken from worldometers.info, but we have removed a few countries, including France, Belgium, Ireland, and Sweden because they either do not provide data for those that recovered from coronavirus or their protocols are so different that they do not even consider people recovered once they tested positive for COVID-19, e.g. Sweden. Microstates have also been left out.)

210411deathsclosed

The rolling 7-day average of new confirmed COVID-19 deaths per million people sadly show that the there's still room for Hungary to go from bad to worse. It is way ahead of everyone in this respect, as well.

coronavirus-data-explorer (9)

And note that the statistics are based on official reports, which show about 23,000 coronavirus victims whereas their actual number is around 31,500 (Operational Corps for 2020: 10,000, KSH for 2020: 7,500+, Operational Corps for 2021: 14,000).

The stats office's figures for 2020 and 2021 are still going to be revised, but if we assume that 10,000 deaths reported by the Operational Corps entailed 7,500 + deaths reported by the KSH, than 14,000 would result in 10,500 deaths and then we're up at 43,000. However, there was no influenza epidemic this year which implies 4,000 to 5,000 fewer deaths than in the previous years.

"Our average 250 deaths [per day] is at least 400 but that's really the lowest estimate," said Balázs Pártos, co-author of our previous analysis, in a post on his Facebook page. He thinks that the ratio of deaths per closed cases is not actually 5.2% because there could be a 3-fold underdetection, "so it's more likely that there are 2.0 million infected, with 40,000 deaths and 1.6 million recovered people. Consequently, the actual rate is between 2.0% and 2.5% instead, but for 10 million people it's still extremely high [...] a lot more than [the number of people that died] in along the River Don.

There were over 8,000 new daily confirmed COVID-19 cases and 245 deaths reported on Saturday.

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