COVID-19: Pandemic is clearly gathering pace in Hungary

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Hungarian authorities diagnosed 1,141 people with COVID-19 and 11 people died of coronavirus-related diseases over the past 24 hours. The test positivity rate jumped to 7.0%, and a much higher share of hospitalised COVID-19 patients require mechanical ventilation than a year ago. Coronavirus is spreading at an accelerating rate in Hungary.
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The top two charts show the number of new confirmed daily COVID-19 cases (7-day rolling average, green chart) and the percent positive (7-d rolling average, orange). The trough was hit around 4 or 5 July. This does not mean, however, that what the general public calls a ‘fourth wave’ in the pandemic kicked off at that point, no.

This ‘wave’ started at the end of May, only the daily figures did not yet reflect it, because they were concealed / superimposed by the petering out of the ‘third wave’.

There is a much more accurate indicator for the start of such waves, namely the derivatives of 3-day / 21-day ratio of the CFR/OCC rate where CFR is the Case Fatality Rate (CFR = deaths / confirmed cases) and OCC = deaths / (deaths + recoveries).

Charts and insights in association with Balázs Pártos.

June started with slightly more than 300 cases (7-d avg) and a percent positive slightly north of 2.0% (7-d avg). A month later the figures fell to 30 and 0.5%, respectively, and now we are at 750 and 5.6%. Note that these are the official figures, the actual data are higher.

As you can see on the CFR chart below, the CFR curve is not steep enough, and this is exactly why. CFR = deaths / confirmed cases and if there’s such a massive underdetection of cases (mostly those test positive who seek medical help due to severe symptoms) then the CFR will be ’false’.  

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Also note that the daily percent positive hit 7.0% on Wednesday, with 1,141 new cases, 742 in hospital, and 113 on ventilator, which compare with an 8% positivity rate, 920 new cases, 1,538 hospitalised Covid patients, with 156 of them on ventilator a year ago.

When this ’wave’ started, there was a delay of 10 to 12 days, but it is already down to about 7 days. Coronavirus is clearly spreading at an accelerating rate in Hungary.

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The four charts below show the absolute number of COVID-19 patients in hospitals and on ventilators (top two) as well as two ratios (COVID-19 cases in hospital / Active cases, and COVID-19 cases on ventilator / Cases in hospital, bottom two.) The left-hand charts depict a longer period (15 June - 13 Oct), while the right-hand ones show changes over a shorter period (25 July - 13 Oct). 25 July was chosen as the starting point for it was when Covid hospitalisations hit their lowest.

The ascending trend is clear as regards the number of people in hospital and on ventilator. In terms of the number of patients in hospital we are back at early summer levels, i.e. where we were at the end of the previous ‘wave’, whereas there are a lot more people on ventilator than at that time.

The outlook is bad, as both figures are going to rise further.

Authorities will soon report the same numbers as in May, and – if things turn for even worse – it will be April all over again. Overall, those that are in hospital are in a worse condition, which is attested by the fact that their number has been rising a lot more sharply than it decreased before and the steepness of this particular curve is greater than that of hospitalisations.

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The charts below show a sharp rise in the ratio of hospitalised Covid patients to the number of active cases, which came to pass because (i) there are more people with Covid in hospital, and (ii) with the current testing practices the number of active cases is a joke (well, it’s not but whatever). Underdetection at its finest, only the outcome is exactly the opposite of what could have been the original goal.

As for the ratio of those on ventilator to those hospitalised, the 3-day averages show stagnation around 15% for the past week or so. There was a spike at the end of the ‘third wave’ when only those remained in hospital who were in critical condition but then they died and dropped out of this set of statistics. Then the ‘fourth wave’ started where only those in serious condition were admitted in hospitals, hence the steady value of around 15%. We should not expect much improvement in this regard, unfortunately.

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The pair of charts below are entirely different although they both depict how the changes change. Here’s what you need to know about them.

On the left-hand chart the 0% line is important. When the curves are under 0% there’s a decline, when they go over 0% it’s an increase. The changes show that the situation in terms of hospitalisations started to worsen after 20 August.

More importantly, when a value is north of 0% but the curve descends, it means an increase at a slowing rate, rather than a decrease. If the curve is above 0% and ascending, it is an increase at an accelerating rate. When we are under 0% and the curve goes lower, it translates into an accelerating decrease, and when it goes up it marks a decelerating decrease.

Now, the right-hand chart. It looks like an EEG. It’s not clear why the chart looks like that, but the upward or downward spikes occur when there’s very little change in the 7-day averages of active cases (the closer the change is to 0%, the larger the spike is). Again, this has to do with the artificial nature of the number of active cases.

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The next chart is a reversed-scale CFR chart, i.e. whatever you perceive is a rise, it marks a drop in the CFR and vice versa.

If the figures reflected reality more accurately, the chart would be steeper, but with such a dramatic underdetection of new cases the fatalities / registered cases ratio does not change as much officially as it actually does. Simply put, the ‘fourth wave’ is starting to kick in but this chart does not do it justice. If you’re looking for more solid evidence, check the number of people with SARS-CoV-2 in hospitals and on ventilators. That should make the situation pretty clear.

Again, when the CFR drops the pandemic starts to gather momentum, because CFR = deaths / registered cases. There is an increasing number of new confirmed COVID-19 cases but the number of Covid fatalities trails this change with quite a delay. Whatever looks like a drop on the chart, is actually an increase in reality.

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Another interesting phenomenon to round off this charming little story of pain, misery and death.

Focus on the right-hand chart. Can someone tell us what is going on in the realm of quarantines? What is the deal here? How come a lot of quarantines end just before the weekend? The situation cannot even be compared to what we had a year ago. As much as one third of quarantined people were 'let go' this weekend and two weeks before that. Any ideas are appreciated.

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Cover photo: Getty Images

 

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