COVID-19: New cases up 35% w/w, positivity rates on the rise too

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Hungarian authorities diagnosed 8,921 people with SARS-CoV-2 infection, and 73 people died of coronavirus-related diseases over the past 24 hours, koronavirus.gov.hu reported on Friday morning. The number of new cases shows a 37% week-on-week increase and the 7-day average is 66% higher than a week ago. The 7-day average test positivity rate has not been this high since end-November, early December 2020.
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A year ago, the longer-term percent positive averages were all subsiding, while this year the Omicron variant has made sure the fifth wave in the coronavirus pandemic starts before the fourth wave is over. It is spreading extremely fast, doubling the number of cases every two days.

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As the erratic testing practices have rendered the daily and even the short-term average positivity rates practically useless, we need to use longer-term averages to see where the pandemic is headed.

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Here's our 'new' indicator, the 7-d / 28-day average and its 7-day average, for two periods: starting from 1 October 2021 and starting from 1 September 2020. Both are at their mid-Nov levels.

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The 7-day rolling average of new COVID-19 keeps on rising, and the number of Covid deaths is likely to follow suit, unless the Omicron variant causes less severe disease than Delta. While this may be true on average, experts of the World Health Organisation (WHO) warned against taking Omicron lightly.

Maria Van Kerkhove, the WHO’s Covid-19 technical lead, warned earlier this week that "it is not just a mild disease", stressing that "this is really important because people are still being hospitalized for Omicron."

Dr. Mike Ryan, director of the WHO’s health emergencies program, said on Wednesday that Omicron represents a “massive threat” to the lives of the unvaccinated.

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How's the situation in hospitals?

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On the charts below the 0% line is important. When the curves are under 0% there’s a decline, when they go over 0% it’s an increase.

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. As you can see, we are witnessing the latter here, and there was a turnaround in the improvement around 27-29 December. The number of active cases started to go up at an increasing rate at that time and the pace has only picked up. The changes in terms of hospitalisations and mechanical ventilation have been showing a similar start but then a different and mixed pattern.

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What do the changes mean?

The chart below shows the number of hospitalised Covid patients as a percentage of active cases and the On ventilator / In hospital ratio.

When a pandemic 'wave' starts, the percentage of hospitalised patients relative to active cases always soars, because there is still a relatively low number of official cases due to inferior testing practices, and because early on most people with positive tests are likely in hospital.

The green curve peaks around 7% in every 'wave' and then the ratio starts to drop as authorities 'find' more and more infections. The reason why this curve starts to descend even though the number of hospitalisations goes up drastically is because the increase in new confirmed COVID-19 cases is even more staggering.

When there's a relative calm, the red curve picks up sharply, because only those Covid patients are left in hospital that are in severe condition. The others either recovered and were discharged or died.

Early in these waves this ratio always rises rapidly (low number of tests, many in severe condition in hospital, a lot of them in ICUs), but then the ratio starts to improve.

There was an anomaly here, namely that this trend was broken in late November 2021. The proportion of those in hospital to active cases starts to drop, but the proportion of Covid patients in intensive care (relative to those in hospital) goes up. This indicates that there are too few people in hospital compared to before, i.e. there are more serious cases. As it is not the course of the disease that has become more severe, this indicates insufficient hospitalisation. As the number of active cases is on the rise, while the number of Covid patients in hospital is still dropping, the In hospital / Active cases ratio keeps on falling, while the other ratio (On ventilator / In hospital) remains largely unchanged; it has been hovering around 13.3-13.4% for more than two weeks now. (The ratio is currently down at 13.1%.)

Vaccination stats, 4th doses to be available

While about one third of the population (3.3 mn people) are inoculated with three doses of COVID-19 vaccines, about 3.5 million people have not received a single shot yet. Also, as the effectiveness of vaccines wanes over time, about three million Hungarians have diminished or no protection against coronavirus infection, even after two jabs.

The cabinet has announced a new vaccination campaign for January where Hungarians may, after on-site registration, ask for their first, second or third dose of a COVID-19 vaccine. The shots will be administered at vaccination locations between 2 and 6 p.m. on Thursdays and Fridays and between 10 a.m. and 6 p.m. on Saturdays.

Hungary is to make a fourth COVID-19 shot available to people who ask for it, after a consultation with a doctor, Prime Minister Viktor Orbán's chief of staff, Gergely Gulyás, told a news conference on Thursday.

Anyone can get a fourth COVID-19 shot based on a consultation with a doctor, the (government) decree about this will be published this week,

said Gulyás.

On Wednesday, Denmark said it would offer a fourth coronavirus vaccination to the most vulnerable citizens.

The European Medicines Agency (EMA) has expressed doubts about the need for a fourth dose and said there was no data to support this approach as it seeks more information on the fast-spreading variant. Chile and Israel have already begun a rollout.

While use of additional boosters can be part of contingency plans, repeated vaccinations within short intervals would not represent a sustainable long-term strategy,

the EMA's Head of Vaccines Strategy, Marco Cavaleri, told a media briefing earlier this week.

The official raised concerns that a strategy of giving boosters every four months hypothetically poses the risk of overloading people's immune systems and leading to fatigue in the population.

Hungary was the first country in Europe to authorize the administration of a third dose in early August. Therefore, those who were among the first to take it (especially doctors, the elderly, those immunocompromised) might need their second booster shot as early as February.

Prime Minister Viktor Orbán was also asked about the possibility of a second booster shot at a nearly four-hour press conference he held at the end of last year.

“If I have to go for a fourth vaccination, it will be difficult for me,” he said, adding he was disappointed that he did not know how many vaccinations would be needed.

Do we need a fourth? Also a tenth? Will we look like Emmental cheese?

The Embassy of Switzerland in Hungary did not particularly like this comment, and even posted on its Facebook page to this end.

Encouraging the public to get a third dose of a COVID-19 vaccine, it said: "As far as Swiss cheese is concerned, we firmly believe that the holes do not result from the vaccination. But we know for sure that Swiss cheese and a delicious Swiss fondue create a good mood and are solid boosters for a good spirit!"

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Cover photo: Getty Images

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