COVID-19 in Moldova: flying blind through the storm. Op-Ed by Ala Tocarciuc

“We are flying blind through this storm and want to clear it as soon as possible. Today we have two options: guide ourselves out of it or wait for the tide to turn. To be able to navigate through this storm, we need to take prompt and right decisions, from the ones, guiding us...”

The COVID-19 pandemic is often compared with a storm, which came unexpectedly and generated several crises across the World. From them, the sanitary crisis and the data management in the healthcare, have proved to be the biggest challenge.

To be able to provide a quick and efficient response to a crisis, it is key, to develop a mechanism for rapid and coordinated decision taking. These decisions need to be based on real time processed data, collected and analysed daily, by the public health system.

Several platforms for collecting COVID-19 data, including on-line dashboards, have been activated in Moldova. Some local experts are analysing the official numbers on a weekly, bi-weekly, or monthly basis, deriving forward looking evaluations and suggestions.

These delivered forecasts apart of a feeble attempt to navigate through the deep fog – fact already confirmed by multiple international experts. The quality of primary data, their inconsistent sources, as well as the diversity of applied models are among the key factors, hindering us from delivering long term reliable forecasts.

Data sources

Moldova has only one primary source of COVID-19 data, namely the State Agency of Public Health. The way these statistics are collected, is unclear and lacking transparency at this moment, raising a big question mark about the quality of the data. The daily consolidation of new cases data, received from the labs, indicate them as a key data source. We assume, that the statistics concerning the severe cases come from medical institutions, which are involved in their treatment. Otherwise, a high level of ambiguity is dominating the data collection process. No independent instruments of validating the received statistics or alternative data collections exist today in the country. So, the only option we have today, is to take them at their word. Despite this, being at the core of public debates almost daily, since the beginning of the pandemic, the data collection process has never been explained to the public.

Pandemic evolution

Several experts express their opinion upon the frequency of information collection and its analysis. Some claim, that we should focus on the 7 days numbers, as this is the length of the incubation period for this virus in Moldova. This despite the fact, that WHO is looking at statistics over 14 days, which reflects the official global incubation period for this virus. Newly, data across periods of 21 or 28 days is being used, to derive the longer-term exponential evolution line of the pandemics. However, all these methods are only yielding credible results, if underlying figures are from reliable and verified sources. Irrespectively of applied methodology, using of trustful data, should drive the same long-term evolution.

Why do we need a reliable and correct data?

The COVID-19 crisis faces us with an array of critical decisions. These decisions can be taken in a sound way only based on veridic and accurate data. For example, we wish to re-open schools and kinder gardens. To be able to take this decision, we need to know the number of cases across 100 000 people (incidence). Assuming we would have 1 confirmed case to 100 people within this community, for a school of 500 pupils, the probability is high, that 5 COVID-19 cases would be present at September 1-st. Should we have 1 case for 1000 people, chances are high, that no COVID-19 cases would be present within the same school. How do we know exactly the number of infected people within this community? Only from reliable and correct data.

These statistics are essential not only for the Government, but also for us, to be able to take the right decisions and protect our children.

Why are we flying blind through the storm?

The number of tested people and of serios cases is not enough to assess the progression of this pandemic. Further statistics are required.

Some countries use the hospitalisation figures, others look at the incidence of the primary care visits.

Some countries apply contact tracing statistics and study the level of the herd immunity. Various formulas, rates and logarithms are applied to derive a short term 7 days forecast.

Moldova could benefit from these epidemiological models, to evaluate and predict the short-term developments and prevent some local outbreaks. Nevertheless, it is critical to understand, that no model will bring us out of the fog, if the quality of the primary data is low and the validation tools are missing.

We are flying blind through this storm and want to clear it as soon as possible. Today we have two options: guide ourselves out of it or wait for the tide to turn. To be able to navigate through this storm, we need to take prompt and right decisions, from the ones, guiding us.

The Moral of the story is simple! The quality of the taken decisions rely on the underlying data. Without accurate and veridic data, it is almost impossible to clear this storm in a controlled way.

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