Do we have a public health emergency or not?? Op-ED by Ala Tocarciuc

My conclusion is that we are trapped in a regulatory trap. We decide by indicators, and it seems that we decide correctly, following the approved algorithm of decision-making. At the same time, we allow the virus to spread freely in the community. The consequences can be unpleasant for all.” ...
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In April, we were all concerned, and here I am referring to the people of Moldova, by contradictory reports about the emergency situation determined by COVID-19.

We even lived a few days in complete relaxation, without any pandemic restrictions. At the end of the month, i.e. On April 29, the National Emergency Health Commission issued a decision No. 54 of April 29, 2021, which noted:  "Since April 29, 2021, in administrative and territorial units for which the Red Alert Level is established, based on the COVID-19 incidence rate over the last 14 days, more than 100 cases per 100,000 population, administrative territorial health commissions establish a state of emergency in health.”

How do we interpret the document?


I have read this document carefully several times to make sure that I have understood the Commission's message correctly.

According to the document, the Republic of Moldova as of April 29, 2021 as a country does not have an emergency and is not in a state of public health emergency.

Only administrative-territorial units, where more than 100 new cases per 100,000 people are recorded in 14 days, will have to establish a public health emergency state.  

I decided to look at the situation in the light of numbers. There are several digital platforms that analyse COVID-19 data for each country. None of these platforms guarantees us correct numbers. Their functionality is based on computational algorithms, which do not always consider the local specifics of the situation.

The "number of new cases per 100,000 population" on almost all these platforms are easily calculated. The difference in this indicator is determined by the total population used in the calculations. For example, the WHO platform uses 4.044 million people for Moldova. Other platforms, such as Reuters, use a figure of 3 million people, which, in my opinion, is closer to reality.

Reuters collects daily COVID-19 infections and deaths data from 240 countries and territories around the world, regularly updated every day.

Today, Reuters gives us 53 new cases per 100,000 population in the last 7 days in the Republic of Moldova, or 106 new cases per 100,000 population in the last 14 days, or an average of 202 cases in the last 2 weeks. According to this indicator (106 - more than 100) in the Republic of Moldova, as a country, should be assigned a "Red level" with the appropriate restrictions.

It is obvious that at the consolidated number of 106 at the national level, we cannot have indicators of more than 100 at the level of territorial administrative units. Local commissions have not applied the Red Level, and they have quite an excuse for this, the number of new cases per 100 thousand population on their territory is less than 100 in 14 days.

For these reasons, we have also seen several public events with mass participation of the population these days and with minimal adherence to precautions. On paper, everything is right. However, the virus is now like a wolf, which was put by a guard for sheep.

Let's go back to the numbers

If we look at some of the figures presented by the authorities over the last two months, we will see a gradual increase in the number of new cases, with a maximum in the third decade of March and a very linear sharp decline in the figures. Epidemiologists here may need to do their homework to tell us what factors influenced this rapid, linear descent from the top of the mountain? It would be interesting to know to be more prepared for future waves.

We have seen an increase in the number of tests conducted daily and a decrease in their level of positivity. This is certainly a positive change, but it does not allow us to see the full real picture of the situation. Many countries have opened their borders to our citizens with certain conditions. One of the conditions of entry will be a negative PCR test, conducted no earlier than 72 hours before crossing the border of the destination state. That is, we have a lot of healthy people who do PCR test on COVID-19 just for travel purposes. It is unfair to calculate the level of positivity from the total number of tests performed, because we will get a lower figure. It would be fair to calculate the positivity rate among those who came to the test with signs of the disease.

The presence of the British strain was confirmed in Moldova in February. There is no information about other strains in the public space. Are we still a territory without strains from Brazil and South Africa? Do we have new tests capable of reading these strains in our country? Are we ready to meet the Indian strain? Many questions remain unanswered yet.

My conclusion is that we are trapped in a regulatory trap. We decide by indicators, and it seems that we decide correctly, following the approved algorithm of decision-making. At the same time, we allow the virus to spread freely in the community. The consequences can be unpleasant for everyone.

 

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