Coronavirus: we pushed the second Hungarian defense line far behind

Prime Minister Viktor Orbán yesterday announced new measures as part of the fight against the coronavirus. According to this

• The use of the mask will be mandatory in addition to public transport and shops in cinemas, theaters, health and social institutions and reception areas.
• Starting in October, after a fever, students and teachers can enter schools and only they.
• No more than 19,500 HUF can be requested for testing under any title.
• Nightclubs must be closed at 11pm

The new steps were soon criticized, but they were more a superficial dissent than a criticism of the epidemiological strategy. The government moves in line with the logic of selective defense. The point is to try to stem the epidemic not with a blanket shutdown, but with narrower and more specific measures to avoid a severe economic downturn (and the associated social damage). The first strategy sought to reduce human interactions in general, the second focused on areas critical to the spread of the epidemic and also did not necessarily try to slow the spread of the virus there.

It can be argued that these are the most necessary steps down the line, but now that young people are the main carriers of the virus, a restriction after 11pm does not seem irrational, nor does school fever with minimal disruption with good organization. The problem with these measures is greater than they have been so far: it is clear that, taken three weeks earlier, they would have promised much greater success.

Selective Hungarian style

Hungary’s defense strategy is the same as that of all other European countries, which have decided to try to escape the second wave of the coronavirus epidemic with much less economic sacrifices than the first. At one point, however, there is a quirk that does not benefit us. Symptoms include:

• The government will not change its testing practices in the second wave either.
• The second national poll promised for September is out of the question.
• The government emphasizes its confidence in its enormous bedding and ventilation capacity.

What are these symptoms? Apparently, the government’s efforts to learn about the epidemic have not intensified. Instead, he focuses on having a reserve in the event of a strategy failure, but his vision is based on an illusion.

The basis of a selective defense strategy is fast and accurate information. In addition to the more general rules, this can be effective in controlling massive group infections. Typically, the Hungarian epidemiological system is not able to produce an authentic and up-to-date number of active cases even from the number of registered infected persons. More importantly, the epidemic did not even have to reach severe proportions to exhaust testing capabilities, so even contact investigation is slow, stagnant, incomplete. Evidence based on risk assessment arises very partially, since, for example, more general surveys of risk groups (teachers, health professionals, etc.) are not typical. The latest news about the second round of the great test of the national epidemic (HUNCOVER) promised for September was that no money was allocated for it. Although reducing the cost of private tests may improve access to tests somewhat, the scope of this is characterized by the fact that free tests are also available for many other countries.

Anyway, getting pictures of the epidemic situation is not an easy task, but the desire for more accurate information is not really felt. There is also a lot of uncertainty about this in the speeches of the experts.

It is about how we are prepared if the current level of restrictions is not sufficient. Since decision-makers are informed of this delay, there is a risk that selective action will be taken later. This seems to have been recognized by the government as well, since (to borrow from the popular war jargon on the subject) the next line of defense is a long way off: massive chronic supply capabilities.

The promise of tens of thousands of hospital beds and thousands of ventilators is not part of the selective defense. If this were necessary, our main strategy has long since failed, as it means practically infecting millions. It is therefore on this basis that the Prime Minister’s literally unenforceable promise (“Everyone can be sure: if someone contracts this disease, we will cure it”) It’s a complete illusion.

We’ve been writing these days about why it seems risky to rely on the inflated capacity of hospitals, and these considerations are even more vivid when the gist of the reassuring message is that 10,000 beds can be 20,000. It does not help at all. Or if so, the problem is huge.

• It is certainly not the number of beds and fans, but the number of medical personnel is the capacity limitation.
• The widespread spread of the virus also does not spare hospitals, and even hospital workers are increasingly exposed to infection, so the epidemic alone severely destroys health capabilities. In this way, the system can ultimately serve fewer patients.
• Rapid reinfection of society, even without overload, means many more deaths than trying to slow the spread of the virus to the vaccine. The compensation dilemma is a well-known one: choose the economic damage (and its human consequences) resulting from foreclosure, or the more serious epidemic with more freedom of movement, more deaths.
• Such a rapid spread of the virus, even without regulations, would lead to greater caution in humans, in extreme cases, something that is already equivalent to a complete shutdown. That is to say, the compensation is not perfect, the economic sacrifice increases without restrictions as the epidemic intensifies.
• Rapid transmission of infection may not be a durable solution, as there is mounting evidence that in many cases immunity does not develop or disappear.
• Recent experience shows that recovery from the disease is not easy either. Residual effects that slowly alleviate and even permanent damage to health are common: according to our health system information, there are not only Italian but also national examples of this. (Since then, János Slavik has spoken of something similar.)

In other words, when looking for weak points in the selective defense against the coronavirus, we should not be looking around the close of 23 hours or the school thermometer.

Cover image: Getty Images