15 May 2020

Coronavirus in Romania and elsewhere – a May update

Like many others around the world, I have been following the evolution of the coronavirus pandemic closely. I planned to do an update on the situation in Romania at the start of May, but this seems an equally valid moment, since today the government is ending the emergency situation established two months ago, switching to a lighter ‘alert status’. Small shops are allowed to reopen, but not larger commercial spaces like malls; people are allowed to circulate more freely, but traveling outside your town of residence is restricted to specific cases; wearing masks in closed spaces and public transportation is mandatory; medium and large gatherings like weddings and funerals are still forbidden.

But how did the number of cases evolve during this lockdown period? Unfortunately, the results so far look mixed: new cases of COVID‑19 have remained mostly stagnant, oscillating between 300 and 400 daily since the beginning of April; deaths stayed in the average range of 15 to 25 per day. While it is a good thing the epidemic did not spread at an accelerated pace, a long period of stagnation implies that the measures did not have the desired impact. Most countries in Europe saw clear declines in daily cases and deaths; meanwhile Romania is among the few countries stuck on a plateau. Ironically, this negative context prompted one of the rare mentions of my country in international news, along with Poland, the UK and Sweden. I recently discovered a local website with multiple graphs about the evolution in Romania, including one of the reproduction number; as expected from the long plateau, R0 hovered around 1 from April 7th to May 4th, an entire month with little progress on this front.

COVID-19 reproduction number in Romania
COVID‑19 reproduction number in Romania

As a side note, I find it fascinating how the numbers from Romania and Poland have stayed almost in sync from the start of the outbreak. Only over the past week we can see a break starting to form in this unlikely pattern, with Romania reporting a timid drop in daily cases (the 7 day average dropped under 300 for the first time on May 9th), and Poland a slight increase in cases, but with less deceased.

Daily confirmed COVID-19 cases May 2020 Europe
Daily confirmed COVID-19 cases in May 2020 (Europe)

As remarked in my previous entry, there can be several reasons for the lack of effectiveness, but in my opinion, people around here are still not taking the situation seriously. On my weekly trips to the supermarket it feels like the streets are just as full of people as before. At some point it looked like we were starting to embrace masks; now I see them less and less. On a positive note, I had an appointment today and travelled by subway; I am pleased to report that most travelers were indeed wearing masks, and there were a noticeable number of police officers and security personnel around to make sure of that.

Moreover, our president announced three weeks ago that the emergency would be lifted on May 15th, which I think only fueled a popular sentiment that the gravity is overblown, and the measures can be tacitly ignored. In Bucharest, the mayor of the second sector has already opened the parks for the public last weekend, and the rest of the capital will follow this weekend, so I expect large crowds to go out, mingle, and celebrate the end of the quarantine, especially in this warm, late spring weather. On some level I can understand their reaction; we haven’t confronted a crisis of this magnitude since the Cold War and the December ‘89 Revolution in Romania’s case, people have gotten used to a relatively stable world and economy, with its benefits and downsides, and this unexpected upheaval is met with disbelief and denial. Unfortunately, these emotions will not help combat the disease, nor to find solutions for better living under the current circumstances.

The Google mobility reports for the past weeks seem to support my conclusions. Across all categories, the level of activity dropped less compared to other countries. Some of the difference may be attributed to people not being able, or allowed, to work from home (presence in workplaces was down ~18% in Romania, compared to 39% in Italy and France). Despite better than average Internet speeds, many professions are still paper based, which prevents them from switching to working from home on short notice. The activity levels look better in Bucharest – in the capital workplace activity was down 28% – but still less distancing than in other European countries.

The media is contributing to the public restlessness by constantly repeating the narrative that people around the world are protesting restrictions, demanding to return to work and their regular lives. In fact, polls show the opposite, how the majority is supporting social distancing and is reluctant to resume normal routines for fear of infection. I think many Romanians are particularly susceptible to this propaganda, because after overthrowing the communist regime 30 years ago, one primary takeaway was a misguided sense of freedom, “like in America”, that we can therefore do whatever we want without consequences. I can only hope that relaxing measures now, when we have more active cases than at the start of lockdown (113 on March 16th, compared to around 6000 active cases today), will not backfire too badly for us.

A note about the numbers for the charts: people on Twitter noticed that reported numbers have noticeable weekly variations. After checking for myself, I can confirm, but they are quite different from country to country: Romania for example is reporting most cases Fridays and the least Tuesdays; South Korea reported most cases during the weekend, similarly the US and Japan show an excess from Friday to Sunday; whereas France and Spain reach the peak in the middle of the week, Wednesday and Thursday. I can only assume these are caused by differences in administrative procedures and local particularities, nothing related to the actual spread of the virus. Therefore, I have used a 7-day moving average centered on value to smooth out these weekly spikes in my charts.

Elsewhere around the world, the pandemic is spreading to new territories and wreaking havoc in the United States. Over the past days, the number of new cases in UK seems to finally decline; nevertheless, it would be a good policy to wait at least 10 days to confirm the downward trend before easing restrictions. Japan started reacting after an accumulation of cases in Tokyo; some think they postponed measures for fear of delaying this year’s Summer Olympics. Last month some were wondering how India was spared; that time is now long over as cases are rapidly rising with no end in sight, despite their hasty and chaotic lockdown. Russia is on an upward trajectory, while raising questions about their abnormally low death rates. Brazil as well is seeing an explosion of cases, under the horrendous supervision of President Bolsonaro, denying the crisis with his every statement and action. Even Sweden is starting to question their decision to keep the country relatively open, as deaths are multiplying among the old and poor. Unfortunately, this policy provided others with arguments against lockdowns, and it appears Finland is considering adopting this model, despite evidence it leads to increased casualties. Unfortunately, failure of leadership and avoiding accountability is an issue all over the world, not only in the US and China.

Daily confirmed COVID-19 cases May 2020 world
Daily confirmed COVID-19 cases in May 2020 (world)

Related to this, journalists have started investigating excess deaths in several countries, to assess the real impact of the epidemic beyond the reported numbers. In most cases there is a sizeable excess of deaths likely attributable to the disease, but for now I have not found a source for such data in Romania. Other reports have placed the first cases of COVID‑19 much earlier in the US and France, offering a possible explanation for the large extent of the outbreak in these countries.

Multiple articles and experts have warned that the disease may persist for months, if not years, in the absence of treatment, that new waves are likely to follow, that relaxing containment measures too soon will lead to a quick resurgence of cases and increased strain on medical systems. Some of these predictions are already starting to come true in the Asian countries where the disease first spread: Singapore discovered outbreaks in crowded dormitories of migrant workers; South Korea relaxed measures last week and was promptly faced with new infections because people went out partying in clubs and bars over the weekend. Germany took cautions steps to ease restrictions, amid protests demanding reopening, and was reportedly met with more cases – though the trend is small and only a couple of days old, I doubt new infections would turn up so quickly with the long incubation period of this disease. Finding the right balance between containing infection and allowing some freedom of movement and business activity is going to be a long and complicated process, two (small) steps forward, one (large) step back.

Ultimately, it will take years to see the full picture of this massive crisis, to understand the implication of each policy and decide who proved the better leader. It irks me constantly to see people praising the prime minister of New Zeeland, a country with less population than several European cities, with low density and relatively isolated on distant islands – not to mention her reaction to close the borders echoes her campaign promises to reduce immigration. Let us save the praises until the pandemic is safely behind us and concentrate on being vigilant and prepared for the worst.

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