Coronavirus in Romania: skydiving without a parachute

While the attention of the public and authorities has been thoroughly captured by the Russian invasion of Ukraine over the past weeks, and despite massive efforts to diminish the issue in public eyes, the two-year-old pandemic is far from being a thing of the past. As I feared in my previous article, case numbers have skyrocketed here in Romania throughout January, reaching an official daily high over 40,000 on February 1^st, a new record. Like other Omicron waves around the world, the sharp increase was followed by a quick retreat, with new cases declining at a rate of about 35% each week. Currently, in the second week of March, the case numbers hover above 3,000 daily on average.

Mortality has also progressed on a trajectory similar to other Omicron waves: deaths have increased after the typical two-week delay, but at a much lower rate than cases – on average 35% per week compared to almost 90% for cases. The number of daily deaths surpassed 200 on two occasions in the second half of February, considerably lower than the mortality of the autumn Delta wave, which reached as high as 600 a day. Deaths are also currently in decline, although, again, at a lower rate than cases, around 20% per week. Our experience seems to support conclusions from other countries that the Omicron mutation causes less severe disease, at least in populations with sufficient prior immunity, either through infection or vaccinations. But during this wave, medical personnel also had access to new antiviral medication for severe COVID cases, so this might have also contributed to keeping the death rate lower than before.

Coronavirus in Romania: brace for the Big, Bad O.

As expected in my last update, infections soared in Romania over the month of October, reaching as high as around 19.000 a day in the middle of the month, and a total of almost 415.000 for the entire month. Following a similar pattern with other Delta waves around the globe, new cases started decreasing afterwards almost as fast as they were rising before, despite few extra restrictions – you may attribute this pattern to some inherent property of Delta or to the complicated transmission dynamics in a networked population. Personally, I continue to think that school closures contributed significantly to reducing transmission.

The decline continued until the week between Christmas and New Year, when cases started rising again, almost explosively: we went from a weekly average of 650 before Christmas to 1.220 after, an almost 90% increase, and this week the trend accelerated, surpassing 6.000 cases yesterday. This could be an effect of winter holidays, combining less testing with more social mingling, but I fear that it’s in fact the start of our Omicron wave. At this growth rate, we may well reach and surpass the previous record by the end of January – or sooner… Officially, the number of confirmed Omicron infections in Romania remains low, with 91 cases confirmed on January 5th (for a total of 183 so far), but worryingly over half of these 91 cases (51) are in vaccinated people.

Coronavirus in Romania: tsunami warning

After a quiet summer, in early autumn the coronavirus has returned to Romania with a vengeance. In the first half of July, the case numbers had dropped under 50 daily, and the total for the entire month was just shy of 2400, the lowest case number since the beginning in March 2020. For a good portion of July, Romania was recording daily deaths caused by coronavirus in the lower single digits, and the monthly total was slightly under 500.

Since then, the situation has changed drastically. Beginning with the second week of July, cases have climbed at a remarkably steady pace, on average 57% each week – except for last week, when the percent increase from the previous week was even higher, almost 90% – bringing us back to a daily count of 7000 cases. Compared to the earlier stages of the pandemic, this growth rate is unprecedented, likely attributable to the more contagious Delta variant, coupled with the lack of restrictions over the summer and the low vaccination rate. Between people returning from holidays, from countries like Greece with higher infections rates, recent large festivals with high attendance, and children returning to school in person last week, the outlook for the next months (even weeks!) is grim.

Coronavirus in Romania: an end in sight?

In the two months since my last update, the situation in Romania has improved significantly. Week after week, cases have declined at a steady pace of 20–30%, down to only 100–200 daily, a level not seen since late May and early June of last year. The number of tests has remained relatively stable, so we can be reasonably certain these case numbers reflect reality. In parallel, the number of patients in ICU is considerably lower as well, confirming this trend: it declined under 900 on May 9^th for the first time in six months, and is now already under 300. Authorities have lifted several restrictions on May 15^th, starting with the curfew in large cities and mask mandates in open spaces, but masks are still required inside stores, public transportation, and crowded places like bus stations.

As expected, the reported deaths have continued to increase in the first half of April, reaching a record of 237 on April 20^th, and then steadily declined at a rate of around 20% each week. On the other hand, the new increases in June, topping 200 daily deaths again on 8^th and 9^th, is only a reporting artifact. Looking into the detailed daily accounts reveals that many of these deaths occurred in previous months and are just now being added to the official statistic for COVID-related deaths. As an example, on June 8^th the official death count was 277, but 256 took place in prior months, going back to June 2020, so the actual death toll for the day was 21. This follows the discovery of inconsistencies between deaths reported by individual hospitals and central government, so I guess this is the solution chosen by authorities to update the number of deceased because of the pandemic. It is a rather odd way of correcting statistics, as it skews both the old reports and the current ones for June and makes it difficult to correlate current mortality with the case numbers.

Coronavirus in Romania: troubled times

As I have feared when writing my previous update, cases of coronavirus disease in Romania started climbing again following the partial reopening of schools and restaurants. Since the last week of February, cases have increased by 20–25% each week, reaching a peak of around 6650 on March 25^th. Naturally, new restrictions were put in place, stricter curfews in the larger cities during weekends, followed by rounds of street protests and online complaints, and schools will again be closed for the duration of April – officially an extended Easter break. Fortunately, we are already seeing some positive signs, with cases declining slightly last week, by 4%.

This smaller wave has brought with it increased death counts as well, climbing again above 100 deaths daily to a peak of 174 on March 23^rd and 196 on April 6^th. While numbers have remained slightly below the highs recorded during the autumn wave, the mortality rates look worse than before. I am using a rough estimation comparing deaths to cases from three weeks ago, as their evolution appears to track cases with a three-week delay. Calculated this way, mortality in December and January based on official coronavirus deaths dropped to 1.8–2%, while in March 2021 it is back up in the 3.3–3.4% range. Not entirely surprising, considering the increased load on the medical system (the number of ICU patients is constantly climbing and has recently surpassed 1450, above the previous record of almost 1300 in November), and the spread of the new, more lethal UK mutation of the virus.

Coronavirus in Romania: new year, new issues

Contrary to my concerns, the rate of infections in Romania has steadily dropped since my last update, except for a spike in the first week of January that may be a consequence of the Christmas celebrations. Indeed, a similar spike appears in the case evolution of several European countries I regularly check: Poland, Italy, Germany and the UK all reported increases on that week. The current weekly average of new cases is around 2500 here in Romania.

Some people speculate that this reduction is caused by people performing home tests – recently antigen tests have become available for individual purchase – and then not reporting positive results to the authorities to avoid isolation. A disturbing possibility, and a reason why rapid home testing is not a silver bullet against the pandemic – it does not matter if people know they are infected if they do not take proper measures to contain the spread. Nevertheless, daily deaths have also decreased these past two months, to a weekly average of about 80/day, half the average values recorded during November. The number of patients in critical condition has also declined from the November peak of nearly 1300, recently dipping below 1000, although for a single day on January 22.

Coronavirus in Romania: evaluating excess mortality

Since the early days of the pandemic, tracking excess mortality became a valuable tool to evaluate and compare the situation across countries. It should better reflect the overall death toll of the crisis, as strains on the health care system led to a larger number of deaths during this period from unrelated causes, people that would have otherwise received medical care and survived.

Finding the necessary data for Romania proved a bit challenging though. After some searching on the internet, I discovered the site of our National Statistics Institute, which publishes demographic data regularly. Unfortunately for my purposes, the available summary does not offer weekly data, as in many other countries, only monthly. The time series only goes back to 2015, meaning there is less historical data to compare 2020 with. There are delays in publication as well, data is made available around 5 to 6 weeks after the end of the month in question, for example now in December INS released preliminary demographic numbers for October.

Coronavirus in Romania: the third plateau

In stark contrast with the relatively quiet summer months here at home and in Europe, autumn has brought an avalanche of news, most of them bad, but some hopeful as well. The daily reported cases have skyrocketed in many parts of Europe, followed by increased hospitalizations and deaths, and by reports that in some cities, hospital staff are being asked to continue working despite testing positive. Governments have responded by gradually reintroducing restrictions, although not as harsh as the spring lockdowns.

In Romania the number of cases has also steadily increased throughout October, culminating in the first week of November, when almost each day another record was broken, and we surpassed 10.000 cases per day for the first time on November 6^th. The following weeks this upward trend, which started in the second half of September, was finally interrupted: on the second week of the month the number of cases declined slightly, almost 1% compared to the first week, and in the third week it rose again, by a little over 3%. The number of people admitted to ICU is also rising steadily, surpassing 1000 patients on November 4^th. The number of daily deaths peaked at 203 in the second week, on November 11^th, when the weekly death count also climbed over 1.000 for the first time, but at least week-on-week growth slowed last week from 30% to only 7%.

Coronavirus in Romania: summer plateau, autumn records

Almost three months have passed since I wrote my previous update about the coronavirus in Romania, and the situation has not improved since. It did not take long for the number of daily cases to surpass 1000 – two weeks instead of one as I was expecting. Since then, the weekly average has never gone below 1000, with occasional daily dips only during weekends, when fewer tests are processed. As in late spring, we were stuck on a new plateau; the number of infections has remained relatively stable in the 1150 to 1250 range for almost two months, into the first weeks of September.

The beginning of September has brought a series of relaxation measures that were reflected in new increases later in the month. On September 1^st indoor restaurants were allowed to reopen for the first time since the initial declaration of an emergency situation in March – two weeks later, the weekly average number of cases surpassed 1300 for the first time.

Then on September 14^th the new school year started with mostly in-person classes – again two weeks later, on September 30^th, Romania reported over 2000 new daily cases for the first time. There are already numerous reports of clusters linked to schools – these were promptly closed, and students returned to online learning. While I can understand that many parents and children prefer to attend classes in person, I cannot help but think it was a very unwise decision for containing the pandemic. It would have made more sense to suspend the entire school year in the hopes of getting the disease under better control by this time next year.

Coronavirus in Romania – back to square one?

Almost two months into the gradual relaxation period following the stricter lockdown, the situation does not look particularly good for my country. Just this Wednesday Romania announced an all-time record of daily confirmed COVID-19 cases, 555 – a record that was immediately surpassed a day later. The case numbers were already increasing steadily throughout June. The first week of June coincided basically with the lowest point in the curve with 119 cases on June 3^rd, afterwards cases climbed back into the 250 to 400 range, back to April levels. This was reflected in the reproduction number, even if it is not a perfect measure of disease spread – which climbed above 1 in the last week of May and now is already above 1.1 – and coincides with greater mobility of the population – most activity metrics recorded by Google Mobility Trends have nearly returned to pre-pandemic levels. For the time being there is no discernible increase in deaths, but this is a lagging indicator that could spike in the second half of July if cases continue on this trajectory.

It is worrying that infections are multiplying while restrictions and precautions remain in place, with case spikes across multiple counties. Indoor restaurants were not allowed to reopen, despite vociferations in Parliament by our current major opposition party. On the other hand, gyms have opened on June 15^th, but with restrictions allowing only individual sport activities and a 10 sqm area reserved for each customer. Masks are still mandatory in closed public spaces and public transportation – from my limited experience this requirement is generally respected, and promptly enforced by shop keepers. Two representatives, again from the socialist opposition party, made news because they refused to weak masks in a fast food, but the police were called in and the representatives were fined.

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 7^th to May 4^th, an entire month with little progress on this front.

The Verge: “Google uses location data to show which places are complying with stay-at-home orders — and which aren’t”

Google is using location data gathered from smartphones to help public health officials understand how people’s movements have changed in response to the global COVID-19 pandemic. In a blog post early Friday morning, Google announced the release of its COVID-19 Community Mobility Reports.

The reports use data from people who have opted in to storing their location history with Google to help illustrate the degree to which people are adhering to government instructions to shelter in place and, where possible, work from home.

As global communities respond to the COVID-19 pandemic, there has been an increasing emphasis on public health strategies, like social distancing measures, to slow the rate of transmission, the company said in a blog post. In Google Maps, we use aggregated, anonymized data showing how busy certain types of places are — helping identify when a local business tends to be the most crowded. We have heard from public health officials that this same type of aggregated, anonymized data could be helpful as they make critical decisions to combat COVID-19.

Casey Newton

While the pandemic is rapidly spreading through our interconnected world, networking and mobile technologies are also enabling new ways to track and possibly fight the disease. Along this Google initiative, Facebook is also sharing mobile location data with U.S. cities and states to evaluate the effectiveness of social distancing measures – unfortunately only in the U.S.

Tracking the spread of coronavirus in Romania

For better or (mostly) worse, 2020 is shaping up to be an extraordinarily eventful year. I’ve missed writing about some of the more important recent themes, and now they all seem to be dwarfed by the emerging coronavirus pandemic sweeping country after country. I couldn’t resist tracking its spread with hard numbers instead of coincidental tweets, so I turned to the data compiled by the website Our World in Data. I imported their daily file in Excel and did a couple of simple calculations and graphs.

Just to say again, the answer to “who could’ve predicted this?” is everyone who studies infectious diseases.

— James Hamblin (@jameshamblin) April 2, 2020

For the time being, my own country Romania hasn’t been hit very hard by the pandemic, compared to other European countries, but that may well change in the months ahead. I was curious whether the measures implemented here, fairly early, had a measurable impact on the spread of the virus. I’m not going to post my own graphs in this article because they are too heavy with data points to look nice, but I will share other good online resources, including interactive visualizations. With the obvious caveat that I’m by no means an expert, and individual country data may be hard to compare because of different reporting methodologies, here are some of my observations.