Business 7 December 2021, 1:01pm

COVID-19: Deaths hit new record, number of ventilated patients up in Hungary

Portfolio

Hungarian authorities diagnosed 4,311 people with COVID-19 infection and 224 died of coronavirus-related diseases over the last 24 hours, koronavirus.gov.hu reported on Tuesday. The number of Covid patients in hospital rose by 128 d/d to 7,568, while the number of Covid patients on ventilator went up by nearly 5.2%. The 7-day average of new cases is down 17% week-on-week, but we are yet to see a decline in the number of hospitalisations and those ventilated. The accumulated number of coronavirus-related deaths since 1 August is almost 8% higher than in the same period a year ago.

We need to wait until at least Wednesday, but preferably until Thursday and even Friday before reaching more far-reaching conclusions, but the jump in the daily positivity rate is definitely not welcome. Note, however, that the number of tests performed dropped to under 13,000 from over 40,000 in the previous days, which also explains why the number of daily new confirmed COVID-19 cases is suddenly about 33% lower than a week ago, and 61% lower than six days ago.

What is most interesting is that the number of active cases declined by more than 2,500 d/d, which is a shockingly large number, considering that the only day this figure dropped was 1 December, and the decline was merely 61 people. The day before that when the number of active cases decreased was on 28 September (-184).

The fact that all percent positive readings are higher than a year ago also bodes ill for the future. As you can see on the charts below, the 3-day / 21-day test positivity rate dipped to under 100% nine times, always on these three 'weekend' days. After coming down as low as 87.7% on Monday from 113% last Thursday, it ticked back up to over 100%. Again, we'll need to wait a couple of days more to see the trend more clearly. If we want to be certain that the key epidemiological figures are starting to improve, the 7-day average of the 3-d/21-d positivity rate would need to go south of the 100% mark. It is currently at 105.7%, down from 109.3% on Friday, and well under 160% recorded in late October.

The abatement of the current 'wave' will first be indicated by the percent positive peaking and retreating. It will be followed by a drop in daily new COVID-19 cases, hospitalisations, the number of ventilated patients, and eventually coronavirus-related deaths.

Changes in the positivity rate are reflected in the other epidemiological data with a delay:

new cases – 3 to 5 days
hospitalisations – 7 to 10 days
patients on ventilator – 12 to 15 days
deaths – 18 to 22 days.

Whereas the decline in the 7-day average of new cases is a welcome change and might just indicate that the peak in the current 'wave' has been reached, there's no reason to pop the cork just yet. The other metrics will keep going up for days or even weeks after the percent positive reached its plateau.

The 224 fatalities reported by the Coronavirus Task Force for Monday marks a new record in the current 'wave'. Daily deaths were last higher (241) on 15 April this year.

The tables below show how the changes in the number of daily new confirmed COVID-19 cases, hospitalisations and the number of ventilated Covid patients in 2021 and 2020. From the comparison of daily figures we have switched to lining up 7-day averages. This is to avoid distortions caused by comparing weekdays with weekend days when authorities do not publish statistics, and the aggregate data released on Mondays have to be distributed for three days with a certain methodology.

In the top chart we compared the figures of 6 December to one, two, three, and four weeks earlier. The second chart shows the week-on-week changes.

The number of new cases does show an improvement, and the 7-day average is already 17.1% lower than a week ago and 11% lower than a fortnight ago. The other two key metrics, i.e. the number of Covid patients in hospital and on ventilator still worsened more than a year ago, and show an increase of 4.5% and 20.2% w/w, respectively. Note that the ventilation data are adjusted by Portfolio's methodology, i.e. the official daily figures have been adjusted 40% higher since 28 Nov, not just for the sake of comparability but also to reflect reality more accurately.

How is the situation in hospitals?

The number of Covid patients admitted to hospitals and needing mechanical ventilation has been on the rise for a while now, and they are already at mid-April levels.

On the charts below the 0% line is important. When the curves are under 0% there’s a decline, when they go over 0% it’s an increase. The changes show that the situation in terms of hospitalisations started to worsen after 20 August.

More importantly, when a value is north of 0% but the curve descends, it means an increase at a slowing rate, rather than a decrease. If the curve is above 0% and ascending, it is an increase at an accelerating rate. When we are under 0% and the curve goes lower, it translates into an accelerating decrease, and when it goes up it marks a decelerating decrease.

The number of Covid patients in hospital and of those on ventilator grow almost fully synchronously, apart from a period between mid-September and end-October. In that period there was not enough room for Covid patients and that is why there were many on ventilator relative to the number of Covid patients hospitalised. Then Covid capacities were added to the system and the 'link' was back the way it was before.

The same can be observed at the charts below, only with ratios. The share of those in hospital to the number of active cases has come down from its peak because daily testing picked up, and while there are more and more people with coronavirus infection in hospital, the number of active cases has been growing at a higher rate. And the ventilated / in hospital ratio dropped and steadied due to the aforementioned reason, but it has been rising again over the last few days. Given the changes implemented by the Coronavirus Task Force (see above), this ratio is now only an estimate, the best we can come up with.

The number of Covid patients hospitalised (3-day average) is 3.8% smaller than in the base period, while the number of those in ICUs is 27% higher in annual terms. The corresponding figures were -2.2% and +3.8% a week ago, and -44% and -19% eight weeks ago, respectively.

As regards the left-hand chart below, the number of new COVID-19 cases accumulated since 28 August is already 41% higher than in the same period of 2020, while it was 28% lower four weeks ago and 46% lower eight weeks ago. In the meantime, the accumulated time Covid patients spend in hospital is 19% shorter than a year ago, while it was about 33% shorter four weeks ago and 20% less ten weeks ago. (The turnaround came about on 22 September, about a month after the no-restrictions four-day celebrations of the foundation of the state on 20 August.)

On the right-hand chart see that ten weeks ago the number of accumulated days spent in ICUs (practically on ventilator) was 81% higher than the base period's print (+54% eight weeks ago). Since then, the difference has shrunk considerably to 1.9% a fortnight ago (it was as low as 0.93% on 16 November) but grew to 6% by now.

N TERMS OF THEACCUMULATED NUMBER OF COVID-RELATED FATALITIES WE ARE in a WORSE situation than a year ago.

The accumulation is 7.6% higher vs. being 35% lower four weeks ago, 26% lower 8 weeks ago, and -10% 10 weeks ago. Most importantly, same time last year there were no vaccines and cross-immunity (if it works at all) was assumably not as strong as currently. The right-hand chart also depicts that those that admitted to hospital with coronavirus infection are generally in worse condition than Covid patients a year ago. Note that this the accumulation of Covid fatalities reflects only the data provided by the Coronavirus Task Force, i.e. the actual figures that will be shown only in the KSH statistics much later are a lot higher.

Lacklustre progress with vaccinations

The Hungarian government is organising vaccination campaigns in each settlement, and expects the administration of the third doses of COVID-19 vaccines to skyrocket, said Prime Minister Viktor Orbán in his regular interivew with public radio MR1 last Friday.

If you take a closer look at the current vaccination campaign (announced for Nov 22-28 with a 2.5-week preparation time and then extended by another week and then by another one to 12 Dec) where no prior registration is required to get your first, second or third dose of a COVID-19 vaccine, it will be clear that 3rd doses remain vastly more in demand than 1st or 2nd jabs.

It is now evident that it was actually not the “hassle” of prior online registration and appointment booking that prevented around three million Hungarians from getting inoculated against coronavirus. It’s their determination not to get vaccinated or merely a lack of Internet access that prevented them from signing up. And it’s not even a hassle, but a simple procedure that takes a couple of minutes if you have a social security number, Internet access and a minimal level of digital literacy.