COVID-19: Current 'wave' deadlier in Hungary than in autumn 2020

Note that the word 'deadlier' in the headline refers to the data published by the official government website koronavirus.gov.hu. The actual figure is a lot higher. This time last year, the death toll reported by the Central Statistics Office (KSH) was double of the figure released by the Coronavirus Task Force. By April the former reached 17,900 which compared with 9,700 reported by the task force.

2021 vs. 2020 on a few charts that need no explanation

About the positivity rate

After jumping to nearly 28% on 16 Nov, the 3-day average test positivity rate returned to 21.3% on Sunday and edged up only to 23.95% on Monday. Although test positivity continues to rise (the daily percent positive ticked up to 27.66% from 26.63%), the pace is moderate, and it is unlikely to take off. We will know more from the reports of the following days because the weekends (data for Friday, Saturday and Sunday) have a tendency to upset the trend.

As you can see on the charts below, the 3-day / 21-day test positivity rate dipped to under 100% three times, but that has to do with the reporting hiatus on the weekend, and it is back at over 106% already. 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. However, it has been steadily north of 110%, although it came down a lot from around 160% in late October. (Shout out to Balázs Pártos for the comment.)

Hungarian health care system under increasing load

The Hungarian Medical Chamber (MOK) warned last week that amidst a surging in the number of new COVID-19 cases intensive care units are filling up fast. Beyond a certain point their number cannot be further increased rationally because staff required to attend the patients there is running thin.

The chamber warns that with so few professional nurses and doctors attending to coronavirus patients in severe condition we can expect a high percentage of ventilated patients to die, even in international terms, just like during the ‘third wave’ of the pandemic. The chamber urged the government to implement new restriction measures, alerting the public that without these hospitals will eventually find themselves under wartime conditions.

The government decided lastThursday to implement a few restriction measures as a response to the surging number of daily new COVID-19 cases and related hospitalisations. No curfew, and no lockdown measures were put in place, though, which was expected, as the cabinet continues to bet almost exclusively on vaccines and is reluctant to impose measures that would dent economic growth.

Read our latest analysis below on why taking up third doses would be vital:

• mask-wearing has been compulsory indoors as of Saturday (20 Nov);
• as regards services, mask-wearing is compulsory where there are generally more than five customers at once;
• deciding on mask-wearing in schools is at the discretion of the principals, the government only recommends that they do order it;
• events with more than 500 people in attendance can be visited only with immunity certificate (this is not a new measure);
• 3rd doses of a COVID-19 vaccine are mandatory for health care workers (within four to seven months after their second jab);
• full vaccination was made mandatory in the public sector.

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.

In the top chart we compared the figures of 22 November to one, two, three, and four weeks earlier. The second chart shows the week-on-week changes. The red cells make it evident that the epidemiological situation has been worsening at a more alarming rate in almost every aspect than in the base period.

We have already written about the growing load on hospitals, and experts keep warning about it almost every day.

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 late 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.

As you can see, the number of those 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 has also come lower and steadied due to the aforementioned reason.

The comparison of the current situation to the one a year ago in terms of Covid fatalities per days spent in hospital and in ICUs also shows a widening gap in the former (2.11% in 2021 vs. 1.55% in 2020) and a narrowing gap in the latter (19.36% vs. 19.67%), i.e. the situation is worsening in this respect as well.

The number of Covid patients hospitalised (3-day average) is 11% smaller than in the base period, while the number of those in ICUs is 6.0% higher in annual terms. The corresponding figures were -23% and -6.0% a week ago, and -23% and +78% eight weeks ago, respectively.

As regards the left-hand chart below, the number of new COVID-19 cases accumulated since 28 August is already 27.8% higher than in the same period of 2020, while it was 28% lower four weeks ago and nearly 50% lower eight weeks ago. In the meantime, the accumulated time Covid patients spend in hospital is 26.2% shorter than a year ago, while it was about 33% lower four weeks ago and 9% higher 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 120% higher than the base period's print (+81% 8 weeks ago). Since then, the difference has almost vanished by now (+1.9%), although it has grown gradually over the last few days from as low as 0.93% on 16 November. While a couple of weeks earlier there should have been a lot more cases to match the severity of the current 'wave' (in terms of the number of days spent on ventilator), the accumulated number of cases caught up with the base period's print on 10 November.

In terms of the accumulated number of Covid-related fatalities we are where we were a year ago, even a bit worse.

The accumulation is 0.3% high vs. being 35% lower four weeks ago, 10% lower 8 weeks ago, and +60% 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.

The government launched a one-week vaccination campaign on Monday where Hungarians only need to show up and take a jab, without prior online registration or booking an appointment. The campaign was actually announced two and half weeks earlier, and a waiting period this long is incomprehensible. A total of 131,000 doses of five different COVID-19 vaccines were administered yesterday, which certainly gives a boost to the lacklustre pace of new vaccinations, but the results will be palpable only in the 'fifth wave' of the coronavirus pandemic, not in this one.

How does Hungary compare to its regional peers?

Here are a couple of graphs that also speak for themselves.

Hungary's vaccination rate is the second-highest in the region after Austria. By now it should be evident that a 60% vaccination rate will not stop the Delta variant from spreading, especially not without some lockdown measures in place.

In terms of coronavirus-related deaths per one million people (7-day average), only Ukraine fares worse than Hungary in the region, and it has shown improvement in this respect, while there is no sign that the number of Covid deaths will start to drop any time soon in Hungary. The fatality peak is estimated to be reached by the end of the year or early 2022.

Hungary has the highest reproduction rate in the region.

Hungary's Case Fatality Rate (CFR) is the third-highest in the region.

Hungary scores the lowest on the Stringency Index.

Cover photo: Ákos Stiller/Bloomberg via Getty Images