Fifth wave in COVID-19 pandemic will be different in Hungary - and that's the scary thing about it!

Omicron creates new situation

SARS-CoV-2 smashed the door on humanity about two years ago, with Hungary experiencing the outbreak in the spring of 2020, and has proven since that it can still pack a punch. The Despite the availability of vaccines, the Omicron variant kicked off yet another wave globally.

During the previous waves, the nature of the infection got mapped out. Up until now it was clear which statistics (number of new cases, positivity rate, hospitalisations, number of ventilated patients, deaths) should be kept in focus and analysed. Not that Hungary excelled at the quality of these data…

Omicron, however, is creating a whole new situation in Hungary:

• Due to the extremely rapid transmission rate (cases doubling in every 1.5 to 3 days), there is no way authorities can detect infections on time or break infection chains. Due to inferior testing capacities, we have basically no way of knowing how rampant Omicron becomes. These factors give a much greater importance to individual behaviour, increasing the responsibility of people.
• On the other hand, we also know that the Omicron variant causes less severe disease, so the currently available data suggest that the burden on hospitals will not be as great (in the base case scenarios) as in the previous waves, but there will be many more patients that are not in severe or critical condition.
• Thirdly, international examples have already revealed that the virus can break through the defences of those vaccinated with two doses, which has only made the need, importance, and value of third shots even greater.

Estimating the severity of this pandemic wave and implementing new measures are contingent on monitoring key epidemiological data and being aware of the burden on the health care system. These would already affect the lives of economic operators. But the new situation requires new responses. Here’s why:

There will be a lot of sick people off work

In view of examples all over the world, the fifth wave could bring records in Hungary, as well, in terms of the number of new infections. Some think several million Hungarians will contract the disease, which may sound scary for some. Others believe these are not even ‘waves’ of a single pandemic, rather than individual and subsequent epidemics, which makes a lot of sense if you take a look at inconsistencies that cannot be explained by the ‘waves theory’.

In any case, the rapid rise in infections could have a consequence we have not experienced before, namely that

a lot of workers will be off work for days or even weeks at once.

Epidemiologist Beatrix Oroszi has pointed out to Portfolio before Christmas that the large number of confirmed COVID-19 cases in the fifth wave of the pandemic could exert a serious impact not only on the health care system, but also on various other sectors. Businesses and schools will be faced with a shortage of staff unless people step up their defense game against the virus, she warned.

Statistics on the coronavirus-related temporary loss of manpower at enterprises would be a new indicator that would reveal a lot about the severity of this wave. However, we should not hope to have such data, or at least not in real time and not comprehensive statistics. We might be able to draw some conclusions from partial data provided by a couple of businesses in a few sectors.

Employers may find themselves temporarily off work for various reasons: infection, quarantine, restrictions in child’s school, or possibly if they simply cannot go to work due to disruptions in public transport (e.g. if too many drivers fall ill).

We need to admit that this could easily become a snowball effect in the Hungarian economy, and the difficulties that certain companies and sectors paralysed by the high number of infections can cause difficulties for other companies and sectors.

At this point, we need to address two consequences we cannot exclude:

1. The vulnerability of supply chains. If logistics collapse because masses of employees fall out of work at transport companies, trucks will not reach their destination on time, possibly in the case of transnational shipments too.
2. The importance of critical infrastructure. In Hungary, an act adopted in 2012 identifies ten sectors as vital institutions: energy, transport, agribusiness, health, social security, finance, ICT, water, defence and public security-defence. These are the services, equipment, facilities and other system elements that are essential for the performance of vital societal functions and the loss of which would have significant consequences if they were not to continue to perform these functions. However, the list of companies included is not publicly available (405 plants were previously reported).

We have seen several examples over the last few weeks that the extremely sharp rise in infections can upset the operation of whole sectors. In France, hospital staff confirmed with COVID-19 were given clearance by the government to continue to work. Slovenia also exempted coronavirus-infected medical staff from quarantine rules. Even in the United States, specialist portals are reporting that the new variant could undermine the health care system because of the human resources crisis. In the USA, just as the Christmas holidays were in full swing, hundreds of US airline flights were cancelled after staff became infected or had to be quarantined. But the same is happening elsewhere in the world. And the cancellation of flights has a direct impact on the operations of travel agents, meaning that the snowball effect is already having an impact on the global economy. Although it is not about critical infrastructure but indicates the seriousness of the situation that at the end of December, close to 100 NBA players were placed into the league’s COVID health and safety protocols, which sideline any player that tests positive for COVID-19 for a minimum of five days. In early January, more than 60 players were affected. In the second half of December, 11 games were put on hold due to Covid infections.

Austria is a positive example, with the government having an action plan even for worst-case scenarios. Groups of people needed to ensure the smooth running of essential institutions and services have been taken out of the day-to-day routine, living and working in isolation (fifty experts in central energy supply, for example).

A new organisation, Gecko, has been set up (responsible for overall state co-ordination of the Covid crisis) and is taking all measures to try to avoid a massive restriction and lockdown, which would cause serious losses to the economy.

The rules on quarantine are being changed, with negative test results allowing release from isolation after just five days. People with three vaccinations who have been in contact with infected people will no longer be sent to quarantine. Also, to ensure the continued operation of the infrastructure, those who have been in the company of infected persons and have received two vaccinations can continue to work with a mask and daily testing.

Extremely pessimistic scenarios

One of the worst-case scenarios in this pandemic wave is the rapid infection of many employees, particularly in critical infrastructure. If these blocks are cracked, the economy would partly shut down on its own, even without pre-emptive restriction measures.

Another worst-case scenario is the collapse of health care due to a large number of infections among staff. The cabinet could add new hospital beds, open new ICUs, set up additional ventilation capacities, but without qualified staff manning these, such efforts would be futile.

A version of this worst-case scenario if transport capacities hit a brick wall. In this case, those already in hospital would still be treated, but flow-type problems would be left unsolved. An example of that situation is when GPs, outpatient care or ambulance services get under immense load.

Another extremely unfavourable scenario is when the number of hospital and ICU admissions surge a couple of days (former) or weeks (latter) starts to rise sharply after a surge in new cases. This will inevitably lead to a rise in Covid deaths too.

Based on global examples, experts do not project an outstanding load on hospitals or at least a smaller burden than in the fourth wave. Others warn that it is too early to assess the severity of the Omicron variant in terms of hospital and ICU admissions.

What if...

• the sheer number of new cases rises so high that hospitals will be overwhelmed not necessarily by people in severe condition but by patients are just simply not well. How will this affect the treatment of other diseases?
• we will face again what was typical in the previous waves, and what we may call the ‘Florida effect’, when mostly young people are infected at first, but their large number will lead to a high number of infections in more vulnerable groups after a few weeks?
• Omicron ‘finds’ members of the elderly population who are either unvaccinated or received ‘only’ two doses?

In a country with a 9.73 million population, 3.21 million people (one third) have received three doses of COVID-19 vaccines, while

about 35% decided they are good, don't need to get inoculated against coronavirus.

As the effectiveness of vaccines against infection wanes over time, a large share of those with two jabs are either partly or completely unprotected. ECDC data show that about 67% of those in the 80+ age group and about 75% of those in the 70-79 age group have received their booster shots, which is another red fleg in respect of the immunity of the most vulnerable part of the population and their chances of hospitalisation.

What can you do?

Everyone should gear up for the aforementioned worst-case scenarios. This wave will hinge more on individual members of society, smaller communities than on the actions of authorities.

A multi-layered protective shield would be really effective in order to avoid the worsening of excess mortality and severe lockdown measures that cripple the economy, with as little social and economic sacrifice as possible.

To this end, based on the experience of previous waves and international examples, we outline below 3x6 possible measures that can help mitigate risks and that individuals and business leaders/owners may find useful and deployable. It is important to see that none of these alone is a panacea (just as a vaccination alone cannot be expected to end a pandemic in one fell swoop), but when used simultaneously they can make a country, company or individual's defence strategy stronger.

What businesses can do:

1. 1. The secret lies in adaptability. So wherever possible, it makes sense to give preference to working from home, even if it affects only certain units of a company
   2. Ensure the permanent continuity of critical tasks within the company, i.e. if staff are lost, prepare a Plan B. More widely used bubble method.
   3. Provide free testing, contact tracing within the company (Videoton does this at its own expense, for example), to break infection chains.
   4. Encourage people with symptoms not to take up work when ill and communicate this.
   5. Basic preventive measures in confined spaces: use of masks and/or keeping a distance, hygiene rules.
   6. Let’s not forget that companies have been given the power by the government to introduce mandatory vaccination within the organisation. We have already seen several positive examples of company management providing positive incentives to motivate employees to get vaccinated.

What individuals can do:

1. Get vaccinated, unless unable for medical reasons. Get your third dose, as well. The bad news is you have to get your first and second jabs before getting your third. Sorry.
2. Parents should get their children (aged 5 to 11 and 12 to 17) vaccinated.
3. Use Covid testing kits you can buy in pharmacies. In more enlightened parts of Europe, e.g. Austria, governments have made testing free (rapid antigen and/or PCR tests).
4. Take your symptoms seriously and stay away from communities. Note that now you can be simultanously infected with the seasonal influenza and SARS-CoV-2 (a.k.a. 'flurona').
5. Put on that face mask, cover you nose too, in public spaces indoors.
6. Apply Azelastine nasal spray after or during social encounters.

What authorities can do:

1. The emphasis is once again on adaptability, so that officials, epidemiological authorities and decision-makers can quickly adapt to the new environment created by this new variant.
2. Ramping up vaccination (and stressing the importance of getting a third dose): this is perhaps where the greatest flexibility in the current system is seen, as the government has recognised that without prior registration there is a greater willingness to vaccinate. The cabinet has announced a new vaccination campaign for January where Hungarians may, after on-site registration, ask for their first, second or third dose of a COVID-19 vaccine. The shots will be administered at vaccination locations between 2 and 6 p.m. on Thursdays and Fridays and between 10 a.m. and 6 p.m. on Saturdays. However, Hungarians remain reluctant to get their jabs. The tally of the weekend 'vaccination campaign' was less than 105,000 jabs, including 14,400 first, 21,400 second and 68,900 third doses.
3. Rethinking the quarantine rules, as the current ones are no longer viable, especially in the light of the new rules introduced by other Western European countries due to Omicron and the new ECDC recommendation. This could have a two-fold effect: it will encourage better compliance and reduce the risk of employees being off work for a longer time.
4. Addressing the exposure of critical infrastructure, making preparations similar to those of Austria.
5. Central recommenation to working from home.
6. The government heralded weeks ago that immunity certificates will be valid only with three doses of COVID-19 vaccines, but nothing has changed to that effect yet. This should be remedied as soon as possible. It could also encourage vaccination fi immunity certificates were actually good for something, i.e. benefits for the card holders would be greater than currently. There are already a growing number of examples in other European countries where not only the unvaccinated but also those with two jabs are already facing restrictions in their daily lives (e.g. visiting restaurants, etc.).

All in all, we can say that Hungary is facing an unprecedented pandemic wave in the coming days and weeks. In such a new situation, everyone has a responsibility and an opportunity to minimise losses.

Cover photo: Passengers waiting at the San Francisco Airport on 24 December 2021. Due to the spread of the Omicron variant, United Airlines and Delta Airlines cancelled more than 200 domestic flights. Source: MTI/EPA/John G. Mabanglo