Numbers
We had 1459 cases reported in Tbilisi this week. Last week I projected 1033 – 1616. Again, this week, the numbers are on the high end of my projection. The average daily positive test rate went up from 1.64% to 1.85%.
It’s come to my attention that stopcov.ge is reporting positive test rates a bit differently – they’re essentially providing a weighted average, and I’d been providing an unweighted average. I think the weighted average might be better so I’ll report that as well: it went from 1.62% to 1.69%.
Projection
My model predicts 1376 – 2152 cases reported in Tbilisi next week.
If current infection rates hold (there’s no guarantee they will) we’ll have about 4600 cases reported in the week ending on Easter, of which about 800 will be UK strain cases. That would set May up to be significantly worse than November – for reference, we had 4605 cases reported in Tbilisi in the week ending on November 1st, but none of them were the more contagious and more deadly UK strain.
So the status quo outcome – if nothing changes – is that May will be the worst month of Georgia’s pandemic so far. This is a totally avoidable outcome, though! The government is totally able to reduce infection rates, if it chooses to do so. They could also decide to impose a lockdown before the hospitals overflow, rather than a week after they overflow. Will they actually do these things? I don’t think they will. I think May is going to be the worst month of the pandemic, unless it’s exceeded by June.
In maybe slightly better news – even getting one dose of a two-dose vaccine reduces hospitalization and mortality rates, and protection definitely starts to kick in on or before day 14, so vaccination in April could really make a dent in May’s mortality rates, even if it won’t be enough to significantly impact transmission rates. Gamkrelidze says we’re getting 100,000 doses of Sinopharm in April, which is great news, only somewhat undermined by Georgia’s very low vaccine acceptance rate and the apparently low vaccination delivery capacity, which seems to have maxed out at ~750 shots per day, per Gamkrelidze – but hopefully it’s more than that? Still, at this point, the problem is supply, and not demand. There are at least a million Georgians willing to get vaccinated today if a vaccine were available – 35% of Georgians, according to the latest poll – and there are not a million doses in the country now, nor are there plans to have a million doses available before summer. Anyway if May is as bad as I think it’s going to be, vaccine hesitancy won’t be an issue. Again, the issue will be that we just don’t have the doses in country.
Risk assessment
Assume about 1 person in 500 will be carrying an undiagnosed infection. In a collection of 10 people, there’s about a 2% chance that one or more people would be infected.
Hopefully you’ve taken my previous advice of taking care of necessary in-person business before now. At this point it wouldn’t be unreasonable to start prepping for another lockdown, if you’re the type of person who prefers to prep for things.
Teacher Screening and Missed Cases
It occurred to me the other day that the screening tests performed on teachers could be a valuable source of information about how coronavirus is progressing in the country. The argument goes like this: one of the factors cited in arguments to reopen schools was that the infection rate in schools was the same as the infection rate in the general population – that is, there was no added risk from opening schools. If this relation holds then it should go both ways – in other words, the infection rate in schools should be a reasonably accurate proxy for the infection rate in the general population. The infection rate among teachers should generally reflect the infection rate among the general population.
This week’s tests showed that the infection rate among adults in schools – teachers and administrators – was 0.1%. (I would like more precision than that but I’ll take what I can get.) Teachers are tested every two weeks – a randomly selected 20% get PCR tests, and the rest get antigen tests. Of course, these tests don’t include teachers who already know they have covid – why get an extra test? Therefore, roughly, this suggests that in addition to anyone who has been diagnosed through testing for cause (symptoms or exposure), an additional 0.1% of people – or an additional one person in one thousand – have covid but don’t know it at any given time. Applied nationwide, that suggests about 4000 undiagnosed active infections.
As of March 26th, there were 4097 known active infections in the country. So what does this information from teacher testing show us? Basically, it just reinforces our prior understanding that about half of covid cases are being missed at any given time. I’ve already been operating under that assumption for about a year, and building it into my risk projections. It’s probably a good sign that this new data essentially matches up with prior expectations, because it means that in order for us to be wrong, we’d have to simultaneously be wrong about previous studies showing that teachers get infected at the same rate as the general population and also about previous estimates that about half of all cases were being missed in official numbers – and wrong in the same direction – which is fairly unlikely.
The Third Wave
Gamkrelidze and Tsertsvadze are still saying, as of yesterday, that the third wave is preventable. Tikaradze, however, preempted them and already said on Friday that we’re in the beginning of the third wave. I’m trying to game out why these officials aren’t on the same page, but maybe they actually are? I don’t want to read too much into any of these statements, but it’s possible that Gamkrelidze and Tsertsvadze think they can motivate people to act by claiming that the third wave is preventable (hope), whereas Tikaradze thinks she can motivate people by telling them that the third wave is here (fear). For the record, I agree with Tikaradze’s statement that we are in the beginning of the third wave (which I already said last week) and I agree with the pragmatics of informing people of such things rather than pretending the third wave is avoidable. Perhaps Gamkrelidze and Tsertsvadze have some more stringent definition of a “wave” or are simply more cautious about making statements that might be interpreted as predictions rather than observations?
I’m not aware of any serious argument that we aren’t in the third wave. There’s a lot of wishful thinking that maybe there’s some kind of undetected immunity that’s going to protect us – either some giant mass of people who got infected without being reported, or something something blood types, or BCG vaccines, or something else – but all that tells us is that the third wave could potentially be less severe than the second. On the other hand the UK strain means it will probably be more severe, which is what experts are warning about in countries like Germany.
Tales from Bakuriani
We’ve had snow almost every day here. My kids have built at least three snowpersons, and the weather has been ideal for snowball fights – or for skiing. However, the town seems to be mostly abandoned. I’ve heard that most of the tourists in Bakuriani from year to year are foreign, but it’s still striking how absolutely empty everything is. Every time I’ve gone to a big grocery store in town I’ve been the only customer. I imagine there are some people in the hotels closer to the skiing areas – I don’t ski so I haven’t gone up there. It’s cool having a resort town almost entirely to yourself. I’d recommend that everyone come to Bakuriani, but if you did that, it wouldn’t be empty anymore, so I’m going to cordially invite you all to stay put, at least for another week.
My life has gone so online that there is virtually no change between being here and being in Tbilisi, except that here I have better scenery and more space to walk around in. Still, it’s enough to make me think that if I’d known how this would all shake out last March, I would have tried to buy or rent a cottage somewhere in some village to just ride out the pandemic in peace and relative isolation. Heck, I might still do that.
Next Sunday I’ll probably be in transit back to Tbilisi so the weekly update might be delayed. Until then… stay frosty!
(covid stats from stopcov.ge and 1tv.ge)
Georgia On My Mind 