With easter celebrations in Georgia in full swing, many wonder if the insistence of the church on holding services might lead to an explosion of infections in the upcoming days and weeks.
There is ample precedent in order for such fears to be justified. Religious mass gatherings have already caused considerable spread of Covid-19 in other countries. Here is a (by no means exhaustive) list of such events and their consequences:
- In France, the week-long rally of an evangelical church community mid February in Mulhouse (Alsace) played a crucial role in the country’s outbreak. It is estimated that at least half of the 2’000 worshippers left the event infected with the novel coronavirus. They ended up spreading the disease in at least 11 departments all across the country, fuelling an epidemic which has already to date claimed 18 thousand lives in France.
- In Malaysia, the four-day gathering of 16’000 muslim missionaries from over 30 countries in a mosque near Kuala Lumpur has caused a spike of infections not only in Malaysia (where likely over half of the cases can be attributed to the event) but also in some of the pilgrims’ home countries such as the Philippines and Kazakhstan.
- In New York as well as in Israel, hasidic Jewish communities are among the hardest hit by the pandemic. The tight-knit structure of those societies as well as a certain cavalier attitude towards the virus on the part of religious leaders seem to be responsible for it.
- In Ukraine, the branch of the orthodox church under the Moscow patriarchate has repeatedly defied quarantine measures, leading to around 100 worshippers being infected during a service in Kiev’s Pechersk Lavra monastery. Two monks died and the metropolitan himself had to be hospitalised with severe symptoms.
But perhaps the most widely publicised case concerns South Korea: on 9 and 16 February a woman who later came to be known as “patient 31” attended the regular Sunday services of the Shimcheonij Church in the city of Daegu.
On February 18, almost a month after South Korea had confirmed its first case of Covid-19, she became the 31st person in the country to test positive for Covid-19.
Just three weeks later, Daegu had six thousand confirmed cases, the vast majority of which were related to the Shincheonij Church.
It is stunning how the South Korean authorities subsequently managed to contain the situation and constrain the explosion of cases: on March 3, there were almost one thousand new infections registered within 24 hours nationally. Already one week later, this figure was brought down to the order of several dozens. As of today, the total number of confirmed cases has only just exceeded ten thousand (and about seven thousand in Daegu).
A look at the data provided by the Korean Center for Disease Control (KCDC) gives some clues as to how this was possible:
On the one hand, South Korea was the first country to conduct mass testing. While other countries were still scrambling to test even patients with symptoms, South Korea was already pioneering drive-through tests and had deployed many more tests per capita than any other country.
On the other hand, the korean authorities never gave up on diligently tracing the epidemiological links between all confirmed cases. Currently, the KCDC claims they can attribute over 90% of all confirmed infections to known sources, and they provide detailed information about the different infectious clusters. The chart below exhibits those clusters according to their size and type:
As we can see, the Shimcheonij Church is not the only church which has contributed to the spread, but there were at least five others. Another hotbed for the virus were hospitals and nursery homes, followed by gyms and spas, the workplace and local communities. Meanwhile, schools and kindergardens seem to have caused no major spread, likely since the outbreak coincided with a regular school holiday that was immediately prolonged.
Given limited means, Georgia so far seems to have done rather well when it comes to tracing and tracking the links between the different cases. Even though detailed information as in South Korea is not provided, it is implied that most cases can still be linked to existing clusters.
However, were Georgia to experience a similar explosion in Covid-19 infections as Daegu, it is currently hard to see how the country could copy South Korea’s example and regain control of the epidemic quickly.
According to the National Center for Disease Control, the intention of the government is to try and gradually ramp up testing capacities over the coming weeks to a maximum of 1500 tests a day.
During the past month, Georgia has consistently performed around 20 negative tests for every new confirmed case. As the daily number of new cases increases, the daily number of tests performed must increase as well if current testing policies are to be upheld. Hence, for even 1500 tests a day to be sufficient, the system could afford no more than 50-100 new cases a day.
Even at the current low rate of transmission (explored in more detail in this post) this would imply that in two weeks from now there might no longer be sufficient capacity to test everybody who should be tested.
With the situation possibly at a critical point, the government has increasingly been pleading, to little avail, both with the church leadership to suspend or modify services as well as with cititzens to obey the law and stay home.
The debate exposes a deep rift going right through Georgian society. Even the church itself seems divided on the issue, with notable clerics opposing the stance of the patriarchate. Yet hundreds of churches across the country will be holding services tonight and handing out sacramental wine in shared spoons in what seems, at this point, like a trial of courage for many faithful.
Given the relatively long incubation period of the novel coronavirus, it may take an agonising week or two for the outcome of this trial to manifest itself.
The data for most clusters can be found in the KCDC April 16 update report. For clusters not explicitely mentioned in that report I have consulted earlier reports. I obtained the following classification of the total 10’613 confirmed cases:
Churches: Shincheonji Church (5211 cases), Grace River Church in Seongnam (72), Bucheon Saeng Myeong Su Church (48), Manmin Central Church (43), Onchun Church (39), Dong-an Church-PC cafe (20), Geochang Church (10)
Workplaces: Guro-gu call center (118), Ministry of Oceans and Fisheries (30), Research center in Seosan (9), Forest Engineer Institute (3)
Gyms / Spa: Gym facilities Cheonan (103), Wings Tower Spa (10), Gym facilities Sejong (8)
Hospitals / Nursing homes: Second Mi-Ju Hospital (193), Hansarang Convalescent Hospital (127), Cheongdo Daenam Hospital (120), Daesil Convalescent Hospital (100), Bonghwa Pureun Nursing Home (68), Gyeongsan Seo Convalescent Hospital (66), Uijeongbu St. Mary‘s Hospital (57), Fatima Hospital (36)
Local communities: Yechun-gun (31), Goesan-gun Jangyeon-myeon (11), Geochang Woongyang-myeon (8), Wonju City Apartments (3)
Other: Pilgrimage to Israel (49), Suyeong-gu Kindergarden (5)
Other contacts of confirmed cases (1243)
Other small clusters (634)
Imported cases (967)
Related to imported cases (154)
Unknown source (1017)
The area of the bubbles in the bubble chart above is proportional to the number of cases of the respective cluster.