Georgia out of EU “Green Zone”

After a heavily suppressed coronavirus wave in spring, Georgia now faces its first major outbreak under normalised conditions. Its status as an international Covid-19 success story is being put to the challenge.

Following a superspreading event two weeks ago in a cake shop in Batumi, a major holiday hotspot, the virus has quickly popped up in other major cities of the country. Daily new cases have increased exponentially from less than 10 in August to almost 196 today (September 16).

During the first two weeks of September, the number of new cases doubled almost every 3 days, a growth rate seen in March in Western European countries and the US.

The surge could have implications for Georgia‘s status as a nearly Covid-free country. For instance, Georgia is among only a handful of countries worldwide for which the EU commission has recommended the lifting of all Covid-related travel restrictions.

According to the traffic light system recently adopted by the EU commission, a country is considered to be in the „Green zone“ if

  • cumulative cases per 100‘000 inhabitants over the past 2 weeks do not exceed 25, and
  • no more than 3% of all performed Covid-19 tests are positive.

As of yesterday, September 15, Georgia is now failing the first criterium, placing it in the „Orange zone“. Today, the 14-day incidence per 100’000 residents has risen to 32.5. In order to re-enter the Green zone, Georgia would need to register on average less than 66 new cases a day over the duration of two weeks. Given the current epidemic trendline, such a scenario is unlikely to come about before October.

Marina Ezugbaia, Medical Director of Tbilisi Hospital of Infectious Diseases, stated today in her press briefing that Georgia remains in the “Green zone”. This discrepancy is due to the fact that the Georgian health authorities use a slightly different metric with different thresholds.

Cumulative 14-day incidence for a selection of countries. The red line is Georgia. The thin grey lines are all the countries with more than three million inhabitants. The green area corresponds to the Green Zone as defined by the EU commission. [Sources of raw data: (daily cases per capita for all countries, based on data from the European Center for Disease Control), Georgian National Center for Disease Control (for Georgian case numbers) and geostat (for latest Georgian population figure).]

During the past three days, however, growth seems to have stalled somewhat, with health officials and the Prime Minister likewise reassuring the public that everything is under control. The government was quick to rule out a lockdown of the city of Batumi. At the same time, authorities have reinstated a ban on large gatherings, delayed the start of the school year by two weeks and appealed to citizens to take mask wearing more seriously.

The situation is a delicate one for the government in the run-up to the October national elections. Georgia‘s successful suppression of the coronavirus outbreak in spring has become a major election campaign theme of the ruling Georgian Dream party. The next two weeks are likely to shape the narrative of the government‘s coronavirus crisis manegement.

Containing an explosive outbreak fuelled by superspreading events is not impossible, even without major restrictions such as a lockdown. This was impressively demonstrated by the Korean Disease Control and Prevention Agency (KDCA) in March, when it effectively stopped a major outbreak after a superspreader had infected around thousand worshippers in a church. The key element to the Korean success was an army of contact tracers equipped not only with traditional, but modern data tools.

According to the daily press briefings by Ezugbaia, the proportion of new infections whose source could not be traced remains stable at 5-20% day by day. These figures are actually lower than the numbers published by the KDCA at the height of the Korean outbreak (around 30%), which would seem to indicate that contact tracing is, at this point, still working effectively in Georgia.

This is also a consequence of the country‘s high testing rate, a crucial ingredient for effective contact tracing. According to the testing data published by the National Center for Disease Control, the test positivity rate remains firmly below 3%.

Should the national health authorities manage to contain the current outbreak quickly, the government will no doubt feel vindicated. It will point to the fact that the strict measures in spring allowed health authorities in the country to gain time and build up an effective response, saving lives and paving the way for a more sustainable but no less successful epidemic control regime.

If the epidemic gets out of hand, however, voices will grow louder accusing the government of claiming victory too early and having nothing left in the tank to stem the next tide: a surge of the coronavirus during the flu season, accompanied by more restrictions, more economic hardship and growing public resentment.

Cumulative 14-day incidence for groups of countries. The red line is Georgia and the green area corresponds to the EU Green zone. Note the different scale in the bottom two plots. [Sources of raw data as stated in the first figure]

This article was republished in Georgian by netgazeti.

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