Research shows that the next outbreak of disease COVID-19 will be in the Odessa area
No quarantine would have died to 140 thousand Ukrainians. In the Kyiv school of Economics has conducted a study on how many Ukrainians might get sick and die from coronavirus infection. The study examines 81 scenario, how can the development of the epidemic COVID-19 in Ukraine. Model this study uses the Ministry of health to predict outbreaks in the country.
In what scenario is now moving morbidity in Ukraine, how many Ukrainians can die, and why will soon have to re-introduce tough quarantine – this in an interview “Today” told Timofey Milovanov, the President of the Kyiv school of Economics, Minister of economic development, trade and agriculture of Ukraine in 2019-2020
Until the end of the year from the virus will die from 2,000 to 7,500
– Kyiv school of Economics predicts three scenarios how to develop the incidence COVID-19 and how many Ukrainians can die. Can you briefly tell us about them and what scenario now is Ukraine heading?
– Actually scripts a lot more. This is a complex model that is based on the data, which is today in Ukraine the number of deaths, number of severe and moderate cases, how much was recovered and how much we have intensive care beds and where they are. Just seen the 81 scenario, depending on how the virus will evolve, in what regions and at what time. And it depends not only on the virus itself, but from human behavior — is it distance, hygiene, whether the business processes of the surface every hour. All of these scenarios depend on small, but important parameters. Scientists are trying to understand which scenarios are more important and how they can be grouped to talk about the 81 scenarios, and “green”, “yellow” and “black”. And the biggest composite or aggregate indicator is the seasonality. This indicator explains where, who and how sick, how many recover and how soon, how many people can die.
Indeed, there are three groups of scenarios — yellow, black and green. Black is the scenario in which there is no seasonality. That is, regardless of the season the behaviour of the virus, the probability of the incidence, transmission and the number of people who become infected through contacts from one of the sick, are not changed. This scenario is the worst for us. It means that the virus in the summer as aggressively as in the winter.
The average script — yellow — is when the number of new infected from one sick drops 20%.
And the green scenario is the optimistic scenario, when seasonality is 60%. That is, when the transmission drops by more than two times.
Under different scenarios, would be a different number of patients and deaths.
The real data that we are witnessing today in Ukraine show that Ukraine is on the yellow scenario. At worst, black scenario, if the quarantine did not exist, would have died 120-140 thousand people. A green scenario, under quarantine, until the end of the year had killed up to 900 people. We can already see that passed this figure.
The yellow scenario is also quite a lot of people could die as without quarantine and quarantine. According to our estimates, in terms of quarantine from 2000 to 7500 people will die before the end of the year. How many will die depends on how it will be administered adaptive quarantine and how well and clearly the people and the business will follow the rules of conduct. Yet we see that people don’t follow the rules. I also am not sure that the whole business controls the distance of six feet between people, often enough and handles well the surface adheres to other rules.
– That is still possible fade to black scenario, it remains likely?
Black script is about the aggressiveness of the virus. We definitely are not. We’re in yellow, but the consequences may be different, depending on the behavior of people, business and government — from 2,000 to 7,500 deaths. 7500 is if we do not adhere to the requirements, when we neglect their medical safety and the people around us. But 2000 deaths — if all will follow the rules and quarantine will be carried out efficiently: not just to close an area or town, then open, and use a very targeted approach where flash, to impose severe restrictions where no flash is to soften the constraints, but still need to comply with all the requirements. We must understand that ignoring the rules is a human life.
The number of infected grows: how many patients COVID-19 will be able to take hospital
“The total number of patients is not 40 thousand, and 120-130 thousand”
To what extent can we trust the data on morbidity and deaths, offered the Ministry of health?
– This question is hidden a few questions at a time. How reliable is the data of the test results? For example, did tests, but everything is transferred to the public health Center? Or have tested whether a deceased person? Second question: as far as our testing system detects all cases?
In all tests, there are “error 1” and “error 0”. This is when, on the one hand, people can get sick or die from coronavirus, and it is not detected because it was not tested or the test showed a false negative result. Or Vice versa — the test can detect disease when it is not. For example, a person could die from another illness, but it has a virus and he will strengthen the disease or the virus in General no, but the test was positive — this too can be. Of course, all cases are not detected, because all are not tested. If everyone was tested a few times, then we could say that very accurately know the incidence. But our model makes it possible to accurately estimate how many people you’re actually sick. The most important indicator is the number of deaths. When a person dies, then he has a history of illness, tested and, if necessary, the cause identified by the pathologist. That is, the cause of death identificireba with great quality. The model focuses on the fact that it clearly and correctly shows the number of deaths. When we talk about black, yellow and green scenarios, the number of deaths is the main indicator that we orientirueshsya. How many people get sick is important, but many people can recover and recuperate without having symptoms. The most critical — how many people will get complications or die. Therefore, the model must predict such indicators. In these figures, the model gets high quality.
As for incidence, the model can show how many people fell ill after release of the quarantine. The incubation period — an average of two weeks, then the outbreak occurs. We know that a certain percentage of experiencing a difficult disease and there is a period after which they recover or die. We all compare data among themselves and, where they do not converge, the model allows us to identify how many cases of people incorrectly tested or were not tested at all. Studies show that revealed only 30-40% of all cases. The total number of patients is not 40 thousand, and 120-130 thousand as of last week. The figure of 30-40% is similar to the figure of China — there were identified 31% when they started. Ukraine is relatively in a good position. Our testing system works well compared to other countries. But, of course, you can always increase the number of tests.
– If you compared how the virus behaves in neighbouring countries and in Ukraine?
Yes, this model also takes into account. When we make the forecast, how many people will get sick, will the outbreak and how we need to react to, the model takes into account what is happening in other countries. Here are two examples, which shows the model. We go through the scenario of Poland and lagging behind for a few weeks. So we can look at Poland, to see what is happening there, to draw conclusions and be a step ahead. Although in recent weeks we have strayed from the Polish scenario. A more specific example at the regional level — we predicted the outbreak in the Odessa region. We predict that the flash will be in the Odessa region is not so much because of the tourists and of failure to follow rules, but because of the fact that Moldova is now a large outbreak. Odessa is next. It represents for us a certain danger, because the flash can be transferred to Odessa, and through the domestic tourists spread to Ukraine. If you do not take more stringent measures to limit the spread of the virus in the Odessa region, there is a high probability that the virus will deliver in key major cities — Kyiv, Kharkiv, Dnipro and so on. This needs to be monitored, to strengthen the monitoring of implementation of quarantine measures in the region and in Odessa. This is an example of how you can and how to apply this model.
In some areas, statistics show a low and high level testing. For example, in the Kherson region the employment of beds in hospitals — 1.4%, and the level of testing one of the highest in the country. Similar results in the Poltava and Cherkasy oblasts. The impression is that some regions do not show the real situation, although sufficiently long time has launched a transport and train in these regions.
– This is normal and can be. We still 30-40 million, depending on how you count. Even if we take the maximum number of patients 130 thousand, that is 0.3% of the population. This means that 300 people will be one patient. These patients are unevenly distributed. For example, in Kiev can be 30 patients on 300, and in Poltava — 1 in 10 thousand. If there comes 2-3 people from Kiev, it is a question, how many people they will meet, how actively they communicate. If they are home and have the symptoms then the person is not in isolation, test it — so in some areas there are large numbers. She appeared to have or a critical event or the critical number of people. For example, if the train is not one sick man, and 10 in each car. And this train will stop, people will go to drink coffee, each other shake hands and so the whole train will be infected. And then the patient goes to Church, so it is possible to infect the entire city.
If such things happens, it’s good that the virus spreads slowly and in some places not at all be the flash. At the level of individual cities it is difficult to predict the likelihood of outbreaks, as it depends on critical events. And at the country level it is possible to predict — if we have 100-120 thousand patients, we know that the next day will be that much.
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Quarantine may strengthen in the near future
Yellow scenario foresees the re-introduction of a rigid quarantine?
– The probability is, and this can happen in July in the near future. Could it be that the quarantine will increase. When the dynamics of incidence increases and we see flash, then you need to impose restrictions. This compares with inflation. We target inflation (taking control), and not run after every price and tell you what the price of bread should be such that for buckwheat this, and the oil like this. Instead, we say that the average consumer basket should remain approximately the same price, it is possible to grow 1-2% per year. The same idea with disease. Quarantine is not exceeding the total number of patients in all the time and targetroot percentage 100 thousand people at any given time. And we understand that if the regions, cities or in rural areas, the number of patients per 100 thousand more than the critical value, there will be more stringent measures. Currently the threshold is 8 patients per 100 thousand. Then we must look at the dynamics. For example, if you’re driving downhill at a speed of 40 km/h, that is important, not the number 40, and the speed at which the car accelerates, because it is possible to gain such acceleration that when you start to slow down, not stop the car. Similarly, it is possible in some city not 8 per 100 thousand population, and three, but we see that the dynamics is growing every day twice. Then there is need to introduce measures. Somewhere can be 9 to 100 thousand, but the dynamics of diseases is reduced.
– That is, it is not about the possibility of a nationwide quarantine, and at the level of regions or cities?
Yes. Correctly even enter quarantine in cities and villages. Already there were cases when the village was a lot of cases and it was closed, and inside the village people were also in isolation. Let’s say 10% of the affected villagers are in isolation, someone healed, someone needs to stay in hospital two to four weeks the situation is normalised, there are no new cases — then it is possible to access the village. Measures must be be very targeted, targetirovanie for a particular situation in a particular locality. That is, we must look for groups of people who live together and can easily pass the virus.
– I understand that in such circumstances we will live long, because there is no evidence that the virus can leave.
– Now there is a second outbreak in Ukraine and around the world. While there is no vaccine or immunity had been ill. Therefore, this situation will continue. But I think people are not ready to live in strict quarantine. People are not ready to close the house, so we need to prepare for the new reality — to think, how we work, to learn, to move, to communicate, provided that we will pay much attention to their health and the health of the people around us.
“Quarantine most hit the poor and the youth”
– How people and business to prepare for a possible tightening of quarantine and under new conditions?
– Every business has its own situation. Some businesses can work remotely, but not all – many can’t. For example, take education. At first there was a boom of online education, but then it quickly became clear that not everyone is happy — lost social interaction, networking, learning from each other. Now many universities and schools are planning to introduce a new system — synchronous training. This is when some people are online right part — within the class, and they occasionally alternate. This gives you the opportunity to keep his distance from the audience. But there are other issues – how to evaluate the results of the study, if there are more opportunities to write off? Impossible to put five cameras on each student. Therefore, we need innovation in how we evaluate and test people. It’s not easy because you need to give more creative work and the teacher needs more time for review.
Similarly, let’s take restaurants. Many responded that opened the site, but it is still not the volume of customers. Although there may and city to help create the conditions to make it easier to access the site. Because someone can open the site, because physically there territory and someone – no. But it can’t work forever. And in October, it won’t work again, you need to come up with a system of work without pads. Nobody will go to the restaurant and wait until there is a place to maintain a distance of half a meter. It is also a complex system of ordering, reservations may be applications that will allow you to reserve your table in many restaurants. A lot of challenges on the level of organization and logistics.
There are also psychological challenges. Not everyone is easy to work from home, especially in countries such as Ukraine. In developed countries more space at home, more square meters per person, and in Ukraine many people live together in a one bedroom apartment can live three to five people. If they are constantly nearby, they have no opportunity to work remotely full. So we see that it is necessary to pay attention to the psychological state and morale. We need to help people cope with stress caused by changes in lifestyle. And everyone has their own problems — someone at home is not made up and the man went to the office to work, someone on one computer to work with. Many things and psychological effects underestimated.
Further, there are problems with economic inequality. The quarantine has hit the people who are poorer. People who take public transportation, their work can be physical. These are people who are harder to adapt. When shut down public transport, those who had cars, not faced with the problem of how to get work or an appointment. And usually these people have a bigger house, more space, and can even offices in homes. They can afford to overpay for a product or service and pay for the delivery. The quarantine has hit hard at those who are poorer, and this should be taken into account by the government and enter support.
Also the crisis has on youth and those in early career. If I’m a Professor, a politician or an expert, then I already have a public name and reputation. When all offline meetings stopped, I can acccess the online lecture or to write a column and it will be profitable, because more people online. And people who only build a career, lose your group of people with whom they conducted the offline classes. Or take the example of dancing teacher. He has a group of people who went to school. Now he can pursue group or private classes. It can organize an online class. But if I choose an online class, it is best to choose a lesson from the world champion new York or the best teacher of Ukraine. Thus, the more famous went online and got more customers than they had before. If to quarantine people demanded physical individual meetings and to the professional and the novice, and both conducted 10 sessions per day, differed only in price, now online, looks the same and they can 1000 people to learn at the same time. But those who just start their career, lost their clients. Here, too, need some support for those who are just starting out.
In the second part of the interview is available as Ukraine suffered from the coronavirus in comparison with other countries and as we hit the crisis caused by the COVID-19.