„Crisis management experts say that if society lives more than 200 days in uncertainty, then the crisis becomes an existential one. Moldova is living in the COVID-19 crisis for 240 days already. Why do we prefer to live in uncertainty even when we can live differently? We just need a change of tactics in the fight against the pandemic to begin with....”
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The coronavirus pandemic has exposed thousands of lives to challenges and put health systems under enormous pressure.

The first country to apply drastic restrictions was Italy. In February, several cities in Italy, identified as "red zones", were quarantined, hoping to stop the spread of the disease to other parts of the country.

The national quarantine model associated with exceptional situation was applied in most European countries in the first wave of pandemics.

The purpose of applying the first wave of quarantine was to allow health systems to prepare for a response to the pandemic.

Restrictions have included:

1. National events stop;
2. Closure of educational establishments: schools, nurseries, kindergartens;
3. Restrictions on national traffic;
4. Closure of non-essential stores;
5. Restrictions on international traffic;
6. Flight restrictions;

Already in May it was clear that the gradual reduction of containment measures will inevitably lead to an increase in new cases of coronavirus infection.

Countries have chosen various pandemic tactics for the so-called second wave. Some countries chose the virus eradication tactic, others chose the suppression tactic.

Countries with eradication tactics apply mass testing and detection of all those infected, with their subsequent isolation. In addition, these countries test everyone who comes to the country.

Their logic is simple: we completely eradicate the virus present in the country and do not allow it to be brought from abroad.

China and some Asian states apply this tactic frequently. Recently this tactic was applied by Slovakia, a country with a population of 5.5 million people and an average number of new daily cases of 600. With the support of the army, 3.6 million of the population was tested in Slovakia with express South Korean manufacturing tests. A total of 5000 teams of 8 people worked in mobile tents all over the country. Repeated testing is expected over 7 days in certain geographies with a higher incidence. The test was voluntary. People who refused testing were ordered to isolate themselves for 14 days. The aim of the project was to discover all those who carried COVID-19 and their isolation. At the first stage, approximately 38000 people infected with COVID-19 were detected and isolated. The cost of the project was valued at 43 million euros.

The second stage provides for the mandatory testing for all those entering the country. Slovakia will probably be the first European country to declare itself COVID-free, following effective anti-pandemic measures. Their experience is now widely studied by other European countries.

Countries with pandemic suppression tactics (Moldova is among these countries) monitor the evolution of cases and adopt decisions to apply or lift restrictions for certain periods. Those who are infected are treated at home or in hospitals.

The models of restrictions applied in wave one and the models of restrictions applied in wave two are different and now the restrictions depend on several indicators.

Three main sets of criteria have been developed to help countries maintain control of the situation. Each country applies them when assessing, whether it is time to review the measures:
 

1. Epidemiological criteria indicating a sustained reduction and stabilization of the number of hospitalizations and/or new cases for a sustained period of time;
2. Sufficient capacity of the health system, for example, in terms of an adequate number of hospital beds, pharmaceuticals and equipment stocks;
3. Appropriate monitoring capacity, including large-scale testing capability for rapid detection and isolation of infected persons, as well as tracking and tracking capacity.

Among the new elements of restrictions applied in wave two can be mentioned the following:
 

1. Application of night-time traffic restrictions between 23.00 and 5.00;
2. Application of weekend quarantine, i.e. weekend, for two days;
3. Application of quarantine for certain cities or areas, without quarantine the whole country;
4. Mandatory wearing of masks everywhere, including in open spaces;
5. Application of total quarantine for short periods of up to 10 days.

All these measures have one purpose – to slow down the pandemic. When cases start to drop, the restrictions are lifted. The effectiveness of these measures in several European countries is already well proven.

Reflections on possible scenarios in Moldova

We tried to slow down the pandemic here with severe restrictions at the beginning of the pandemic. We were able to brake for a while. As a result, the economy has suffered.

We tried to allow the pandemic to go its way, in parallel with our path. Without slowing down either us or the pandemic. We have recorded a large number of patients, a large number of deaths, and we continue to record them.

According to some calculations, it would be to have in Moldova now about 300 000 people already passed through COVID-19, or about 10% of the population. The National Medical Company has already announced expenses of over 500 million lei for COVID-19.

We didn't reach herd immunity of 60-70%, we didn't eradicate the virus, we didn't brake suddenly. We don't want to apply new restrictions, and we often wonder, what can we expect?

To get rid of the pandemic, we need immunity. Immunity can be natural, i.e.  formed after the disease. Immunity can be artificial, generated by a vaccine. The vaccine is not yet approved and I assume it will not be available earlier than summer 2021.

We now have only two real options:

To apply quarantine and break out of the transmission chains, lower the infection rate to a controllable level and continue to operate in this constant danger. Quarantine may be local, partial, periodic, but it will certainly break some of the chains of transmission of the disease. Treatment costs will remain high anyway and will exceed 1 billion lei for a year.

To organize a mass population test. That means for two days to identify all those infected and isolate them.   In a week to rehearse the exercise and find the remaining ones. Doing that, we eradicate everything on the inside in two weeks and treat the real infected. Then we introduce testing at the 10 border points for everyone who enters. And towards Christmas we may declare our country as COVID-free zone.

Are you going to ask me what the price is? If Slovakia, with 5.5 million population, spends 43 million euros, we spend 2.6 million euros, we would have to spend half of that amount.

A month ago, China tested 10 million people in a city in just seven days. They only detected eight positive cases. It was an example to the whole world of stopping the pandemic. Several Asian countries have applied these eradication tactics and already live more than 200 days without any case of COVID-19.

Crisis management experts say that if society lives more than 200 days in uncertainty, then the crisis becomes an existential one.

Moldova is living in the COVID-19 crisis for 240 days already. Why do we prefer to live in uncertainty even when we can live differently? We just need a change of tactics in fighting the pandemic to begin with.