Why does Moldova have fewer pandemic waves and what to do? Op-Ed by Ala Tocarciuc

It's up to us how we get out of the third wave of this pandemic. We need the power to decide and the will to execute our own decisions. Priority, however, should be to save human lives!”

The pandemic in Moldova has a special shade, determined to a large extent by authentic local approaches. While everyone is wobbling on the third pandemic wave, we quickly rise only on the second wave.

You're going to wonder why we only have two waves?

We, like everyone else, would now be on the third wave. It's just that when we were trying to get out of the first wave, it was presidential election time. The elections did not allow Moldova to emerge from the first pandemic wave, but vice versa, we all entered with the force from the first wave directly into the second one. These two overlapping waves generated a large number of illnesses in November-December 2020.

In January, after the holidays associated with a relative semi-isolation, the number of illnesses began to decrease slowly. Everyone was getting out of wave two. We, in Moldova were getting out of wave one. The joy, however, didn't last very long.

In February the number of illnesses began to increase again. It was increased everything that could raise: the number of positive tests, the rate of positivity, the number of sick people, the duration of the disease.

The hypothesis, which has dominated over the past year, if we test more – we will have more cases, has finally been confirmed in practice. If we did 6,000 tests, we had over 2000 new cases. If we'd done 3,000 tests, we'd have about 1,000 new cases.

The number of deaths has also risen rapidly. The number of daily deaths at the end of March is practically double the number of deaths at the beginning of the month.

However, there was also something new in this wave. The number of the tests and the number of the daily new cases have been increased. The number of the complicate cases was highly stable. It is known that the number of active cases in the general population can be estimated from the number of difficult cases in the general population. It's an alarming figure!

Doctors are exhausted both physically – and emotionally,  students learn online, businesses are on the verge of bankruptcy, politicians go on their agenda, pandemic fatigue dominates everywhere.

How and when are we going to get past this pandemic wave?

If   we look at the characteristics of the first two waves in Moldova and consider their overlap, determined by the presidential elections, then we can predict that the third wave will also overlap with the fourth wave, because of the early parliamentary elections, which are to be  held  in June-July 2021.

The duration of the first two overlapping waves was about 7 months, the wave that began on Trinity in June went down towards Christmas. The current wave started with spring and, if we make an election, it will end in October.

If we look back at everything, we did in the first wave, we can easily see that we've widened the number of hospital beds, equipped some of them with oxygenation equipment, increased testing capabilities, and that's about it. That's technically.

Conceptually, we've adjusted the clinical treatment protocols, and that's about it. We did not have the capacity to do epidemiological surveillance of first-level contacts, we did not test and isolate them further.

We have lost a lot, however, from human potential, including in the health system. We have lost many qualified specialists without immediate replacement reserves.

Assessing the situation and the new circumstances clearly tell us that a change of tactics is needed.

Right now we're doing exactly what we did in the first wave. Nothing is changed in tactics, although changes are required, largely determined by the peculiarities of the virus.

The current virus is not like the virus from the first wave. They say we have the confirmed British strain here. No other strains are confirmed yet. All we see is a new disease clinical evolution. Patients do not get high fever and their tests are apparently good. After two weeks of the disease appear severe pneumonia and their evolution is much more complicated.

The number of patients is increasing steadily and will continue to increase.

There are no beds in hospitals. The opening of new beds for COVID-19 patients cannot be carried out indefinitely. A year ago, the maximal capacity in the country was 2000 beds. Currently we have reprofiled over 4500 beds across the country and that does not cover all current needs.

There are no doctors and nurses. If initially there were rules to have a doctor in 5-6 patients, now we have a doctor in 50-60 patients. The quality of healthcare decreases in geometric progression under such conditions.

The technical capabilities for laboratory services, radiology, are equally limited by the technical factor, and by the human factor.

We are already in Lent or Easter fasting, a period with many important religious traditions and certain impediments in ensuring the epidemiological surveillance process. This period will last at least another 6 weeks and will determine the evolution of wave three.

We are not able to get out of the third wave till the end of May, so that a qualitative election campaign can take place. The election campaign will begin exactly when we are in the middle of wave three.

Imagine now, a lot of teams formed by over twenty parties, circulating from village to village, communicating with dozens of people, carrying with them new strains of virus. They are going to bring it to them without knowing it, they are going to leave them it unintentionally, they are going to cross them sometimes even, and they are going to carry it with them.

I may hear voices saying:  look how Romania made elections in 2020, and Ukraine made elections, and other countries made elections, and everything was fine. Yes, I agree, they made elections just like us, at times when other strains were circulating. Now other strains circulate, much more contagious, much more aggressive, their starting point is from a much broader population. With the old virus from 5 patients per 1000 patients you would reach in 3 months, now from 5 patients to 1000 patients you reach in a month.

To make the right decisions about new tactics, we need to look at the real situation here, within the borders of our country. We can look at the developments in the neighbor countries or countries that entered the third wave earlier than us. All these developments are only going to give us some predictions.

Real changes will only give us the concrete measures, which we are able to take.

It's up to us how we get out of the third wave of this pandemic. We need the power to decide and the will to execute our own decisions. The priority, however, should be saving human lives!


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