COVID-19 in Bulgaria: The Government is Changing the Plan
The government is preparing a new plan to deal with the Omicron wave of the coronavirus variant, which is expected to hit Bulgaria in full force in the second half of January.
Restrictive measures against COVID-19 will be imposed not at the national level, but by district, and decisions on their introduction will be made on the basis of a set of indicators monitored by the authorities, the most important of which are intensive beds in hospitals, the number of affected physicians and the pressure on the Emergency Service. Students will leave the classrooms only if critical levels of hospital occupancy are reached, putting at risk the possibility of rescuing the sick.
This became clear from statements by Prime Minister Kiril Petkov and representatives of the health authorities today. Petkov clarified that today the document has passed its first discussion at the regular meeting of the Council of Ministers and the individual departments are about to give their comments on it. According to the information of Chief State Health Inspector Angel Kunchev, the plan is expected to be adopted and come into force by the end of the week.
The cabinet has already appointed new advisory bodies to discuss the measures. So far, however, ministers have declined to comment on what actions the executive branch is considering to manage the impending fifth wave of contagion. The only indication that changes were being prepared was Health Minister Prof. Asena Serbezova's statement last week that the caretaker government's summer plan on morbidity measures "is not adequate". The deputies from the ruling coalition referred to the government, arguing that all measures were within its competence.
Not morbidity, but intensive beds
From the statements of the health inspector and the head of the Sofia Regional Health Inspectorate (RHI) Dancho Penchev today it became clear that the authorities will monitor many indicators, but three will be of particular importance:
- The load on the intensive care beds
- The number of medics who are ill or unable to work due to quarantine
- The workload of the Emergency Medical Center - the calls and the number of hospitalizations to which these calls lead.
“Unlike so far, we are not just looking at morbidity, although it is a very important indicator, but at the severity - how many beds are occupied, especially in intensive care units”, said Angel Kunchev, Chief State Health Inspector
The arguments of health experts that morbidity is not a primary criterion are hidden in the specifics of the Omicron variant, which is expected to dominate the new wave - it is transmitted much easier and infects many people, but the symptoms are mild and the need of hospital treatment is rare.
Intensive care beds are the most fragile part of the healthcare system during a wave because they cannot increase quickly, Kiril Petkov's explained in an interview with Nova TV today. According to him, the government will manage the wave on the basis of this indicator, because "the lack of beds puts people's lives at risk." This will be the criterion for the closure of the economy and schools, said Petkov, who since the election campaign has consistently reiterated that lockdown should be the last resort in a new wave of coronavirus.
Measures: by districts and on four levels
According to the Prime Minister, the authorities are estimating four steps of measures of varying severity in areas with the filling of between 50% and 80% of hospital beds for intensive care. Public places will be closed when 80 percent of the beds are occupied. "We are not talking about the existing intensive care beds, but about the maximum number that can be created according to state estimates," said Angel Kunchev.
At the peak of the previous waves, hospitals were obliged to set aside 10 percent of their beds for the treatment of COVID-19, and those for intensive care were just over 1,100. So far, the maximum number of occupied intensive care beds was 813. It was reached on April 9 last year. To date, the number of occupied beds is 580.
Mathematical model for early warning
On Tuesday, Health Minister Asena Serbezova said that based on the data accumulated so far from the Unified Information System, mathematical modeling and an attempt to predict how the new wave of COVID-19 will proceed will be made. Later, Angel Kunchev clarified that mathematicians from the Bulgarian Academy of Sciences were involved to make a formula that includes more indicators, on the basis of which to make forecasts for the development of the wave.
Kiril Petkov told BNR that he hopes this model will provide forecasts for the next few days. That way, people and businesses in areas where measures are to be imposed, regardless of their severity, will have time to prepare, he said.
Online studies as a last resort, for the little ones - vacation
In all his statements today, Prime Minister Kiril Petkov stressed that the priority of governance during the new coronavirus wave will be students and their in-class training. "The priority is for them to go to school until the wave starts threatening the capacity of the health system," Petkov explained, assuring that the cabinet has a "very logical and practical approach" to how to act, but without giving details.
From his interview for BNR, it became known that the plan envisages the last to leave the classrooms to be students from 1st to 4th grade. This will happen when 80 percent of the intensive care beds in an area are full. "We discussed with the Minister of Education in these cases to give a one-week vacation, but not to return to long-term online studying, because it does not give the good results we hoped for," said Petkov.
The Prime Minister clarified that with the lower occupancy rate - 70%, children from 1st to 4th grade will continue to go to school, and older ones will have to return online. At 60% all children will continue to go to school.
Asena Serbezova reminded the media last week that before starting distance learning, "extracurricular activities, visits to museums, natural sites can be stopped, it is possible to discuss a measure for more frequent testing, to switch to shift studying". These are likely to be the measures at the lowest threshold for filling intensive beds.
According to the current rules, the decision for distance learning is very conditional. The guidelines of the Ministry of Education stipulate that there should be no restrictions on the presence of education in case of any morbidity, as long as tests are performed on students and teachers without a certificate for COVID-19, when the infected in a municipality are over 250 per 100 thousand population. For comparison, according to official data, the incidence in the Sofia Municipality as of January 12 is 1387 people.
The rest of the measures
It is not yet known what other measures are envisaged in the government plan. The day before, the authorities shortened the duration of isolation for patients with COVID-19 and the quarantine for those who came into contact with patients. They were reduced from 14 to 10 and from 10 to 7 days, respectively, and those who received a booster dose can take a PCR test after the third day and leave their homes after a negative result.
In an attempt to stimulate the vaccination campaign, the cabinet began paying BGN 75 to people over the age of 65 who are immunized. So far, there are no indications that incentives are being prepared for people under this age other than the prime minister's calls for vaccination.
In some areas, such as Sofia, the first step towards restrictions has been the temporary suspension of planned operations. According to Deputy Minister of Health Georgi Yordanov, the COVID zones in the diagnostic and consultation centers are to be increased, where tests and examinations are being carried out and free medicines can be prescribed.
So far, lawmakers from the ruling coalition, which includes "We Continue the Change", "BSP for Bulgaria", "There Is Such a People" and "Democratic Bulgaria", have not planned joint legislative actions related to the COVID crisis. The synchronization is obligatory according to the coalition agreement, which stipulates that the four formations will coordinate their legislative activity and will submit their bills to the National Assembly together.
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