Georgia in the Face of Death

„The vaccination process has failed.“

„The death rate is high.“

„The number of cases is rising so fast that the country is expecting another lockdown.“

Is the situation as bad as these dramatic statements make it out to be? Let us look at the statistics to find out.

The Challenges for the Months Ahead

According to data provided by ourworldindata.org, at the time of writing this article on 12th December 2021, Georgia was ranked eighth in terms of cumulative total deaths per million people. Our country, which has a low vaccination rate, is in danger of rising further up the list during the next few weeks, as it is ranked fourth by the seven-day rolling average number of cases.

Georgia is ranked fifth in the world by cumulative total cases per million people, and second among all countries with a population of more than 1 million.

On 17th August 2021, as I was observing the slow uptake of vaccinations and the worryingly fast-growing infection rate, I wrote on Facebook that we would lose up to a further 4,500 people to the virus by the end of the year. In the four months since then, we have already had 6,341deaths, with two and a half weeks remaining until the end of the year.

Information About Vaccinated Persons 2021.12.13 Condition

Source: Ministry of Health

In September alone, as hospitals were at peak occupancy, the mortality rate (the share of deaths among confirmed cases) was 2.43%. Outside of the peak occupancy period, the figure ranged between 1.3% and 1.4%.

This situation comes as no surprise. Against the backdrop of a low vaccination rate, the government allowed the uncontrolled spread of the virus throughout the summer. As a result, the virus ravaged an unprotected population and overwhelmed an already struggling hospital sector.

The current vaccination rate will not allow us to achieve herd immunity. Herd immunity can be achieved in the absence of new strains appearing. However, herd immunity means huge casualties. It was previously believed that achieving herd immunity and reducing the death rate would be possible if at least 60% of the country’s population was fully vaccinated. However, since the appearance of the Delta variant, countries are aiming for anywhere between 80-85%.

The national vaccination plan of the Georgian government targets a 60% uptake rate among the adult population (3 million people), but at the current speed, even this target will be impossible to achieve. Globally, there is a consensus that the vaccination rate should be measured in terms of the entire population (including children). Since the vaccination of children only started recently, we would need to achieve a far higher figure among adults.

Let us look at what this means:

3.7 million people *60%*2 doses = 4.44 million doses. This means that 4.44 million vaccinations must be administered to reduce the death rate. As of 12th December, 2,308,497 vaccines have been administered, meaning that another 2.1 million doses will need to be administered by 31st December in order to fulfil the national plan approved by the government. This works out to 110,000 vaccinations per day, at a time when the average daily figure currently stands at 10,000. In mid-August, when 26,000-28,000 shots were being administered each day, the government openly spoke about the need to increase the figure to 40,000.

Infection, Hospitalization and Death by Age Groups 2021.10.12 Condition

Source: Ministry of Health

Data from the Ministry of Health shows that the mortality risk among the population above 80 years of age stands at 15% (meaning that one in every six to seven cases is fatal), yet only 19%of people in this age group are vaccinated as of 30th November.

The following circumstances must also be taken into account:

– The vaccination rate is exceptionally low in the regions, which is where the majority of the elderly population live.

– In areas where internet / social media usage is low, reliable information about vaccines is difficult to access due to the government not allowing TV advertising on the subject.

– Access to vaccination points is difficult in many regions, with some villages being tens of kilometres away from the nearest regional locations.

– The quality of medical care is lower in the regions than in Tbilisi.

Consequently, if the virus spreads widely across the regions, we can expect the death rate to be particularly high among the elderly in the provincial areas over the next few months (for more details on this issue, please see my letter on publika.ge “Let Us Take Care of the Elderly in the Regions”).

There is no real prospect of accelerating the pace of vaccinations, but in any case, accelerating the process would only prepare us for next spring and summer, as far as the autumn and winter seasons are concerned, that ship has already sailed. Even those of us who are vaccinated will not be protected from the virus in the sea of new cases that are on the horizon. However, we will be protected from death.

Where Did We Go Wrong, and When?

On 13th May 2020, Forbes published my article entitled “Who is Managing the Crisis – The Virus or Us?” Back then, it was already clear to me how catastrophic it would be for us to manage the pandemic through lockdowns rather than a clear strategy based on public awareness, public cooperation, and public compliance.

As a Member of Parliament, I backed the vote to declare a month-long state of emergency on 21st March 2020, as I realized that we knew very little about this virus and Georgia, like most countries, needed to adapt to the new reality.

However, we cannot simply rely on lockdowns and must create a model for our existence during the pandemic closer to the previous rhythm of life, whilst also not allowing the uncontrolled spread of the virus. Sadly, the unjustifiably prolonged lockdown in spring 2020, when daily new cases were in single or double digits and there was no epidemiological need for such ruthless measures, was followed by the government allowing the virus to run wild during the election period in autumn 2021 without even trying to enforce safety measures such as contact tracing, quarantines, or strict mask mandates.

At one point during the third wave in autumn 2020, the number of active cases exceeded the 30,000 mark. At the peak of the fourth wave in August 2021, the number of active cases rocketed to 60,000. At times when hospitals were at peak occupancy, the government used lockdowns as a remedy (e.g., in autumn 2020 or spring 2021), while at other times it did nothing, it even encouraged the uncontrolled spread of the virus by relinquishing all control of the mechanisms for enforcing regulations (e.g., in July-August 2021).

The solution is the same as it should have been before:

• Get vaccinated

• Wear a mask

• Exercise rational control over your movements and physical contact

• Trace your contacts and isolate if necessary.

However, there is a significant prerequisite for this solution.

Another reason I supported the declaration of the state of emergency on 21st March 2020 was that I believed that managing a crisis of this magnitude required a high level of public confidence in the steps taken by the government, as well as public resilience to the announced regulations. Achieving public trust and compliance required people to see that the crisis was being managed by consensus between political forces. On 21st March 2020, the opposition reached out to the government over the issue of declaring another state of emergency but was ignored in favour of unilateral crisis management, political confrontation and attempts to derive political capital from the crisis. As we can now see, this came at the cost of numerous casualties.

Instead of following the example of developed countries by clearly explaining to the population what kind of threat the novel Coronavirus presented and how important it was for members of the public to work together in the marathon fight ahead (which I described back in February 2020 as learning to co-exist with the virus), the Georgian government chose the “easy” way out: Lockdownsor a complete lack of control.

As I mentioned earlier, we will never achieve herd immunity at the current rate of vaccination. Prime Minister Gharibashvili declared that “the minority will no longer impose its will on the majority.” At present, the majority does not want to be vaccinated, just like it did not want to wear a seat belt in the past. This is because the government has failed to explain the importance of vaccines. Had the pandemic been managed in accordance with a coherent strategy based on public awareness, public cooperation, and public compliance from the very beginning, we would not need to talk about mandatory vaccinations today.

I find this type of approach unacceptable, as it is usually designed to compensate for public immaturity. Informed free citizens make choices that are both rational and based on solidarity. Informed citizens are more imbued with compassion towards others and understand that vaccines are there to protect not only them but also other people, including those who cannot get vaccinated for health reasons.

With the government having lost the information war due to a lack of strategic communication, mandatory vaccinations are certainly worth taking into consideration, especially by the public sector. Otherwise, Georgia may well become an example cited by epidemiologists in the future – an example of how not to manage a pandemic in the 21st century.