Kiisler: Estonia's testing strategy will leave us the back marker in Europe
Radically different coronavirus testing strategies of European countries make it virtually impossible to gauge Covid prevalence using PCR testing, with some countries no longer testing fully vaccinated people or those who have recovered. At the same time, Estonia and its Baltic neighbors continue to make massive use of hugely expensive PCR tests, Indrek Kiisler writes.
Some countries have refrained from building up an extensive testing network throughout the crisis. One such example is Poland. Many were surprised to see Poland's considerably lower infection rate this summer.
For example, Polish citizens could travel to Finland without any additional conditions this summer because they easily met Finland's very strict criteria. The reason couldn't have been simpler – Poland's rate of testing per one million residents was among the lowest in Europe. Finnish officials paid no mind to this "minor detail."
Comparing the official infection rates of Estonia and Finland has also become rather pointless as Finland hasn't deemed it sensible to test fully vaccinated people since October 1. Vaccinated people are expected to stay home as with any viral infection. Publishing the number of daily infections has also stopped.
"A fully vaccinated person does not need to be tested if they have the symptoms of an ordinary viral infection, such as a headache, fever or a runny nose. What is important is staying home instead of going to work or school. People need to contact their doctor if the symptoms worsen," Otto Helve, chief doctor of the Finnish Institute for Health and Welfare, said.
Radically changing the rules of the testing strategy in October has seen a sharp decline in the number of tests analyzed in Finland. In a situation where 172,196 tests were administered in the first week of September, the figure had fallen to just 64,605 last week. A difference of almost three times.
What effect has this had on the infection rate? Testing three times as intensive managed to diagnose 3,596 cases in the first week of September, while the figure came to 3,195 last week. Therefore, official statistics tells us that the prevalence of the virus had fallen by 10 percent from September to October.
However, we see something else entirely if we look at coronavirus-related deaths and hospitalization.
The first week of September, Finland registered 14 Covid deaths, while it had climbed to 34 last week. The number of people who need to be treated in the hospital has skyrocketed in recent weeks and tripled since early September. Luckily, it is not quite as high as in Estonia.
What conclusions can we draw? The coronavirus is much more widespread in Finland than daily statistics suggests. Finland has managed to fully vaccinate 68 percent of the total population.
Even though recent weeks have seen the vaccination pace slacken also in Finland, fewer and fewer people are tested. Basically, only a third of the population qualifies for testing.
Romania makes for another characteristic example where the official infection rate per 100,000 people came to 1,067 and the country of 19.5 million people administered 25,350 PCR tests (and 53,356 antigen rapid tests) on October 27.
To compare – Estonia administered 10,155 PCR tests in the last day, having a population 15 times smaller than Romania. Hospitals in Romania saw the deaths of 520 coronavirus patients, which adjusted to population would amount to 35 daily deaths in Estonia. In other words, the reality is much starker than the official infection rate suggests.
No point to even mention countries like Russia, Turkey or Belarus in this context as authoritarian regimes, hardly betting on mass testing in the first place, are always ready to "embellish the results."
But why should we care about how other countries are recording the coronavirus?
Firstly, because the already chaotic international picture has become even more muddled as even neighboring European countries cannot be compared to one another anymore.
Some certainty can be distilled from comparing hospitalization and coronavirus deaths. But as we now know, Sweden's record coronavirus deaths last winter were caused by the virus making its way to massive nursing homes. Therefore, the devil, as always, is in the details.
We should definitely not lower the PCR testing threshold in the current situation where the virus is widespread and hospitals struggling only to make Estonia and its Baltic neighbors appear better internationally. That would be cynical.
However, once the acute phase of the crisis passes, we should ask whether we should continue burning through funds at the recent rate. We cannot order lab work every time someone has a runny nose or a sore throat. However, that is precisely what we are doing, whereas it seems we will be reporting sky-high figures also in the future in a situation where other countries might be sporting far worse actual indicators but come off cleaner courtesy of different testing strategies.
For example, Germany only tests people with a certain set of symptoms. In Estonia, every person stepping off a plane is offered a free Covid test on the first floor of the airport.
The problem is of the reputation of the Estonian state and its people as people in the West have been conditioned using a particular risk metric – infection rate per 100,000 residents – for two years. Many know the current figure in their sleep.
Member of the government's coronavirus advisory body Andero Uusberg said this summer than the infection rate will not be the most important aspect in the third wave. And yet, push notifications from private media publications reporting the latest infection numbers keep popping up on my phone also in October.
Finnish, German or Italian tourists do not have to know different countries' coronavirus statistics and its background, while they can all read the infection rate as it has been paramount so far. It is the main indicator whether we like it or not.
The European Center for Disease Prevention and Control uses more complicated matrices to calculate infection, while it still recommended against traveling to the Baltics based on the infection rate per 100,000 people. That is enough for a tourist to postpone their Estonia trip, leaving our tourism sector to tally up the damages once more.
Even more important is the pressure this international fun house mirror puts on domestic decision-making processes. Our high rates compared to other countries sow fear and panic and cause us to make decisions that have not been too sensible in hindsight.
While counting coppers is an unpopular activity in the coronavirus crisis, allow me to ask whether spending dozens of millions of euros on tests is sensible in place of pledging it for promoting vaccination? Or fixing up ventilation systems or training more medical personnel?
We could at least give this matter some thought before we rush to commend Mayor Mihhail Kõlvart for his "bold and decisive" move to close Tallinn schools as the infection rate is soaring again.
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Editor: Marcus Turovski