Subject: FW: Request for your support in update COVID-19 info
From: Ketevan Goginashvili
To: Maia Nikoleishvili <([email-masked])>; [email-masked]; Maia
Date: Mon, 22 Jun 2020 12:55:29 +0000

Begin forwarded message:

From: "KOCHISHVILI Nika (EEAS-TBILISI)" <[email-masked]>

Subject: Request for your support in update COVID-19 info

Date: 22 June 2020 14:29:45 GMT+4

To: Lajos Kovács <[email-masked]>, Lika Gamgebeli <[email-masked]>

Cc: "DE MERCEY Colombe (EEAS-TBILISI)" <[email-masked]>

Dear Colleagues,

I again need your urgent  support in the updating the COVID related information provided below:

I thank you in advance for your prompt reply,

Nika

I.               COVID measures

1)    What measures have the authorities put in place to respond to the COVID 19 crisis in terms of:

Georgia has moved extremely fast (and certainly much faster than many EU countries) with introducing restrictive preventive measures, including suspending schools, closing its borders and suspending air-travel after having registered less than 10 COVID infections and before any fatalities. This is also shown in the very low number of infected persons (just over 900) – Georgia has the lowest per 100.000 ratio in Europe.

o   testing: Georgia currently has a capacity to conduct 1600 PCR tests a day. Since the beginning of the pandemic they’ve conducted over 85 791 tests (by 18 June, for a total of 893 reported cases in Georgia); testing is widely available and can also be carried out on demand / privately; tests are regularly being procured by the authorities without difficulty (lately: 30 000 rapid tests purchased through WHO on 20/5; 40 000 PCR tests and 20 000 antibody tests arrived on 29/4 etc). Besides PCR tests Georgia is also conducting serological studies - rapid simple tests in certain groups based on antigens and antibodies, however, the cases are confirmed only by PCR testing. As of June 17, 15 laboratories were conducting PCR testing. GE has recently offered tests to help Armenia.

o   surveillance: anyone in contact with a COVID infected person, showing symptoms or infected has to self-isolate or move to a quarantine facility. The number of quarantine rooms used for COVID is around 6500 rooms in 84 hotels, used for 22.000 people quarantined. Currently there are around 2700 persons under quarantine. GE also designated  "COVID clinics" and so-called "Fever Clinics" for the management of COVID-19 suspicious and confirmed cases. The services provided by Fever Clinics include triage of all fever cases, diagnostics of COVID-19 infection, determination of further treatment tactics and referral of confirmed cases to the respective facility. In total, 3,279 beds were mobilized across the country to manage COVID-19 and 1,050 beds were distributed in 16 clinics for the management of fever patients (at least one clinic in all regions). As a result, Georgia has achieved a ratio of 7.7 critical beds and 8.1 artificial respiration apparatus per 10,000 inhabitants for the response to Covid-19 respectively (the World Bank standard envisages 5-7 respectively, (Gottlieb S., Rivers C., etc. National Coronavirus Response: A road Map to Reopening. American Enterprise Institute). All patients with confirmed coronavirus disease of any level of severity are subject to hospitalization.

o   contact tracing: is systematic with very few cases of unexplained infections; when clusters appear, whole villages are closed off (a successful method insofar as they are then reopened when no new cases emerge). The "history of contact map" of the patient is compiled within 24 hours after the diagnosis. GE has also developed a tracing app. Contacts with symptoms of Coronavirus, considered to be possible cases, are taken to a medical facility, where Coronavirus is diagnosed. Contacts without a symptom are given two options: to be placed in self-isolation at home or to be transferred to a quarantine facility.

o   containment: Georgia has introduced a state of Emergency, closed its borders and schools in March to contain the spread of the disease. Following the lifting of the SoE (22 May) GE amended the Health Law to allow for maintaining some restrictive measures and in particular quarantine and compulsory self-isolation. Educational establishments could in principle re-open since 8 June, but the school year has ended. Sports venues remain closed, most cultural venues also, except the gradual reopening of museums from 15 June. Teleworking is recommended both for the private and public sector. It is compulsory to wear face masks in public spaces and in public transport and taxis. People arriving from abroad (primarily repatriation flights) need to self-isolate for 14 days. Lockdown of villages is maintained by the Army / police.

o   treatment : All infected persons are treated in hospitals. In total, 297 inpatient facilities operate across the country with 17,514 beds, out of which 2,290 are for intensive care and emergency medical services and own 2043 operating or reserved ventilators. 1749 are suitable for the management of respiratory distress syndrome. The fatality rate in Georgia is 1.6.

o   reporting: The National Center for Disease Control has a dedicated stopcov.ge homepage. It daily reports to the Government and has until now issued two very detailed reports (in Georgian). The Head of NCDC is seen daily in the news. The NCDC has been comparing the mortality rate and epidemiological statistics with similar periods of previous years to assess excess mortality potentially linked to COVID. The number of confirmed cases is 1.1%, which indicates that the quality of case detection in the country is quite high and probability that timely detection of cases cannot occur is low.

2)    How are these measures implemented in practical terms?

During the SoE detected violations of the curfew, the compulsory self-isolation and the ban on gathering more than 3 people, including in shops, was heavily fined (1500 GEL – more than the average salary) and strictly implemented by the police. People were rather disciplined including respecting the ban on gathering more than 3 people. The violation of compulsory wearing of face mask is fined 20 GEL.

3)    What are the potential limitations?

The relatively limited capacity of the hospital sector, as well as a limited number of resuscitators and infectious disease specialists: the NCDC assesses that the employed 488 resuscitators and 256 infectious disease specialists could provide service to only 1,200 critical and 853 infectious patientsper day – currently there are 267 people under hospital supervision). However, Georgia has until now managed to contain the spread of virus extremely efficiently therefore never got even close to the phase where its health care system would have gotten overwhelmed by cases.