Living in a COVID Bubble

Covid is returning to Ukraine. When Ukraine was invaded, the entire world was just climbing out of social and economic upheaval caused by a murderous, historic pandemic. Then, on Feb. 24, 2022, the morning of Russia’s horrific attack, a great number of nations erupted with indignation, responding to a new crisis with political turmoil, new sanctions, and embargoes.

For Ukraine, the present was a struggle to survive continuous explosive attack and, very probably, few have had the time to deal with the consequences of COVID, emotionally or physically. However, according to an infectious disease expert, Ukraine has benefitted from a COVID-19 bubble for six months, attributable specifically to the Russian invasion. That protective bubble is about to burst as the country returns slowly to a pre-war lifestyle and as hostilities continue in the southeast crescent.

When war ripped through Ukraine, its COVID infection rate was at its highest spike in the course of the disease and, ostensibly, at the peak of the Omicron strain. New cases were predicted to reach 30,000 daily for the beginning of March, modelled by the National Research Foundation of Ukraine.

Data collection was never very good. Only about 37 percent of the pre-invasion population were considered fully vaccinated, due partly to an active anti-vax campaign by Russia. The outward flow of millions of Ukrainians very probably took the disease over the borders with the refugees. We don’t know if they died of the disease or if they were killed by missiles. Most likely millions were uprooted by the violence and carried their illness with them as they fled.

Then it seemingly disappeared.

Conversations with an infectious disease expert who for national security reasons cannot allow their identification and will use the pseudonym Sam, scoffed at the suggestion.

“We can’t know where we were on the COVID graph on February 24, nor where we are now,” Sam contended. “We could have been at the top of the spike, or we might have been at the very beginning of a much larger spike. We don’t have any idea where we were because we don’t have the data.”

Some on social media questioned whether the war could have had one positive outcome: that it effectively stopped COVID’s transmission. Last week, one Telegram site questioned whether some unidentified wartime effect, such as continual, maximized adrenaline, could be an as-yet undiscovered effective cure.

Sam claimed we are in a COVID bubble, and offered several explanations for the apparent lull in infection transmission:

• The disease moved over the borders with the fleeing refugees;
• The COVID infection seeped out of the cities and moved away from close contact into the countryside;
• The general population is much lower now;
• The curfew has impacted night life and social interaction;
• Families are flung piecemeal into far distant countries.

In a March 2022 article, ”Impact of war on the dynamics of COVID-19 in Ukraine,” by Dr. Dimytro and Tetyana Chumachenko, the authors identified six key factors preventing a determination of the extent of infection here.

First of all, it’s difficult to identify new cases in territories occupied by Russian troops and where there are hostilities because medical facilities have been destroyed and there are few medical personnel.

Secondly, consultations are often being done online, laboratory diagnostics are not available, and PCR tests cannot be administered, so diagnosis is rare. Laboratories providing COVID testing in larger cities are operating at less than three percent capacity. Therefore, only cases requiring hospitalization are diagnosed.

Thirdly, it’s difficult to report cases. The electronic system for recording COVID’s incidence is limited to telephone reporting where connection is available. Even the WHO hasn’t recorded or reported cases on its site since the war began.

Fourthly, treatment is severely limited because the hospitals are overcrowded with civilian and military wounded.

The fifth problem is that measures to limit epidemic exposure are impossible in military situations, as well as with overcrowding in shelters, basements and subways where civilians are forced to hide from airstrikes and active hostilities. Evacuation is another high-exposure situation where individual isolation isn’t practicable.

A sixth key factor has been the very low vaccination rate of only one third of the pre-war population, the active Russian anti-vax campaign, and the cancelation of mandatory vaccination of particular groups with the introduction of martial law.

Sam, the epidemiological expert, contends that by shelling medical facilities and infrastructure such as water pumping stations, as well as driving civilians into crowded shelters and evacuation, that Russia is trying to effect an epidemic.

The Kyiv Department of Health Protection is warning that the bubble could be ending soon.  Children who cannot be vaccinated due to their age are the canaries in the coalmine for COVID-19. Two children with COVID were in the intensive care unit of one of the Kyiv children’s hospitals on August 3, according to Valentina Ginzburg, director of the department. One was not yet two years old and the other was a baby born 14 days earlier.

Ginzburg explained: “It is possible to draw certain conclusions about the tendency to increase cases of severe forms of coronavirus infection among the children’s population.”

“If in the first four months of 2022 only a few children with COVID-19 were in hospital treatment, and no children were admitted to the intensive care unit at all, then in July the doctors of the intensive care unit cured two children of the disease and are currently saving two more, this clearly indicates that COVID in its most severe course is returning,” said Ginzburg, adding, “It is coming back quickly and aggressively, not sparing the most vulnerable – the youngest.”

Ginzburg urged parents to avoid crowded places and to vaccinate everyone of age. According to her data, the number of infected increased rapidly last month. In early August, there were 78 confirmed cases in the Kyiv healthcare system, including 5 children. By mid-August there were 316 confirmed cases, including 30 children. Only one week later, by August 21, that number had tripled to 956 cases (a number wasn’t indicated for children).

She pointed out that vaccination is available in medical institutions as well as mass vaccination centers in shopping centers Gulliver, River Mall, and Ukraine Department Store.

“Actually, the situation looks alarming enough. I would recommend going back to wearing masks and putting hand sanitizer in your bags and pockets again… and most importantly – vaccination! This is what can save the capital from a serious outbreak, similar to those that took thousands of lives of Kyivans…tens of people a day died in severe pain – someone’s parents, grandfathers, grandmothers, brothers and sisters… This horror must not be repeated,” Ginzburg warned.