The withholding of data about the coronavirus is “downright life-threatening,” stated Tamás Ferenci, biostatistician, and Associate Professor at the University of Óbuda. In an opinion piece published on his own website, he draws attention to the shortcomings and inconsistencies in the reporting of epidemiological data in Hungary. Head of the prime minister’s office, Gergely Gulyás, was also recently asked about the secrecy regarding the government’s coronavirus policy.
What can be expected from the public?
According to Ferenci’s second point, “…people can only be expected to behave according to the weight of the situation if they are aware of the weight of the situation,” and they “cannot be blamed for not doing so if they are kept in the dark about the real situation. He later writes that “some people think it is ‘incomprehensible’ why people do not get vaccinated. But there is one word that would make it understandable: trust.” Ferenci continues: “Don’t tell me that ‘it doesn’t work like that in reality,’ that there are anti-vaxxers and that unfortunately, nonsense is spreading on Facebook. Portugal has 99% vaccination coverage. Denmark 90%. Norway 92%. France 90%. Spain 91%. Is there no Facebook in these countries? No anti-vaxxers?”
According to him, “a social discourse that thinks this through, with political support that puts the health of the population first, could lead to a lot of useful conclusions.” Ferenci also writes that “perhaps the most important pillar of managing an epidemic is to gain and maintain the trust of the population. Transparency is a basic tool for this because withholding data is the best breeding ground for conspiracy theories and can cause serious damage to epidemiological control.”
However, when Gergely Gulyás was asked about this at his weekly press conference, he said that based on the information that is known to the public (i.e. the daily fatalities and new infections registered in the country), he doesn’t think that it wouldn’t be “enough motivation for someone who is thinking rationally to get vaccinated.”
Data in context
Ferenci thinks that if the government finally decides to share more detailed data, “the numbers will only be usable, become real data if they are presented with the right background information.” And he is not the only one who thinks so. When the government announced how many vaccinated people were among those infected between August and the end of October, the data was incomplete and therefore confusing. Even Beatrix Oroszi, a member of the Epidemiological Modeling and Epidemiology Project Team, which advises the Ministry of Innovation and Technology and therefore the government, pointed out how socially damaging it is to publish data on the effectiveness of vaccines without interpretation.
When Gulyás was asked about the lack of data regarding the vaccinated and unvaccinated in hospitals, and a journalist cited Slovakia to him, where data is published every day on the percentage of hospitalized and newly infected people who have and have not been vaccinated, he said that “they are vaccinated with Western vaccines, so this is objective data that can be used here as well,” adding, however, that Slovakia, unlike Hungary, did not use the Sputnik vaccine. Also, and Gulyás failed to mention it, in Slovakia not only did they not vaccinate with the Russian vaccine but they did not use China’s Sinopharm either. Millions of people received these two types of vaccines in Hungary, including Prime Minister Viktor Orbán, whose first two jabs were with Sinopharm. Therefore, it is questionable how a country’s data that has been vaccinating with exclusively Western vaccines, excluding Sputnik and Sinopharm, could be used in Hungary’s case.
Gulyás later added that “some countries do not publish as many statistics as Hungary. Surely there are others where more are published.” However, Ferenci mentions several countries where there is more detailed data published: for example, in the USA, England, Germany, Italy, and non-Western countries too, such as Romania, Ukraine, Albania, Bosnia and Herzegovina, Slovakia, Czech Republic, Bulgaria, and Northern Macedonia.
“Every citizen pays for public healthcare and therefore has the right to know all its data that does not infringe on the rights of others, especially if it relates to their exposure to risk, but indeed most people would not directly consume this information,” Ferenci says. Instead, people are informed by experts and analyses by researchers, but these also require data that needs to be analyzed. “But if it doesn’t exist, it’s not just a problem, it’s downright life-threatening, because there’s no external control, and therefore much less chance of errors being discovered. It is very important that I am not just talking about deliberate mistakes, this applies equally to the most honest, unintentional error. No expert can ever be infallible, so it is wrong if only a narrow circle of experts carry out analyses.” If there are more independent observers, it is more likely that errors will be detected and new and better ways of analysis are revealed, according to Ferenci.
Mayors lack coronavirus data
Recently, when the opposition mayor of Szombathely asked the local government office to send him the actual local epidemiological data so he could act accordingly to the situation, the government office wrote in response that they need 45 days to send it to him due to the severe pandemic situation. Many found this move both pathetic and absurd.
But Gulyás believes that “this is not the time” for a mayor to ask hospitals for daily data, putting a strain on patient care. However, hospitals are obliged to report the data to the National Center for Public Health, so mayors should not get the data from the hospitals themselves, and therefore it would not put a strain on patient care. In addition, the National Authority for Data Protection and Freedom of Information (NAIH) has issued a notice earlier which states: “In the Authority’s view, the public interest in knowing the municipal infection figures is significant, and the figures are necessary for both mayors and the public to make informed decisions about how to protect themselves against the epidemic.”
Gulyás added that “…in the fight against an epidemic, I don’t think the most serious problem is that the data is reported – within the otherwise legal deadline for completion – in the last weeks or days of the deadline.” However, the 45 days in this case, which can be extended for another 45 days, makes it questionable whether the data will still be relevant at the time of release.
Healthcare system capacity
According to Gulyás, the fact that intensive care unit capacity cannot be expanded indefinitely is true for all healthcare systems in the world, “…but if you look at the number of beds that are currently being used and the capacity that the healthcare system has, whether of intensive care beds or non-intensive care, we are not even halfway to the point where we can expand capacity.”
Meanwhile, a statement by the Hungarian Medical Chamber noted recently that “…even though the Emergency Departments are working in full swing, they are still drowning in patients, more and more departments are being converted and opened for COVID care, with ophthalmologists, urologists, surgeons, and nurses from these departments being transferred here.” Ferenci also says that due to selective coverage of the reality of the situation, “…people who follow the public media are under the impression that everything is perfect in hospitals, that there are no problems, no difficulties, no staff shortages, no staff fatigue, no doctors under indescribable pressure, no professional staff without help in desperate situations, no medical staff, not a single word in a year and a half, and certainly not a single word about the possibility that a patient might receive less than perfect care. There is a limited point in complaining that healthcare workers under their command, hundreds of kilometers away from their families, struggle 14 hours a day to ensure that others can go to the cinema freely when ‘others’ think that everything is perfectly fine in the healthcare industry.”
Opportunity for development
It is also essential to make data public about the quality of care. “If these are only reflected in ‘internal communications,’ there is much less pressure to improve, but if those involved know that the public is aware, then this in itself is typically a very good way of forcing much better quality work,” Ferenci writes.
The press conference with Gergely Gulyás can be watched here, and Tamás Ferenci’s full opinion piece can be read here.
Featured image via Nándor Veres/MTI