Last night, about five minutes after I posted my piece on the latest Fidesz attack against the city of Budapest and specifically against Mayor Gergely Karácsony, I read that the mayor, who is a mild-mannered man known and often criticized for his readiness to compromise, at last had had enough. He produced documentary evidence proving that the accusations against him were baseless. It wasn’t the negligence of the city’s management that caused the outbreak of the coronavirus in the large nursing home facilities where 126 older residents were found to be infected.
All told, Karácsony made four “secret documents” available on his Facebook page as well as on the official site of the city. Three of them show that Mayor Karácsony “in vain was asking the head of the government office [Botond Sára], the minister in charge of healthcare [Miklós Kásler], and the chief medical officer [Cecília Müller] to administer coronavirus tests to residents of nursing homes before their release from hospitals.” The fourth, which Karácsony considers to be the weightiest, is a letter from Botond Sára in which he explains the reason for his refusal to honor the request. “Several hospitals have indicated that they take only patients with a negative SARS-CoV-2 test from another institution or hospital. I would like to inform you that this procedure in professional terms is without merit. A negative test simply means that no virus was detectable at the time of the test. Testing can provide a false sense of security and generates unnecessary laboratory tests and costs. Please, do not make the transfer of patients from one facility to the next more cumbersome during the epidemic.”
Botond Sára has a law degree and for a number of years worked for a law firm until, in 2018, he was elected mayor of District VIII. Given his professional background, his information about the efficacy of SARS-CoV-2 testing most likely comes from the Chief Medical Officer, Cecília Müller. I, of course, cannot weigh in on this issue, so let’s see what the World Health Organization has to say on the matter. “Diagnostic testing for COVID-19 virus is critical to tracking the virus, understanding epidemiology, informing case management, and to suppressing transmission.” The document offers guidance to health organizations, pointing out that when the availability of tests is limited, priority should be given to the most vulnerable segments of the population. As we know from examples from all over the world, elderly people with underlying conditions are the most defenseless against COVID-19. The U.S. outbreak began in a nursing home in Washington State, half of all Belgian victims were nursing home residents, and, just today, The New York Times reported that, in the tri-state area (New York, New Jersey, and Connecticut), 2,000 residents of nursing homes have died from the virus.
I don’t know whether more extensive testing would have saved lives in these cases. But, for anyone who follows Cecília Müller’s daily announcements, it is evident that Hungary’s chief medical officer doesn’t believe in the usefulness of testing. Every time she receives a question about the very limited testing in Hungary, she has some explanation for why tests are not really necessary. For example, on March 30, she questioned the accuracy of the tests that were developed under the pressure of the pandemic. Moreover, she claimed that “there is no test that would prevent the spread of the epidemic or have an influence at any level. Testing gives us information only.” Perhaps Dr. Müller didn’t study the WHO documents, which clearly state that testing is critical to “suppressing transmission.”
Müller’s aversion to testing might have two possible explanations. One is that, although they don’t admit it, the Hungarian government doesn’t have enough test kits. For example, it was announced today that, from an unnamed source, Hungary just received 20,000 test kits, 5,000 gloves, and 5.1 million masks. The other reason, which is more insidious, is that Viktor Orbán wants to keep the reported number of affected people low. The fewer cases reported, the better it looks, especially in comparison to countries like the United States, the United Kingdom, Italy, Spain, France, or Belgium. In any case, according to Worldometers, Hungary to date has performed 3,308 tests per 1 million population, which is the third worst performance in the European Union, ahead only of Romania (3,081) and Bulgaria (2,663).
Let me now turn to a piece of news from Italy that, I believe, has some relevance to the Hungarian government’s failure to test nursing home residents. 444 reported today that, according to La Repubblica, the public prosecutor’s office is investigating the case of the director of a nursing home in Milan on suspicion of murder. Since the outbreak of the pandemic, at least 100 residents of the institution have died. The charge is that the management didn’t follow safety standards and “endangered residents and workers when transporting patients between hospitals and the home without proper control and segregation.” If I were Cecília Müller, I would quickly get off the topic of the limited efficacy of testing.
April 11, 2020