New european CV hotspot- Ukraine

[Tomasz + 1,608]

Let me inform you what is happening in the Ukraine.

On March 16, a 33 year old woman from Chernivtsi Oblast, Ukraine died from COVID-19 complications, nine days after the appearance of symptoms. This was the second official death in that country following the death of a 44 year old man who had been abroad in Kiev oblast.

According to various reports, the Ukraine has onlyperformed 640 tests, putting it amongst Third World nations such as India and the Philippines in per capita terms.

Needless to say, it is very hard to contain an epidemic with Corona’s high r0 and capability for symptomsless spread without extensive testing.

Of these, 16 people were confirmed to be COVID-19 positive. That’s a death/case ratio of 12.5% – amongst countries with early stage epidemics, figures of over 5% are only observed in Sudan, Guyana, Guatemala, Algeria, Cuba, Indonesia, the Philippines, Iraq, Jamaica, Domina, and Bangladesh.

More importantly, the median age of a COVID-19 casualty hovers around 80 years; a person in their 30s or 40s “only” faces a ~0.2-0.4% risk of death, relative to 10%+ amongst people in their 70s and older.

For both of Ukraine’s official deaths to have been in these age groups either implies a most remarkable coincidence – or that there have already been dozens of undiagnosed deaths amongst the elderly.

Another comparison we can make is with Belarus. As a functional country, it has managed to perform 16,000 tests, of which 51 have come in positive.

There are only 9.5 million Belorussians, relative to an estimated 37.5 million Ukrainians, which translates to a fourfold difference.

There are millions of Ukrainian Gastarbeiters on temporary work contracts in the EU, including 70,000 in Lombardy, Ground Zero for Corona in Europe.

Although it is true that large numbers of Belorussians have started going for guest work in the EU in recent years, it’s still on a much smaller scale than Ukraine, where this phenomenon has depopulated entire regions (e.g. a recent government estimate found that there were almost 30% fewer people than expected in Ternopil oblast relative to official Ukrstat projections).

If Belarus, which tests widely, has four times fewer people in total, and perhaps 20 times fewer people working in the EU, but has nonetheless registered 51 cases, then the numbers for the Ukraine should be at no less than a thousand.

All of this suggests that Corona is already rapidly burning through the Ukrainian undergrowth and will explode imminently.

Unfortunately, I only see things getting worse from here:

(1) Unlike the Third World polities mentioned above, the Ukraine has a median age of 40.6 years, and 17% of the population is over 65 years old. This is well in line with the European standard. Its African-tier dysfunction isn’t going to be canceled out a Sub-Saharan African age pyramid, where the median age is 18 years and only 3% of the population is over 65 years old. Moreover, as in Russia, the “effective age” of Ukrainians will be even higher, since they suffer from a much higher incidence of risk factors, such as high smoking rates and poor cardiovascular health (the result of decades of alcohol abuse), relative to the developed OECD countries.

(2) Although Ukraine closed its borders on March 16, in the wake of most of the EU, it’s worth noting that – as anywhere else – it doesn’t apply to its own citizens. As the EU goes into an economic stall over the next few weeks, Ukrainian Gastarbeiters are going to be losing their jobs and flooding back into the Ukraine, strengthening an already raging epidemic.

(3) The Ukrainian healthcare system is perhaps the most dilapidated bar none in all of Europe. Though one can cite many figures, consider that regional Russian cities of 0.5-1 million people, such as Perm (520 units) and Irkutsk (633 units), have as many ventilators as all of the 450-480 units in the Ukraine. Now in fairness, another source claims that there are 3,500 ventilators in Ukraine. Even so, that’s still less than the 5,000 units in the city of Moscow in absolute terms, and more than ten times less than the 40,000 units in all of Russia. International comparisons: Belarus – 2,000; UK – 5,000; Germany – 25,000; USA – 160,000.

Sophisticated ECMO machines are used in the most extreme cases of viral pneumonia to provide direct oxygenation to the blood supply. There are just 5 ECMO machines in all of Ukraine. This is equal to the ECMO machine stock of a singlestandard Chinese hospital, which have been reported to typically have 50-60 ventilators and 5 ECMO machines each. For comparison, Russia has 124 ECMO machines. The US has 264 facilities that offer ECMO services.

(4) The human capital in Ukrainian hospitals may well be even more woeful than its lack of hardware. Would you want to be treated by “doctors” and “nurses” who burst out singing “Ukraine Is Not Yet Dead” when they find out they wouldn’t have to host Corona infectees?

In recent days, journalists and pundits have taken to pushing the idea of “flattening the curve” – that is, drawing out the epidemic over time in such a manner that everyone gets access to hospital treatment, thus lowering mortality rates from ~4% to ~1%. But the extent to which this will work is questionable even in countries with functional, well-stocked healthcare systems, since a true “surge” that sees a sizable percentage of the population infected over a few months could see even very good healthcare systems with plenty of spare capacity, such as Germany’s, overwhelmed by the sheer press of bodies. In Ukraine, the difference between the laissez-faire approach and “flattening the curve” may well be quite minor, given the very low capacity of their healthcare system in the first place. Their only hope, more so even than in the West, is to “crush the curve” outright, and yet thanks to the peculiarities of its economic model – sending millions of their youth to the EU, who in turn feed local purchasing power with their remittances – make that into an even more challenging undertaking for what is already one of Europe’s weakest states.

Consequently, there is a high chance that within the next few weeks, the Ukraine will emerge as one of Europe’s worst Corona hotspots.

Needless to say, I take no pleasure in reporting these unhappy statistics and conclusions.

The Ukrainians have been duped into tying their fate to the goodwill of Americans and Europeans who never cared for their well-being beyond their role as cannon fodder against their Russian kinfolk, and who have themselves in recent days have taken up a stance of “sauve qui peut” even in relation to fellow Westerners. Ukrainians do not deserve to have their already collapsing demographics further ravaged on that account, and it is perhaps especially unfair that the brunt of the Corona death toll is likely to fall on the older, more urbanized, and more pro-Russian East and South.

It is not going to be good for Russia either, which shares a “turnstile” with the Ukraine in the form of the LDNR, where the elderly still cross the border to collect their Ukrainian pensions while well more than 200,000 locals have obtained Russian citizenships. While Moscow is currently in the most immediate danger, I would not be surprised if the focal point of the crisis shifts over to the Kuban over the next few months.