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22 February, 2021

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COVID-19 SAFE CLINICS Evex Clinics Develops At-Home Laboratory and other Remote Services

for providing services for the most important thing - human health. It is the largest company in the country in the field of primary healthcare and makes a great contribution to the development of the field. Continued on p. 4

How Evex Clinics Have Responded to Covid-19 Pandemic Challenges By GELA MEGENEISHVILI

s the largest chain of clinics and serving around 500 000 Georgian patients in 2020 alone, Evex Clinics has held an

especially crucial role amid the ongoing pandemic. To maintain a stable healthcare system while enabling patients to have access to top-notch services was one of the many primary goals of Evex Clinics which prove its status as one of the most stable healthcare establishments. To gain

further insights into how the team have handled the pandemic, The FINANCIAL reached out to CEO George Gordadze and Commercial Director Natia Kapanadze.

MEGALAB in pursuit of JCI, the Continued on p. 2 highest US-standard accreditation MEGALAB - Patients ask for any tests, we simply provide for laboratories By GELA MEGENEISHVILI

s the largest multi-profile laboratory in the Caucasus region, MEGALAB deals

with the sample analysis of a significant portion of Georgian patients. Having such a strong establishment especially in the face of a pandemic is of crucial importance to the country. Continued on p. 6

By GELA MEGENEISHVILI

s the largest laboratory in the Caucasus region, MEGALAB deals with more

tests in a single day than other laboratories deal with in a month. The strong and stable establishment with modern equipment and a dedicated team has proved to be of great importance whilst facing the pandemic. To understand the efforts the company goes

through to deliver top-notch services to its patients, The FINANCIAL reached out to Nino Chikovani, its Clinical Director, to answer its questions. Continued on p. 9

Coronavirus and the social impacts on Great Britain

The FINANCIAL Most (90%) parents said a child in their household had been homeschooled because of the coronavirus, according to the latest data of the Office of National Statistics (UK). Continued on p. 11

CURRENCIES 1 USD 1 EUR 100 RUB 1 TRY

Feb. 13

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3.2888 3.9824 4.4277 0.4678

3.3215 3.9775 4.4333 0.4687

„ Team of Evex Clinics is on the frontline of the pandemic fight, caring about the most important thing humans health.’’ G.Gordadze CEO of Evex Clinics

covid-19 safe clinics

HEADLINE NEWS & ANALYSIS 22 February, 2021 | FINCHANNEL.COM

How Evex Clinics Have Responded to Covid-19 Pandemic Challenges By GELA MEGENEISHVILI

s the largest chain of clinics and serving around 500 000 Georgian patients in 2020 alone, Evex Clinics has held an especially crucial role amid the ongoing pandemic. To maintain a stable healthcare system while enabling patients to have access to top-notch services was one of the many primary goals of Evex Clinics which prove its status as one of the most stable healthcare establishments. To gain further insights into how the team have handled the pandemic, The FINANCIAL reached out to CEO George Gordadze and Commercial Director Natia Kapanadze. Q. What have been the toughest challenges you’ve faced and how have you handled them? A. Similar to many other businesses, as healthcare service providers we also faced major challenges, with the exception being that we were forced to be on the frontline at all times. Firstly, we had to take measures to protect our personnel and provide a safe working environment in our clinics, to allow our doctors to take proper medical care of their patients. We separated potentially infected and healthy patients from one another, therefore we created special locations outside of the clinics for COVID-19 testing. This challenge was further intensified by uncertainty over how long the pandemic would last for, while it remained vital to demonstrate to all of our frontline employees dealing with potential COVID-19 infected patients that they would be able to continue working in a safe environment and keep their jobs irrespective of how severe the pandemic got. We fully understood the impact the crisis had on other industries leading to possible job losses or income reduction which could affect many families. In turn, we increased the Evex Clinics fund by GEL 100 000 to address the needs of our employees. Q. What preparations did you undertake when the pandemic was officially declared? A. Since the emergence of COVID-19, we put ourselves into intensive communication with our foreign colleagues, especially those in countries that had faced the pandemic earlier than Georgia. We started to actively collect crucial information and listened to the shared management experience while preparing for all possible outcomes, in response to the potential spread of the disease in Georgia. Q. What was your role as CEO in that process? A. It was quite a challenge, pushing us as a medical institution to the frontline and forcing us to engage both proactively and reactively. Our management had to be ready to make instantaneous decisions as the information on COVID-19 was constantly updating on a monthly, sometimes even on a daily basis as well, requiring a dynamic management response from our team. Courageousness also mattered a lot in the frontline, due to the fact that it was necessary to take non-

GEORGE GORDADZE, CEO of Evex Clinics

NATIA KAPANADZE, Commercial Director of Evex Clinics standard decisions at times. Despite the difficulties we faced to protect our staff, while also providing smooth service delivery to all our customers, including primary healthcare, we had to stick to our core values. Q. What was the main challenge you faced after COVID-19 was first detected in Georgia? A. From the first days of its emergence, we took proactive steps to protect our personnel and our customers. First, we made sure to provide a safe environment to avoid both the contamination and spread of the disease, since many western countries had already faced the issue of medical personnel being the cause of the spread of the infection. We introduced rules and regulations that were to be followed 24/7 as well as training, guidelines and

protocols for our medical staff on how to protect themselves. While the Government was taking steps to curb movement in the country, patients continued to come to our clinics for outpatient services. Consequently, we had to manage the surge of regular patients and COVID-19 test-seeking ones, which we separated by setting up two booths. In total, we delivered more than 2 000 000 services to more than 500 000 patients throughout the year. Another issue that the country faced back then was the increased rate of hospitalizations, but we proved to be ready for that scenario as well. Our regional community clinic with 20-30 beds became involved in hospitalization processes and 7 clinics with 250 beds were deployed as well. I would like to take this op-

portunity to thank all our personnel including medical, service, office and administrative ones, whose daily efforts enabled us to effectively manage the needs of patients. We organized online doctor’s consultations to increase availability. More than 20 000 customers subscribed to those services. We also joined the Emergency Service 112 project and provided home care to more than 20 000 patients nationwide. Additionally, we engaged in diverse service delivery and our institution delivered more than 100 000 PCR and Antigen tests, making us the number one primary healthcare provider for our citizens. Q. What do you identify as the major challenges that primary healthcare is facing? A. Primary healthcare has experienced a certain degree of development and COVID-19 has clearly shown us its importance throughout the country, as it holds a crucial role in saving lives. Ultimately, the effectiveness of the healthcare system can be measured by one of the main indicator - the quality of life expectancy and that is exactly what the system we are a part of serves. We believe that different needs emerged at each stage of the healthcare system’s reforms. Initially, the affordability and availability of primary healthcare were the major priorities, while now it is the quality that must be enhanced. There are several changes to be made, and I am certain health officials are working on the issue, while we maintain direct communication with them. The pandemic might increase the time before it arrives, but I am sure a quality-focused payment system will soon be implemented. Today, primary healthcare for the most part relies on the state allowance of the beneficiary. In other words, quality enhancement needs to be encouraged more, as it would allow service providers to offer better outpatient care. State financing of primary healthcare is about 25 percent, while hospital service expenses are thrice as much. Let me explain with the simple example, it is well known that early detection of cancer cases is both effective on a patient vitality and cost-effective as well. Therefore, the system is totally oriented on early detection and treatment of the disease. The same logic should apply to chronic diseases. So, the early detection, diagnosis and managing the

disease by primary health care system can avoid possible future complications, need for hospitalization and is cost-effective as well. Raising customer awareness of their own health is crucial and therefore we, as a part of the healthcare system, are duty bound to inform the public about healthcare practices. In turn, patients should also be actively involved in their own healthcare activities. No matter how good a doctor is, they simply cannot succeed without cooperation from their patient. Q. What CSR activities has Evex Clinics rolled out during the pandemic? A. [Natia Kapanadze] Evex clinics have always prioritized increasing public access to healthcare services as part of its corporate social responsibility. While the objective was becoming more urgent due to the pandemic, our first step was to provide full support for those in need from the very beginning. At first we initiated a corporate campaign for those companies failing to adjust to remote working, yet whose functioning was vital for the city. Our specially-trained medical crews delivered on-the-spot medical assistance to them through Evexmobile to provide COVID-19 check-ups and medical recommendations intended to both curb and avoid the spread of the disease. We covered around 50 major companies, while screening more than 5000 employees. The initiative proved to be essential, as confirmed by the fact our corporate partners responded with very positive feedback. We have also launched another major campaign by releasing special medical card, since a lot of people lost their jobs at the start of the pandemic and could no longer enjoy private insurance or special privileges in regard to medical discounts. We designed medical cards to allow 50 and 70 percent discounts on full outpatient services, such as laboratory and instrumental assistance, ultrasound diagnostics, and medical consultations. Around 50 000 customers enjoyed the benefits, including free consultations with a family doctor. We also joined the social programme initiative by Liberty Bank to extend accessibility to 800 types of outpatient services with up to 50 percent discounts to its 1 200 000 social card holders. We have involved all of our 33 clinics in this project. The contribution of Evex Clinics in the programme allowed around GEL 400 000 worth of discounts in 2020 alone, which has proved to be very helpful during the pandemic. Another noteworthy social programme of ours was the family doctor’s free consultation services. We enabled services to be totally free for those working remotely or in person, regardless of their insurance status. Every individual could get a free medical phone or video consultation, while our doctors were ready to fully answer all their questions concerning ongoing or general medical issues. We designed free Facebook doctor’s offices which everyone could pay a virtual visit to, with our doctors ready to instantly respond to all of their questions. The initiative included three vitally-needed medical directions, these being paediatrics, family doctor, and gynaecology. This social project continues to this day, and our doctors remain happy to provide free consultations for all those in need. All our projects serve the sole purpose of enhancing public accessibility to medical services and we believe that common effort and unity will ultimately guide us to defeating this pandemic.

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covid-19 safe clinics

FINCHANNEL.COM | 22 February, 2021

Don't Let Pandemic Stop You From Taking Care of Your Health

Laboratory Home Service From Evex Clinics is now available

Laboratory Home Service includes all type of analysis.

Analysis are sent to a Tbilisis central laboratory equipped with the latest technologies.

COVID-19 testing is also available at home, both PCR and Antigen.

Book a service by the hotline 0322550505 and our medical group will come for next available day; Home Services are available in Tbilisi, Batumi, Zugdidi, Foti.

Advertiser: Evex Clinics. Contact FINANCIAL Ad Dep at marketing@finchannel.com

HEADLINE NEWS & ANALYSIS

covid-19 safe clinics

22 February, 2021 | FINCHANNEL.COM

Evex Clinics Develops At-Home Laboratory and other Remote Services

he pandemic has emphasised the importance of healthcare more than ever. It has highlighted the importance of keeping on top of your health and knowing who your family doctor is; who cares for your health. Evex Clinics is responsible for providing services for the most important thing - human health. It is the largest company in the country in the field of primary healthcare and makes a great contribution to the development of the field. The pandemic has hit the medical field even harder - the very field that has had to face Covid-19 front on. Despite the difficulties produced by the pandemic, Evex Clinics’ 3 500 employees and 33 clinics across the country have not stopped caring for patients for a single day. From the moment the very first case of Covid-19 was reported in Georgia to now, along with simplifying healthcare for patients and increasing access to medical services Evex Clinics has continually implemented important projects. Such projects have included responding to the challenges of the pandemic alongside patients’ needs, as well as introducing remote services and developing at-home laboratory services.

At-home laboratory services As a result of the pandemic, working, studying, having fun and communicating virtually and remotely have become the new norm. Due to this, at-home laboratory services have become a necessary development for both the convenience of patients and to save time. Thus Evex Clinics have introduced athome laboratory services in every district of Tbilisi, Batumi, Zugdidi and Poti. Customers can get any laboratory service at home at no extra charge and for a minimal fee. In addition, there is a special laboratory package for Covid-19 infected patients, which includes all types of recommended tests for such cases. For the residents of Tbilisi, Batumi, Zugdidi and Poti, Covid-19 testing is also available at home, both PCR and Antigen ones. Analyses taken in clinics and in people’s homes are then sent to a central laboratory equipped with the latest technologies in accordance with modern standards. In the future, the company plans to enrol all its clinics in providing at-home laboratory services. Before this happens though, people can still access laboratory services in the 33 branches of Evex Clinics located across 6 regions of Georgia. Evex Clinics provide up to a million modern standard laboratory services annually. The accuracy of its laboratory tests is important for peace of mind, timely treatment and health. Evex Clinics can also provide the service of giving flu vaccines at home. The pandemic has emphasised the importance of the flu vaccine for ensuring strong immunity. Yearly vaccination

protects the body from seasonal flu. French company Sanofi’s flu vaccine is already being given to patients in their homes. To ensure a safe vaccination process it is necessary to observe certain safety norms. As a result, the athome procedures are carried out by trained medical personnel.

Introduction of online video and phone consultations

As most of the population avoids going out due to restrictions imposed to combat the pandemic, Evex Clinics has developed online consultations with family physicians and other specialists to increase access to medical services. Thanks to the project people can now access doctors’ consultations

online. Via either an audio or video call doctors can contact patients, providing them with consultations and appointments. Within the framework of corporate social responsibility a consultation with a family physician used to be free. During 2020, 22 896 patients used this service and more than 4000 patients used other specialists’ online consultation services. To improve the quality of remote services, Evex Clinics has created its own online conference which leading specialists working both in Georgia as well as abroad take part in. To increase the quality of its remote medical services, 13 professionals meet virtually to discuss important or difficult medical cases that have been identified in their various online consultations. Evex Clinics’ doctors are also involved in Covid-19 state programmes. As a part of these projects family physicians remotely manage the health of infected patients at home. Evex Clinics’ doctors within the 112 project remotely manage up to 20 000 infected patients only in November and December. Evex Clinics continues to develop its remote services and projects to increase access to medical services.

HEADLINE NEWS & ANALYSIS FINCHANNEL.COM | 22 February, 2021

covid-19 safe clinics

Local and national restrictions in England reduced contacts in small and varied ways

he various local and national restrictions in England during the summer and autumn of 2020 gradually reduced contacts between people, but these changes were smaller and more varied than during the lockdown in March, according to new research published in BMC Medicine. Local restrictions and the ‘Rule of Six’ was associated with modest reductions in social contacts, and instructions to work from home associated with larger reductions. The researchers found little evidence that the 10pm closing time for bars and restaurants had any appreciable effect. Led by the London School of Hygiene & Tropical Medicine (LSHTM), the study used data from the English participants of the UK CoMix survey, an online survey asking individuals to record details of their direct contacts in the day prior to the survey. The researchers then combined this with information on local and national restrictions from Gov.uk collected between August 31st and December 7th 2020. They compared the number of contacts in different settings, such as work, school or home, reported by individuals before and after the introduction of individual restrictions in England. These included the Rule of Six (announced 14th September), 10pm closures of pubs and restaurants and encouraging people to work from home (24th of September), and entering into tiers 1, 2 or 3 (14th October). The team also compared entering into national lockdown from any of the tiers in November 2020. Result suggest that the impact of these restrictions on the number of contacts that people reported was mixed. Following the introduction of the Rule of Six, 1,314 (33.8%) out of a total of 3,884 participants included in the analysis for this

restriction reported reductions in their non-work and non-educational contacts. Just over 40% of participants reported the same number of contacts and 25.7% reported a higher number of contacts. The average number of contacts was two before and after the introduction of the Rule of Six. For the 10pm rule, 990 (25.5%) out of 3,887 participants included in the analysis recorded a smaller number of contacts, while 52.8% recorded the same number of contacts and 21.7% recorded a higher number of contacts. The average number of contacts was zero to one before and after the rule came into effect. Under local restrictions, partici-

pants on average reduced their contacts, reporting an average of 0.69 fewer non-work and non-school contacts compared to before the restrictions. The impact of the tier system was found to be mixed, with Tier 1 and 2 having little impact on the average number of contacts, but Tier 3 reducing contacts. The subsequent November lockdown appeared to have the largest difference for those entering lockdown form Tier 1, with 750 (35.8%) out of 2,095 participants in Tier 1 reporting that they reduced their contacts by about 1.40 contacts per day, on average. The effect of moving from Tier 2 or Tier 3 to lockdown was less pronounced, with 428

(29.4%) out of 1212 adults in Tier 2 and 85 (26.3%) of 236 adults in Tier 3 reporting that they reduced their contacts. Dr Christopher Jarvis, Assistant Professor at LSHTM and the corresponding author said: “To put these changes in context, the full national lockdown in March reduced average daily contacts from an estimated 10.8 to 2.8 – a 74% reduction. While, in absolute terms, the changes following more recent restrictions were relatively small, this may indicate that restrictions were applied at a point when individuals had already lowered their contacts, and not that the restrictions did not have an effect.”

Genetics May Play Role in Determining Immunity to COVID-19 Computational studies suggest a set of genes that regulate immune response help determine robustness and durability of neutralizing antibodies to virus The FINANCIAL

ased on this reasoning, the researchers computationally analyzed all possible fragments of the spike protein

RBM, which is a trigger for both the human immune response and for vaccine activity, in connection with the more than 5,000 different MHC molecules represented in the global human population. To their surprise, the authors

found that the average propensity of the MHC to display RBD-derived peptides is low. Since MHC binding is an indirect measure of the probability that the T cell will be activated and stimulate the B lymphocyte into producing

antibodies against the RBM, the authors said it follows that the production of RBM-specific antibodies could be hampered by the poor fitting of these portions of the virus to the MHC. “This then could lead to poorer neutralizing antibody responses,” said first author Andrea Castro, a member of Carter’s lab. “And in the case of SARS-CoV-2, the poor presentation of key RBD fragments by many MHC alleles could stand as an obstacle to the production of neutralizing antibodies targeting the RBM.” The scientists suggest that the immunological history of individuals may play a role in T cell response and subsequent activation of B lymphocytes that can produce robustly targeted neutralizing antibodies. The potential implications of the study are twofold, said Carter. “One is that the ability to generate antibodies with potent neutralization activity may vary considerably from individual to individual within the general population, reflecting the large genetic diversity Continued on p. 12

GDP down by 0.6% and employment up by 0.3% in the euro area In the EU, GDP down by 0.4% and employment up by 0.3% The FINANCIAL – In the fourth quarter of 2020, seasonally adjusted GDP decreased by 0.6% in the euro area and by 0.4% in the EU, compared with the previous quarter, according to a flash estimate published by Eurostat, the statistical office of the European Union. These declines follow a strong rebound in the third quarter of 2020 (+12.4% in the euro area and +11.5% in the EU) and the sharpest decreases since the time series started in 1995 observed in the second quarter of 2020 (-11.7% in the euro area and -11.4% in the EU). According to a first estimation of annual growth for 2020, based on seasonally and calendar adjusted quarterly data, GDP fell by 6.8% in the euro area and 6.4% in the EU. ompared with the same quarter of the previous year, seasonally adjusted GDP decreased by 5.0% in the euro area and by 4.8% in the EU in the fourth quarter of 2020, after -4.3% and -4.2% respectively in the previous quarter. During the fourth quarter of 2020, GDP in the United States increased by 1.0% compared with the previous quarter (after +7.5% in the third quarter of 2020). Compared with the same quarter of the previous year, GDP decreased by 2.5% (after -2.8% in the previous quarter).

Employment growth in the euro area and EU The number of employed persons increased by 0.3% in both the euro area and in the EU in the fourth quarter of 2020, compared with the previous quarter. In the third quarter of 2020, employment had increased by 1.0% in the euro area and by 0.9% in the EU.

covid-19 safe clinics

HEADLINE NEWS & ANALYSIS 22 February, 2021 | FINCHANNEL.COM

MEGALAB in pursuit of JCI, the highest US-standard accreditation for laboratories By GELA MEGENEISHVILI

s the largest multi-profile laboratory in the Caucasus region, MEGALAB deals with the sample analysis of a significant portion of Georgian patients. Having such a strong establishment especially in the face of a pandemic is of crucial importance to the country. To find out how the team has been dealing with the pandemic and what makes MEGALAB one of the most stable laboratories, The FINANCIAL reached out to Ana Khakhnelidze, HR and Organizational Development Director, who gave a closer insight. Q. Has the pandemic been a unique challenge for you? A. 2020 was the year of a sudden pandemic which indeed brought unique challenges, out of which I would highlight finding a proper way of taking care of patients and employees, creating a safe environment, and adjusting operating processes in the fastest and safest way possible. Q. Were you forced to change internal communication channels during the pandemic? A. It was at the announcement of the pandemic as we went to remote working, yet we made sure that communication was tight across the whole company, a process which the top management was closely involved in. Zoom and mail were the major communication channels, while we arranged both formal and informal as well as remote and physical meetings to discuss important strategic matters. As the office was working remotely, we initiated a virtual coffee morning among employees, where we recalled the sweet old times when the office was so lively. The talks were positive, full of emotions and kept us looking forward, awaiting the future where everything will be as it used to be. Another initiative to create a better working environment and maintain team spirit was implementing various activities such as the online celebration of MEGALAB’s birthday as well as ringing in the New Year. Q. How about your operating model, what has been serving you the best? A. I would say that amid the hardest of times we must keep our calm. While the environment is full of uncertainty, it is natural for people to be full of emotions, yet we must always be in control. As a manager, I always tried to maintain close communication with the team, take and consider information about their needs and find solutions to how to cope with their problems and create a better working environment.

ANA KHAKHNELIDZE, HR and Organizational Development Director of Megalab Q. How did communication methods change with the top management? A. MEGALAB is a daughter company of the Georgia Healthcare Group and the top management was very supportive as they actively helped us to reorganize and implement the new processes. At the first stage of the pandemic, it was quite tough financially as the company had a lot of unexpected expenses, however across all of our chains, we had a firm policy to maintain all of our employees and pay their full salaries, without any reductions. Moreover, during the period we

decided to pay bonuses and additional incentives too. The GHG management created an additional fund of GEL 2 Million, which was oriented towards taking care of employees and making sure they were sound both physically and psychologically. Through the initiative, we began employee consultations with business coaches that helped us greatly in dealing with a stressful environment. As our employees are in close contact with infected patients, the job comes with an innate element of stress and fear of infection which the coach helped us deal with.

The fund also supported infected employees both financially and materially which was a crucial help at the time. Q. What have you learned about making decisions when there’s so much uncertainty? A. The pandemic was a period of extreme uncertainty therefore we found ourselves at a point where we had no idea what to expect for tomorrow, the major thing that kept us going forward was taking care of customers and employees. Despite the uncertainty we kept creating new projects to serve

customers and created new working places, almost doubling our staff, we trained them and sent them onto the battlefield against the virus, where the hero-employees worked almost 24/7. The times were tough yet the action held great importance. Q. Do you offer remote services? A. Despite the pandemic situation, MEGALAB is oriented towards improving the existing services and implementing new ones. We offer free remote services to our patients and are about to launch a new innovative project called “Mega-Drive”, which will enable patients to receive laboratory services without leaving their cars. The service will be available in just a few days. Q. What is the standard precaution? A. The pandemic period has been quite rough and involved substantial risks, however, I believe that the major accomplishment for our company was to strengthen our team bond and unify our hero-employees, who have been fighting on the frontline all along. Overcoming the key challenge brought us loyal and satisfied employees which always transforms into loyal and satisfied patients. Q. What are the safety measures in place in your laboratory? A. As we are a medical laboratory, corporate social responsibility is deeply rooted in our corporate culture. We take safety measures to the highest level to protect employees and our customers. Firstly, no-one enters the building without thermal screening and we have separate routes to keep our employees and patients separate. We actively perform disinfectant works and we always maintain a 2-metre distance and when the waiting hall is overcrowded we have an additional waiting space for patients. We also conduct biohazard training and our employees always follow protocols to take care of their own and their customer’s safety. Q. What are your expectations of 2021? A. I believe that 2021 will be a post-Covid adjustment period. As for the goals, before the pandemic, we were aiming to get JCI accreditation which is the highest standard a laboratory can get to deliver services to patients. Coronavirus halted the process, however we are beginning to start taking steps in that direction. The goals are big and we have every resource to pursue them. The pandemic was a harsh period as there were a lot of risks involved, however we managed to unite our employees and I believe they are the capeless heroes who are in service to their patients 24/7. MEGALAB maintains customer care which is part of our corporate culture and guides us towards success. We have many ongoing educational projects as well, such as the residency studying programme oriented towards teaching future generations.

HEADLINE NEWS & ANALYSIS FINCHANNEL.COM | 22 February, 2021

covid-19 safe clinics

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22 February, 2021 | FINCHANNEL.COM

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ISET Consumer Confidence Index | January 2021: A Slight Rebound in Confidence ISET Confidence has rebounded in January, but slightly. The improvement has however put a halt to the negative trend observed during the last two months. The index is up by 1.4 index points and the pattern is similar for both sub-indices: the Present Situation Index went up by 0.6 (from -43.7 to -43.1) and the Expectations Index by 2.3 (from -35.7 to -33.4) as can be seen from Chart 1. What happened? Throughout December and January, the Government of Georgia maintained restrictions on trading activities and public transport to reduce the number of COVID-19 cases. It paid off and the daily cases plummeted from 5,000 to under 1,000. This surely helped the CCI in January in spite of the unavoidable social costs. Pandemic has almost equally harmed high and lower social class. A gap in confidence always existed between those with higher education and the rest, but it had significantly reduced since early 2018 before almost disappearing with the pandemic (see Chart 2).1 However, that gap has reappeared as the pandemic continued. Since the pandemic started, a higher number of people report running into debts. This may explain why the gap is resuming. All felt at first that they were equal in front of the pandemic but as COVID-19 settled in the country, the more educated, who typically have more financial means, realized that they were better cushioned. This does not change the fact that those reporting that they could make ends meet accounted for 54.6% in January 2020 against 48.8% in January 2021. During the same time, the number of people taking loans increased from 17.4% to 23.8%. 1 In January, the share of the survey respondents with higher education accounted for 73% whereas, according to the 2014 General Population Census, only 44% qualifies as highly educated.

COVAX and the United States By ANNA ROUW, JENNIFER KATES

ne of the most daunting and urgent challenges facing the world as it seeks to address the COVID-19 pandemic is ensuring broad access to vaccines, without which it will be impossible to achieve needed levels of global population immunity. To date, the majority of vaccine doses (56%) have been purchased by high-income countries, who only represent 16% of the global population, locking in much of the market. In addition, while many high-

income countries have started to vaccinate their populations, as of February 8, fewer than 100 doses have been administered in low income countries. COVAX, an international partnership led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO), was created to respond to this challenge. Its goal is to distribute 2 billion doses of a safe and effective COVID-19 vaccine to the most vulnerable by the end of 2021. While virtually all countries are participating in COVAX, until recently, the U.S. was one of only a handful to sit out

formal participation, when the Trump administration decided not to join, although Congress did provide $4 billion in emergency COVID-19 relief to Gavi in support of COVID-19 vaccine access, which Gavi says it will use to support the AMC. On January 21, 2021, soon after taking office, President Biden announced that the U.S. would join COVAX and play a more active role globally on COVID-19. Although COVAX has purchased 1.1 billion doses to date, with most of these doses to be distributed to lower-income countries, it ended 2020 with a funding gap of $755 million and faces a gap of $6.4 billion

in 2021. There are also numerous other challenges including competing with bilateral and regional agreements to secure vaccine doses and navigating diverse regulatory landscapes. There are also key questions about the nature of U.S. participation including how much funding the U.S. will provide for COVAX going forward, either as a self-financing country to access vaccines in the COVAX portfolio and/or as a donor to the COVAX advance market commitment intended help supply vaccines for lowand middle-income countries, and if the U.S. will donate surplus doses to COVAX in the future.

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MEGALAB - Patients ask for any tests, we simply provide By GELA MEGENEISHVILI

s the largest laboratory in the Caucasus region, MEGALAB deals with more tests in a single day than other laboratories deal with in a month. The strong and stable establishment with modern equipment and a dedicated team has proved to be of great importance whilst facing the pandemic. To understand the efforts the company goes through to deliver top-notch services to its patients, The FINANCIAL reached out to Nino Chikovani, its Clinical Director, to answer its questions. Q. How have the healthcare habits of patients changed during the pandemic? A. Coronavirus has drastically changed patient behaviour. While patients were not so quick to test before, as we are now in the middle of flu season, patients are testing even in cases of just a slight temperature rise. The pandemic has brought so much uncertainty and fear, that today every Covid patient closely monitors their health. The statistics are clear and show that patients are visiting us more often to monitor their health. Q. What do you think is the weakest chain in the healthcare system? A. If we examine the Georgian healthcare system, hospitals have been in a rough spot during the pandemic. I believe that the primary healthcare system was not as prepared as it could have been, yet, to sum up, I think that Georgia has dealt very well with the pandemic. Even in leading countries such as the US, primary protection equipment (PPE) was quite scarce, while in Georgia it was much easier to access. When the government announced a full lockdown, I believe it was necessary for the country to better prepare for the so-called second wave of the virus. The first wave, as hyped as it was, was not as powerful as in western countries. The appraisal by WHO, which recognised Georgia’s efforts to fight the pandemic, stood us out among other eastern countries. Q. What safety measures do you have in place in your laboratory? A. Considering that Covid-19 spreads via droplet

NINO CHIKOVANI, Clinical Director of Mgalab

contamination, the laboratory is up to all the biohazard standards, which enabled us to participate in the Covid-testing government programme across the country. On top of that, PPE is being used properly, for which we had several training programmes for lab workers as well as for all the staff at MEGALAB. Many Covid-infected patients come here, therefore it is crucial that we use protection equipment properly. The focus has always been on the safety of patients. I believe that MEGALAB creates

maximum safety for all patients by following protocol and constantly changing PPE to avoid any risks. Q. Which tests have been the most in-demand during the pandemic? A. PCR and antigen tests for Covid-19 have been the most in-demand. Considering the flu season, a minor rise in temperature often leads patients to test for Covid. In the event a test is positive, they contact their family doctor and undergo further tests such as blood sampling, kidney tests and much more. Q. What are the statistics on Covid-19?

In the year 2020, we have conducted more than 92 000 PCR and around 7000 antigen tests. We should note that antigen tests were available at MEGALAB before the Government’s initiation. Q. How could Georgia improve its healthcare services? A. MEGALAB is always oriented towards offering better services. Our goal is to create such an environment where patients just step in and get any type of test they desire, while the ultimate goal would be to completely stop relying on sending tests to Europe for credibility,

and perform all analysis within our laboratory. I believe that MEGALAB is the establishment that has all the resources and potential to become such an establishment. Q. What is the difference between tests and screening tests? A. Tests are for patients who have symptoms, while screening is blind testing by taking random members of the population and testing them individually. We have had cases where screening proved to be quite effective as well. While the government provides us with antigen tests, we have one of the highest quality PCR tests that have extremely high sensitivity for detecting Covid and even their mutations. MEGALAB is an establishment that can detect all the mutations of Covid-19. Q. What methods do you implement in the laboratory to avoid risks? A. From the beginning of the pandemic we have been following the protocol of the Ministry of Healthcare with the collaboration of the Centre for Disease Control. We followed the guidelines cautiously as the doctors are fighting on the frontline and infection of even a single one of them would be problematic to our continuing to provide services. We have hired a biohazard officer, who has been leading the training of staff and we pursue daily term screening of employees as well as following other interaction guidelines and utilizing PPE such as masks, gloves, waterproof robes, glasses, and face shields. Our staff has undertaken full training on how to perform safe testing in a non-laboratory environment as well. Q. How do your laboratory personnel remove biohazard waste from the laboratory? A. The treatment of biohazards is strictly regulated by the protocol of the Ministry of Healthcare and is followed meticulously. Q. Can a diagnostics test show how infectious someone is? A. Current tests are unable to detect the level of infection in patients. What we can currently do is detect whether the virus is found in a patient or not. There is no direct method for detecting risks. When doctors evaluate the potential threat to health they look more at the patient’s history, whether they have a chronic disease, what their current health status is, etc.

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Indirect effects of the pandemic on UK health

Alasdair HENDERSON Research DEGREE STUDENT AT THE LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE

ven for those who have been spared infection, the COVID-19 pandemic has had major impacts on our health and wellbeing. Population lockdowns have been necessary to disrupt the spread of the epidemic but we cannot ignore their effect on other health problems. The remarkable transition general practitioners have made to predominantly remote and telephone consultations is to be applauded. Yet this has brought its own challenges which may have meant that less se-

rious health conditions have gone untreated. Many patients will have had understandable fears about the risk of infection or burdening the health service. Others may lack the digital access or skills to join a remote appointment. So has the pandemic, and resulting barriers to obtaining care, reduced consultations for acute medical conditions? This hypothesis was the catalyst for new research which used anonymised routinely collected electronic health records from general practices to find out what these changes meant for patients. An analysis of 10 million people during the first national lockdown, between March and July 2020. saw a rapid reduction in GP contacts compared with the three previous years. To take one example, people with

diabetes are at risk of potentially life-threatening diabetic emergencies. Thankfully this is rare – in April 2019 only 6 in every 100,000 people with diabetes in our study contacted their GP for a diabetic emergency. Yet in April 2020 this was only 1 in every 100,000. Why did this happen? Did these people with very serious illness bypass their GPs and go straight to Emergency departments or was there a genuine reduction in these events? Despite a wealth of evidence that mental health worsened during the first lockdown, GP contacts for anxiety, depression, obsessive compulsive disorder, self-harm and eating disorders fell dramatically. What is not clear is whether these people were self-managing mental health issues and what the long-term consequences are.

Of course, the rapid reduction in GP contacts we saw after the March 2020 lockdown could be due to genuine improvement in some health conditions at this time. For example, more regular routines may have helped people with diabetes manage their blood sugars. People with lung diseases may have had have fewer exacerbations because air pollution was less during lockdown while those shielding were less likely to be exposed to respiratory infections. However, it is likely that some of the reduction in GP contacts represents a troubling level of unmet need for healthcare. Did some people try to manage potentially serious illnesses at home? Did some become too sick to see their GP, going directly to hospital or dying before they ever saw a doctor? Sadly, increases in non-COVID excess deaths and re-

ports of reduced hospital attendance suggest that some of these people may have died, suggesting that our findings might partly reflect unmet need. There is hope in the recovery of GP contacts by Autumn 2020 and there is political commitment to make this third national lockdown the last. However, the collateral effects of the pandemic are likely to be felt for years to come. Work needs to be done to find those with heart, lung or mental health issues who were missed. As we build back better, we need stronger consideration of the ramifications of this potentially unmet need. We must find ways to reach these people and ensure they receive the necessary support when our lives and health service move from the phone back to the doctor’s office.

Pulse Oximeter Accuracy and Limitations The FINANCIAL

he Coronavirus Disease 2019 (COVID-19) pandemic has caused an increase in the use of pulse oximeters, and a recent report suggests that the devices may be less accurate in people with dark skin pigmentation. The U.S. Food and Drug Administration (FDA) is informing patients and health care providers that although pulse oximetry is useful for estimating blood oxygen levels, pulse oximeters have limitations and a risk of inaccuracy under certain circumstances that should be considered. Patients with conditions such as COVID-19 who monitor their condition at home should pay attention to all signs and symptoms of their condition and communicate any concerns to their health care provider.

Recommendations for Patients and Caregivers

How to take a reading: Follow your health care provider’s recommendations about when and how often to check your oxygen levels. Be aware that multiple factors can affect the accuracy of a pulse oximeter reading, such as poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish. To get the best reading from a pulse oximeter: Follow the manufacturer’s instructions for use. When placing the oximeter on your finger, make sure your hand is warm, relaxed, and held below the level of the heart. Remove any fingernail polish on that finger. Sit still and do not move the part of your body where the pulse oximeter is located. Wait a few seconds until the reading stops changing and displays one steady number. Write down your oxygen levels with the date and time of the readContinued on p. 11

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It’s totally normal to experience side effects from COVID-19 vaccines. Here’s what you need to know By LINDSAY SMITH ROGERS

You will be told about the side effects of the vaccine and when you should consult a health care worker at the time you are vaccinated.

COVID-19 vaccines are the first to be produced using the mRNA platform. These vaccines are highly effective, but they are also “reactogenic,” meaning that they’re likely to cause a noticeable immune response. For help understanding what side effects to expect after a COVID-19 vaccination, the Expert Insights website of the Bloomberg School of Public Health turned to expert epidemiologist and executive director of the International Vaccine Access Center William Moss. Below, Moss answers questions about side effects of COVID-19 vaccines, what to know before and after your vaccination, and when to contact your doctor or a medical professional.

Is it possible for me to contract COVID-19 between doses?

What side effects should I expect from COVID-19 vaccines? Side effects may vary with the type of COVID-19 vaccine. We know the most about side effects following vaccination with the Pfizer and Moderna messenger RNA—or mRNA— vaccines. The most common side effect is soreness at the site of injection. Other side effects include fatigue, headache, muscle aches, chills, joint pain, and possibly some fever.

another? Side effects are similar after the Pfizer and Moderna mRNA vaccines but could differ with other types of vaccines.

Why do these How long do side vaccines seem effects last? to have more Usually 24 to 48 hours, and no noticeable side more than a few days. effects than the Since COVID-19 vaccines come in two doses, will I experience the same flu vaccine? How side effects after each dose? do they compare Side effects were more frequent after the second dose in the vaccine to other vaccines’ trials. side effects— Do the side effects like the shingles vaccine, for differ from one example? manufacturer’s vaccine to These side effects are typical of the

inflammation induced by vaccines and are a sign of the body’s immune response to the vaccine. Some vaccines are more reactogenic—the term used to describe these types of side effects—and some people have more severe reactions than others. The side effects of COVID-19 vaccines are similar to what is observed after the shingles vaccine.

have been less frequent and severe in adults older than 55 years in the vaccine trials.

Do children experience side effects from COVID-19 Can side effects be vaccines? younger than 12 years of more pronounced ageChildren have not yet received vaccines in in people who are clinical trials, so we do not yet know. at higher risk of severe COVID-19 How do I know if what I am disease—i.e., experiencing is people who normal or if I are older, have should alert my comorbidities, doctor or health etc.? care provider? No—in fact, vaccine side effects

Yes—and this is why it is important to continue to wear a mask, practice social distancing, and wash your hands. The first dose will not provide complete protection, and it will take about seven days after your second dose before you will achieve a full protective level of immunity that develops in about 95% of vaccine recipients. If you are exposed to SARS-CoV-2 before this time, it is possible that you could develop COVID-19. Even once you have received both doses of the COVID-19 vaccine, it will still be important to continue practicing public health mitigation strategies like masks and distancing until the pandemic is under control and we know more about how the vaccines prevent transmission.

How will I know whether what I am experiencing are side effects or possible COVID-19 infection? The side effects of the vaccine typically start within 12 to 24 hours of vaccination, but it may be difficult to tell the two apart if you become infected between vaccine doses. If you experience side effects that last beyond 48 hours, you should contact your doctor or medical provider for advice. A version of this article originally appeared on the Expert Insights website of the Bloomberg School of Public Health.

Coronavirus and the social impacts on Great Britain The FINANCIAL

ost (90%) parents said a child in their household had been homeschooled because of the coronavirus, according to the latest data of the Office of National Statistics (UK). Compliance with most measures to stop the spread of the coronavirus (COVID-19) remained high, with similar proportions to last week reporting always or often handwashing after returning home (89% this week compared with 90% last week), using a face covering (96% this week compared with 95% last week) and avoiding physical contact when outside their home (93% both this week and last week).

Personal well-being measures for life satisfaction (6.4), feeling that things done in life are worthwhile (7.0) and happiness (6.5) remained at some of

the lowest levels recorded since March 2020; however, the level of anxiety (4.1) improved slightly this week compared with last week (4.2).

Around a quarter (26%) of adults in Great Britain reported they had received at least one dose of COVID-19 vaccine, 68% reported they had not yet been offered the COVID-19 vaccine, 4% reported that they had been offered it and were awaiting it, and 1% reported that they had been offered it but declined it. Most (90%) parents said a child in their household had been homeschooled because of the coronavirus (COVID-19) pandemic in the past seven days, with 52% of men and 67% of women with a school-aged child saying they had personally homeschooled. Of parents who had personally homeschooled, half (50%) said it was negatively affecting their well-being in January 2021 compared with 28% in April 2020; whilst almost two-

thirds (63%) said that it was negatively affecting their children’s well-being, compared with 43% in April 2020. In January 2021, nearly half (45%) of parents said their child spent 21 hours or more learning using resources provided by their school in the past seven days; this was up from 18% in May 2020. Fewer parents of school-aged children said that their child struggled to continue their education at home in January 2021 (38%) than in May 2020 (52%). ONS also asked those aged 16 to 18 years in full-time education directly about their experiences, with two-thirds (65%) agreeing that they were concerned that their future life plans will be negatively affected by continuing their education at home.

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Natia Turnava:

STATEMENT:

“FITCH’S ASSESSMENT LEFT GEORGIA’S CREDIT RATING UNCHANGED AGAINST THE BACKDROP OF MANY COUNTRIES IN THE POST-SOVIET SPACE, EASTERN EUROPE AND OUR REGION WHICH HAD THEIR RATINGS DOWNGRADED.”

VERDICT:

FACTCHECK CONCLUDES THAT NATIA TURNAVA’S STATEMENT IS HALF TRUE. Zurab MAISASHVILI

The Minister of Economy and Sustainable Development of Georgia, Natia Turnava, speaking of Fitch’s credit ratings, stated: “Fitch’s assessment left Georgia’s credit rating unchanged against the backdrop of many countries in the postSoviet space, Eastern Europe and our region which had their ratings downgraded.” A country’s credit rating gives investors information about risk factors associated with investments in certain countries as well as the reliability of these countries. Generally, Fitch employs the following assessment system: AAA is the highest rating in their assessment which is followed by AA+, AA, AA- above average – A+, A, A-, below average – BBB+, BBB, BBB-, noninvestment grade speculative – BB+, BB, BB-, speculative B+, B, B-, highly vulnerable CCC, on the verge of bankruptcy CC and default D. According to Fitch’s ranking system, Georgia’s credit rating is BB with a negative

FactCheck

RESUME: According to the Fitch credit

agency’s latest updates, Georgia’s outlook was kept at BB negative. Georgia’s credit outlook worsened in April 2020 amid the pandemic from stable to negative. In this part, Natia Turnava’s statement is indeed true. However, of those countries which Fitch assessed, only ratings for Belarus, Armenia and Slovakia were downgraded. In the case of Belarus and Armenia, these changes were stipulated by domestic political instability and the NagornoKarabakh conflict, respectively. Therefore, the claim that many countries had their credit ratings downgraded and Georgia’s performance is better in light of current trends is false.

ANALYSIS:

outlook, meaning that there are certain speculative risks in the economy. Of note is that a BB rating is a non-investment grade. According to the Fitch credit agency’s latest updates, Georgia’s outlook was kept at BB negative. In this part, Natia Turnava’s statement is indeed true. However, Georgia’s credit rating outlook worsened in April 2020 from stable to negative amid the pandemic. The second part of the statement refers to the downgraded credit ratings in Eastern European and post-Soviet countries. Only three countries – Belarus, Armenia and Slovakia – had their credit ratings downgraded as compared to the previous assessment. However, Armenia’s downgrade was caused by hostilities in the region whilst the drop in the ratings for Belarus was stipulated by domestic political turmoil and Western sanctions. The ratings of other countries were left unchanged.

Table 1: Fitch’s Assessment System Moody’s

S&P

FITCH

The best investment environment, reliable and stable

Investment Grade

Pulse Oximeter Accuracy and Limitations Continued from p. 10

ing so you can easily track changes and report these to your health care provider. How to interpret a reading: When taking pulse oximeter measurements, pay attention to whether the oxygen level is lower than earlier measurements, or is decreasing over time. Changes or trends in measurements may be more meaningful than one single measurement. Over the counter products that you can buy at the store or online are not intended for medical purposes. Do not rely only on a pulse oximeter to assess your health condition or oxygen level. If monitoring oxygen levels at home, pay attention to other signs or symptoms of low oxygen levels, such as: Bluish coloring in the face, lips, or nails; Shortness of breath, difficulty breathing, or a cough that gets worse; Restlessness and discomfort; Chest pain or tightness; and Fast or racing pulse rate. Be aware that some patients with low oxygen levels may not show any or all of these symptoms. Only a health care provider can diagnose a medical condition such as hypoxia (low oxygen levels). When to contact your health care provider: If you are concerned about the pulse oximeter reading,

or if your symptoms are serious or getting worse, contact a health care provider. If you think you may have COVID-19, contact your health care provider or local health department about getting a diagnostic test for COVID-19. Pulse oximeters cannot be used to diagnose or rule out COVID-19.

Recommendations for Health Care Providers Be aware that multiple factors can affect the accuracy of a pulse oximeter reading, such as poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish. Review the information in the sections below to better understand how accuracy is calculated and interpreted. Refer to the device labeling or the manufacturer’s website to understand the accuracy of a particular brand of pulse oximeter and sensor. Different brands of pulse oximeters and even different sensors (finger clip versus adhesive) may have a different accuracy level. Pulse oximeters are least accurate when oxygen saturations are less than 80%. Consider accuracy limitations when using the pulse oximeter to assist in diagnosis and treatment decisions. Use pulse oximeter read-

ings as an estimate of blood oxygen saturation. For example, a pulse oximeter saturation of 90% may represent an arterial blood saturation of 86-94%. When possible, make diagnosis and treatment decisions based on trends in pulse oximeter readings over time, rather than absolute thresholds.

Device Description A pulse oximeter is a device that is usually placed on a fingertip. It uses light beams to estimate the oxygen saturation of the blood and the pulse rate. Oxygen saturation gives information about the amount of oxygen carried in the blood. The pulse oximeter can estimate the amount of oxygen in the blood without having to draw a blood sample. Most pulse oximeters show two or three numbers. The most important number, oxygen saturation level, is usually abbreviated SpO2, and is presented as a percentage. The pulse rate (similar to heart rate) is abbreviated PR, and sometimes there is a third number for strength of the signal. Oxygen saturation values are between 95% and 100% for most healthy individuals, but sometimes can be lower in people with lung problems. Oxygen saturation levels are also generally slightly lower for those living at higher altitudes.

Aaa

AAA

Aa1

Aa+

Aa2

Aa3

AA-

A+

A2 A3

A A-

Baa1

BBB+

Baa2

BBB

Baa3

BBB-

Genetics May Play Role in Determining Immunity to COVID-19 Continued from p. 5

Good investment environment, higher risk than AAA

Economic situation can affect debtor solvency

Medium investment environment which is satisfactory at the moment

Non-investment Grade Ba1

BB+

Ba2

Ba3

BB-

B1 B2 B3 Caa1

B+ B BCCC+

B+ B B-

Financial situation varies noticeably

Caa2

CCC

Highly vulnerable and a very speculative environment

Caa3

CCC-

Ca C

CC C D

There are speculative risks in the economy

CC C D

of the MHC. The other is that lack of effective cooperation between T and B lymphocytes may affect the longevity of neutralizing antibody responses in infected people.” The authors note that multiple studies have reported that neutralizing

On the verge of bankruptcy Default

Source: FactCheck.ge Table 2: Fitch’s Assessment for Eastern European and Post-Soviet Countries Country

Previous Assessment

Current Rating

Difference

Georgia

BB (Stable)

BB (Negative)

Armenia Azerbaijan Russia Ukraine Estonia Lithuania Latvia Belarus Poland Hungary Czech Republic Slovakia Bulgaria Romania

BB- (Negative) BB+ (Negative) BBB (Stable) B (Stable) AA- (Stable)) A (Stable) A- (Negative) B (Stable) A- (Stable) BBB (Stable) AA- (Stable) A+ (Stable) BBB (Stable) BBB- (Negative)

B+ (Stable) BB+ (Negative) BBB (Stable) B (Stable) AA- (Stable) A (Stable) A- (Stable) B- (Negative) A- (Stable) BBB (Stable) AA- (Stable) A (Negative) BBB (Stable) BBB- (Negative)

Downgrade Downgrade Downgrade -

Source: Fitch Credit Agency

antibodies in infected persons (hospitalized patients, health care workers and convalescent individuals) drop within three months. “To these considerations, one may add the impact of the newly discovered mutations in the RBM, such as those in the UK, South African and Brazilian variants of the virus,” said Zanetti. The

topology of the mutations in these new variants is indicative of further potential breakdown of the immunological relay between T and B lymphocytes, with additional negative impact on the ability of individuals in the global population to generate high quality and long-lived neutralizing antibody responses against SARS-CoV-2.”

Excess mortality in 2020 reached its peak in November The FINANCIAL

n spring 2020, the number of deaths in the EU started to rise rapidly due to COVID-19: in some parts of Europe, deaths were exceptionally high, when compared with the average mortality of previous years. From here came the idea of assessing the impact of the pandemic by looking at the

excess mortality, i.e. the increase in the total number of deaths, from any cause, compared with deaths in the previous years. In total, over 450 000 more deaths occurred in the EU between March and November 2020 compared with the same period in 2016 – 2019. During the early rise of COVID-19, the excess mortality in the EU reached its first peak in April 2020, with an increase of 25% compared with the average of

the same month over 2016 2019. Between May and July, a lower level of excess mortality was registered, while yet another surge in mortality started in August – September with the next wave of the pandemic. The excess mortality in the EU was 8% above the average in September, +17% in October and +40% in November, with the indicator rising in all EU Member States.

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People with disability struggling to make ends meet

Irakli Kovzanadze:

STATEMENT:

“UNDER HIGH DOLLARISATION AND IMPORT-DEPENDENCY, THE DEFICIT GROWTH LEADS TO HIGHER MACROECONOMIC RISKS. THE LOAN ATTRACTION INCREASED AND CURRENTLY WE HAVE A 60.1% DEBT TO GDP RATIO WITH A LARGE PORTION OF FOREIGN LOANS. WHEN MOST OF THE FOREIGN DEBT IS DENOMINATED IN FOREIGN CURRENCY, INCREASED RISKS HAMPER THE CONSOLIDATION OF BUDGET REVENUES AND APPROPRIATIONS.”

VERDICT:

FACTCHECK CONCLUDES THAT IRAKLI KOVZANADZE’S STATEMENT IS TRUE. Vakhtang DEMURIA FactCheck

ANALYSIS:

The FINANCIAL

ogo Statistics Explained In 2019, 26.1% of adults in the EU with a disability (activity limitation) lived in households that reported having difficulties in making ends meet (i.e. whose financial re-

sources did not cover their usual necessary expenses), compared with 16.0% among the adult population with no disability. Among the EU Member States, approximately twothirds of people with a disability faced financial difficulties in Greece (76.5%) and Bulgaria (65.7%). Just under half of the population were

in this situation in Croatia (49.2%), Cyprus (43.2%) and Romania (40.9%). At the other end of the scale, less than 20% of people with a disability had difficulties making ends meet in Finland (9.9%), Germany (10.4%), Sweden (13.1%), Luxembourg (14.0%), Denmark (15.8%), Austria (16.2%), the Netherlands (18.2%) and Estonia (19.6%).

Family businesses risk missing the mark on ESG PwC Family Business Survey The FIANNCIAL - In a year where business has had to transform the way it meets the needs of society and the environment, family owned businesses risk falling behind, according to a new global survey of 2,801 family business owners. While more than half (55%) of respondents saw the potential for their business to lead on sustainability, only 37% have a defined strategy in place. European and American businesses are lagging their Asian counterparts in their commitment to prioritising sustainability in their strategy. 79% of respondents in mainland China and 78% in Japan reported ‘putting sustainability at the heart of everything we do’ compared to 23% of US and 39% in the UK. Larger businesses and those owned by later generations also buck the trend, with greater focus on sustainability. This reluctance to embrace sustainability comes despite the fact family owned businesses are highly likely to see a responsibility to society. Over 80% engage in proactive social responsibility activity, and 71% sought to retain as many staff as possible during the pandemic. Nor is it a

Chairperson of the Budget and Finance Committee of the Parliament of Georgia, Irakli Kovzanadze, stated: “Naturally, the deficit was poised to grow. We have high dollarisation and import-dependency. Under these conditions, the deficit growth leads to higher macroeconomic risks when the deficit grew, loan attraction also increased and currently we have a 60.1% debt to GDP ratio. Here, it is important to take a look at the debt composition where the portion of foreign loans is large. When most of the foreign debt is denominated in foreign currency, increased risks hamper the consolidation of budget revenues and appropriations.” In the context of the COVID-19 pandemic, budget deficit growth is one of the critical problems. The difference between budget revenues and expenditures constitute a budget’s operational balance and the difference between the budget’s operational balance and the changes in non-financial assets (privatisation/ selling property) is the total budget balance. The total positive balance is the budget surplus whilst the total negative balance is the budget deficit. The budget deficit means that the budget has less revenues as compared to expenditures and the government has to borrow to finance the difference. Apart from incurring expenses needed to fight the pandemic, deficit spending is also used to stimulate the pandemic-induced drop in consumption. However, this also entails a number of negative consequences such as inflation, downsized savings, higher interest rates, etc. In other words, the effect caused by the current deficit as well as the negative consequences associated with the growth of the foreign debt will be felt in the upcoming years. The threshold of the second macroeconomic param-

eter, as determined by Georgia’s Economic Liberty Act, is about the consolidated budget deficit. In particular, the consolidated budget’s deficit should not exceed 3% of the GDP. Therefore, the goal of this legislative commitment is to ensure that the government-planned expenditures do not substantially exceed the planned revenues. Budget planning or/and executing the planned parameters beyond the thresholds set by this law is possible under Georgian legislation in the case of a declaration of martial law or a state of emergency and if there is a need to fund measures to liquidate those consequences which arose as a result of the declaration of martial law/state of emergency. At the same time, the Government of Georgia has to submit a plan to the Parliament of Georgia to restore the legally prescribed parameters. The plan for returning back to the legally prescribed parameters should not exceed three years. The forecasted figure for the consolidated budget deficit in 2020 is 8.5% which is 5.9 percentage points more and exceeds the legally allowed threshold. According to 2021’s plan, the consolidated budget deficit is 7.5%. Of note is that according to the preliminary data of the National Statistics Office of Georgia, the GDP decreased more than 5% as was the figure forecasted in the budget. Therefore, it is expected that the actual deficit for 2020, which is not yet available, is even larger as compared to the planned figure. Georgia is an import-dependent country. Although export has been growing in the past years, import also grows annually. As a result, the trade deficit; that is, the difference between export and import, does not decrease substantially and fluctuates between USD 5.7 billion to USD 5.1 billion. In 2020 amid the pandemic, the foreign trade balance constituted USD 4.6 billion and this figure does not fit into the aforementioned trend. In spite of this, pressure on the exchange rate is naturally very high. GEL depreciation vis-à-vis foreign currencies directly

impacts the government debt and deficit figures. Government debt comprises domestic debt, denominated in a national currency, and foreign debt, denominated in a foreign currency. According to 2020’s data, the total government debt amounts to nearly GEL 29.5 billion which is approximately GEL 9.7 billion more as compared to the same period of the previous year and exceeds the legally allowed 60% threshold. Similar to the budget deficit, government debt over 60% is allowed for three years during the time of the pandemic. The GEL to USD exchange rate fluctuation is something take into account whilst analysing the government debt dynamic. In particular, both new debt (borrowed in one year) and the previously accumulated debt balance (the unpaid portion of a loan borrowed in the past) are recalculated amid the currency exchange rate fluctuation in accordance with a new exchange rate. In the last years, the growth of the government and the national debt was largely stipulated by a recalculation of the previously accumulated debt balance in accordance with the new exchange rate. The growth of the total government debt is mostly associated with the growth of the foreign debt. The domestic and foreign debt ratio as part of the total government debt is illustrated in Graph 2. In 2012-2020, the government debt’s foreign currency denominated portion was nearly 80% whilst the debt in the national currency was almost 20%. Naturally, servicing the increased debt stipulated by the budget deficit growth will become more expensive given GEL depreciation. In turn, this will give rise to some significant budget problems in the future. In particular, the government’s disposable funds will shrink and paying for the deficit will also be needed; therefore, the government will have to cut budget expenses and consolidate additional revenues which is a separate problem which will inevitably come true in the near future.

Table 1: Consolidated Budget Deficit in 2017-2014 (GEL Million, Forecasts)

function of economic pessimism - less than half (46%) expect sales to fall despite the pandemic and survey respondents felt optimistic about their business’ abilities to withstand and continue to grow in 2021 and 2022. Instead, the issue is an increasingly out-of-date conception of how businesses should respond to society, with 76% in the US and 60% in the UK placing greater emphasis on their direct contribution, often through philanthropic initiatives, rather than through a strategic approach to ESG matters. Family businesses are also somewhat insulated from the investor pressure that is currently

pushing public companies to put ESG at the heart of their long term plans for commercial success. ‘It is clear that family businesses globally have a strong commitment to a wider social purpose”,Peter Englisch, global family business leader at PwC says. “But there is a growing pressure from customers, lenders, shareholders and even employees, to demonstrate a meaningful impact around sustainability and wider ESG issues. Many listed companies have started to respond but this survey indicates that family businesses have a more traditional approach to social contribution”.

Revenues

2017

2018

2019

2020*

2021*

2022*

2023*

2024*

10921

11822

12907

12626

13402

14969

16331

17827

Expenditures

9194

9493

10519

12921

13407

13518

14434

15243

Changes in Non-financial Assets

2085

2654

3740

3905

3986

3850

3710

4230

Operational Balance

1726

2329

2387

-295

-5

1451

1897

2584

Deficit Deficit to GDP Ratio %

358

325

1353

4200

3991

2399

1813

1646

0.9%

0.7%

2.7%

8.5%

7.5%

4.1%

2.9%

2.4%

Source: Ministry of Finance of Georgia Graph 2: Ratio of Government Debt Figures Denominated in National and Foreign Currencies (GEL Shown at Graph) in 2012-2020

Source: Ministry of Finance of Georgia

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22 February, 2021 | FINCHANNEL.COM

More Americans Than People in Other Advanced Economies Say COVID-19 Has Strengthened Religious Faith Nearly threein-ten U.S. adults say the outbreak has boosted their faith; about four-in-ten say it has tightened family bonds

The FINANCIAL

n nearly every country surveyed, those who say religion is very important in their lives are more likely to say both their own faith and that of their compatriots has grown due to the pandemic. Americans’ greater proclivity to turn to religion amid the pandemic is largely driven by the relatively high share of religious Americans (In several countries, those who say religion is somewhat, not too or not at all important to them personally are less likely take a clear position either way on how their faith has been affected by the pandemic.)

Americans most likely to say COVID-19 bolstered religious faith, though majorities around world see little change Majorities say coronavirus has not changed their religious faith muchIn 11 of 14 countries surveyed, the share who say their religious faith has strengthened is higher than the share who say it has weakened. But generally, people in developed countries don’t see much change in their own religious faith as a result of the pandemic. A median of 10% across 14 developed countries say their own religious faith has become stronger as a result of the coronavirus outbreak, while a median of 85% say their religious faith had not changed much. Among the countries surveyed, the U.S. has by far the highest share of respondents who say their faith has strengthened, with about threein-ten holding this view. By contrast, in Spain and Italy, two of Western Europe’s more religious countries, roughly one-in-six people say their own religious faith has grown due to the pandemic. In Canada, 13% say their religious faith has become stronger because of COVID-19. And in other countries surveyed, one-in-ten or fewer report deeper faith due to the coronavirus outbreak. People who prioritize religion are more likely to say COVID-19 strengthened their religious faithThe pandemic has led to the cancellation of religious activities and in-person services around the world, but few people say their religious faith has weakened as a result of the outbreak. Across the countries surveyed, a median of just 3% say their own religious faith has decreased, including 4% in the U.S. In South Korea, 9% say their personal faith has become weaker as a result of the coronavirus outbreak, making it the coun-

WHO lists two additional COVID-19 vaccines for emergency use and COVAX roll-out AstraZeneca/ Oxforddeveloped vaccines to reach countries in the coming weeks

try where people are most likely to hold this view. Perceptions about the pandemic’s influence on faith are tied to people’s own levels of observance – those who are more religious are more likely than their less religious compatriots to say COVID-19 has strengthened their faith and that of others in their country. In Spain, for example, 49% of those who say religion is very important in their lives say their own religious faith has been bolstered because of the pandemic, compared with 6% among those who say religion is less important. A similar pattern occurs in the U.S.: 45% of those who say religion is very important in their lives say the pandemic has made their faith stronger, compared with 11% who consider religion less important. Overall, 24% of Spanish adults say religion is very important in their lives, as do 49% of Americans. Wealth and education also play a role: In some countries, people with lower incomes and less education are somewhat more likely than others to say the pandemic has bolstered their religious faith. People with lower incomes more likely to say coronavirus boosted their faith When it comes to income, the largest gaps appear in the U.S. and Spain, where people at or below the national median income are 12 percentage points more likely than the rest of the population to say their religious faith has become stronger. There are also significant differences by income group in Canada, Italy, the UK, the Netherlands, France, South Korea and Japan. People with less education are significantly more likely than those with a secondary education or higher to say their personal religious faith has deepened in five of the countries surveyed: Spain (those with less education are 11 points more likely to say this), Italy (8 points), the U.S. (7 points), France (5 points) and Japan (3 points). There are few differences on this question by gender, even though women are generally more religious than men, particularly in Christianmajority countries. Two exceptional cases in this survey are Italy and South Korea, where women are more likely than men to report that their faith has been bolstered by the pandemic.

Americans most likely to say country is more religious because of

pandemic Most people say coronavirus has not changed compatriots’ religious faithThe survey also asked people if the strength of religious faith in their country as a whole has changed due to the pandemic. Responses largely mirror how people answer the question about their own religious faith, although respondents may additionally be taking into account their views on the role of religion in their nation’s public life. Majorities in nearly every country surveyed say that the religious faith of people in their country has not changed much as a result of the pandemic. A 14-country median of 66% say the religious faith of people in their country is about the same as before the pandemic, while 15% say faith in their country has become stronger and 8% say it has become weaker. Among Americans, about half of adults surveyed (47%) say the religious faith of people in the U.S. has not changed much, while 28% say the country has become more religious. A relative handful of Americans (14%) think that religious faith in their country has weakened as a result of the coronavirus outbreak. In some countries, significantly more people say their country has experienced religious renewal than say they themselves have greater religious faith. In the Netherlands, 17% say their country has become more religious, even though just 7% of Dutch adults say they, personally, are now more religious. In Sweden, 15% say the religious faith in their country is stronger, compared with 3% who say they themselves have experienced stronger religious faith.

In the U.S., White evangelicals most likely to say COVID-19 boosted faith Half of White evangelicals in U.S. say their faith has grown due to COVID-19White evangelical Protestants in the U.S. – one of the most religious groups in the country, by a variety of standard measures – are among the most likely to see stronger faith due to the coronavirus outbreak. Nearly half (49%) say their own religious faith has grown, while 43% say the same about the faith of Americans

as a whole. Three-in-ten U.S. Catholics say Americans’ religious faith has strengthened, while roughly a third report that their own religious faith has become stronger. Nonevangelical (mainline) Protestants show a similar pattern: Roughly two-in-ten say their own faith has deepened, while another 21% offer a similar assessment of other Americans’ religious faith. Just 5% of Americans who report no religious affiliation say their religious faith has increased due to the coronavirus outbreak. However, 20% of unaffiliated people say they see deeper religious faith among Americans in general.

Family bonds have strengthened for many in countries surveyed In some countries, younger people are more likely than older ones to say family relationships tightened due to COVID-19Religion is by no means the only way people cope with crisis. Family relationships are often a bulwark of support. And as many families in countries surveyed remain confined to their homes because of mandated work from home and closed or virtual schools, more people say their relationships with immediate family members have become stronger than say these relationships have weakened. A 14-country median of 32% say relationships have grown stronger, while just 8% say the opposite. Majorities in 11 countries say the coronavirus outbreak has not changed their relationship to immediate family much. About four-in-ten adults surveyed in Spain, Italy, the U.S. and the UK say their relationship with immediate family has strengthened. By contrast, only about two-in-ten in Germany, Japan and South Korea say they now have deeper relationships with their family. Record numbers of younger adults in the U.S. have moved home since the start of the pandemic, and young Americans are more likely than their older counterparts to say their relationships with immediate family members have strengthened. Half of U.S. adults ages 18 to 29 say their family bonds have tightened, compared with 38% of those ages 50 and older. Similar age gaps appear in Spain and Belgium (both 20 points), as well as Australia and Sweden (13 points).

WHO listed two versions of the AstraZeneca/Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through COVAX. The vaccines are produced by AstraZeneca-SKBio (Republic of Korea) and the Serum Institute of India. WHO’s Emergency Use Listing (EUL) assesses the quality, safety and efficacy of COVID-19 vaccines and is a prerequisite for COVAX Facility vaccine supply. It also allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines. “Countries with no access to vaccines to date will finally be able to start vaccinating their health workers and populations at risk, contributing to the COVAX Facility’s goal of equitable vaccine distribution,” said Dr Mariângela Simão, WHO Assistant-Director General for Access to Medicines and Health Products. ‘But we must keep up the pressure to meet the needs of priority populations everywhere and facilitate global access. To do that, we need two things – a scale-up of manufacturing capacity, and developers’ early submission of their vaccines for WHO review.” The WHO EUL process can be carried out quickly when vaccine developers submit the full data required by WHO in a timely manner. Once those data are submitted, WHO can rapidly assemble its evaluation team and regulators from around the world to assess the information and, when necessary, carry out inspections of manufacturing sites. In the case of the two AstraZeneca/Oxford vaccines, WHO assessed the quality, safety and efficacy data, risk management plans and programmatic suitability, such as cold chain requirements. The process took under four weeks. The vaccine was reviewed on 8 February by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), which makes recommendations for vaccines’ use in populations (i.e. recommended age groups, intervals between shots, advice for specific groups such as pregnant and lactating women). The SAGE recommended the vaccine for all age groups 18 and above. The AstraZeneca/Oxford product is a viral vectored vaccine called ChAdOx1-S [recombinant]. It is being produced at several manufacturing sites, as well as in the Republic of Korea and India. ChAdOx1-S has been found to have 63.09% efficacy and is suitable for low- and middleincome countries due to easy storage requirements

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Experts Say the ‘New Normal’ in 2025 Will Be Far More Tech-Driven, Presenting More Big Challenges BY JANNA ANDERSON, LEE RAINIE AND EMILY A. VOGELS Pew RESEARCH

plurality of experts think sweeping societal change will make life worse for most people as greater inequality, rising authoritarianism and rampant misinformation take hold in the wake of the COVID-19 outbreak. Still, a portion believe life will be better in a ‘tele-everything’ world where workplaces, health care and social activity improve When pandemics sweep through societies, they upend critical structures, such as health systems and medical treatments, economic life, socioeconomic class structures and race relations, fundamental institutional arrangements, communities and everyday family life. A new canvassing of experts in technology, communications and social change by Pew Research Center and Elon University’s Imagining the Internet Center finds that many expect similar impacts to emerge from the COVID-19 outbreak. Asked to consider what life will be like in 2025 in the wake of the outbreak of the global pandemic and other crises in 2020, some 915 innovators, developers, business and policy leaders, researchers and activists responded. Their broad and nearly universal view is that people’s relationship with technology will deepen as larger segments of the population come to rely more on digital connections for work, education, health care, daily commercial transactions and essential social interactions. A number describe this as a “tele-everything” world. Notable shares of these respondents foresee significant change that will: worsen economic inequality as those who are highly connected and the tech-savvy pull further ahead of those who have less access to digital tools and less training or aptitude for exploiting them and as technological change eliminates some jobs; enhance the power of big technology firms as they exploit their market advantages and mechanisms such as artificial intelligence (AI) in ways that seem likely to further erode the privacy and autonomy of their users; multiply the spread of misinformation as authoritarians and polarized populations wage warring information campaigns with their foes. Many respondents said their deepest worry is over the seemingly unstoppable manipulation of public perception, emotion and action via online disinformation – lies and hate speech deliberately weaponized in order to propagate destructive biases and fears. They worry about significant damage to social stability and cohesion and the reduced likelihood of rational deliberation and evidence-based policymaking. At the same time, a portion of these experts express hope that changes spawned by the pandemic will make things better for significant portions of the population because of changes that: inaugurate new reforms aimed at racial justice and social equity as critiques of current economic arrangements – and capitalism itself – gain support and policymaker attention; enhance the quality of life for many families and workers as more

flexible-workplace arrangements become permanent and communities adjust to them; produce technology enhancements in virtual and augmented reality and AI that allow people to live smarter, safer and more productive lives, enabled in many cases by “smart systems” in such key areas as health care, education and community living. These six themes were commonly expressed by these experts in their responses to a question that asked them to consider the changes that were set in motion in 2020 by the COVID-19 outbreak and describe what the “new normal” might look like in 2025. Some 47% of these respondents said life will be mostly worse for most people in 2025 than it was before the pandemic, while 39% said life will be mostly better for most people in 2025 than it was prepandemic. Another 14% said most people’s lives in 2025 will not be much different from the way things would have turned out if there had been no pandemic. Among the 86% who said the pandemic will bring about some kind of change, most said they expect that the evolution of digital life will continue to feature both positives and negatives. These expert views link in interesting ways with public attitudes. A Pew Research survey in August 2020 found that 51% of U.S. adults said they expected their lives to remain changed in major ways even after the pandemic is over. This is a nonscientific canvassing, based on a nonrandom sample. The results represent only the opinions of the individuals who responded to the queries and are not projectable to any other population. The bulk of this report covers these experts’ written answers explaining their responses. They

sounded many broad themes about the ways in which individuals and groups are adjusting in the face of the global crisis, describing the most likely opportunities and challenges emerging as humans accelerate their uses and applications of digital technologies in response. It is important to note that the responses were gathered in the summer of 2020, before the completion of the presidential election in the United States and before COVID-19 vaccines had been approved. As these experts pondered what was happening in mid-2020 and the likely changes ahead, they used words like “inflection point,” “punctuated equilibrium,” “unthinkable scale,” “exponential process,” “massive disruption” and “unprecedented challenge.” They wrote about changes that could reconfigure fundamental realities such as people’s physical “presence” with others and people’s conceptions of trust and truth. They wondered, too, if humans can cope effectively with such farreaching changes, given that they are required to function with “paleolithic emotions, medieval institutions and god-like technology,” in the words of biologist E.O. Wilson. Among the scores of changes they see is the emergence of: an “Internet of Medical Things” with sensors and devices that allow for new kinds of patient health monitoring; smart millimeter wave machines to diagnose people with disease symptoms; advances in synthetic biology and computational virology that improve drug testing and targeted disease therapies; diagnostic screenings that cover a person’s diet, genes and microbiome; handheld detection devices that citizen swarms use to address environmental problems; and a new class of tele-care workers.

Additionally, these experts forecast the creation of 3-D social media systems that allow for richer human interaction (sometimes via hologram avatars); mediated digital agents (interdigital agents) gradually taking over significantly more repetitive or time-consuming tasks; a “flying Internet of Things” as drones become more prolific in surveillance, exploration and delivery tasks; ubiquitous augmented reality; an expanded gig economy built around work-from-home free agents; urban farming that reaches industrial scale; advances in trusted cryptocurrency that enable greater numbers of peer-to-peer collaborations; locally based, on-demand manufacturing; “local in spirit and local in practice” supply chains; a robust marketplace of education choices that allow students to create personalized schooling menus; “tele-justice” advances that allow courts to handle large numbers of cases remotely; “truth valuation” protocols that diminish the appeal of disinformation; and small, safer nuclear reactors for energy production. At the more everyday level, these experts also think there will be better speech recognition, facial recognition (including sentiment discernment from facial expressions), real-time language translation, captioning and autocorrect capacity, sensory suits, robust video search, body motion sensors, 3D glasses, multimedia databases and broader network bandwidth that will enable full 3D virtual experiences and developments in AI allowing it to serve more of people’s needs. These themes and more are outlined in the accompanying tables. Emerging change: As the global pandemic unfolds, experts predict people will develop greater reliance on swiftly evolving digital tools for

good and for ill by 2025 The pandemic proves that worldupending phenomena can emerge from anywhere. The turn to living and working more intensively within digital communications networks shows the value of these complex systems. The pandemic brings more focus on both the upsides and the downsides of digital life. Tele-everything is embraced: The broad adoption of “remote” processes – telework, telemedicine, virtual schooling, e-commerce and more – is growing. In 2025, there will be more people working from home, more virtual social and entertainment interactions and fewer forays in public than has been in the case in recent years. Humans’ yearning for convenience and safety fuels reliance on digital tools: The pandemic has rearranged incentives so that consumers will be more willing to seek out smart gadgets, apps and systems. This will speed up adoption of new education and learning platforms, rearrange work patterns and workplaces, change family life and upend living arrangements and community structures. The best and worst of human nature are amplified: The crisis is enhancing digital interconnectedness that engenders empathy, better awareness of the ills facing humanity and positive public action. On the flip side, some individuals, cities and nation-states will become more insular and competitive as survival mode kicks in. Xenophobia, bigotry and closed communities will also increase. Worries: As the global pandemic unfolds, experts fear growing social and racial inequality, worsening security and privacy and the further Continued on p. 20

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22 February, 2021 | FINCHANNEL.COM

Overcoming COVID-19 and its collateral effects Dr HANS HENRI P. KLUGE,

disease, cancer or tuberculosis.

No time to drop our guard

WHO REGIONAL DIRECTOR FOR EUROPE

ith more than 37 million cases and nearly 830 000 deaths, the trend in the WHO European Region shows decreasing cases for a fifth week in a row. For the first time since September last year, the number of new cases reported in a week is less than a million. Although still high, new deaths also declined for the third consecutive week. Transmission in most of the Region has begun to slow. Europe now accounts for a decreasing proportion of the global burden of disease and mortality, currently at 28% of new cases and 21% of new deaths.

Dual-track approach When cases of COVID-19 are at lower levels in many countries, as they are now, health authorities are presented an opportunity to focus on evaluating and improving the performance of their response. To that end, I have written to all health ministers in the European Region, providing an assessment of the current situation and a checklist of additional actions that Member States should consider. But this is also a time to prepare our health services to get back on track, strategize, and deliver health services beyond the COVID-19 response. Globally, 9 out of 10 countries report disrupted essential health services. Cancer patients have been hugely impacted. They are more vulnerable due to their weakened immune systems, and their treatments have been postponed or halted. For some countries, sending cancer patients abroad for treatment has become impossible. COVID-19 wards have not been the only ones reaching a breaking point in past months. Several psychiatry wards have too. Some feel guilty

for speaking about their fatigue while others are literally fighting for their lives. Many of us are trying to deal with a roller coaster of emotions: anxiety, grief and depression. Antimicrobial resistance is another growing peril, threatening the effective prevention and treatment of infections. Research conducted in 9 countries and areas where treatment guidelines are not available or followed, where people can buy antibiotics over the counter, shows a concerning rise in the use of antibiotics based on the misconception that antibiotics can prevent COVID-19. One study, based on global data, estimated that in a period of 12 weeks in 2020, some 28.5 million surgeries that had been scheduled had to be cancelled due to COVID-19. Childhood immunization programmes have been disrupted in almost all countries, with temporary suspension of vaccination programmes in some countries. These are only a few of the many issues that need attention.

Immunizing health workers In the coming weeks, as more and more health workers get immunized, the capacity to address the backlog of postponed surgeries, cancelled chemotherapy and halted vaccination campaigns also grows. This is where our focus needs to gradually shift, while suppressing COVID-19 transmission. A resilient health system requires adequate human resources to ensure everyone, everywhere, receives services. To date, between 1% and 46% of health workers, or 19% on average, have completed a COVID-19 immunization series, based on available information from 20 countries in the Region. A stronger, vaccinated health workforce, fewer COVID-19 hospital admissions, and fewer deaths as older population groups get vaccinated should give us space and time to recalibrate – in itself a monumen-

tal task. Waging a war on numerous fronts requires resources and vigilance, and once again, those carrying the heaviest burden are health workers. In the past year, health workers have put their own lives on the line every single day, and shown extraordinary resilience and compassion. For their sacrifice and commitment, I have nothing but respect – particularly as it is they who are now called upon to deliver vaccination programmes. It is they who will be tasked with getting our routine and essential health services back on track to tackle the collateral effects and fallout of this pandemic. They have gone to extreme lengths, and are now required to go further. To allow them to do this, those of us who do not work on the frontline must continue to act responsibly and follow protective public health and social measures so that our health systems can strive to save not only COVID-19 patients, but also those with diabetes, cardiovascular

What matters now is how we respond to positive epidemiological trends. Despite an overall encouraging picture, improving epidemiology can prompt a sense of security that results in hasty decision-making that in turn leads to a resurgence of cases. This slowing spread of the virus, for the most part, is driven by public health and social measures. We as individuals have the power to undermine the positive trend we see today or support it on its course. We have the tools. Let’s continue using them to full effect. Although new variants pose additional challenges, all of them are SARS-CoV-2 and all can be controlled with the tools we have at hand. Several countries have significantly decreased transmission of these variants. Some 40 countries in the European Region have started vaccinating against COVID-19. Nonetheless, in the 30 countries that have provided data, only 1.8% of the population has received a complete vaccine series. Vaccines are certainly a game changer, but since supply is limited, our most effective tools remain public health and social measures. Faced with reports on new variants, confusion and fatigue are understandable. But let me assure you that the circumstances are temporary. Yes, we will still need to take precautionary measures for months to come, but if we all play a role and shoulder the responsibility to keep transmission rates low, the restrictive measures that have been put in place will be lifted. Now is the time to minimize the damage inflicted by severe disruption of health services, to counteract the collateral effects of COVID-19 while simultaneously keeping it under control. Stay safe. Thank you.

Longer infections could fuel a variant’s quick spread The FINANCIAL

catch it are infected for a relatively long time, and can therefore infect a larger number of contacts. This suggests that longer quarantine periods might be warranted for individuals infected with this variant. The findings have not yet been peer reviewed. Seven newly identified coronavirus variants in the United States share a similar mutation, but the significance of this change is not yet clear. Coronavirus variants emerging in a range of geographical locations seem to share certain mutations — possible evidence that the changes aid transmission. Jeremy Kamil at Louisiana State University Health Sciences Center in Shreveport and his colleagues identified a new variant that they named Robin .

reliminary findings suggest that B.1.1.7, a SARSCoV-2 variant first identified in the United Kingdom, might be more transmissible because it spends more time inside its host than earlier variants do. Previous studies have estimated that B.1.1.7, which is now spreading rapidly in a number of countries, is roughly 50% more contagious than earlier coronavirus variants are. Yonatan Grad at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts, and his colleagues examined the results of daily SARS-CoV-2 tests on 65 people infected with SARS-CoV-2, including 7 infected with B.1.1.7 (S. M. Kissler et al.

Robin’ leads a flock of new US COVID variants

Seven people infected with B.1.1.7, infections lasted an average of 13.3 days, compared with 8.2 days in people with other variants. There was little difference in the peak con-

centrations of the virus between the two groups. These findings hint that B.1.1.7 is more easily transmitted than other variants are because people who

Drug can be a lifeline for people hospitalized for COVID

An anti-inflammatory drug can save the lives of people hospitalized for COVID-19 whose immune systems have gone into overdrive against the coronavirus. The drug also cuts the need for invasive ventilation, according to a large study. Many people with severe COVID-19 symptoms show evidence of widespread inflammation. The drug tocilizumab is designed to dampen such an immune response, but previous clinical trials of its benefits in people infected with SARS-CoV-2 have been equivocal. Peter Horby and Martin Landray at the University of Oxford, UK, and their colleagues compared more than 2,000 people treated with tocilizumab with a similar number who did not receive the drug (RECOVERY Collaborative Group. He authors report that 54% of people who received tocilizumab left hospital within 28 days, compared with 47% of those not taking the drug. An analysis showed that tocilizumab provided benefits on top of those from dexamethasone. The team estimates that roughly half of all people hospitalized with COVID-19 in the United Kingdom would benefit from the drug.

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COVID-19 situation update worldwide, as of week 6, updated 18 February 2021 The FINANCIAL

ince 31 December 2019 and as of week 2021-6, 109 206 497 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 2 407 469 deaths. Cases have been reported from: Africa: 3 754 326 cases; the five countries reporting most cases are South Africa (1 491 807), Morocco (478 474), Tunisia (223 549), Egypt (173 813) and Ethiopia (147 092). Asia: 20 826 077 cases; the five countries reporting most cases are India (10 916 589), Iran (1 518 263), Indonesia (1 217 468), Israel (727 485) and Iraq (643 852). America: 48 933 836 cases; the five countries reporting most cases are United States (27 694 168), Brazil (9 866 710), Colombia (2 198 549), Argentina (2 029 008) and Mexico (1 995 892). Europe: 35 633 482 cases; the five countries reporting most cases are

Russia (4 086 090), United Kingdom (4 038 078), France (3 465 163), Spain (3 086 286) and Italy (2 721 879). Oceania: 58 071 cases; the five countries reporting most cases are Australia (28 900), French Polynesia (18 263), Guam (7 699), New Zealand (1 980) and Papua New Guinea (955). Other: 705 cases have been reported from an international conveyance in Japan. Deaths have been reported from: Africa: 98 520 deaths; the five countries reporting most deaths are South Africa (47 899), Egypt (9 994), Morocco (8 477), Tunisia (7 575) and Algeria (2 939). Asia: 349 690 deaths; the five countries reporting most deaths are India (155 732), Iran (58 945), Indonesia (33 183), Iraq (13 179) and Pakistan (12 333). America: 1 152 349 deaths; the five countries reporting most deaths are United States (486 325), Brazil (239 773), Mexico (174 657), Colombia (57 786) and Argentina (50 327). Europe: 805 691 deaths; the five

countries reporting most deaths are United Kingdom (117 166), Italy (93 577), France (81 814), Russia (80 520) and Spain (65 449). Oceania: 1 213 deaths; the five countries reporting most deaths are Australia (909), French Polynesia (135), Guam (130), New Zealand (25) and Papua New Guinea (10). Other: 6 deaths have been reported from an international conveyance in Japan.

Epidemiological curves These histograms are based on the available information at the time of publication, originating from several sources. Data completeness depends on the availability of information from the affected areas. All data should be interpreted with caution as the outbreak is evolving rapidly. In addition, due to the unavailability of date-of-onset data and different testing policies per country, this figure might not be reflective of the evolution of the epidemic.

Geographic distribution of COVID-19 Region

Places reporting cases

Sum of Cases

Sum of Deaths

Confirmed cases during the 14-days of the reporting period

Europe

Albania

93075

1555

14948

2021-05 and 2021-06

Andorra

10538

107

601

2021-05 and 2021-06

Armenia

169255

3147

2167

2021-05 and 2021-06

Austria

429894

8101

18909

2021-05 and 2021-06

Azerbaijan

232197

3183

1978

2021-05 and 2021-06

Belarus

268687

1849

20351

2021-05 and 2021-06

Belgium

739761

21720

27752

2021-05 and 2021-06

Bosnia_and_ Herzegovina

126139

4916

3940

2021-05 and 2021-06

Reporting period YYYYWW

Bulgaria

229679

9624

10931

2021-05 and 2021-06

Croatia

237725

5339

5205

2021-05 and 2021-06

Cyprus

32513

221

1637

2021-05 and 2021-06

Czechia

1090860

18250

103531

2021-05 and 2021-06

Denmark

204799

2301

5839

2021-05 and 2021-06

Estonia

52827

501

8619

2021-05 and 2021-06

Faroe_Islands

657

2021-05 and 2021-06 2021-05 and 2021-06

Finland

50319

716

4837

France

3465163

81814

268049

2021-05 and 2021-06

Georgia

265722

3363

7371

2021-05 and 2021-06

Germany

2338987

65076

117016

2021-05 and 2021-06

Gibraltar

4219

105

2021-05 and 2021-06

Greece

172128

6126

15171

2021-05 and 2021-06

Guernsey

797

258

2021-05 and 2021-06

Holy_See

2021-05 and 2021-06

Hungary

388799

13752

20089

2021-05 and 2021-06

Iceland

6033

2021-05 and 2021-06

Ireland

209582

3948

13035

2021-05 and 2021-06

Isle_of_Man

436

2021-05 and 2021-06

Italy

2721879

93577

168847

2021-05 and 2021-06

Jersey

3202

2021-05 and 2021-06

Kosovo

64341

1544

4123

2021-05 and 2021-06

Latvia

76706

1451

10465

2021-05 and 2021-06 2021-05 and 2021-06

Liechtenstein

2540

Lithuania

190937

3080

8044

2021-05 and 2021-06

Luxembourg

52884

607

2215

2021-05 and 2021-06

Malta

19945

295

1918

2021-05 and 2021-06

Moldova

170186

3651

10382

2021-05 and 2021-06

Monaco

1760

271

2021-05 and 2021-06

Montenegro

68921

890

7262

2021-05 and 2021-06

Netherlands

1030786

14826

50339

2021-05 and 2021-06

North_Macedonia

97052

2989

4359

2021-05 and 2021-06

Norway

66501

593

3535

2021-05 and 2021-06

Poland

1591497

40832

78112

2021-05 and 2021-06

Portugal

787059

15411

60738

2021-05 and 2021-06

Romania

763294

19445

33238

2021-05 and 2021-06

Russia

4086090

80520

218003

2021-05 and 2021-06

San_Marino

3317

292

2021-05 and 2021-06

Serbia

420879

4230

25616

2021-05 and 2021-06 2021-05 and 2021-06

Slovakia

278254

5952

28341

Slovenia

179482

3977

13009

2021-05 and 2021-06

Spain

3086286

65449

263481

2021-05 and 2021-06

Sweden

615964

12453

40945

2021-05 and 2021-06

Switzerland

540593

9020

18065

2021-05 and 2021-06

Turkey

2586183

27471

108720

2021-05 and 2021-06

Ukraine

1268049

24285

44170

2021-05 and 2021-06

United_Kingdom

4038078

117166

220902

2021-05 and 2021-06

“Don’t let the COVID-19 crisis become an AMR catastrophe The FINANCIAL

n the midst of the COVID-19 pandemic and all the pressures faced by public health providers, partners in countries across the WHO European Region nonetheless showed great commitment to marking World Antimicrobial Awareness Week (WAAW) 2020. Partners and other organizations in Member States conducted a wide range of activities to raise awareness about antimicrobial resistance (AMR), operating within local restrictions and shifting events online to keep participants safe. Dr Nino Berdzuli, Director of WHO/Europe’s Division of Country Health Programmes, expressed the satisfaction felt by all involved at the high level of activity in countries,

despite the difficulties caused by the pandemic. “It is most gratifying to see so many Member States maintaining and even increasing their activity for WAAW,” she commented. “I see enthusiasm and innovation coming to the fore in a most challenging year. The pandemic has put into sharp focus the fact that we all need to redouble our efforts in controlling antibiotic resistance.”

Reaching audiences safely with online activity WHO/Europe organized a webinar, working with tripartite partners from the Food and Agriculture Organization of the United Nations (FAO) Regional Office for Europe and Central Asia, and the World Organisation for Animal Health (OIE) Sub-Region-

al Representation for Central Asia. The online event attracted some 255 high-level representatives from both human and veterinary public health. The tripartite partners’ sister group in Turkey – Tripartite Turkey Working Group – also held an online symposium entitled “Action and partnership on antimicrobial resistance to ensure a coordinated One Health approach in Europe and central Asia”, involving 300 participants from relevant professions, such as physicians, nurses, pharmacists and veterinarians. In Bulgaria, information videos were prepared for the general public and also for health-care workers. Materials were disseminated via a patient portal. In Lithuania, 200 people participated in an online conference on “Antimicrobial resistance in the context of COVID-19”, organized by the Ministry of Health and the Institute

of Hygiene of Lithuania. Participants included directors of hospitals and primary care institutions, doctors and infection control specialists. Similar events were held in other countries including Slovenia, Croatia, and Greece, where an event reached 70 doctors working across the Greek islands. Webinars in Ukraine reached 500 people in key jobs.

Getting the point across with social media and giant bacteria With support from WHO/Europe, many countries produced local language versions of WAAW materials and initiated widespread media outreach and social media campaigning. In Lithuania, WAAW

received national press coverage and films were shown on public transport. In the Croatian capital Zagreb, people handed out information dressed in giant bacteria costumes. The WHO Country Office in Ukraine conducted a social media campaign to raise awareness and highlight best practice. In Romania, more than 50 articles appeared in traditional media and a social media campaign was conducted in Romanian. Georgia enjoyed extensive television coverage of WAAW and an raising awareness team toured primary health centres giving presentations. In Bulgaria, 3 different films were produced and disseminated in tandem with a social media campaign. Continued on p. 20

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Georgia’s NATO Aspirations and Biden Administration

Ambassador IAN KELLY Northwestern UNIVERSITY

n his confirmation hearing before the Senate Foreign Relations Committee, Antony Blinken stated unequivocally that Georgia would be safer as a part of the NATO alliance, noting that “we have seen in the past that countries that are members of NATO have not been such a target for Russian aggression.” Clearly referring to the more secure posture of the Baltic states, which also border Russia, he added “there is ample evidence that Russia is aggressive against countries that are not in NATO and are not under [its security] umbrella.” Such a forthright argument for Georgia’s membership was music to the ears of those of us who have long believed that not only was Georgia’s accession the right thing to do, but that it would make the country and the region more secure. To be sure, under both Obama and Trump, U.S. policy had always been, as Blinken stated, to support an open door for Georgia “if the country meets the membership criteria and contributes to our common security.” But since 2008, Washington has prevaricated on the issue of enlarging the alliance to include Georgia. Neither the Obama nor the Trump administration made the argument that Georgia would actually be safer under NATO or provided the necessary diplomatic push for membership. The U.S. position was close to that of many European allies, who believed the possibility of antagonizing Russia precluded any enlargement to Georgia. Rather than pointing out the example of the Baltic states’ enhanced security post-NATO accession, officials on both sides of the Atlantic looked to Russia’s invasions of Georgia in 2008, and Ukraine in 2014, as evidence that enlargement would be destabilizing. In contrast, the Biden administration has signaled that it would no longer prioritize relations with the Kremlin over those of its allies and partners. In his speech “On America’s Place in the World,” Biden said “the days of the United States rolling over in the face of Russia’s aggressive actions ... are over. We will not hesitate to raise the cost on Russia and defend our vital interests.” By all indications, the Biden administration is positioning itself to be the most forward-leaning on the issue of NATO enlargement since the Bush 43 administration. This is good news for the overwhelming number of Georgians who support closer relations with and membership in NATO. But it does not mean Georgia’s work is done. Far from it. NATO membership will occur only if all members concur. Georgia has much to do to convince skeptical allies that Europe will be more secure, not less, with Georgia in NATO. Georgia must reassure those allies that granting membership to a country with 20

percent of its territory occupied by Russia does not automatically lead to war. And just as important, in light of an ongoing political crisis in the country, Georgia still has much to do to prove it is ready to meet the alliance’s standards for stable and democratic governance. On the military side, Georgia long ago proved it can be a net contributor to alliance security. Cooperation between NATO’s Maritime Command and Georgia’s Coast Guard has increased Black Sea security. Georgia has also supported Operation Active Endeavor, NATO’s counterterrorism surveillance operation in the Mediterranean, and provides troops to the NATO Response Force. Most significantly, it has also participated in important, and dangerous, military operations outside the alliance’s territory. It is the largest non-NATO contributor to the Resolute Support, NATO’s mission in Afghanistan to train, advise, and assist Afghan security and defense forces. It also provided combat troops to Operation Iraqi Freedom. Georgia has paid a high price for its partnership with the U.S. and NATO. In Afghanistan alone, Georgian forces suffered 32 dead and around 280 wounded. Georgia has worked hard to fulfill the alliance’s military criteria for membership. As NATO requires, Georgia’s defense budgeting is transparent, and its military is firmly under civilian control. Georgia contributes the requisite 2 percent of its GDP to defense. It has worked hard with NATO to ensure it meets alliance standards for strategic planning and defense reforms. Thanks to its cooperation in NATO operations, it has achieved interoperability for deployment with NATO militaries. As NATO Secretary General Jens Stoltenberg put it in 2016, Georgia already “has all the practical tools to become a member of NATO.” Perhaps the biggest obstacle to gaining consensus for Georgia’s NATO membership is the threat of further Russian aggression. Right

now, Russia has learned that all it has to do to block the NATO aspirations of Georgia and Ukraine is to invade and occupy those countries’ sovereign territory. The presence of Russian troops within the internationally recognized borders has led to fears that the occupation would trigger Article Five of NATO, and the alliance would be at war with Russia the instant Georgia and Ukraine become members. This kind of veto by an outside power is remarkably debilitating to the alliance’s credibility, particularly to its open-door policy. It is in the interests of both members and aspirants that a way be found to overcome this virtual veto. In Georgia’s case, one way has been suggested by Luke Coffey of the Heritage Foundation. He argues that “Georgia can be invited to join NATO by amending Article 6 of the 1949 North Atlantic Treaty (which defines which territories fall under the Article 5 protection) to temporarily exclude the Russian-occupied Tskhinvali region [or South Ossetia] and Abkhazia from Article 5 protection. This amendment can be made with Georgia’s accession protocol, as it was in 1951 when Turkey and Greece joined the Alliance. It is important to point out that this would only be a temporary measure until Georgia’s full, internationally recognized territory is re-established by peaceful and diplomatic means at a future date. ... This would allow Georgia to join NATO more quickly and would deny Moscow’s de facto veto on countries under partial Russian occupation that want to join the Alliance.” As Coffey recognizes, a deal to enter NATO without South Ossetia and Abkhazia will be politically difficult for the Georgian government. The idea of ceding Georgian territorial integrity, even if temporary, would be emotionally charged, and such a move would have to be supported by all pro-Western parties. But it would be a necessary move, in terms of both overcoming the reluctance of allies to accept Georgia in the face of Rus-

sian resistance and signaling that the Georgian body politic is willing to make the politically difficult decisions to join the alliance. Georgia’s brash form of politics has long been polarized, but leaders of both the ruling and the opposition parties, virtually all pro-Western, have come together before to support their common goal of Georgia joining the Euro-Atlantic community. Regrettably, just as a new, more trans-Atlanticist administration took office in Washington, a full-blown political crisis was underway in Tbilisi, making bipartisanship all but impossible. Evidence of fraud in the Fall 2020 parliamentary elections caused an uproar among all parties who had crossed the threshold to enter parliament. They declared that until the ruling party met their demands, including an early election, they would refuse to take up their seats in the new parliament. With the exception of a handful of deputies who broke with the opposition’s boycott and took up their seats, parliament is represented by only one party, Georgia Dream. At the time of this writing, there is no clear path to resolving the impasse (the last talks between the sides took place in December 2020). Georgia may have aspirations to join the Euro-Atlantic community, but one-party rule is not compatible with NATO membership. As senior NATO official James Appathurai said, “the essence of how the governments in NATO countries operate” includes the idea of a “sitting and active opposition.” The tendency toward one-party rule has long been an unfortunate feature of Georgian politics, from the era of Shevardnadze, through Saakashvili, to the present day. The government led by the Georgian Dream party has been in power since 2012, when it defeated Saakashvili’s United National Movement. That government started out well. It began as a coalition, consisting of Georgian Dream and five other parties, most prominently two liberal democratic,

pro-Western parties, the Free Democrats and the Republican Party. Since then, there has been a steady move from consensus-driven coalition government to one-party rule. Before the fall 2016 election, the two key coalition parties, the Free Democrats and the Republicans, were not asked to run again with Georgian Dream. It was clear GD saw a chance for additional seats, and a veto-proof majority, in the 2016 elections — which they obtained, given that the GD’s erstwhile coalition partners did not reach the 5 percent minimum threshold of votes to remain in parliament. There is concern as well that the government is also trying to control judicial outcomes. A number of international and local observers have accused the government of not moving forward with serious judicial reforms. The State Department’s 2019 Human Rights Report noted that sixteen NGOs accused the government of failing to demonstrate sufficient political will to strengthen judicial independence. These NGOs claimed that “since 2015 diligent efforts have been made to ensure strengthening and extending the influence of the so-called dominant group of corrupt and compromised judges” in the Georgian judiciary.8 This lack of trust in the independence of the courts prevented a credible adjudication of the opposition’s claims of election fraud: the opposition claims the courts dismissed as much as 99 percent of the total requests for recounts. If Euro-Atlantic integration is indeed a priority for both the ruling party and the main opposition parties, they must resolve the parliamentary impasse as rapidly as possible. Neither the EU nor NATO will take seriously requests for membership or closer cooperation from a country ruled by virtually one party. The lack of opposition representation means some 40 percent of Georgian voters are essentially disenfranchised. Not only is such a situation incompatible with Western standards, it is also a recipe for eventual instability — particularly in light of the challenges Georgia faces from a Russia already bent on destabilizing the country. It is incumbent on both sides to take immediate action. A good step would be an agreement to refrain from inflammatory rhetoric, such as calls for revolution or acts of disobedience. Another would be a declaration that the present status quo is not acceptable and that both sides commit to good faith efforts until the impasse is resolved. It is up to Georgia’s elected representatives to come up with a solution that enables a representative legislature. The removal of this obstacle to closer links with the West is in their hands. With its strategic location on the Black Sea, and its long track record of security cooperation with NATO, Georgia’s prospects for EuroAtlantic integration should be bright. But neither side should expect Washington to solve this crisis for them. Given the scope of domestic and international challenges facing the Biden administration, it will be a long time before it will be able to focus on issues beyond those immediate crises facing the U.S. Still, the new administration has begun conducting a comprehensive foreign policy review, including a global examination of the U.S. military’s force posture. Let’s hope that when it reaches a review of the U.S. relationship with Georgia, it sees a stable partner that has recommitted, as President Biden has, to the renewal of pluralistic and accountable government. Published by Economic Policy Research Center

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Experts Say the ‘New Normal’ in 2025 Will Be Far More Tech-Driven, Presenting More Big Challenges Continued from p. 15

spread of misinformation The advantaged enjoy more advantages; the disadvantaged fall further behind. Concerns particularly focus on the growing power of technology firms. Many suggested solutions have a double-edged quality because they threaten civil liberties. Automation could take many humans out of the work equation. And the spread of lies via social media and other digital platforms is likely to further damage all social, political and economic systems. Inequality and injustice are magnified: The pandemic and quick pivot to the use of digitally driven systems will widen racial and other divides and expand the ranks of the unemployed, uninsured and disenfranchised. Power imbalances between the advantaged and disadvantaged are being magnified by digital systems overseen by behemoth firms as they exploit big data and algorithmic decision-making that are often biased. More people will be pushed into a precarious existence that lacks predictability, economic security and wellness. As risk grows, security must also; privacy falls and authoritarianism rises: The health crisis spawned by the pandemic and broader dependence people have on the internet heighten threats of

criminal activity, hacks and other attacks. Optimized security solutions may further reduce individuals’ privacy and civil liberties. They are likely to expand mass surveillance, as authoritarian states will use this as an opportunity to silence dissent and abuse citizens’ civil rights. Threats to work will intensify from automation, artificial intelligence, robotics and globalization: In order to survive, businesses are reconfiguring systems and processes to automate as many aspects as possible. While artificial intelligence (AI) and robotics will enhance some lives, they will damage others, as more work is taken over by machines. Employers may outsource labor to the lowest bidder globally. Employees may be asked to work for far less; they may have to shift to be gig and contract workers, supplying their own equipment, and they may be surveilled at home by employers. Misinformation will be rampant: Digital propaganda is unstoppable, and the rapidly expanding weaponization of cloud-based technologies divides the public, deteriorates social cohesion and threatens rational deliberation and evidence-based policymaking. People’s mental health will be challenged: Digital life was already high-stress for some people prior to the required social isolation brought on

by the pandemic. The shift to tele-everything will be extensive and that will diminish inperson contact and constrict tech users’ real-world support systems and their social connections. Hopes: As the global pandemic unfolds, experts urge that calls for social justice be heeded and that technology design focus on human wellbeing People have the chance now to reconfigure major systems such as the structure of capitalism, education, health care and workplaces. Advances in technologies such as artificial intelligence, smart cities, data analytics and virtual reality could make all systems safer, more humane and more helpfully productive. Better communication of more-accurate information can dramatically improve emergency responses in crises and alleviate suffering. Social justice will get priority: The reawakening of public movements for social justice and economic equality may create more-responsive government and sociopolitical systems that are more attuned to diversity, equity and inclusion. This includes a focus on closing digital divides. People’s well-being will prevail over profit: Businesses may start to value serving the greater good above the typical goals of market capitalism. This could produce policies to fund broader safety nets such as universal health care, uni-

versal basic income and broadband as a basic utility. A reckoning for tech companies and their leaders might also occur. The quality of life will improve: The transition to homebased work will reduce urban air pollution, overcrowding and transportation gridlock. It will enhance the overall quality of life, create a better environment for family life, allow more accommodations for those with disabilities and inspire other enhancements. AI, VR, AR, ML will yield good: Artificial intelligence, virtual reality, augmented reality, deep learning, machine learning and natural language processing will make virtual spaces feel much more real, in-person, authentic and effective. People’s mental health will be challenged: Digital life was already high-stress for some people prior to the required social isolation brought on by the pandemic. The shift to tele-everything will be extensive and that will diminish in-person contact and constrict tech users’ real-world support systems and their social connections. Smarter systems will be created: Municipal, rural, state and independent services, especially in the health care sector, will be modernized to better handle future crises, quickly identifying and responding to emerging threats and sharing information with all citizens in more timely and helpful ways.

“Don’t let the COVID-19 crisis become an AMR catastrophe Continued from p. 17

Greece launched a social media campaign, in cooperation with youth partners, reaching over 30 000 users. They also launched a digital awareness campaign, in partnership with selected news websites.

Partnerships get results The WHO Country Office in Ukraine partnered with an nongovernmental organization, Ukrainian Medical High School, to record and publish 5 video lectures on rational use of antibiotics for medical professionals and students, funded by WHO/Europe. The lectures covered various topics, from the basics of antimicrobial stewardship to using antibiotics rationally during upper respiratory tract infections. The lectures were watched by more than 1500 people during the awareness week alone. WAAW in Romania also featured a strong partnership with both the Romanian Society for Microbiology and one of the main news platforms in the country – DC News. A lively online debate, moderated by a prominent health journalist, was held involving the WHO Representative in Romania, Dr Miljana Grbic, as well as professionals active in the field. The debate

was broadcast live and also featured an audience survey that gathered responses from more than 45 000 people – showing that 15% of respondents still believe that antibiotics treat viruses. The WHO Country Office in Greece participated in a joint press conference on AMR, with the Greek Ministry of Health, the National Public Health Organization, the Center for Clinical Epidemiology and Outcomes Research, and the newly formed Agency for Patient Safety and Quality Improvement. Youth outreach was also conducted to engage with 700 Greek medical students. In Kazakhstan, the National Centre for the Rational Use of Medicines conducted an information campaign among the medical and pharmaceutical community, specialists in the field of agriculture, and the general public, resulting in television and radio coverage, as well as live events. In Tajikistan, a well-attended event was held for healthcare workers in the paediatric infectious diseases hospital. The WHO Country Office in Turkmenistan assisted the Ministry of Health in delivering important messages to the public by supporting the translation and printing of campaign materials. Five types of posters in Russian and Turkmen were printed and distributed in regional health facilities.

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UAB EST LT together with its partner Thermoindustria LLC from Georgia implemented the Development Cooperation Project “Installation of a Solar Power Plant in Waldorf School, Georgia”, financed by the Ministry of Environment of the Republic of Lithuania Climate Change Special Program. The aim of the project was to reduce energy intensity at the Waldorf Free School-Kindergarten in Tbilisi by increasing RES production and consumption. Funding of EUR 30,047.50 from the Climate Change Special Program of the Ministry of Environment of the Republic of Lithuania has been allocated for the implementation of the project. The outcome of the project – the installation of a 20 kW solar power plant. The beneficiary of the project – the community of the Free Waldorf School-Kindergarten in Tbilisi. A 20 kW solar power plant installed during the project implementation will allow to achieve such an environmental impact: – Electricity consumption will reduce the cost of electricity for the school-kindergarten community; – CO2 emissions will be reduced, i.e. 17,392 tons per year. CO2 emissions will be reduced by 347,84 t over the entire 20-year project evaluation period. Indirect benefits of the project – during the project implementation, the expertise of Lithuanian companies in the design, installation and commissioning of a solar power plant in Georgia was shared with the Georgian partner Thermoindustria LLC. Start of project activities: 2020 April 17. Completion of project activities: 2021 February 17. The project was administered by the Environmental Project Management Agency of the Ministry of Environment of the Republic of Lithuania.

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Best Western Tbilisi 4 Freedom Square Tel: 2988 988, Fax: 2988 910 E-mail:gmt@gmt.ge, www.gmt.ge

Tel: 277 00 40/50 Addr: 20 Metekhi str. http://www.tbilisiinn.com/ info@tbilisiinn.com

Addr: 11, Apakidze str. Tel.: 2 300 777

Hotel “Tiflis Palace” 3 Vakhtang Gorgasali St, (+995) 32 2000245 reservation@tiflispalace.ge

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FINCHANNEL.COM | 22 February, 2021

Red Café Bistro & Cafe

NINO BERIDZE'S ORTHODONTIC CENTER 4, Besiki Str. Tel: 2 519 966 # 1 a D.Tavkhelidze Str. Tel.: 2 32 22 27 www.orthodont.ge

Literary cafe “MONSIEUR JORDAN” V. Gorgasali st.,17 Tel.: 275-02-07

Respublika Grill Bar

# 71 Vazhaphavela Ave. Tel: 2201 211 info@redcafe.ge

PREGO

PICASSO

84, Barnovi Str. Tel: 225 22 58 15, Erekle II. Tel: 293 14 11 19 Pavle Ingorokva str. Tbilisi +995 555 004151

2, MarjaniSvili Str. Tel: 2 999 723

4, Vashlovani Str. Tel: 298 90 86

https://www.facebook.com/RespublikaGrillBar/

BUREGERCLASICO

Book Corner

13b, Tarkhnishvili Str. Tel: 223 24 30 contact@bookcorner.ge

2 24/

40, Chavchavadze Ave. Tel: 229 42 30

1. 7 Sandro Euli St. Tel.595 99 22 77 hello@stradacafe.ge Each Day 10:00 – 01:00 2.#5 Marjanishvili Str. 595 99 22 88

Tbilisi 13 Taktakishvili Street, Tel.: (+995 595) 90 71 80 19 Petriashvili Street, Tel.: (+995 595) 33 82 10 7 Pekini Street, Tel.: (+995 591) 19 39 68 78 Chavchavadze Avenue (Bagebi), Tel.: (+995 599) 09 56 70;47 Kote Apkhazi Str (Leselidze), Tel.: (+995 599) 095670 12 Amaghleba street (Sololaki), Tel.: (+995 599) 08 34 53 1 Ateni Street, Tel.: (+995 591) 70 90 22 25 Gagarini street, Tel.: (+995 591) 19 39 68 24A Pekini street, Tel.: (+995 591) 96 19 90 7 Mtskheta Str.

Tel.: 599 21 53 83

LE MARAIS 1 Brother Kakabadze Str.

37 Chavchavadze Ave. Tel.: 291 30 26; 291 30 76

Tel: 292 29 45; Fax: 292 29 46; tk@mcdonalds.ge

32 Abashidze Str. Tel: 222 40 83

TIFFANY BAR AND TERRACE

PROSPERO’S BOOKS

TWINS - gift store.

Exclusive decor, designer Items from U.S. 25 Akhvlediani str. Tbilisi

34, Rustaveli Ave. Tel: (+995 32) 2923 592

La Brioche Addr: Batumi, Georgia, Parnavaz Mepe №25

Tel.: 260 15 36 info@piazza.ge, www.piazza.ge

Address: Mari Brose Street, Open today · 11:30AM–11PM Phone: 0322 24 22 44

BRAND WINE GEORGIA Vake, Mtskheta street 48/50 Contact: +995322830303; +995577755555 Instagram: brand_wine_georgia Mail: Brandwinegeorgia@mail.ru Web adress: brandwine.ge

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BUSINESSTRAVELCOM

HOTEL AND AIRTICKET BOOKING: 2 999 662 | SKY.GE

marketing@finchannel.com

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marketing@finchannel.com

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Address: 23 P.Kavtaradze Str. Tel: 0322 05 11 11 Working Hours: 24/7 E-mail: info@megalab.ge Advertiser: Megalab Contact FINANCIAL Ad Dep at marketing@finchannel.com