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2020 coronavirus pandemic in Bulgaria

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2020 coronavirus pandemic in Bulgaria
COVID-19 Outbreak cases in Bulgaria.png
Number of confirmed cases by province
(as of 31 March)[1]
  0 confirmed
  1–9 confirmed
  10–50 confirmed
  51–99 confirmed
  100+ confirmed
DiseaseCOVID-19
Virus strainSARS-CoV-2
First outbreakWuhan, Hubei, China (globally)
local source unknown
Index casePleven, Gabrovo
Arrival date8 March 2020
Confirmed cases457
Recovered25
Deaths
10
Official website
Bulgarian Ministry of Health

The 2019–20 coronavirus pandemic was confirmed to have spread to Bulgaria when the country's first case was confirmed on 8 March 2020. As of 1 April 2020, there are 457 confirmed cases in 23 out of 28 Bulgarian provinces, with 10 recorded deaths and 25 recoveries. A total of 6454 PCR tests had been performed by 26 March.

Background

A National Crisis-management Staff was formed by the Bulgarian government on 5 March to deal with the coronavirus pandemic.[2] The Government has appointed Major General Professor Doctor Ventsislav Mutafchiyski as the Chairman of the Staff. MG Prof. Dr. Mutafchiyski is the Director of the Military Medical Academy and the most senior medical officer of the Bulgarian Armed Forces. The MMA combines the military medical services of the country in their entirety with several hospitals in the capital Sofia and around the country. At the same time it is one of the country's leading medical institutions and possesses large medical treatment capacity and know-how. The Staff fulfills a direct operational role in the management of the crisis and its decisions are implemented through executive orders of Bulgaria's Prime Minister and the country's Minister of Health.

On 23 March a separate Medical Council for dealing with the coronavirus pandemic was appointed by the Prime Minister. The Council is chaired by Professor Kosta Kostov, a leading pulmonary disease expert. The Council's mission is to provide the government with complementary analysis and action proposals and the general public with professional guidance and information. Unlike the National Crisis-management Staff, which is a formal national institution with executive power and tasks, the Council has mostly a knowledge-based advisory role.[3]

Timeline

8 March

On 8 March 2020 Bulgaria confirmed its first two cases, a 27-year-old man from Pleven and a 75-year-old woman from Gabrovo. Neither of the two reported having traveled to areas with known coronavirus cases. The man tested positive for the virus after being hospitalized for a respiratory infection, and authorities announced plans to test several people who were in contact with the two individuals.[4] Two other samples in Pleven and Gabrovo were found positive on 8 March.[5] Patient zero remains unknown.[6]

On the same day, the hospital in Gabrovo requested additional personnel from other hospitals in the country, as it only had three communicable diseases specialists. All of its internal medicine specialists have been quarantined after one of the four initial cases was confirmed to be a nurse at the hospital.[7] The government issued a nationwide ban on closed-door public events.[8] The origin of the outbreak remains unknown, and the Ministry of Interior is tracking down all individuals who have been in contact with the patients.[9] As of 8 March, 254 suspected cases were under quarantine across the country.[10]

10 March

COVID-19 cases in Bulgaria  ()
     Deaths        Recoveries        Active cases
Date
# of cases
# of deaths
2020-03-08
4(n.a)
4(=)
2020-03-10
6(+50%)
2020-03-11
7(+17%) 1
2020-03-12
23(+229%) 1(+0%)
2020-03-13
31(+35%) 1(+0%)
2020-03-14
41(+32%) 2(+100%)
2020-03-15
51(+24%) 2(+0%)
2020-03-16
62(+22%) 2(+0%)
2020-03-17
81(+31%) 2(+0%)
2020-03-18
94(+16%) 2(+0%)
2020-03-19
112(+19%) 3(+50%)
2020-03-20
127(+13%) 3(+0%)
2020-03-21
163(+28%) 3(+0%)
2020-03-22
187(+15%) 3(+0%)
2020-03-23
201(+7%) 3(+0%)
2020-03-24
218(+8%) 3(+0%)
2020-03-25
242(+11%) 3(+0%)
2020-03-26
264(+9%) 3(+0%)
2020-03-27
293(+11%) 3(+0%)
2020-03-28
331(+13%) 7(+133%)
2020-03-29
346(+5%) 8(+14%)
2020-03-30
359(+4%) 8(+0%)
2020-03-31
399(+11%) 8(+0%)
2020-04-01
422(+6%) 10(+25%)
2020-04-02
457(+8%) 10(+0%)
Sources:
  • Republic of Bulgaria - Ministry of Health [1] [2]

Two additional cases were confirmed in Sofia on 10 March 2020: a 74-year-old man and his 66-year-old wife. Both have arrived from Lom two weeks prior to admission.[11][12] The woman died on the next day, becoming the first COVID-19 victim in the country.[13]

11 March

A suspected case of a 33-year-old man was reported by the Saint George Hospital in Plovdiv on 11 March.[14] The same day, a 40-year-old woman in Varna showed COVID-19 symptoms on CT scan, although regional health authorities have not yet confirmed the case.[15]

12 March

By 12 March, the number of cases had increased to 23, most of them in Sofia. Many of these had been in contact with the elderly couple admitted to the Pirogov Hospital on 10 March.

13 March

On 13 March, after 16 reported cases in one day, Bulgaria declared a state of emergency for one month until 13 April. Schools, shopping centres, cinemas, restaurants, and other places of business were closed. All sports events were suspended. Only supermarkets, food markets, pharmacies, banks and gas stations remain open.[16] Additionally, all arrivals from Italy, Spain, Iran, South Korea and China were placed under a mandatory 14-day quarantine.[17] There were 13 breaches of quarantine; patients involved were returned to treatment facilities and warned of repercussions, including fines and prison sentences.[18]

14 March

On 14 March, a second death and a third case in Pleven were reported. The second victim of the virus was the 74-year old husband of the first victim.[19]

15 March

The number of confirmed cases in Bulgaria rose to 51 on 15 March. A total of 83 tests were done at the Military Medical Academy, of which six were positive, and 51 were processed at the National Reference Laboratory, of which two were positive. In Varna, one test out of 12 samples proved positive.

16 March

The Ministry of Health announced that citizens from a number of countries would be prohibited from entering Bulgaria starting 00:00 on 18 March. These are China, Iran, Bangladesh, India, the Maldives, Nepal, Sri Lanka, Spain, Italy, South Korea, France, Germany, the Netherlands, Switzerland and the United Kingdom. Additionally, sanitary control units will be established on some border crossings with Serbia, North Macedonia, Greece and Romania.[20] The number of total cases rose to 62, including two British citizens vacationing in Bansko.

17 March

81 cases were reported, several linked to an outbreak in Bansko. None of the patients were in critical condition.[21]

18 March

The total number of cases increased to 94 by 18 March, with new cases appearing in Smolyan, Veliko Tarnovo and Pernik among recent arrivals from outside the country. The previous day, Bansko became the first town in the country to be put under quarantine.[22][23]

19 March

On 19 March the cases rose to 105 and an 80-year-old woman, who recently had a stroke, died from COVID-19 on the same day, making her the third victim from the disease in Bulgaria.

20 March

The total number of cases increased to 127 and the first recovery occurred.

21 March

The number of cases increased to 142 by noon, and three patients had recovered. Two cities, Dobrich and Shumen, confirmed their first cases, the latter related to the Bansko cluster. There are 84 male and 58 female patients, the youngest being 4 years old, and the oldest 81 years old. More than 5,000 tests had been carried out, and an additional 10,000 tests would be made available at short notice.[24]

24 March

The cases increased to 218 and the first case in Stara Zagora province was confirmed. A man from the town of Kazanlak was admitted in the Infectious unit in the hospital in Stara Zagora. He is believed to be 60 years old and returned from France on the 14th of March.[25]

25 March

The number of cases increased to 242 by the end of the day, with the city of Sliven reporting its first confirmed case. 16 new cases with no relation between them were registered in Sofia, with some being medical staff from a local hospital. Two new cases were confirmed in Blagoevgrad, two in Plovdiv and one in Pleven. Two of the patients who were in critical condition were stabilized but remain "in stable but severe condition". One recovered completely, bringing the number of total recoveries to 5.

26 March

A total of 22 cases were reported, bringing the overall number to 264. The coronavirus were registered for the first time in Kardzhali and Haskovo. 15 of the newly confirmed cases were in Sofia, 2 in Smolyan, one in Pleven, one in Veliko Tarnovo and one in Varna. Two people were admitted to hospital in critical condition, while three new patients recovered, bringing the number of recovered to 8. Two soldiers were confirmed to have be infected - one was stationed in Kosovo and was immediately brought back to Sofia, and the other contracted the virus in Romania, where he was hospitalised. The national quarantine was extended by additional two weeks and is now expected to finish on April 12.

27 March

29 new cases were registered, with the total number reaching 293. From these, 17 were in Sofia, 5 in Plovdiv, 3 in Burgas, and one each in Varna, Kyustendil, Sliven and Pazardzhik. At least 93 people remained hospitalized, with 53 in Sofia alone.

28 March

The total number of cases reached 331, an increase of 38 from the previous day. The new cases included 19 in Sofia, 5 in Blagoevgrad, 4 in Burgas, 3 in Varna, 2 each in Kardzhali, Plovdiv and Shumen, and 1 in Smolyan. Four new deaths were also reported, with two occurring in Blagoevgrad and one each in Kyustendil and Sofia.[26]

29 March

A total of 15 new cases were reported, with 8 in Sofia, 3 in Plovdiv, and one each in Kardzhali, Sliven, Smolyan and Varna. Three new recoveries were also announced, while the number of deaths rose to 8 after a 51-year-old woman died in the Blagoevgrad hospital, one day after her mother had succumbed to the virus. The Ministry of Health announced that 125 out of 324 active cases remain hospitalized, with 13 of those in serious condition. The total number of tests performed exceeded 7,000, with 276 done on 29 March alone.[27]

30 March

Thirteen new cases were reported, with seven in Sofia and one each in Blagoevgrad, Kardzhali, Montana, Pleven, Plovdiv and Sliven, for a total of 359 cases. 113 patients remained hospitalized, with 13 in serious condition. Around 56% of all those infected so far were male versus 44% female, with a median age of 45. The total number of recoveries rose to 17.[28]

31 March

The total number of confirmed infections increased by 40 to 399, and the first two cases were reported from the province of Silistra. 20 of the new cases were registered in Sofia, four each in Burgas and Kyustendil, three each in Plovdiv and Varna, two in Silistra, and one each in Kardzhali, Pernik, Shumen and Stara Zagora. The number of hospitalized patients increased to 146, with 14 in serious condition, while 20 medical workers were announced to have contracted the disease so far. No new deaths or recoveries were announced. From the total of 399 confirmed cases, just under 57% (227) were male, versus 43% (172) who were female.[29]

Statistics

Cases

Day New cases Total cases Total deaths Total recoveries Tested[30]
8 March 2020 4 4 0 0 99
9 March 2020 0 4 0 0 158
10 March 2020 2 6 0 0 199
11 March 2020 1 7 1 0 231
12 March 2020 16 23 1 0 99
13 March 2020 8 31 1 0 ?
14 March 2020 10 41 2 0 183
15 March 2020 10 51 2 0 ?
16 March 2020 11 62 2 0 240
17 March 2020 19 81 2 0 ?
18 March 2020 13 94 2 0 332
19 March 2020 18 112 3 0 ?
20 March 2020 15 127 3 1 129
21 March 2020 36 163 3 3 ?
22 March 2020 24 187 3 3 ?
23 March 2020 14 201 3 3 ?
24 March 2020 17 218 3 3 ?
25 March 2020 24 242 3 4 350
26 March 2020 22 264 3 8 276[a]
27 March 2020 29 293 3 9 ?
28 March 2020 38 331 7 11 ?
29 March 2020 15 346 8 14 276[b]
30 March 2020 13 359 8 17 ?
31 March 2020 40 399 8 17 ?
1 April 2020 23 422 10 20 ?
2 April 2020 35 457 10 25 ?
  1. ^ The total number of tests reached 6,454.
  2. ^ The total number of tests exceeded 7,000.

New cases per day

By province

COVID-19 cases in Bulgaria by province ()

Date Province Confirmed cases Deaths Recoveries Active cases Source(s)
BLA BUR VAR VID VTA GAB DOB KAR KYU LOV MON PAZ PER PLE PLO RUS SIL SLI SMO SOF STZ HAS SHU N/A New Total New Total New Total Total ICU Hos.
March 2020 11 18 20 2 2 6 6 6 1 17 7 6 9 24 2 4 7 244 2 1 4 399 8 17 374 N/A N/A [31]
1 April 2 2 2 1 2 1 1 10 1 1 23 422 2 10 3 20 392 18 207 [32][33]
2 April 1 3 1 1 2 1 1 1 4 20 35 457 10 5 25 422 18 179 [34]
Total 14 20 23 1 3 2 10 7 6 1 18 8 6 9 27 1 2 5 11 274 3 2 4 457 10 25 422 N/A N/A [35]
BLA BUR VAR VID VTA GAB DOB KAR KYU LOV MON PAZ PER PLE PLO RUS SIL SLI SMO SOF STZ HAS SHU N/A New Total New Total New Total Total ICU Hos. Source(s)


Deaths

Number of deaths per day

Recoveries

Number of recoveries per day

Response

At the time of the announcement, schools had already been closed until March 11 due to an influenza B epidemic.[36] A massive increase in influenza B cases prompted suspensions of routine medical examinations, and a recommendation by the government for suspension of lectures at universities.[37] According to the latest Ministry of Health data, there were 2063 intensive care and 740 infectious disease hospital beds in the country, with a total of 1605 ventilators across the health system.[38] However, Chief Health Inspector Angel Kunchev stated on 5 March that there is a shortage of medical personnel.[39]

Following the announcement of positive SARS-CoV-2 test results, the Bulgarian government immediately banned the exports of protective equipment and placed orders for masks and protective suits to local manufacturers. In addition, 30,000 masks and 50,000 protective suits will be delivered by Turkey.[40] Some 111,000 suits and masks are required every month and the government plans to distribute them to health workers, social assistants, law enforcement personnel and border guards.[41] Sofia Municipality has increased disinfections to four times daily at public institutions and in public transport.[42] Personnel in all hospitals is being screened for the disease.[43]

By mid-March, large-scale imports of protective equipment from Vietnam, China and India had begun. Many volunteers were also signing up to join the handling of the crisis, including Nikola Vaptsarov Naval Academy cadets.[44]

On 30 March, the Minister of Health Kiril Ananiev decreed wearing masks in public mandatory, both outdoors and indoors, despite nationwide protective equipment shortages and soaring prices.[45][46][47] The policy seemed to contradict Ananiev's earlier statement from 9 March that producing the needed gear "will take months".[48] Under article 209a of the Health Law, which was passed on 13 March and does not discriminate between offenses, failing to wear a mask in public would result in a fine of BGN 5,000 (EUR 2,555).[49] On 31 March Ananiev rescinded the decree, citing "a lack of public consensus" on the measure.[50]

Testing

As of 24 March, there are 5 laboratories testing for COVID-19 in the country with a capacity of 300 tests per day. The total number of tests done by March 26 was 6,454, with 264 confirmed cases and a rate of infection around 4.1%.[51]

Medication

After testing positive for COVID-19, business magnate Kiril Domuschiev announced that his company will procure chloroquine from foreign sources and donate it to the national coronavirus task force. Chloroquine, a quinine drug, has shown positive effects on COVID-19 patients in China and France. The Bulgarian government is looking into import opportunities from China and domestic production by local pharmaceutical companies.[52] Exports of all quinine-based drugs were prohibited until further notice, and 35,000 doses of quinine-based Analgin for export have been diverted for domestic consumption. Another 250,000 doses of the drug can reportedly be produced on a short notice by local pharmaceutical companies.[53] On the 24th of March, Mr Domuschiev donated 100 packs of chloroquine containing 100 pills each. This will be enough for 320 critically ill patients.

Bulgarian biotechnology company Micar21 has been developing a general coronavirus vaccine in the past four years, and announced that it will begin clinical trials of a SARS-CoV-2 vaccine based on this research in mid-2020.[54] The company announced that with government support in funding and shorter clinical trial protocols, the drug could be synthesised in two months.[55]

Criticism

Georgi Todorov, a Bulgarian doctor with experience in viral breakouts in Ghana, criticised the handling of the COVID-19 threat. In particular, Todorov stated that Bulgaria's health administration is so rife with nepotism that it cannot come up with any coherent response; as a result, infectious disease specialists were not taken into account when formulating response policies, and no specific locations were designated for potential COVID-19 cases. Todorov further assumed that infected individuals may have not been identified because of improper application of testing procedures.[56]

According to Prof. Milan Milanov, former manager of Pirogov Hospital, the government's response was "catastrophically delayed", although he added that there's no room for panic as COVID-19 treatment was "the same as with influenza".[57]

References

  1. ^ "Коронавирус COVID-19 на територията на България". ESRI Bulgaria: COVID-19 Tracker (in Bulgarian). 28 March 2020. Retrieved 29 March 2020.
  2. ^ "Спешни мерки срещу коронавируса и у нас (ОБЗОР)". Retrieved 9 March 2020.
  3. ^ "Медицинският съвет ще работи за справяне с COVID-19".
  4. ^ "Bulgaria, Moldova Report First Coronavirus Cases". Radio Free Europe/Radio Liberty. 8 March 2020.
  5. ^ "Проф. Тодор Кантарджиев: От Плевен имаме две положителни проби за коронавирус, от Габрово също" (in Bulgarian). 8 March 2020. Retrieved 8 March 2020.
  6. ^ "Официално: Има четири потвърдени случая на коронавирус в България". 8 March 2020. Retrieved 8 March 2020.
  7. ^ "Габрово поиска подкрепление от инфекционисти заради двата случая на Covid-19". 8 March 2020. Retrieved 8 March 2020.
  8. ^ "Правителството забрани всички масови прояви на закрито в страната". Retrieved 8 March 2020.
  9. ^ "Четири случая на COVID-19 в България". Retrieved 8 March 2020.
  10. ^ "Министър Деница Сачева: 254 са болничните листове с карантина за коронавируса в цялата страна". Retrieved 8 March 2020.
  11. ^ "За още два случая на новия вирус у нас - в София, съобщи Бойко Борисов". Retrieved 10 March 2020.
  12. ^ "Жената от заразеното семейство в "Пирогов" е неконтактна, Борисов свиква Съвета за сигурност". Retrieved 11 March 2020.
  13. ^ "Коронавирусът взе първа жертва в България". Retrieved 11 March 2020.
  14. ^ "33-годишен мъж от село Кадиево е приет в Инфекциозната клиника на УМБАЛ "Св. Георги" в Пловдив със съмнение за коронавирус". Retrieved 11 March 2020.
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  19. ^ www.dnevnik.bg
  20. ^ "Нова заповед забранява влизане у нас на граждани на 15 страни!". Retrieved 16 March 2020.
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  22. ^ "11 нови положителни проби, вирусът стигна Смолян и Велико Търново". Retrieved 18 March 2020.
  23. ^ "Майка и син са заразените с коронавирус от Перник". Retrieved 18 March 2020.
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  30. ^ "Mostly from daily TV briefings of the emergency response center". 18 March 2020.
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  32. ^ "20 са вече излекуваните граждани от COVID-19 в България". mh.government.bg. 1 Apr 2020.
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  38. ^ "Осигуреността с болнични легла в България е над средната за Европейския съюз". Retrieved 18 March 2020.
  39. ^ "Ангел Кунчев: Ако се появи коронавирус у нас, ще имаме проблем с недостига на лекари". Retrieved 18 March 2020.
  40. ^ "Форсмажорното производство на защитни облекла и маски ще е без печалба". Retrieved 8 March 2020.
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  44. ^ "85 хил. облекла и 15 хил. маски пристигат от Турция, варненските курсанти готови за доброволци". Retrieved 18 March 2020.
  45. ^ "В Стара Загора шият предпазни маски на акорд. По модел от съветско време". www.dw.com (in Bulgarian). 26 Mar 2020. Retrieved 30 March 2020.
  46. ^ "Прокуратурата започна дело за спекула заради маски от 10 лв". mediapool.bg (in Bulgarian). 26 Mar 2020. Retrieved 30 March 2020.
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  48. ^ "Ще са нужни месеци, за да се изработят необходимите маски и защитни облекла, обяви Ананиев". dnevnik.bg (in Bulgarian). 9 Mar 2020. Retrieved 30 March 2020.
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  53. ^ "Борисов възложи на Ананиев да осигури хининови лекарства за българите". Retrieved 21 March 2020.
  54. ^ "Костадин Петков, София Тех Парк: Работим с иновативни фирми, които са разработили молекула за лечение на коронавирус". Focus. 10 March 2020. Retrieved 10 March 2020.
  55. ^ "Химикът Филип Фратев: До 2 месеца можем да имаме лекарство срещу коронавируса". Retrieved 18 March 2020.
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  57. ^ "Проф. Милан Миланов: Очаквам взрив от коронавирус в София". Retrieved 11 March 2020.
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