SARS-CoV-2 virus outbreak and the emergency public health measures in Bosnia and Herzegovina: January – July, 2020

Abstract

Between March 5 and July 25, 2020, the total number of SARS-CoV-2 confirmed cases in Bosnia and Herzegovina (BH) was 10 090 corresponding to a cumulative incidence rate of 285.7 per 100 000 population. Demographic and clinical information on all the cases along with exposure and contact information was collected using a standardized case report form. In suspected SARS-CoV-2 cases, respiratory specimens were collected and tested by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) assay. The dynamic of the outbreak was summarized using epidemiological curves, instantaneous reproduction number Rt and interactive choropleth maps for geographical distribution and spread. The rate of hospitalization was 14.0 % (790/5646) in Federation of Bosnia and Herzegovina (FBH) and 6.2 % (267/4299) in Republic of Srpska (RS). The death rate was 2.2% (122/5646) in FBH and 3.6% in the RS (155/4299). After the authorities lifted mandatory quarantine restrictions, the basic reproduction number increased from 1.13 on May, the 20th to 1.72 on May the 31st. The outbreak concerns both entities, Federation of Bosnia and Herzegovina and Republika Srpska, and it is more pronounced in those aged 20-44 years. It is important to develop the communication and emergency plan for the SARS-CoV-2 outbreak in BH, including the mechanisms to allow the ongoing notification and updates at the national level.

Presjek Stanja Covid-19 Pandemije U Zapadnohercegovačkoj Županiji

“…Osim prijenosa s bolesnih ljudi, moguće je prenošenje virusa i s asimptomatskih bolesnika (2). Inkubacijsko razdoblje, vrijeme između izlaganja virusu i pojave prvih znakova i simptoma oboljenja, iznosi 2 do 14 dana, odnosno prosječno 5 dana (3), (4). Medijan vremena od pojave simptoma do prvog prijema u bolnicu bio je 7,0 -9,0 dana, dok su simptomi infekcije COVID-19 pojavljuju se nakon razdoblja inkubacije od otprilike 5,2 dana (5).Razdoblje od pojave simptoma COVID-19 do smrti bolesnika, kretalo se u rasponu od 6 do 41 dana, s medijanom od 14 dana.…”

Presjek Stanja Covid-19 Pandemije U Hercegovačko-Neretvanskoj Županiji

“…Izbijanje se odnosi na oba entiteta, Federaciju Bosne i Hercegovine i Republiku Srpsku, a izra-ženije je u onima u dobi od 20 do 44 godine. Važno je razviti komunikacijski i hitni plan za izbijanje SARS-CoV-2 u BiH, uključujući mehanizme koji omogućavaju trajno obavještavanje i ažuriranje na nacionalnoj razini (26). Novi dokazi iz Kine sugeriraju da je koronavirusna bolest 2019.…”

Epidemic Location Intelligence System as Response to the COVID-19 Outbreak in Bosnia and Herzegovina

“…Group of data analysts, consisting of 22 experts from these public health institutions and university clinical centers, and five faculties of medicines have used ELIS as an expert system and produced reports about spread analysis and evaluation of the epidemic situation, for different areas and time periods [20,21,22]. Geographical, demographic, and other data combined with epidemic data was processed using the selected analytical methodology, and the results were arranged in the ELIS geoportal in the form of diagrams, attribute tables, interactive maps, and animations.…”

“…Current state themes are: 1. dispersion of cases by addresses with time presentation; 2. cumulative disease rate per municipalities (with a percentage share in total and the ratio "per thousand inhabitants"); 3. overview of confirmed cases per settlements by annotation and choropleth map; 4. list of all tested per settlements by annotation of number of tested and choropleth maps and ratio tested in the settlement "per thousand inhabitants" by annotation; and 5. cumulative presentation of the ratio of cases by sex and age for the passive and active population with diagrams showing the statistics of diseased. Predicted conditions themes are:  expected total number of cases with needs for health care in relation to the entire population;  total cumulative number of hospitalized (with mild, moderate, and severe symptoms) and isolated (supervised) and number of cases of respirator use;  expected increase of cases for the next 7 days (optimistic and pessimistic);  epidemic curves (Epi-curves) [20,21]; and  instantaneous (weekly) reproductive number (Rt) to control the effects of the applied measures [20,21].…”