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Professor at Istanbul University, Istanbul Faculty of Medicine, Department of Microbiology and Infectious Diseases, and Member of the Coronavirus Scientific Committee of the Ministry of Health. Dr. Serap Şimşek Yavuz provided important information on the current situation in epidemic management. Prof. Dr. Yavuz pointed out that people infected with Covid-19 may not always show symptoms, and gave a clear answer to the question of ‘do asymptomatic people not transmit the disease?’, Which has been very controversial on social media recently. .
Prof. Dr. Yavuz said: “The people we call asymptomatic are cases that carry the virus and do not show any symptoms. Or they don’t show any symptoms at the time the test is done, but symptoms may appear later. We also call them “presymptomatic”. Those who do not show any symptoms, that is, who are asymptomatic, are certainly at risk of transmitting the virus. For this reason, it is very important to isolate these cases in terms of fighting the epidemic ”. At the beginning of the outbreak in Turkey, the reporting followed this method as Prof. Dr. Yavuz said: “This is how it has been done around the world from the beginning. These people are isolated, as are symptomatic cases. Periods of isolation have also been defined, in some periods these periods have been updated, modified as new information comes out, but these people must remain in isolation during this period. Do you carry the virus less or more? Of course, studies are done in this area. But the truth is that these people are also contagious, “he said.
“DETERMINING THE ASYMPTOMATICS THOSE SHOWS THE POWER OF THE HEALTH SYSTEM”
Highlighting that the detection of asymptomatic cases shows the power of the healthcare system, Prof. Dr. Yavuz said: “Because those who have symptoms already come to the hospital, you don’t need to call them. They are already accessing a health center. Tests and treatments are performed. But what should you do to catch the asymptomatic? Either you need to search and find those who are in contact with your symptomatic case and test them, or you need to screen high-risk groups. The resulting symptoms in Turkey if they find the contacts of which they were symptomatic or establish them as high risk assets while taking samples. This is actually the power of a healthcare system. Therefore, determining the number of asymptomatic cases is a very good thing in terms of infection control, in terms of controlling this disease in society. “Currently, countries that scan and capture asymptomatic patients are reporting more cases to the World Health Organization (WHO).”
“THE COMPARISON BETWEEN COUNTRIES IS NOT REALISTIC”
Highlighting that comparisons between countries should be made according to these standards, Prof. Dr. Yavuz continued his words as follows: “You never look at it as a country, you will have few cases. But if you do an effective screening, if you do an effective screening for risk groups, you will find cases. Currently, there is no standardization to make such a comparison in the world. Because some countries, like England, say that only seriously ill patients should go to hospital. Then you just scan seriously ill patients and the number stands out. According to WHO standards, those who normally have 2-3 symptoms are examined. However, unlike the WHO screening, it is done in Turkey even with two symptoms. So if you show more people you could say there are more cases. We can only compare ourselves to what we were before. In other words, making comparisons between countries is not possible and healthy at the moment in this regard. Of course, whoever scans more finds more cases. Whether the case is symptomatic or asymptomatic, nothing changes in terms of our isolation measures. In the fight against this epidemic, symptomatic, asymptomatic and presymptomatic are all isolated in the same way. “
THE USE OF A MASK DETERMINES THE RISK STATUS OF THE CLASS
Touching the question marks on the opening of schools, Prof. Dr. Serap Şimşek Yvuz gave the following information when speaking about the risk classification: “Schools are opening, what kind of approach will there be? We need to consider them within the framework of reason and science. Because these tests are not limitless. Nowhere in the world. Therefore, you need to create the test strategy accordingly. Here, the category of contact risk becomes important. When we say contact, for example, we evaluate it in health workers and in radiation studies; We first assess the contacts with the highest risk of contact. What is that? For example, if I am now positive, if I have been with someone with masks, using a mask and at a distance, there is a medium risk contact. This is not a high risk contact. But if I have been with someone for more than 15 minutes without a mask, if I go out as a carrier or as a patient, the risk increases for the person in front of me. If the other person is not wearing a mask, the risk is at the highest level. Therefore, this contact risk is also classified. “High risk, medium risk, low risk.” This is also the case in schools. So if everyone wears the mask correctly and the distance is sufficient, let’s say there is a case in the classroom, we are talking about moderate or slight risk. The scans are also performed accordingly. But if there is more than one case in the classroom, then the risk is understood to have increased, education is interrupted, and the whole class is evaluated accordingly. The person says that he may be masked, but he may not actually be wearing a mask. “
“WE ARE FAR FROM COMMUNITY IMMUNITY”
Mentioning that social immunity regarding coronavirus cannot yet be mentioned, Prof. Dr. Yavuz emphasized the following:
“Currently, the information about this disease is just sitting there. So it is very difficult to say certain things. If so, it is not possible to say that society will be immune. Also, let’s find a medicine right away, let’s find the solution for this job, let’s get a vaccine right away; there is no such thing. No one should expect this. But what do we have? We have protection measures. For society to be immune, one must be immune. There is still no defined protective immunity in this disease. Studies are always new. For example, we know that the coronavirus, which causes a cold among these coronaviruses, can become ill again after a year, according to these studies. What kind of immunity are we going to talk about then? In other words, there may be a risk of reinfection (reinfection). We cannot say that we never tell our patients anything like you have survived. According to the data obtained so far, it shows that the disease leaves an important title especially in those with severe disease, and this seems weaker in those with mild disease. But cellular immunity, humoral (secretory) immunity have different parameters; The only thing we have is that we cannot yet speak of permanent immunity to this disease at this stage. The only trump card we have is still protection. “
“INDOOR NON-VENTILATED AREAS ARE THE MOST RISK AREAS”
Prof. Dr. Yavuz said that the best option in this process is to reduce the risk as much as possible: “No matter how much you reduce your risk, of course we will never be able to restart it, we work, we go to school, we use public transport, etc. But by wearing our mask, we can achieve this by protecting the other person (wearing a mask is actually source control), protecting our distance, and paying attention to our hygiene. Please everyone should know that the most risky environment in terms of this disease are unventilated, crowded and maskless environments. Do not be in a closed and unventilated environment without a mask, even with your relatives, relatives, friends. Maybe we can be more comfortable after the vaccine is found. There are really many studies on this topic, but we cannot talk about social immunity at this time; less than 10 percent appear to have the disease at this time. “
