Autumn will prove challenging in fight against virus: Expert

Barçın Yinanç - ISTANBUL

This photo, taken just two weeks after the normalization process started on June 1 on the famous İstiklal Avenue in Beyoğlu district of Istanbul, shows residents ignoring anti-virus measures.

The coming of fall will result complicate Turkey’s virus fight due to the onset of flu season, according to a member of the Health Ministry’s Coronavirus Science Committee.

Can you assess the current situation?

The pandemic peaked in April and was brought under control by the end of May. But this was not followed by the expected downward trend. On the contrary, there is an upward trend, so we can say that the first wave is not under control.

We need to have three consecutive weeks exhibiting a downward trend in order to say that the pandemic is under control, but cases are on the rise.

The upward trend came with normalization on June 1. Did the opening come too early, or do you think measures were not properly implemented during the opening?

In my opinion, it was too early to go to with whole-scale opening. But as it was summer, it was thought that cases would decrease with [people being in] the open air. It did not turn out like that; summer turned into an occasion that people sought for socializing. When you look at the nature of Turkish society, weddings are held during the summer. And we also had religious holidays. Too many people got together.

The same thing happened in other countries. The number of cases in Spain and France are on the rise. We saw that the virus did not have a seasonal characteristic. That was not the expectation from summer. Although there were still fears about what might happen, the tendency was to have an optimistic perspective for the summer. Currently, however, we are confronting a scary picture.

So summer proved disappointing in terms of expectations.

The opening was supposed to take place in the form of a new normal. But people did not perceive it like that; they were too frustrated [by the earlier stages]. We should have done a better job explaining that the opening process entailed a new normal.

There is a debate; some put the blame on people, while others put the blame on the state saying people had to work.

Everyone has responsibility. The state does not have the chance to say, “I have done my part; the rest should be done by the people,” and the people cannot say, “There is only so much I can do; the state should take action.” This has to be managed jointly. The state should continue testing and diagnosing patients. It should do contact tracing and isolate those have been exposed to COVID-19 patients. It should also continue educating people, and people should implement the measures vigorously. I also work, we all need to work, and obviously using public transport is risky.

It is good news that there will be flexible working hours in the public sector. The private sector should be encouraged to work from home. The less we use public transport, the better. Those taking public transport need to wear a mask. Bringing the pandemic under control is directly related to people abiding by the rules.

How is the government currently performing in terms of fulfilling its duties?

There is an upward trend in testing. This has to continue and speed up. We will need more tests with the opening of schools. The more people start to come together, the more we need to increase the numbers of tests.

But there is difficulty not just with the tests but also with the additional material that accompanies the tests. Turkey is trying to produce it locally and has developed its own tests to an early state. The performance of the current tests must be improved, while tests need to be used in a rational way.

Can you elaborate?

In addition to those showing symptoms, tests need to be done on the exposed as well as on risk groups like health personnel, for instance. But this depends on your production capacity. At present, the Health Ministry is being criticized for not testing those exposed to COVID-19 patients. It is being criticized because there is a limit to its capabilities.

How are individuals performing? There is no open objection to wearing masks in Turkey.

The young are rather unwilling to wear masks. When there are controls conducted by the state, the level of adherence increases. The problem in Turkey is also the mistaken use of masks. At any rate, the mentality that each individual can pose a risk to another even if she or he does not show any symptoms needs to be better [understood].
Initially, the Turkish health system was not overwhelmed, but currently, there are signs that hospitals are unable to cope with the rising number of cases.

The health system was not exhausted in the first three months because very serious efforts were undertaken to decrease infection levels. There were lockdowns and quarantines. We no longer take these measures, and infection levels are going up. As the pandemic spread to Anatolia, some hospitals in Anatolian cities started having problems, especially in terms of intensive care units. There are more beds in Istanbul, but the problem here is that hospitals have now opened for patients with other health issues. And the private hospitals are not taking in COVID-19 patients, so there is an increasing burden on state hospitals.

Criticism is on the rise about the credibility of the numbers provided by the Health Ministry. What is the ministry’s Science Committee doing about it?

We are not officials of the ministry. We are an advisory body. We see the same figures as the public, so I can’t make any comment. We want to trust the credibility of these figures.

What is the latest in terms of a vaccine?

Our primary priority is to produce it locally. The minister had stated that there are 13 separate projects on the vaccine. I have to say that the push for a vaccine has received a lot of support in Turkey. Thirteen is a good number. But as the ones in Turkey could be delayed, Turkey is participating in third-stage trials for vaccines that are at a more advanced stage in the rest of the world.

What are your projections with the start of fall?

It frightens us. People will go back to closed areas with the arrival of cold weather. With October, [seasonal] flu will start. We therefore have to have a very strong surveillance system and need to rapidly increase our test capacity. Tests are becoming critical; we need to be able to test for seasonal flu. If the two come together, there is a concern as to whether the health system will be able to cope. Individual measures will become very important; we will have to take measures to decrease crowds. We can’t handle it with all these crowds.

Do you think there will be a resort to measures like total lockdowns or bans?

I don’t think that will be easy. I don’t want to talk about bad scenarios, but large gatherings have to be reduced.

Turkey’s initial performance was seen as a success. What went wrong?

Remember, in the early days, the streets were empty. The more people went out and got together, the more there was a rise in cases. This is not a surprise. The economy is important, but an out-of-control infection can lead to worse results. There needs to be a balance. We need to get ourselves together.

*Who is Serap Şimşek Yavuz?

Professor Serap Şimşek Yavuz is the secretary-general of the Turkish Association of Clinical Microbiology and Infectious Diseases (KLİMİK) and a member of the Health Ministry’s Coronavirus Science Committee, which was established in January.

A graduate of Istanbul University Medical Faculty (1992), Şimşek-Yavuz is a specialist in cardiovascular infections. At present, she is the head of a working group on cardiovascular infections within KLİMİK. She also has a position at the Istanbul Medical Faculty’s Infectious Diseases and Clinical Microbiology Department.

At the same time, Şimşek Yavuz is a member of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), a Swiss-based non-profit scientific international organization.