The Increasingly Spreading Covid-19 Disease

A short while ago, I wrote an article about the course of the Covid-19 disease in my country, in which I also tried to be a bit humorous (The Number of Ambulances Passing by the Bull, 12punto, August 27). Today, I have no intention of being humorous.  

1. There are no Covid-19 vaccines in my country. For some reason, while flu and pneumonia vaccines are available, Covid-19 vaccines are not. Yet, in civilized countries, these vaccines are available, and those in older age groups—where it is certain that the disease follows a more dangerous course—and citizens whose resistance is thought to be compromised for any reason are warned at regular intervals to get vaccinated. 

2. In my country, the drug consisting of the combination of the active ingredients Nirmatrelvir and Ritonavir, which is known to reduce mortality by at least 80% when used especially within the first 5 days, is not available and has never been available. However, the same drug was distributed free of charge to patients in some civilized countries during the pandemic.                                                                                                                 On the other hand, there is a drug licensed by the Ministry of Health in 2022 with the active ingredient Molnupiravir, which is reported to reduce mortality by 30-50% when used within the first 5 days. During the pandemic, it was distributed free of charge by the Ministry of Health to elderly and immunocompromised patients if their PCR tests were positive.  When I had the disease two years ago, it was given to me as well due to my advanced age. I do not know if this practice is still continuing, and many people, including some physician friends, are not even aware of this practice. 

3. With the opening of schools, cases of both Covid-19 and the flu and common cold—which have symptoms and signs that resemble it and are often indistinguishable from it—seem to have increased significantly. On the other hand, there is no concrete data available to prove this mentioned increase. Meanwhile, let me underline that the ailment we/you dismiss as just the flu is not a harmless disease either.  

4. I must also state with regret that in current practice, for patients presenting with symptoms and signs of Covid-19, the flu, or a cold, a Covid-19 screening is performed only with a rapid test (agglutination test)—and even then, usually only if the patient requests it. However, this rapid test, which can also be done at home, has a quite low positive rate among Covid patients (in some studies, only around 50%). The PCR test, which is what should essentially be done, has a significantly higher positive rate in Covid-19 patients. For these reasons, telling patients whose rapid test is negative that they do not have the disease without performing a PCR test is wrong, just as it is wrong not to perform a PCR test in addition for patients whose rapid test comes back positive. There are 3 reasons for this latter mistake: 

a. Collecting reliable data on the course of the pandemic, if there is such an intention, is only possible with PCR data.    

b. The drug with the active ingredient Molnupiravir, which I mentioned above, is provided by the ministry only to patients who have undergone a PCR test and tested positive. 

c. Those who test positive for PCR and recover from the disease are highly unlikely to catch this disease again in the near future, at least for 4-6 months. Knowing this is undoubtedly useful, at the very least, for the patient to adjust their own lifestyle.   In other words, in a country where those managing public health do not give the necessary importance to vaccination, the patient becomes as if they were vaccinated. Before closing the subject of tests, it is also important to know this: The main utility of the rapid test is that it helps us significantly in determining whether a Covid-19 patient is infectious or not.    

5. Although not supported by official data, the Covid-19 disease, fortunately, still follows a significantly milder course compared to the recent past. However, let's make an assumption. Let's say the frequency and lethality of Covid-19 have dropped only to the levels of the flu. Wouldn't such a possibility double the number of deaths from flu + Covid-19 if a significant number of patients are dying from the flu within a certain period? 

6. In summary, the Covid-19 virus is still spreading rapidly in our country. It causes a relatively mild disease, which in a way makes society increasingly more resistant to this virus through herd immunity. However, there is another aspect to this spread. As the same virus transmits from person to person, it inevitably mutates (that is, changes its structure) and one day it can become much more lethal. This is exactly why the civilized world is both trying to prevent the spread of this virus and closely monitoring whether it has undergone a mutation.  

7. There is a point here that everyone must know, and know very well. That mask you don't like to wear doesn't just protect you from the virus; it prevents you from transmitting the virus—which you may be carrying without showing any symptoms—to others, thereby extending the life of the virus and preventing it from undergoing a change one day that would cause you and your loved ones to catch a much more severe disease. 

I am observing this with deep regret. It seems that what I have listed here is not a priority concern for health administrators, nor for many people other than a handful of physicians whose number does not exceed the fingers of two hands.  Unfortunately, our medical schools are also included in this indifference and this lack of discomfort regarding the absence of data.