Filenews 7 February 2021 - by Marilena Panagi
A breath away from the effective start of the lifting of measures and restrictions, the head of the Advisory Scientific Committee, Assistant Professor of Pathology, Infection Prevention and Control at the European University of Cyprus, Konstantinos Tsioutis, defines new "lines". "Fear and terror," he says, are not the means to fight the pandemic. The instrument is proper information and trust between us and we have not achieved this as much as we would have liked."
He admits that over the past year, the "language" of scientists may have caused a mix-up among citizens. It calls for everyone's cooperation and stresses that 'we cannot operate in fear of a new internment, but we must all set safe frameworks with the common aim of restricting the transmission of the coronavirus'.
It does not omit, to highlight the danger, to warn of a new flare-up, if the measure of distancing and masking is not respected and calls everyone to be alert. 'Health protocols are not there to cause malfunction in businesses, nor to make checks and to impose fines. They are there to protect us and help us live in as smooth a state as possible."
"The best way to change someone's behavior is to help them understand the problem," he said in the interview with "F."
The pandemic "was an unprecedented situation for the whole world. The mistake would be not admitting that we made mistakes or that some things we could have done better or otherwise. I consider the issue of our behaviour as a society to be crucial to improving the situation, whether we are in a period of exacerbation or relaxation," he said, adding: "that is where proper communication plays an important role and this is an area in which we scientists and academics find it difficult to get the right messages across. Often speaking in scientific language, with difficult terminology, we probably confused the world more. Unfortunately in this piece, we often did not accept the right questions or the right stimuli to get through the messages we wanted and often the discussion with the media ended up serving specific directions."
To move on from Monday, to a safe process of lifting the measures, "the key lies in our behavior. To think about what we have achieved so far, the sacrifices we have all made, the suffering we have suffered over the months, and to have our minds, what we will be called to achieve next, because the pandemic is not over and at the same time we cannot continue to talk about internment or continue to operate in fear of closing again."
To understand, that "it does not matter when the pandemic ends, but it is important to learn to live with it, and in order to achieve it, I consider that the contribution of experts in psychology and sociology is extremely important and, although a relevant committee has been appointed with remarkable colleagues, no one can ignore the value they would have , if we had them by our side earlier."
The pandemic has affected all sectors of our lives, and for this reason, we must all acknowledge the need for a multi-thematic approach. None of us are experts in everything and even the members of the EES, we have different specializations that often translate into different roles within the committee itself."
Regarding the management of the pandemic, the Professor admitted that "the winter wave that hit us could indeed have been of lower intensity if we had prepared properly" and explained: "it is not a question of infrastructure or measures, as I believe that the measures we proposed in November and December were not only appropriate and least intrusive in other sectors of society and the economy while , their effectiveness has been shown over time".
However, he said, "the issue of preparation was more psychological, as a successful summer de-escalation period created the impression that we had wiped the virus out of our country. Certainly in this, our own statements played a role, in which we created a climate of excessive security and when the October outbreak began, people were already prepared that it could be controlled easily and without major interventions."
"We did have a serious issue in the nursing homes, with quite a large number of patients with COVID19 and unfortunately, deaths, despite the preventive measures that were being taken" he stressed and went on to say: "the implementation of stricter controls and the recruitment of the tools of repeated tests, which continue to this day, have undoubtedly improved the situation, although now we have to deal with the consequences of the long-term isolation of the stayers in these areas".
Now, 'and after we have managed and reached the point of checking the situation, twice so far, in two major flare-ups, that of March and that of December, we need to restart with more experience. We will achieve this if we feel within ourselves exactly what we experienced in the December outbreak, which was also the worst month statistically in all respects. Thousands of people were infected and suffering, hundreds of people had to be admitted to hospitals for hospitalization, many dozens of people died and unfortunately continue to die."
"We have now arrived, a month later, to be able to discuss a restart, adapted to the peculiarities and characteristics of Cyprus. We all know at least one person who passed the coronavirus and we now know very well how he went through it. It's time to analyze within ourselves what we've been through. Identify solutions that will help us protect our own health, but also the health and possibly the lives of those around us."
This time, "we must take advantage of our knowledge and the experience we have gained from what we have already experienced and with a clear mind, in a calm and rational way, to work together. To try to understand each other, from the position each of us is in, to try to act in the context of solidarity.
"Fear and terror are not the means to fight the pandemic. The means is proper information and trust between us. So far we have not achieved it as much as we would like, but we can do it then."
"We must walk with patience"
"In Cyprus we have used specific weapons and characteristics in an effort to limit the transmission of the virus, in such a way as to affect as little as possible social and economic activity. We must recognise that we have made sacrifices and there are many of our fellow citizens affected by both the pandemic and the measures. However, we are now at a point where we have significantly controlled the transmission, precisely with these measures that were targeted and clearly based on data. We have important weapons in our hands to use. These include the large number of laboratory tests, as well as targeted controls, tracing, which has helped us to detect early flare-ups and on which we rely that it will continue to assist us during the relaxation period, effective evidence-based therapeutic protocols, the cooperation of multiple governmental and non-governmental bodies, the continuous and detailed epidemiological analysis of our data. , increased controls at airports. Early intervention where a problem was detected. Keeping these in mind we owe it to ourselves to proceed with care and patience, to continue to evaluate data and developments, and to take care of the coming period, to continue to improve and correct what we have identified in the past."
Tools and risks for de-escalation
- "Many tests are a tool but they are not a panacea. They are not going to replace any measures, and they are certainly not going to replace the rule of keeping distances between people and using masks. When we say distance, we mean the two measures we must keep in our social interactions and reduce overcrowding."
- "The virus is transmitted from person to person. If we manage to reduce transmission and stop dispersion, then we too will be able to move and act with safety every day."
- "This is where we will reach, only if we truly understand the "cost" of transmission of the virus between humans so far and if we understand that non-compliance was one of the reasons why our lives have changed in the last year. If we do not understand, we will not even feel the need to implement the measures imposed."
- "This is all based on studies. Those of us who have been involved in the field of infection prevention and control, which is a very special field in medicine, know very well that the best way to implement measures that will be successful is to understand the problem that will lead to a gradual change in our behaviour."
- 'Protocols are not simply to exist on a piece of paper or to be checked and fined or to lead to business malfunctions. They are there to ensure a safe everyday life."
Answers to important questions and misreading data
Inevitably, the pandemic has led to some wrong approaches, which must be avoided and has also created dozens of questions to which answers must be given:
- COVID19 is a simple flu: it can be a respiratory virus, but there are several clinical data that show us that it leads to a syndrome that is much more severe than influenza and often, with several more serious manifestations
- The mostseriously ill are the elderly: age is certainly associated with more severe symptoms, but because it is transmitted very easily from person to person, within a short period of time we have many people with symptoms, including severe symptoms. In addition, there are young people with chronic diseases, which also increase the risk of having severe symptoms
- The virus is transmitted mainly by air droplets: the most common way of transmitting the SARS-CoV-2 virus is with droplets, from person to person, at a short distance. Transmission by air droplets, i.e. with smaller droplets suspended over long distances and for a long period of time, is a less common mode of transmission that occurs mainly in a hospital environment
- Lockdown is always the solution: we are experienced enough now and have enough data to be able to implement measures to limit transmission, targeted and based on local data and specificities. Although lockdown is proven to help in some cases, there are other measures which, when combined and implemented correctly, can have the same effectiveness
- The virus can be eradicated: this approach is wrong and misleading. Pandemic control, of course, must be based on aggressive strategies, but we should not assume that we can eradicate the virus, especially since it continues and is transmitted at such an increased rate in most countries of the world.
- Mass tests can replace measures: tests are an important tool, but they are not the only measure. Studies have shown that only if combined with other measures do they have a substantial benefit. In the field of infection control, it is known that no measure in itself is sufficient to control the transmission of an infection. On the contrary, the widespread use of tests must be done correctly and with knowledge of their properties.
- We could operate normally if we closed all their 'vulnerable' homes: it is estimated that the vulnerable make up 30-40% of the population. Therefore, being confined for such a long time is not a viable long-term solution, as it will have a significant impact on society and the economy.
- The biggest investment is treatment, not prevention: this is a basic principle of public health and is based not only on experience but also on studies. Prevention, as a public health strategy, has much more important effects, both in reducing the disease and in cost. On the contrary, treatment, is a practice applied after the diagnosis of a disease, is an individual approach and if calculated overall, has a much higher cost
- Another animal testing and other therapeutic programs: "It is different to have evidence in laboratory experiments or animal trials, and different to integrate drugs into therapeutic protocol. In addition, even after use in clinical trials, actual data after widespread use may reverse the original data. For example, initial studies on hydroxychloroquine showed promising results, but when well-organized clinical trials were conducted, it appeared that this drug was ineffective and at the risk of significant side effects.
ANOSIA IS NOT APPROVED
"The concept of collective immunity (herd immunity) has concerned us since the beginning of the pandemic. It has also been shown in practice, however, in many parts of the world, that immunity after disease is not enough to protect the entire population through herd immunity. Therefore, our hopes of getting herd immunity are placed in the vaccine."
>Is collective immunity the goal of vaccinations? "First of all we do not know what percentage of the population needs to be vaccinated in order to achieve collective immunity. The other point is that we do not yet know to what extent vaccination reduces transmission. Finally, as we do not have a large enough number of vaccines at our disposal immediately to cover our entire population, at this stage the priority is to vaccinate those who need it most, who are the most vulnerable groups and frontline professionals."
>Are vaccines dangerous? "The vast majority of side effects from a vaccine occur in the first days/weeks after vaccination. The clinical trials were carried out with the participation of tens of thousands of volunteers, which made it very clear to us very soon how safe these vaccines are. We now have experience vaccinating millions of people, confirming this safety profile."
