Turkey’s Ministry of Health has introduced a new practice regarding the hospitalization of COVID-19 patients. Accordingly, the Ministry, which changed the algorithm of home attendant care and in-patient treatment for coronavirus patients, has imposed conditions of having respiratory distress, shortness of breath, difficulty in oral intake and feeding in order for in-patient treatment.
Stating that patients with fever, cough, sore throat, headache, muscle and joint pains, stomach ache or diarrhoea, disorders of smell or taste perception will now receive treatment at their homes, the Ministry of Health noted that if respiratory distress, shortness of breath, difficulty in oral intake and feeding are observed in addition to these symptoms, home-cured patients can be hospitalized for in-patient treatment.
Patients to be followed up at home are defined as mild/moderate pneumonia by the Ministry in its recent changes in the treatment procedures, while patients who require in-patient management are defined as severe pneumonia.
The Ministry had required in-patient treatment before for those who had moderate pneumonia.
DRUG THERAPY FOR ASYMPTOMATIC PATIENTS
According to new treatment procedures, if the patient does not have symptoms of respiratory distress, shortness of breath, difficulty in oral intake and feeding, s/he will be considered as mild/moderate pneumonia and receive drug therapy with hydroxychloroquine, which has potential, but controversial (due to its several side effects) characteristics to combat pathological inflammation associated with COVID-19, or with favipiravir, an oral antiviral selectively inhibiting RNA dependant RNA polymerase (RdRP) ─ an enzyme needed for RNA viral replication within human cells ─ for 5 days.
Patients, who are asymptomatic and tested positive, will also be administered these drugs for 5 days to destroy the coronavirus and reduce the risk of transmission.
The Ministry, which will then start contact tracing for COVID-19, will take a sample if the person has symptoms of the virus, and if the result is positive, it will evaluate the patient, and ask the authorities to decide whether the person should be hospitalized or receive treatment at home.
If the person has not developed symptoms yet, s/he will be kept in isolation at home for 14 days, and if no symptoms have still developed at the end of this duration, the isolation will be terminated.
THE MINISTRY’S NEW DECISION IS DUE TO RAPID INCREASE IN THE NUMBER OF PATIENTS IN INTENSIVE CARE UNITS AND INTUBATED PATIENTS
Turkish government’s ‘‘normalization’’ attempts to loosen the preventive measures for the sake of the capitalist class in fighting the COVID-19 as of June 1 resulted in a serious decrease in the public compliance with the measures.
As a result of the government’s policy, there has been a dramatic increase in the number of patients in intensive care and intubated patients since June 15. Experts warn that this situation points out that the hospitals in the country will be faced with an overcapacity problem starting from autumn 2020.
Speaking about the newly introduced practice of the Health Ministry regarding the hospitalization of the COVID-19 patients, public health expert and soL news columnist İlker Belek noted that the reason why the Ministry has changed the treatment procedures and started home treatment is a dramatic increase in the number of patients in intensive care units and intubated patients.
This decision means that the dentists, dieticians, midwives and nurses within the filiation teams are authorized to diagnose and treat COVID-19, Belek underlined.
Saying that the Turkish government aims to reduce the burden on the hospitals with the new treatment procedure, Belek also stated that non-COVID-19 patients have not been able to access health services efficiently for a long time due to the pandemic, and hospital staff are already overwhelmed with excessive coronavirus cases.
‘HOME TREATMENT’ DECISION INCREASES RISKS OF SPREAD OF COVID-19
In fact, patients who did not need to be hospitalized were sent home before. Yet, the government’s new circular has given this practice status of official decision and a medical algorithm this time.
İlker Belek warned that ‘‘home treatment’’ is very risky in terms of the spread of the disease in society because it places a patient infected with a very contagious disease like COVID-19 together with non-infected people in a narrow living space.
Emphasizing that the most important condition in this regard is that the COVID-19 patients must receive treatment by isolation, Belek suggests a few options to reduce the workload of hospitals.
‘‘First of all, some of the hospitals can be turned into pandemic hospitals,’’ says Belek, and adds: ‘‘As another option, patients whose condition does not require hospitalization can be treated outside of the hospital, but only in health institutions allocated to the patients infected with the coronavirus.’’
‘‘And finally, new hospitals can be built to provide health services for only patients with COVID-19,’’ he remarks.
As can be seen, the primary target of all these options above is both to isolate the patients and to keep them under surveillance in special health institutions in order to prevent possible medical problems that may arise during the treatment process.
‘‘One of the most important factors that Turkey has failed to have the pandemic under control is because Turkish authorities did not choose any of these options,’’ Belek noted.
RATE OF PEOPLE IN CONTACT WITH COVID-19 PATIENTS TO TURN INTO CASES RISES BY 1.3 TIMES ACROSS TURKEY
As the Ministry of Health announced 1,182 new daily COVID-19 cases and 1,103 new recoveries in Turkey on August 9, the number of total cases increased to 240,804 with 1,182 new cases and the death toll in the country rose to 5,844 with 15 new fatalities.
Moreover, the rate of people in contact with the COVID-19 patients to turn into cases rises by 1.3 times across Turkey, the Health Minister Fahrettin Koca announced on his Twitter account on Sunday.
This new policy of the Turkish government, which the Ministry of Health has been implementing since the very beginning of the pandemic process indeed, is criticized by many scientists for increasing the spread of the outbreak.