Coronavirus, rumours, facts

Dr. Nuriye ORTAYLI*

“But a teacher is not congratulated for teaching that two times two equals four.
Perhaps they are congratulated for choosing this profession.”
“The Plague”, Albert Camus

During the days of the coronavirus, Hüseyin Rahmi Gürpınar’s book Kuyruklu Yıldız Altında bir İzdivaç (A Marriage Under the Comet) often comes to mind, especially the conversations between the Istanbul ladies next door, brought to life with incredible success by the great master, as they chat from window to window:

“A comet is going to hit the world…

“…Let it hit if it must… What’s the big deal? I’ll close my door and stay in my little house…”

“Emine, sister, how foolish you’ve become! That huge comet, that fringed Raziye, if it hits this world, will your house even remain standing?”

It goes on and on, describing both the fear felt in the face of the unknown and how this fear was dealt with by inventing all sorts of ridiculous and baseless information, which Hüseyin Rahmi’s contemporary Istanbul ladies interpreted in their own way, sometimes exaggerating it, sometimes turning it into something fun and light-hearted. Hüseyin Rahmi’s characters are so vivid, his dialogues so natural, his language so beautiful that both my brother and I are amazed at how much of the novel’s dialogues we remember by heart. During quarantine, we recite these dialogues to each other and have fun. Of course, the main reason I remember the novel so well is that, in social media and phone conversations with friends and acquaintances who have all read and written, I read and hear things that I think are just as far from reality as the rumours Hüseyin Rahmi satirised.

A factor we know little about

The SARS-CoV-2 virus, which causes the disease known as Covid-19 (short for Coronavirus disease first seen in 2019) as named by the World Health Organisation, is a virus that we have seen in humans for the first time, but we know that its precursors exist in some mammals. Although the analysis of genetic material shows that the virus spread from animal to human through a change (mutation) that occurred either in these species or in humans who contracted the virus from animals, and that we know such mechanisms were also effective in other viral outbreaks (HIV, Ebola, H1N1, SARS, MERS, etc.). Despite this knowledge, all sorts of illogical and unscientific rumours are spreading faster than scientific information through every channel, claiming that the virus was produced in a laboratory as a biological weapon, that it is not actually a virus, that the deaths we are seeing are the result of G5 signals, and so on. Faced with these claims, even in doctor discussion groups, I no longer wish to speak at all. I simply say, ‘A comet is going to hit the world, no, it won’t hit the world, it will just graze it with its tail.’

The first doctor to suspect the Covid-19 disease, which is now a pandemic, was Dr Zhang, who saw four atypical pneumonia patients, three of whom were from the same family, at Wuhan City Hospital in China on 26 December 2019 (just 120 days ago). The doctor alerted the local health authorities on 27 December. When three more similar cases were seen at the same hospital the following day, they reported the ‘mysterious pneumonia cases resembling SARS’ to the Chinese Centre for Disease Control and Prevention on 31 December, who in turn notified the World Health Organisation. Just eleven days after the first suspected cases, on 7 January 2020, the virus we now know as SARS-CoV-2 was isolated. Five days later, the virus’s genetic sequence was shared with other research centres around the world, and one day after that, on 13 January 2020, the first diagnostic test was developed. Today, both in traditional media and social circles, the question arises as to why there was such a delay, partly due to the emotional reactions triggered by the tragic consequences of the pandemic. For my part, I bow with respect to the speed and efficiency outlined above, which demonstrate the level humanity has reached in science and technology.

A virus that can be transmitted even by those who are not ill

It is true that we know very little about the behaviour of this virus, as until 109 days ago it was thought to exist only in animals and attracted little attention beyond a few specialists. Now, however, most of us are rebelling with anger and despair at the complexity of the virus’s transmission and disease mechanisms (if it weren’t complex, it would have been controlled and defeated without causing a pandemic). A significant reason for this complexity is the inability to obtain definitive results due to the necessity of conducting research retrospectively (looking back) under pandemic conditions. Moreover, the gold standard test we have, PCR, requires sophisticated laboratory equipment and can only detect two-thirds of infections. Add to this the difficulty created by the fact that the data collected during the pandemic comes from different countries with diverse demographics, healthcare infrastructures, and pandemic response policies that change rapidly over time, thus limiting its comparability. Inevitably, this leads to different results and even more varied interpretations.

We know that the new coronavirus is highly contagious from both population-based data and detailed case reports on when and from whom patients contracted the virus. For example, four of the first cases in Germany were businessmen who had a two-hour meeting after shaking hands with business partners arriving from Wuhan. During those two hours, the businessman from Wuhan sneezed once. According to a report from China, an elderly couple who attended a crowded Chinese New Year fair on 19 January infected all family members who visited them between 21 and 23 January, but the elderly couple’s first symptoms did not appear until 25 January. From this and similar reports, we know that people are contagious even before they show symptoms, but we do not know exactly how long this period lasts. Nevertheless, based on limited data for epidemic control, we assume that contagiousness begins two days before symptoms appear. It is said that people without any symptoms can also transmit the infection, but we do not know the rate at which this occurs.

We do not know for certain how long after symptoms subside the infectiousness disappears; for this reason, some countries use a criterion of seven days after symptoms have completely subsided, while others use fourteen days. Some countries, such as China, conduct two PCR tests within 24 hours, while others do so within 12 hours, thereby attempting to reduce the false negative rate from one in three to one in nine. Some countries, including Turkey, are unable to routinely perform these control tests on patients recovering at home due to limited testing capacity and healthcare personnel constraints, relying instead on the patient’s self-reported symptoms.

Abundance of speculation

On the one hand, the leaking of studies conducted with a limited number of patients, whose quality is questionable and which have not even been published in a peer-reviewed journal, is further confusing us: barely three to four months after the first cases, hypotheses are being put forward that the coronavirus will cause permanent damage, and we are believing this in fear. We are pinning our hopes on vaccines and preventive treatments being released onto the market within just two weeks, even though it is imperative that they undergo at least one to one and a half years of testing to ensure they are safe and effective for millions of healthy people. We are attempting to plan our lives according to speculative timetables published about the course of the pandemic, which no sane person would dare to predict due to the multitude of factors influencing it and the unpredictability of some of them.

Even the media reflected that there were those who were betting on the course of the pandemic and the number of deaths that would occur.

Since the initial recognition of the pathogen, despite the crisis conditions, I believe that the wealth of information gathered and the fact that the countries most affected by the pandemic are those with the most developed research infrastructure will enable us to provide much clearer answers to most of these questions within weeks or perhaps a month or two. But until then, we have no choice but to proceed by trial and error, systematising our limited observations as much as possible and adjusting our practices accordingly.

Remembering to live with uncertainty

Our ancestors managed to live in a world where many things were unpredictable until very recently. Born in the second half of the 20th century, when industry and technology accelerated, weather forecasts were 99% accurate, and our belief in our ability to control many natural forces grew stronger, we never suffered from infectious diseases other than seasonal flu and colds. and even, with the complacency this created, refrained from having our children vaccinated against measles. We, on the other hand, have acquired a modern habit of trying to predict everything, planning the coming weeks, months, even years from today, and getting angry when our plans do not come to fruition. This Coronavirus pandemic is teaching us an important lesson: that we are not as powerful as we thought, that we must accept uncertainty as a natural part of life, and that we must abandon the claim that we can plan the future as we wish. Once again, we need to return to the wisdom of older generations, who were able to live with uncertainty and face the difficulties that arose with resignation.

* This article was published in Yetkin Report.