CORONAVIRUS - THE BAROMETER FOR CONTINUITY

 Filenews 8 November 2020 - by Giannis Antoniou

The epidemiological picture to be taken over the next 24 hours in Cyprus will largely judge the further steps for the opposition of the virus, since it will largely demonstrate whether the restrictive measures put in place are effective or not. Depending on the valuation, the necessary moves will be made. If the sign is positive and things start to move towards improving the epidemiological picture then the countdown to de-escalation of restrictive measures will mean.

Otherwise, however, the escalation of measures will be a one-way street and the scenario of extended lockdown will be on the table, as has happened in Greece and many other European countries, which are facing the unprecedented wave of the virus. Although there was concern about more drastic measures being taken in Cyprus, Wednesday's Cabinet did not raise a question of lockdown as experts believe there is currently no reason to do so. Or better yet, this extreme measure is considered the ultimate weapon that the government has in its bag and will resort to it when it is judged that the data on the ground do not allow for another solution. The equation also takes into account the economic dimension of a lockdown, which in any case should be accompanied by the subsidy of the workers and businesses that will be affected.

At present the situation is considered manageable and the whole effort is focused on curbing the spread of the virus so that there is no uncontrolled increase in the number of people who need to be hospitalized.

Experts estimate that the most difficult period in Cyprus may be in December-January when the second wave of coronavirus may coincide with seasonal infections, is a factor taken into account in the recommendations for the escalation of restrictive measures, their scope and their duration. That is why the strategy developed provides for three categories of measures, medium-term measures with effect on a global basis until 15 January, exceptional measures also on a cyprus basis with effect until 30 November and exceptional measures with effect in the Limassol and Paphos Provinces, until 16 November.

In particular for Limassol and Paphos, the increased epidemiological burden recorded exceeded all previous ones and reached three times the values of the previous fortnight. For Limassol the cumulative incidence was 420 people per 100 thousand and in Paphos, 294 people per 100 thousand.

In recent days the elements of the epidemiological picture have created a complex and largely contradictory picture. The reduction of the reproduction index to 1 brings relief but at the same time the increased cases and their many contacts (one in 7 examined through the tracing process tested positive for the virus) are of great concern, because they lead to the rapid spread of the virus and at the same time hinder the process of tracing, which until recently was the "super-weapon" , which allowed Cyprus to record very good epidemiological performance.

It is precisely because of the large spread of the virus, particularly in the city of Limassol, that the process of tracing has moved very slowly, resulting in the detection of "old" cases, which alter the accuracy of the temporal evolution of the epidemiological picture. As a result of this situation there was no timely identification and isolation of close contacts and potential cases, which effectively undermined the three-fold strategy pursued by Cyprus, i.e., many tests, meticulous tracing and isolation of suspected cases. This raises a serious question if there are many cases that have not been detected. In such a case there is a risk of a rapid deterioration of the situation.

The Ministry of Health strengthens its quix by using Rapid Test technology, which will help to capture the image more quickly, in specific groups of the population and in highly critical areas, such as hospitals and health centres, nursing homes and structures. In the last 14 days of October out of 1,800 recorded confirmed cases of COVID, 85.3% (1,536) involved domestic transmissions, while 8% (144 cases) had an unknown epidemiological history. Also, of the 1,716 laboratory confirmed cases of COVID-19 in the last 14 days of October, 463 (27%) did not report any symptoms at diagnosis while 1,253 (73%) reported at least one symptom. Also, 421 people (24.9%) reported at least one underlying disease.

The system is pressed

The increase in the number of hospitalized patients is the aspect that causes the strongest concerns for the very simple reason that the strength of the health system has a certain ceiling. Based on the updated action plan presented by the State Health Services Agency to the Minister of Health since mid-October, Famagusta Hospital in Paralimn, designated as the Reference Hospital for Koroniovirus, has a capacity of 88 beds, of which six are in the Increased Care Unit. Spaces are currently being used by the Urology of the Nicosia General Hospital, with a capacity of 16-26 beds. If the occupancy at Famagusta Hospital reaches 100%, then the utilization of the rooms of the Limassol General Hospital, with the possibility of 70 beds, will begin.

For patients suspected of being infected with the coronavirus and in need of hospitalization, part of the 5th floor of the Limassol Hospital will initially be used. Based on the design, if necessary the 5th floor will be used for the needs of the pandemic. In order for the 5th floor of Limassol to function entirely, the Famagusta General Hospital and the ward must be filled at the Nicosia General Hospital. In this case, the scheduled surgeries and other serious incidents of Famagusta Hospital will be referred to Larnaca General Hospital, which will not accept covid patients. If all 70 beds of the Limassol General Hospital are filled, then other areas of the Nicosia General Hospital will be used.

On standby is the new Intensive Care Unit (ICU) of GN Nicosia, with a capacity of 28 beds, which will be used exclusively for covid cases. The existing ICU of The General Hospital of Nicosia will remain for other incidents, except for the crown. During the summer months, 148 nurses were trained to work in an ICU if necessary. In total the beds in the two ICU are 60 with the potential to increase to 110 and then, using the ICU of the Limassol ICN and other hospitals, the adequacy amounts to 200. Ventilator proficiency may increase but the problem more has to do with the lack of health professionals to staff Intensive Care Units. The plans provide for the requisition of services and facilities by the private sector if a need arises for this.