Minister of Health Fahrettin Koca made statements at the press conference held after the Coronavirus Scientific Committee Meeting held at Bilkent Campus.
Emphasizing that the desired agenda change that will concern humanity in the same way has not yet taken place, Koca said, “So far, approximately 33 million people have been infected with the virus and more than one million deaths have occurred. There is an increase in the number of cases in Europe. The World Health Organization suggests that the number of people who will lose their lives in the pandemic could reach 2 million.”
Koca stated that the global coronavirus table data, which he also shares from time to time, is based on the official statements made by the states to the World Health Organization, and said that the numbers in question include those that have been detected.
Stating that the world is not sufficiently agile, determined or even willing to detect cases, Koca said: “As such, conclusions can be drawn against those who show the necessary agility against the pandemic. What is worrying in an outbreak in an age when the world population is so mobile is not the cases detected. What is worrying is that no cases are detected. In an epidemic, every invisible risk is much more frightening than the isolated risk.”
Minister Koca continued his words as follows:
“My dear citizens, if there is this or that speculation about our beloved country, you should look at it like this. Those whose aim is to fight the disease effectively reach the case. It does not wait for the application of an advanced case. Instead of leaving the epidemic to its natural course and focusing only on vaccination, it fights day by day. Turkey is an example of this.
Our social behavior has changed during this period, as well as our moods and psychologies. We can reach consensus on some issues more easily, and on others we find it difficult to reach consensus. In the face of uncertainty, it is normal for there to be a sense of anxiety and controversy in society. It is important that this is kept at a manageable level and does not harm the spirit of unity and solidarity. Everyone can put forward an interpretation, a problem, or raise other concerns. What should not be forgotten at this point is the fact that we are dealing with a common issue of society, and that in doing so, we must protect the interests of society, whether visible or invisible to the naked eye. In criticism, one leg of the compass should be at this point. If one leg of the compass is here, the other leg can draw as wide a circle as it wants.”
“In many places we have achieved a reduction of about half”
Minister Koca stated that he would also respond to some allegations and evaluated that these allegations were put forward at a time when health workers were sweating from head to toe, the number of tests increased, cases were mobilized for their contacts, local measures were put into effect in the fight against the epidemic, and they started to travel from province to province.
Koca noted the following:
“Everyone knows that after the last escalation of the virus, we have achieved a decrease of about half in many places. Considering that we have 2-3 months left for the vaccine, the end of the tunnel and the light is visible. Some people want to come out of this tunnel successful, without making any effort, just by talking, and while we are in the twilight, they are making some claims that will be forgotten tomorrow. The laborers of this road have a right of reply. It is also the right of those who have followed the measures and have clear trust in their state.
I will speak on their behalf. First of all, it is important to use words in their proper place. There were some words that came into our lives with the pandemic. The progress made in vaccination has led to some changes in these words. We no longer talk about waves and peaks, but about treatment, immunity. We are now talking more about the carrier, the patient, the severely ill, rather than the test and the case.
We need to know this. Not every case is sick. Because there are those who test positive but do not show any symptoms, and these are the vast majority. Our filiation teams, which are tracers, predominantly detect them. We call these people asymptomatic positives. Their importance in terms of the pandemic is that they are infectious, that is, carriers. If they are not detected and isolated, they cause the outbreak to grow. When they are isolated with the necessary support, the test of these people is already negative after an average of 1 week.”
“Every person who tests positive is a case”
Stating that since these conditions have been fulfilled, those in this group are no longer of primary importance in terms of the pandemic, Koca said, “This situation has become the routine of the pandemic. Seeing asymptomatic coronavirus positives as the first-degree problem of the process means still being stuck in March when looking at the outbreak. This is the prevailing perspective on a global scale. In addition to the above clarity, the other thing we simply need to know is the fact that the symptomatic person is a carrier.”
Koca continued his words as follows:
“In the later months of the pandemic, these are the people and patients who are accumulating in numbers and who are important in the fight against the pandemic. Against the increasing number of patients, the most important issue is the preservation of the health system’s strength. The ‘Number of New Patients’, which is announced and emphasized every day, should be the main subject of attention.
The essence of the situation is this. Each person who tests positive is a case. Most of them are asymptomatic carriers. The rest are patients who have symptoms and are being treated. We follow up and treat some of them at home and a significant number in hospital. We also report those we treat in the hospital as inpatients.”
“Respect our losses”
Koca, who also defined the definition of a severely ill patient, said: “We define a patient as ‘severely ill’ when Covid-19 goes beyond being a viral respiratory infection, becomes a systemic disease and makes the patient in need of external support. This is how we report our patients whose blood oxygen level is below a certain level or who are intubated.”
Koca underlined that the meaning of the word case, which refers to anyone who has tested positive, whether they have symptoms or not, is not the same as the meaning of the word patient. Stating that the difference between a patient and a seriously ill patient is clear, Koca made the following statements:
“The struggle in the field and the struggle in the hospital are now partially separate. In the sixth month of the pandemic, it is the health system itself that comes to the fore. When these are understood, everything finds its place in the order of importance.
We have a second and extremely important issue. This is a subject on which morality forbids speculation. There are interesting claims about the number of deaths. I appeal to those who expect to win a debate on this issue. If you are looking for a numerical victory, please do not trample on spirituality. Respect our losses. Where do those who seek to score points with the death toll, those who try to make the numbers seem higher than they really are, where do they find a basis?”
“The form used for death notification is not new”
Stating that death information in Turkey is collected in two sources, one of which is the burial records of municipalities and the other is the Turkish Statistical Institute, Koca pointed out that the use of two separate databases together is incorrect.
Pointing out that some categorical information in death reports is misinterpreted, Koca said that he wanted to clarify the issue of the number of deaths.
“The form used for death notification is not new, it has been used since 2013,” said Minister Koca.
Stating that the “manner of death” and “cause of death” sections in the document are important, Koca said that the “manner of death” section includes the answer to whether a person died in a forensic case such as an armed attack or in a normal way.
Stating that “infectious disease” or “non-communicable disease” was added to explain natural death due to disease in this household, Koca shared the following information:
“Records show that in about 1 in 10 of the total deaths this year, the mode of death was natural death due to an infectious disease. Another 9 out of 10 were marked as non-communicable disease, old age and the like. The information in this household does not indicate the cause of death by disease. This does not give an indication of the number of COVID-19 deaths. Anyone who thinks that Covid-19 is the only communicable disease is mistaken. The ’cause of death’ section of the report is the part that provides the main information. In this section, the record of the physician following the patient is confirmed and finalized by a second physician. In the death certificate received after the burial, the confirmed cause of death of the patient is included in this section. The fact that Covid-19 can be shown as the cause of death in statistics is based on the data here.”
Emphasizing that misleading claims regarding the number of deaths are based on the statements of some municipalities, Koca pointed out that the “cemetery information system”, which is also included in the e-government database of municipalities, includes the number of burials in the province in question.
Stating that burial reports are issued in the province where the person died, Koca said that the deceased is buried either in the province where they died, in the province where they officially reside or in the province where their family deems appropriate.
“Municipalities’ data reveal the number of burials in their provinces”
Pointing out that three different places and provinces are in question, Koca said
“Data from municipalities reveal the number of burials in their provinces. In the Turkish Statistical Institute data, the distribution is based on the residence address of the deceased. In other words, if the person lived in Istanbul but his/her address of residence was Sivas, TÜİK records him/her as Sivas. Therefore, there is a difference between the municipality and TÜİK data. You see this difference in the 9th month of the year. But when you carry over from December 31st to the new year, the total number of deaths is equalized in the two sources. Looking at data from 11 provincial municipalities and drawing conclusions or blending these two sources is wrong. If we wait until the end of the year, we will see that the data from TurkStat and other data overlap. It should be known that those who want to discredit the state and the fight against the pandemic will discredit themselves. There is no way to hide someone’s death. This is 2020. It is not possible to make the living look dead, nor is it possible to make the dead look alive. According to TURKSTAT data, the number of deaths in the first 9 months of last year was 329,274. With a projected annual increase of 2.2 percent, this is now expected to be 336,518. So far, 339,26 deaths have occurred, including deaths from Covid-19. The difference is 7,244. The number of deaths detected from COVID-19 is 8,62. It is not less or more.”
Stating that the causes of death are published by TurkStat according to the standard classification of the World Health Organization, Koca stated that there are 21 sub-headings and 932 diseases under the title of infectious and parasitic diseases in this classification.
Stating that intestinal infections, hepatitis, tuberculosis, AIDS are among these, Koca stated that Covid-19 is the one that comes to mind the most for the moment.
Stating that 8 thousand 977 people died in the first 9 months of last year due to 932 diseases under 21 headings, while this year it was 8 thousand 785, excluding Covid-19, Koca said, “It is also less than last year. It is clear that Covid deaths are not given under the heading of infectious diseases. Anyone who writes them under Covid-19 just because they are ‘deaths due to infectious diseases’ is mistaken.”
Minister Koca emphasized that they were sorry for being forced to make such statements.
“I believe we have overcome the most difficult part of the road”
Koca continued his words as follows:
“During the fight against the pandemic, our state protects its national interests as well as the health of its people. Because the attack of this virus is not only on the human body, but also on education and all areas of life. The pandemic also targets the obligations of the state towards its citizens. Therefore, the criticism of some unaccountable people is no different from looking at a point of the photograph with a lens and looking for a stain. I believe that we have overcome the most difficult part of the road. When we meticulously put measures in place, fear is replaced by self-confidence.”
Stating that they have seen the results of the regional interventions made in the last 3 weeks, Koca said that they have achieved success in many provinces where high increases were mentioned.
Reminding that they made evaluation visits to Diyarbakır, Van, Izmir and Samsun, Koca made the following statements:
“We also included the neighboring provinces in the evaluations. We devoted one week to reviewing the work done in Istanbul. Thus, we had the opportunity to discuss the health infrastructure and activities carried out in 23 provinces in detail. In our meeting two weeks ago, I evaluated the situation in Ankara and stated that the increase in numbers was high. This increase was not limited to Ankara, but affected many regions of Anatolia. Ankara attracted the most attention. The number of patients in Ankara has halved in the last 2 weeks. This can also be seen in the reduced density in our hospitals. Early results of tests, starting treatment earlier, increasing the number of filiation teams and shortening the filiation time, contact tracing and isolation, rapid sampling of symptomatic patients and isolation are effective and known factors. In addition to family physicians, in the call system established specifically for Ankara, 110 officers call homes and follow up symptoms. In the last month, we have formed teams of 120 doctors who go to homes and follow up patients. We have 780 filiation teams consisting of three people each in the field, and I am only talking about Ankara. With these measures, the number of daily patients has decreased by nearly 60 percent in the last 10 days. The number of cases, which was twice that of Istanbul, has fallen below that of Istanbul. Parallel to this, the number of patients hospitalized in intensive care units and the number of seriously ill patients have also decreased.”
“On average, it takes us up to 8 hours to identify a contact”
Emphasizing that the vaccine has gone far beyond trials and that Turkey has started procurement initiatives, Koca said: “We will have a program that prioritizes age and chronic diseases. The countries we are connected to report that they have received results from the vaccine. In parallel with this process, our domestic vaccine studies continue. There are currently 13 studies. There are those who are about to start phase 1 experiments. Animal experiments have been largely completed. I believe that we will start the production of our own vaccine very soon.”
Stating that a new column has been added to the coronavirus table published every day, Koca explained the information in the new column.
Sharing the information that the bed occupancy rate is 49.3 percent, the adult intensive care occupancy rate is 67.1 percent, the ventilator occupancy rate is 32.3 percent, and the family physician monitoring rate is 82 percent, Minister Koca said, “Our average filiation tracing time has decreased to 13 hours. The average contact detection time has decreased to 8 hours.”
Stating that the newly added column shows the occupancy rate in health institutions, Koca continued as follows:
“We want to be more active in the field. We want to do widespread filiation in this period. Especially we know very well that this is extremely result-oriented. We believe that an approach that makes filiation, which is not done in the world, more effective day by day, conducting more intensive tests especially in the early period, making filiation strong and isolating it, will get results in the pandemic.”
Sharing a table showing the number of cases and pneumonia, Koca stated that according to the table, there was a slight increase in the number of cases in 10-12 provinces, while the rate of pneumonia increased slightly in 1 province.
Providing information on the bed occupancy rates in Turkey, Koca said that the ward bed occupancy is 234,316, intensive care bed occupancy is 40,850, and ventilator occupancy is 24,299.
“We are not only talking about covid patients in occupancy rates”
Regarding the number of cases in provinces, Koca said, “The number of cases in Istanbul decreased by 2.8 percent.”
Stating that the ward bed occupancy rate in Istanbul is 51.1 percent, the intensive care occupancy rate is 61.3 percent, and the ventilator occupancy rate is 35.8 percent, Koca said, “When we talk about occupancy rates, we are not only talking about covid patients. We are talking about the occupancy rate of all patients except covid patients.”
Stating that the ward bed occupancy rate in Ankara was 50.1 percent, the intensive care occupancy rate was 76.5 percent, and the ventilator occupancy rate was 25.8 percent, Koca said that the number of cases in Ankara decreased by 24.8 percent in the last week, and the decrease in the number of cases was around 60 percent compared to 3 weeks ago.
Stating that the number of cases in Izmir dropped to 26 percent, Koca noted that the ward bed occupancy rate was 47.9 percent, intensive care occupancy rate was 74.5 percent and ventilator occupancy rate was 46.6 percent.
Pointing out that Konya is also one of the provinces with an increase in the number of cases, Koca stated that the number of cases in the province decreased by 43.5 percent in the last day.
Minister Koca stated that the ward bed occupancy rate in Konya was 46.6 percent, intensive care occupancy rate was 73.8 percent and ventilator occupancy rate was 29.9 percent.
“Smart wristband” app
Upon a question about smart wristbands, Minister Koca said that they are not in favor of using the “smart wristband” application unless it is mandatory.
Koca explained that the smart wristband is a system that works over GPRS, overlaps Google Maps, HES and gives a warning when it is interrupted or when moving after a certain distance, and continued as follows:
“The software related to this has been developed and a point has been reached. In addition, we worked on a system that can be fixed, that can be attached to a fixed place at home when necessary, that we can adjust the distance, that if there is more than one person in the family, more than one person can be tracked when necessary, that is, 30, 40, 50 meters, whatever interval you need to give, and when that distance is exceeded, it is activated with a warning system.”
Emphasizing the importance of applying the smart wristband mostly to people who do not want to be isolated at home or who are worried about being isolated at home, Koca said, “We are thinking of using the fixed one to be activated when necessary for people who do not have smartphones. In other words, not in a widespread, wristband-for-everyone style, but more for those who we see problems in isolation at home, whom we find suspicious and have problems.”
Reminding that a dormitory alternative is currently offered for people who are not isolated, Fahrettin Koca said, “In that case, we want to offer a wristband alternative. In the coming weeks, I will express the development on this issue more clearly.”
“Face-to-face education will be on the agenda at the cabinet meeting”
In response to a journalist’s question on whether there have been any cases for pre-school and 1st grade students who started face-to-face education and when face-to-face education will be introduced in intermediate grades, Koca gave the following information
“Today, the situation regarding education was discussed in our Science Committee. So far, we have not experienced any serious problems with face-to-face education in the preparatory and first grades. The Science Board’s proposal will be on the agenda at the cabinet meeting on Monday. The Science Committee had previously considered preparatory, 1st and 2nd grades. We will probably clarify and present the Science Board’s proposal for grades 2, 8 and 12. If a clearer decision-making process is reached next week, it will already be announced.”
Upon being reminded of the claim that community immunity was ensured, Minister Koca stated that a study was conducted with 153 thousand people across Turkey.
Pointing out that a study was conducted with both antibody immunity and PRC method in that research, Koca continued his words as follows:
“We announced the figures at that time. 0.28 percent carriage and 0.82 percent protective immunity was in question. More than 2 months have passed. We have decided to repeat this study again and it will start next week. We want to see the difference between the difference between the carrier status and the immunity status at this time when the epidemic is increasing. We will start this in the coming weeks. We will share the results with you as they come out.”
Upon being asked whether private hospitals are included in the nationwide bed occupancy and ventilator figures he announced and the Ministry of Interior’s practice of using the HES code in transportation, Fahrettin Koca reminded that the Scientific Committee had a recommendation for the widespread use of the HES code in previous meetings.
Stating that the HES code should be made widespread, Koca said:
“In this context, we know the importance of the widespread use of the HES code in transportation. It will be processed into the card system and people who are positive and risky will be prevented from boarding, but there may be problems with foreign people who do not have any cell phones. We have suggested that a system that we can block, if necessary, the passage of people who are positive and have cards should be activated during this period. Our Ministry of Interior has issued a circular on this. It will also be widely used in the following process.”
Minister Koca emphasized that the HES code application will also be used in accommodation facilities.
Stating that provincial sanitation boards can expand the HES application when necessary, Koca said, “We say that provincial sanitation boards can take these decisions in their regions, including more widespread parks when necessary.”
“Additional payment discussions are extremely unfortunate”
Upon being reminded of the news about the additional payment given to healthcare professionals and other auxiliary staff, Fahrettin Koca said the following:
“I find it extremely unfortunate. There is a class of servants meant here. The additional payments of these auxiliary servants are low. There are also gardeners and barbers among the auxiliary servants. There are 11 defined classes. This also includes the gassal. In other words, it was a practice related to the people who wash the deceased, especially in Kovid. Here, we are talking about an average of 200-250 liras, which seems like 100 percent.”
Emphasizing that the additional payment given to that class such as barbers and gardeners in January was completed and corresponded to a figure of 100 percent, Koca said, “The 100 percent rate is something corresponding to 200-250 liras. It is not 100 percent of his salary. It is expressed incorrectly. The class here was a situation related to the gassals, the people who wash the funeral. It has never been right to abuse this. This should not be sacrificed to politics.”
“All the data in the table, all the figures are correct”
In response to a question on whether the Scientific Committee has had a meeting with the Turkish Football Federation regarding the spectator football matches, Koca stated that the issue was not on the agenda this week and that they may put it on the agenda in the coming weeks, starting with the boxes when necessary, depending on the course of the pandemic.
Regarding the claims about the total number of cases made by CHP Ankara MP Murat Emir based on a document, Koca made the following statements:
“There is no date on the document claimed to be a document, there is no note as to when it was received, and our software program SİNA does not have such an interface. On the day of September 10, the number of tests performed is 112 thousand. On the day of 112 thousand tests, it is said to be 152 thousand. I tried to express in my speech that the fight against the pandemic is extremely important, especially in the course of the pandemic. We are doing especially the filiation of everyone identified in the field, we are doing contact tracing. We do not do contact tracing by hiding any of our citizens and we do contact tracing for all cases. I tried to explain the definition of case and patient in my speech, and apart from that, all cases are also in our HES system, which is in operation at the point of creating a safe area. So all cases are in the HEPP. Therefore, can you prevent filiation by hiding the case? Can you fight this epidemic when you cover and eliminate the safe area in the HEPP code by hiding the case? If it had happened the way it is said to have happened, why are our bed occupancy rates in hospitals still below 50 percent in an environment where so many cases are claimed? Why are our occupancy rates in intensive care still at 66 percent? Therefore, I want our citizens to know that all of the information in the table we have given is correct. I underline it especially, all the data and figures in the table are correct. In the struggle, especially in this period, nothing is being done in secret. The fight is based on all positive cases, including filiation, HES code and contact tracing. If you don’t do this, can you imagine a case rate of nearly 60 percent in a province like Ankara, a province that was twice the size of Istanbul 2-3 weeks ago? Can this be done by hiding it?”
Koca continued his statement on the number of cases as follows:
“When I say occupancy rates, I mean the ratio of hospitalized cases to total beds. What is the number of intensive care beds? Our number of intensive care beds is 28 thousand. The number of intensive care beds we added only during the pandemic period was close to 3 thousand. What is the number of severe cases? It is around 1500. In other words, only half of the 3 thousand beds we have added are for severe patients. Therefore, we say occupancy rates of 66 percent not only for Covid-19 patients, but for all patients. We are not saying this only for Covid-19 patients. Covid-19 patients constitute 66 percent of the 28 thousand severe patients and approximately 5 percent of these are severe patients. Would it be like this if what was said had happened?”
“You said that not every case is considered a patient. The number of new cases in the table was changed to the number of new patients. Are these asymptomatic positives not included in this number? If not, how many asymptomatic positive cases are there in Turkey and can they be added to the table?” Upon the question, Koca stated that they have given the number of patients per day since July 29.
Stating that the work on employment in health continues, Koca said, “In the coming weeks, the numbers and the areas in which recruitment will be made will be clarified. I do not think this will take too long. I would like to say that this recruitment will take place this year, especially in our newly opened hospitals.”
Asked about the current R0 value of the virus transmission coefficient, Koca said, “The R0 value is currently decreasing. I would like to say that it has decreased gradually, especially in the last 2 weeks, and has fallen below 1. I can state that in the following period, the number of these cases will decrease by remaining below 1.”
In response to the question “How much higher is the number of cases than the number of patients on average?”, Koca said, “The number of patients is not only the number of hospitalized patients. When we say patient, we are talking about people with symptoms. We give the number of hospitalized or non-hospitalized people with symptoms as the number of patients per day.”
Source: https://www.aa.com.tr/tr/koronavirus/saglik-bakani-koca-her-vaka-hasta-degildir/1991187
