President of the Department of World Health Systems at Harvard University, Turkish Cypriot professor Dr. Rifat Atun, has said that only the first hundred meters have been covered in the battle against Covid-19, adding that the pandemic is like a marathon and is still in its infancy.
In an interview with Turkish Cypriot daily ‘Yeniduzen’ Professor Atun was asked what he thought about the outcomes in North Cyprus regarding the Covid-19 outbreak.
He said: “ We can say that it was successful in the first stage in TRNC. Cyprus is a small place and an island. The islands have become more successful in this process since there is no entry-exit. Large islands such as New Zealand and Australia, which took early precautions, were also very successful. External traffic to the TRNC is not high, the number of cases was low at first, and the number of cases did not increase when the measures were taken. A vector, a carrier is needed to spread the virus, these vectors are also humans. If people do not get involved, if someone who carries the external virus does not come to the island, the virus will not spread. How to manage this first phase, the second phase is very important … Because if the borders are suddenly opened, if individuals from countries carrying infections come to TRNC and these individuals are not effectively quarantined, there will be a further spread of the virus”.
Noting that the second stage is the most difficult and important, he said that it is very important to perform antigen and antibody tests for the COVID-19 virus at the second stage.
Rapid Testing for Covid-19 in North Cyprus and Immunity
Professor Atun, noting that he did not have a profound knowledge of Covid-19 testing practises in North Cyprus, said only the PCR test can show whether or not someone has the COVID-19 virus: “I couldn’t understand why it was done in that order. [Rapid testing for antibodies] IgM and IgG are antibodies that occur after infection, after which PCR is not necessary. I have never heard of such a method in other countries, but of course I do not have a deep knowledge of the tests conducted in the TRNC. A PCR-based antigen test is checked for a person for infection or no infection, and nothing more. An antibody test is also performed to see if an individual has had the infection.
“Antigen tests, i.e. tests with the PCR system, indicate whether the virus is currently present. The antibody test, on the other hand, tells if the body has reacted to the virus. But these tests certainly do not show that immunity is formed because this coronavirus is a new virus. We still do not know how long the immune level lasts and how long it will take in individuals with antibodies. If we look at other viruses in the coronavirus family, we often see that viruses in this family create immunity, and this immunity can last 12-18 months. We currently do not know the level of immunity for the new coronavirus and how long the immunity will last. Even though it is an antibody, we cannot know the state of immunity.”
Stressing that North Cyprus does not have a universal, high-quality health system, the professor recalled that between 2007-2008, he visited North Cyprus with a group, as an official representative of the World Health Organization (WHO) and added: “Within the context of the WHO, a study was prepared, delivered, but not used. We also see the side effects. We had developed some solutions to set up a good health system. It has been 13 years, if they were implemented, today there would be a good health care system in the TRNC. The primary care system does not work well, there is no effective public health system. That’s why health care costs people. The health system must function fully … Unfortunately, at the moment there is no universal, high quality health system in Northern Cyprus. “
Asked what constituted a good health system, he replied:
“A good health system has five main elements. First, is good leadership, transparency and an effective organization, namely, what level to decide, what data to collect and use for these decisions is determined by social participation. Secondly, financing is important here both to provide sufficient financing and to use equitable financing efficiently. The third is to use the resources available efficiently and effectively. It is related to the first three inputs, the fourth and fifth elements are output. The fourth element of a good health system is community health, and the fifth is individual health services. These outputs should be both efficient, effective, equitable and flexible and able to respond”.