Feverish, very well clinically and in the laboratory, very improved, the suspected case of coronavirus under investigation is being treated at the General Hospital of Nicosia. According to the Epidemiological Surveillance Unit of the Ministry of Health, the results of the specialized examinations for confirmation or not of a coronavirus case will be ready by tomorrow afternoon.
Speaking at a press conference of the Epidemiological Surveillance Unit of the Ministry of Health, the Director of Medical Services and Public Health Services of the Ministry Dr. Elisavet Konstantinou stated that the preparation for dealing with such cases started early with the preparation of the protocol by the and the European Infection Center (ECDC) for the treatment of coronavirus cases both outpatient and inpatient.
In his turn, Dr. Costas Konstantinou, Pathologist-Infectious Diseases, after referring to the history of the virus, said that yesterday an incident was identified by the checkpoints that would potentially meet some of the criteria. He also explained that the epidemic is ongoing and the data and instructions are constantly changing. "We had a change in the directive that while initially the incident could be considered simply under surveillance, then it became an incident that could be further investigated. And that is what we did ", he noted.
He went on to refer to the measures already taken in recent weeks, concerning the increased surveillance at the points of entry of the Republic, the management of a suspicious incident by health professionals, and the management of this incident by various services, such as ambulances, hospitals, etc., ensuring in particular the protection of staff and taking measures to prevent the transmission of the virus within hospitals. "We review the instructions every day and where we need to take additional action, we do so," he added.
Asked about the patient's state of health, Dr. Konstantinou pointed out that he is in very good health, explaining that the patient was never in danger. Speaking about his clinical condition, Dr. Konstantinou said that the patient had a fever and mild nasal congestion. "Today he has a fever, very good clinically, very improved in the laboratory," he added.
Asked to say when we will have the results for confirmation or not of a coronavirus case, Dr. Konstantinou initially stressed that "as a probability (s.s. to be confirmed) is very low for many reasons related to the nature of the incident. This patient started from China on January 18 from Beijing. He was not from the area (the epicenter of the epidemic). So based on the definition that existed then, it is not considered a suspicious case and in the area that was then they did not take extra measures. It was confined to Wuhan City at the time. Has not come into contact with confirmed cases or cases under investigation. However, because in the course of time the definitions have changed somewhat and if we count from the 19th of January that arrived in Cyprus until the 31st of January when we located him -because he had made a trip to a neighboring country in between-, it is the 12th-13th day. The question mark was raised whether we go with the strict criteria and the new ones that had been changed by the ECDC, while the WHO had not changed them yet, theoretically falls under the new definition, but if we go since it left, then it does not fall under the criterion of investigation . And there was - let's say - a small misunderstanding that existed and what happened yesterday ".
In addition, he said that "to be on the safe side, we considered it suspicious. It was also a good opportunity to test our capabilities in a suspicious low-probability incident, so that even a small mistake can be made or not done right, there is no great risk of causing anything further, and we can see how we can manage it. . "Once we decided to check it out, the procedures were done as they should have been and I think we did quite well."
Asked to say when we will know the result of the specialized examinations, Dr. Konstantinou said that we will have it by tomorrow at the latest. In the same question, the Director of Medical Services explained that it takes time to set up a new method. The examinations, he said, will be made by the Cyprus Institute of Neurology and Genetics, which will be ready from next week to conduct the specific examinations in Cyprus.
Then, answering a question whether the fact that yesterday afternoon the Ministry of Health denied the information about a suspicious case in Cyprus and then confirmed it, is due to misunderstanding, Dr. Konstantinou stressed that this is due solely to the fact that "many things are evolving times when we issue a directive, then a new directive may come out that modifies the original design. I have told you characteristically that, for example, the ECDC until this morning on its website still considered the likelihood of an incident being imported from China as mediocre and the risk assessment made by the previous night considers it moderate as high. So because the directive can change at any time, until we see it, evaluate the new directives and move on, there may be a small gap. "But we fixed that very quickly."
Asked if the others who traveled with the patient for examinations were called, Dr. Ioanna Grigoriou, Occupational Physician and Public Health, said that there are details of his passengers and as soon as more information about the incident is extracted, they will be notified immediately. Dr. Konstantinou, for his part, clarified that there is no information that the virus is transmitted by asymptomatic, but only when a person has shown symptoms. "Someone who has come in contact, does not transmit, must be infected and the incubation period must pass and show symptoms, in order to start transmitting further. The basic protocols say that we start the process after we confirm the incident ", said Dr. Konstantinou, with Dr. Grigoriou pointing out that on the plane the patient did not have the symptoms that could theoretically transmit the disease and there were no passengers in the adjacent seats. "While the instructions of the ECDC and the WHO were to check passengers coming from Hubei Province only, we from the beginning of our airports checks, we check all passengers coming from China and for this reason the specific incident in we had located him immediately ", added Dr. Grigoriou, adding that based on the initial instructions that existed, the specific person should not have been checked, because he had not passed through the said Province.
He also explained that the procedures are performed on travelers coming from China with symptoms on the plane, at the airport and on passengers who just came from China, undergo a medical examination and there probably, like this case, appears that they may have something.
Asked if his relative is under investigation, Dr. Konstantinou reiterated that there are epidemiological criteria and symptoms for a case to be considered suspicious. When, he added, we have only the epidemiology that says that when someone comes from this region of China without symptoms, he enters into a form of monitoring, on the basis of categorization into high or low risk. In this context, since we considered that the incident could potentially be considered suspicious, at the same time the people who came in close contact with it, enter into a kind of surveillance. He noted that his relative was examined and showed no symptoms. There is regular communication with him and his health condition is monitored at regular intervals. If, he said, he shows symptoms, he immediately turns from under surveillance to a suspect and the established procedures will be activated.
Asked about the measures taken to implement the control at the roadblocks, the Director of Medical Services said that a meeting was held with the involved authorities of the Republic to co-decide the measures to be taken and it was decided to give a brochure and ask specific questions. In relation to the Bicommunal Committee for Health, a meeting has been arranged in the presence of the President of the Republic and the Turkish Cypriot leader for Monday afternoon.
Asked if there is anything that can be improved based on yesterday's experience, Dr. Konstantinou said that there should be better coordination and cooperation, as well as more timely communication between those involved. "I believe that people should not panic, but neither should they be stigmatized if for any reason someone should be investigated, whether he is a tourist or a Cypriot citizen. It is also a matter of personal data and they need sensitive and discreet handling ".
Finally, Dr. Linos Hadjichannas, Infectious Diseases Specialist, stated that the patient had a fever and very mild nasal congestion and the reasons he was kept for treatment were purely preventive. He said that some viral infections were excluded from the tests that were performed, he is in isolation at the General Hospital of Nicosia in good condition and today he was without a fever.