Dr. Gökhan Hotamışlıgil was quite sad when we spoke on the phone about the coronavirus on March 16. Most of Harvard University’s biomedical research laboratories, where Nobel Prize-winning studies were conducted, were temporarily closed due to the coronavirus. Out of all the laboratories of the medical school at Harvard University, one of the top universities in the world, only clinical laboratories would remain open for coronavirus research and diagnostics. “It’s sad,” said Professor Hotamışlıgil, “we’ve been working here for 25 years, every single day. It’s sad but it’s the right decision.”
The reason I called Hotamışlıgil was a tweet he had posted earlier. In this tweet, “the pace of the epidemic is the same in all countries across the world,” said the renowned scientist; “it’s only the starting times that differ.” This means that Turkey’s got a week before the situation gets as bad as in the U.S., and perhaps two weeks before it hits the level in Italy. As we spoke, it became clear that the opposite could be true as well. So, if Turkey was to take the right steps at the right time and vigorously, it might not find itself in as bad a situation as in the U.S. or Italy. Turkish Health Minister Fahrettin Koca’s announcement on the night of March 16, that the number of cases shot up from 18 to 47 in one day, validated the claims and warnings of Hotamışlıgil: the spread had begun.
We don’t know how this epidemic will evolve but one of the reasons for this is that we don’t know how people will behave in the coming days. According to Hotamışlıgil, two issues are vital in our fight against Covid-19 at this stage: personal hygiene and social distancing as well as more thorough social isolation — a sort of national quarantine.
How important is social isolation?
Neither frequent hand-washing nor socially distancing ourselves as much as possible were enough on their own to control the spread: we had to apply both seriously and rigorously to get results. Of course, what drives these practices are knowledge, scientific competence, effective and widespread testing, transparency, and the establishment of diagnosis-treatment chain. According to Hotamışlıgil, South Korea, neighboring China, was one of the best examples in implementing these measures.
China was able to recover from its initial mistakes in a relatively short time, managed the process well, and was, therefore, able to suppress the speed of the virus’s spread. The secret to that was full social isolation to an unforeseen extent. Added to that, of course, is the strength of the country’s health infrastructure. “There is no other country in the world that can build five 10-thousand-capacity portable hospitals in two weeks,” says Hotamışlıgil, and adds that China, at the moment, has conducted the “biggest public health experiment in human history”. Of course, one must also add to China’s credit list is that the virus has been isolated, and its entire genetic sequence has been revealed and shared with the world in record-breaking time.
But China’s initial mistake was that it didn’t acknowledge the disease, and underestimated it until mass death began in Wuhan. “As long as the governments act as though there was no illness to avoid panic,” says Hotamışlıgil, “if screenings and virus detection are not done as frequently as necessary, and unless the number of cases is disclosed transparently, the effort will not yield the best results and people will see the suggested precautions as unnecessary and struggle to apply them. This affects the social isolation aspect the most because the virus spreads more easily among those without symptoms as people keep up with close social contact”.
US problematic. Italy, Spain worst examples
According to Hotamışlıgil, the U.S. situation is very problematic, while Italy and Spain are the worst examples. Even though scientists had begun to warn the US as early as the beginning of January, and the National Security Agency announced the possible outbreak as the greatest threat to national security, the Donald Trump administration failed to take any serious preventive action up until last week. Then, and only with pressure from scientists and state administration efforts the situation was gradually brought under a little bit of control. As of today, the virus testing issue is still not resolved. However, social distancing measures are being implemented with increasing rigor, schools are closed in many states, and some cities have begun to restrict all areas of assembly. For example, churches were closed to worship and some were turned into nurseries, especially for the children of healthcare professionals who had to keep working. In Italy and Spain, however, according to Hotamışlıgil, “we see the worst examples” because “as the illness was coming at full force, they underestimated the situation while the people, without any worries, carried on with their lives, as usual, sitting around in parks, and this is the result”.
What about Turkey?
According to Dr. Hotamışlıgil, Turkey can be considered “successful so far” in the fight against Corona. He says that, although at first Turkey gave the impression of being rather slow to act without enough communication, it then started to swiftly take precautions. A private institution was created (the Coronavirus Scientific Committee), flights with high-risk countries were banned, borders were closed, campaigns were launched to inform the public and those returning from the Umrah were quarantined. Hotamışlıgil thinks that, compared to his counterparts in the U.S., Health Minister Fahrettin Koca in Turkey was managing the process well, calmly and transparently, relying on scientific data. These are positives but much more is needed.
The Harvard professor underlines that Turkey has still got the chance to avoid further spread of the virus and flatten the curve, despite unavoidable and unfortunate casualties; he emphasizes that the widespread and strict implementation of social isolation is key in ensuring this. A crucial point here is the protection of high-risk people whose lives are in danger; to make sure they can get those people and that they can get the necessary care at this time, and to ensure the health system runs smoothly. It is also essential to protect the health care workers who deliver the essential services.
Precautions must be strictly applied
As we were speaking on the phone, the Turkish government had temporarily closed entertainment venues and “postponed” worship at the mosques until further notice, including the Friday prayers. Hotamışlıgil said that “all restaurants, coffee shops, shopping malls, and weddings must be stopped. In Boston, they put at least two meters in-between tables in restaurants and reduced the number of customers but this is not enough, they should be closed. The same goes for shopping malls and all other places where people can gather. It will be uncomfortable and difficult for about 3-4 weeks but the alternative will result in a much worse outcome”.
A short while after our talk, the Interior Ministry declared that all of the above except for the malls were temporarily closed. Then, Hotamışlıgil posted another tweet in favor of this decision.
I also think that these precautions are necessary and that they must be strictly abided by. We must make up for the lost time and fix mistakes such as the Umrah issue. Hotamışlıgil believes that should citizens abide by the rules, Turkey’s health infrastructure should be able to get through this outbreak with the least damage possible. This is no joke and no time for politics. Political parties too, for example, despite mistakes like AKP and MHP members visiting Umrah returnees and CHP not canceling the women’s branch meeting, are now canceling all meetings. We have to get this over in solidarity.