Following the decision of curfew, the IMM Science Committee made a statement reminding the management of the scientific fight against the epidemic, especially on social distance violations in Istanbul. Stating that the Friday curfew statement made some problems visible in terms of epidemic control, the Board made the following suggestions: “It should be ensured that patients who are sick are diagnosed, isolated, screened, and tested for everyone who has complaints, and isolation of patients who do not need hospital treatment. If social mobility is restricted, arrangements should be made to ensure that those who do not have regular income, who can earn daily, and the poor are not victims. Managing the outbreak requires inter-agency cooperation. Communication plays a key role in outbreak management and reducing social anxiety. ”
The IMM Scientific Committee pointed out that the banning of the curfew by the Ministry of the Interior for two days in 10 metropolitan and Zonguldak provinces on Friday, April 30 has made certain problems visible in terms of outbreak control. It was stated that when the curfew was announced to the public two hours before 24:00, the night when the ban would begin, it was observed that many citizens turned to places like markets, bakeries, and crowds that would not be able to maintain the physical distance were observed.
The IMM Scientific Committee stated that not informing the city administrators in the provinces where the ban was declared does not allow the services provided by the municipalities to be harmonized. The continuation of the statement that the Board shared its “evaluation and suggestions on outbreak management and communication” is as follows:
DECISIONS SHOULD SIT ON A SCIENTIFIC BASIS
“Decisions taken in epidemic processes must have a scientific basis. The knowledge that the virus spreads from infected people, and that there is no vaccine or drug to protect the intact, has focused on the main strategy for "cutting out contact" to control the outbreak. The practical response of this control strategy is to identify infected people by performing multiple tests, to isolate those known or suspected to be infected from intact (isolation), and to make arrangements for the rest of the community to reduce contact as much as possible. In some countries, the main goal of curtailment, which we see as an example, is to reduce contact in the society and to prevent the circulation of the factor, and the times applied for this are determined by considering the epidemiological characteristics of the factor such as incubation time, disease duration and spread rate. The two-day curfew, as of last Friday, has no place in the control strategy of the disease, nor has a scientific basis. Moreover, due to the way it was applied, it led to the disappearance of the physical distance between the people and the possible increase in the speed of the epidemic. In an incident where individuals such as epidemics are highly concerned, the curfew that could cause panic should be announced carefully and with a certain preparation period left. At the current stage, the effective mobility of community mobility should be continued until the epidemic loses its pace. It should be ensured that patients who are sick are diagnosed, isolated, screened, and those who have complaints can be tested, and isolation of patients who do not need hospital treatment should be emphasized. If social mobility is restricted, arrangements should be made to ensure that those who do not have regular income, who can earn daily, and the poor are not victims.
MANAGING THE OUTBREAK REQUIRES COOPERATION BETWEEN INSTITUTIONS
Istanbul province where more than half of Covidien-19 cases in Turkey, has a population of many more European countries. This shows the fact that there should be as few mistakes as possible in outbreak management processes in Istanbul.
Outbreak management is a process that aims to control the infectious disease causing epidemic and to protect the health of the society in this way, using the knowledge of microbiology and epidemiology sciences at its center, as well as requiring the application of management science, and also taking into account the sociological and cultural characteristics of the society.
Outbreaks are situations that require more manpower and financial resources than those used in routine services. In this respect, outbreaks similar to disasters require the cooperation of all institutions, including the Ministry of Health, the Ministry of Interior and all other public institutions, including non-governmental organizations. In extraordinary situations, cooperation between institutions will make it possible to obtain the highest level of efficiency from the works to be carried out in line with the possibilities and roles of each institution.
Parties to cooperation should cover all elements of the fight against epidemics, especially public institutions and organizations. The cooperation mentioned in the face of this devastating epidemic has to be a real and strong cooperation. Providing municipalities to participate in all epidemic processes in all provinces, especially in Istanbul, ensuring participation in decision-making processes and mobilizing their possibilities is essential for epidemic control.
KEY ROLE TO COMMUNICATE COMMUNICATION, AGE MANAGEMENT AND REDUCTION OF SOCIAL ANXIETY
Communication is an important concept as much as collaboration in outbreak management. As stated by the World Health Organization, outbreak communication should be part of the outbreak management plan.
Outbreak communication includes transparent and reliable information, informing the society about risks correctly, not presenting the risk in a lighter or exaggerated way.
The messages should be simple and short because individuals have difficulty remembering all of the information, tend to misunderstand and accept the wrong information correctly, and individuals tend to continue their old habits and tend to accept information that complies with their belief values.
It is important to reach fast information during the outbreak. However, the tendency to believe in speculative messages increases in the lack of information or partially during information. This usually results in rumors and gossip dissemination of qualified information. For these reasons, information should be transparent.
Another important point is “uncertainty”. Uncertainty worries individuals and leads to unrealistic decisions. Managers should not make decisions that increase uncertainty. Explaining the curfew to the last 2 hours increased this uncertainty.
Uncertainty has a great effect on the increase of our anxiety during the epidemic process. Situations that will increase tolerance of uncertainty are that managers share the ban and rules with the community in a planned and programmed way. Since sudden, rapid and sudden decisions cause loss of control along with uncertainty, individuals try to take control in order to deal with anxiety, and they can display risky behaviors for themselves and the society.
Another important point in epidemic communication is that information is provided by the people who manage the process. statement made by the institutions that govern regular outbreaks of the Ministry of Health in Turkey, is a positive example of communication with the public, but there are still aspects that need improvement.
It is true that the COVID-19 pandemic experienced has more effects on society than many other epidemics. The only cause of anxiety that occurs in the society is not the threat of disease transmission, there are also economic and social dimensions of anxiety. Taking this whole picture into consideration, a transparent process that will create trust in the society should be carried out, where people do not doubt about the impact and reality of the announced decisions.