From the perspective of Dr. Nada Koluder Ćimić: The end of the match between the virus and humans is not yet in sight

(Patria) - Part of the PZU “Eurofarm Centar – Poliklinika” team, prim. prof. dr. sc. med. Nada Koluder Ćimić, specialist infectologist, gave an overview of the COVID-19 pandemic in our community on behalf of Eurofarm Centar.

COVID-19 is a planetary scourge that has seriously threatened humanity. It is caused by the SARS CoV-2 virus, whose biology and immunology we know little about. It belongs to the same family as SARS, MERS, but also common cold viruses. The virus has powerfully imposed itself with its strong potency, aggressiveness, and affinity for unprotected humans, which has led to its uncontrolled spread.

Is the coronavirus similar to the flu virus we are familiar with? What are its epidemiological and clinical characteristics?

Compared to the flu, the epidemiological picture is milder, but it is more dangerous because it is new, "invisible", and mainly transmitted by carriers, i.e., asymptomatic individuals, of whom there are about 90% in the population. The remaining elderly, hospitalized, chronically ill, as well as people with acute illnesses, are a huge problem in every community.

Namely, when a healthcare system encounters a large number of severely ill respiratory patients, and the candidates are primarily those just listed, then a large and constant pressure under which it breaks is inevitable. Such a dark scenario is being attempted to be avoided by taking certain, already applied hygienic-epidemiological measures, which certainly slow down the transmission of the virus.

This, among other things, included the isolation of those under 18, who are largely asymptomatic carriers, and those over 65, who would generally have severe forms of COVID-19 in contact with the coronavirus. Middle-aged individuals, the backbone of work processes, were excluded because it was assumed they would behave more responsibly regarding potential infection, and in case of COVID-19, they would generally develop mild to moderately severe clinical symptoms.

The measures taken in our community in the first phase of the epidemic seemed effective. However, increasingly frequent outbreaks of clinically clear infections and deaths speak of the silent omnipresence of an invisible enemy, whose deadly march cannot be stopped by measures of restricted movement, social distancing, hand washing, protective masks, gloves, and disinfection.

An evaluation of the coronavirus epidemic in our community at the present time clearly indicates a further upward exponential trend and the now mandatory urgent introduction of new measures. Therefore, ISOLATION, ISOLATION, ISOLATION should be supplemented with TESTING, TESTING, TESTING.

Based on exact indicators obtained through expanded, controlled, and further professionally indicated testing, i.e., active searching for infected individuals, epidemiologists would be able to predict the further dynamics of spread and the time of plateauing as a projection of flattening the trend line, when a gradual normalization of life would begin.

The expansion of testing in the field with reliable molecular-biological tests should be defined. It should include not only those with clinical symptoms but also targeted contacts, suspicious individuals, and those admitted to the hospital.

Ultimately, it should be said that with all these measures, the virus will not be overcome, but by slowing it down over time, we will either achieve "herd immunity" or gain precious time until the global production of a quality vaccine, which would prevent the further existence of the virus in the given population. The end of the match between the virus and humans is not yet in sight. Let's be reasonable and patient.