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Why you should not require a test for the first symptoms of a cold and how strict quarantine is justified: says the infectious diseases doctor Fedor Lapiy

Ukraine tightens quarantine day by day in connection with corona virus. It all started with the harmless transfer of schools to distance learning, the closure of entertainment areas in shopping centers and cinemas. Then the authorities announced the 
termination of flights with other countries. And today, President Zelensky called for a stop on the metro in Kiev and a ban on any passenger traffic between cities.
Is it a bust - for a country in which only five cases are officially registered (after the publication of the interview, the number of cases increased to seven, in Kiev two 

people confirmed the disease) corona virus And is it worth it to seek a corona virus test with the first symptoms asked these questions to the famous infectious disease specialist , associate professor of the Department of Pediatric Infectious Diseases and Pediatric Immunology of the Shupik National Medical Academy - Fedor Lapiy

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- How justified is the tightening of quarantine measures in Ukraine, up to the closure of borders and the metro? This is not too much
- I don’t think that there is a political element here, as it was in 2014, when the metro was constantly “mined” during the Maidan, or in 2009, when a pandemic influenza virus came before the presidential race. Although I am not a sympathizer of Zelensky and his political strength, but these measures, I believe, are absolutely justified. Our task is, taking into account the capabilities of our healthcare system, to delay the number of patients to the maximum and avoid the simultaneous spread of the virus, as it was in Italy. It’s just that at our place people first see the zrada in the fact that the metro works and there are many people who breathe in each other’s faces, and then they see the zrada in what they heard and the metro closes. Now it is important to distinguish between contacts and keep a distance to other people more than a meter. Metro at rush hour is not the best barrier to infection.

- According to the Ministry of Health, Ukraine has purchased a test system to

 identify a new coronavirus, which is enough to examine 960 people. In Kiev, they were assigned to seven clinics. Is this quantity enough, in your opinion
- The question is how much they are needed at all and for what. Sweden said it was refusing to be diagnosed because it does not matter for the management of the patient. Quoting the Swedes, “we know that there is coronavirus in Sweden, and we must respond to every case as if it were a potential coronavirus infection.” There are no specific medicines for coronavirus Most patients who have a mild course of the disease need only self-isolation, as with the flu. Sick - stay at home. Perhaps it makes sense to do such tests in clinics in intensive care units. To say: yes, we have such, here is the confirmation.
- That is, there is no sense in testing Ukrainians without a trace, with the slightest symptoms of viral diseases?
- To talk about the universal use of tests, what I wanted, went and did - there really is no point in this. There is a PCR method that requires qualified personnel, equipment and a competent assessment, otherwise there is a risk of a pseudo-positive option. There are rapid tests for the determination of immunoglobulin M and G, here we must determine the immune response to the virus. And the answer is delayed. That is, this test for those who are only infected and are at the beginning of the disease is not informative.
These rapid tests would be appropriate for a scientific approach from an epidemiological point of view. When a random sample is made, by the principle of exit polls in elections, people from different age groups for a certain period, and the test results make it possible to determine that conditionally 15-20-30% of Ukrainians have already met with coronavirus.
I emphasize once again that tests can give pseudo-results. And frankly, I have a concern about their fakes . I can even tell you how it can be. Pregnancy tests are redeemed, labeling is changed and passed off as coronavirus tests. It seems to me that scammers are already starting to do this, so here I do not suggest an idea, rather I warn.

If tests are done, is it better in those clinics to which they came from the Ministry of Health

- Yes, in which tests were imported on behalf of Ukraine. This does not mean that the tests give a 100% guarantee of the correct answer, but nonetheless we know that they are sourced from the state. Those samples that are taken in Ukraine are still selectively tested in reference laboratories. That is, the national laboratory of the Center for Public Health of the Ministry of Healthcare sends them for control testing abroad, to London, to make sure that the result in Ukraine is true.

In Britain, it is expected that up to 80% of the population will be infected with COVID-19 within a year Can this data be transferred to Ukraine

- Absolutely. And not only to Ukraine, to any other country. There are certain epidemiological reasons for this. There is such a thing as a reproduction index or a reproduction rate when it is believed that the population has an absolute perception of infection: for how many people one infected person can become a source of 

infection. For example, in measles, this index is from 12 to 18. That is, you will become a source of infection for 12-18 people, each of them will become a source of infection for 12-18 people, and so on down the chain. Based on this, calculations are made on collective immunity: for measles to be controlled, there should be 92-95% of the population with measles immunity. And we are trying to achieve this percentage coverage by vaccination.

If we talk about coronavirus, the reproduction index is 2. One person becomes a source of infection for the other two. When immunity appears in 80% of the population, it will be very difficult for it to be transmitted from person to person, and the outbreak will decline. But let's be honest. Yes, we can achieve a quick immune layer due to the fact that we will not resist the outbreak - no quarantines. The question is, at what 

cost? If mortality reaches 20% in older people, are we ready to sacrifice, sorry for such a rude word, these people? I do not share the opinion that in the name of collective immunity we must make so many sacrifices: when, having one ventilator and three patients who need it, you can provide ventilation for only one, and refuse the others. It's just about that reducing the load will allow a more rational use of resources. Here it is possible to treat the authorities with sympathy or antipathy, but nevertheless these measures justify themselves so that we do not find ourselves in a deep crisis.

Five people in Ukraine infected with corona virus - do you believe this figure? Or, since we are not testing everyone, we don’t know

I believe that five people in Ukraine have a confirmed corona virus. And I don’t think that someone is trying to specifically hide information from us. But, of course, corona virus is also beyond diagnosis. And it is spreading. This information is sufficient at this stage.

 In Ukraine, there have already been cases of advertising mythical drugs from corona virus. Why can’t you believe such an advertisement

Fraudsters are trying to make money in a panic. Once again I draw attention to: there are no drugs that would act on the corona virus in the body. When they begin to claim that they have investigated the drug, and it kills the virus outside the body  Well

listen, you use 60% alcohol-containing solutions to treat your hands or wash them with soap and water. But you do not breathe soap or alcohol, do not fill them in the lungs? Because this will damage the airways. This question is not so much for ordinary Ukrainians as consumers of this fake product, but for colleagues either have a conscience, or don’t rubbish. Or 

Ukrainians, do not buy medicines in pharmacies, they are ineffective. Officials and businessmen, help Ukrainian medicine and Ukrainian hospitals with ventilators. You can’t help with the devices - help with the means for processing hands, it is very effective. Help buy a mask or buy a respirator. This will count towards you.

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