D.med Turkey response to COVID-19 pandemic

A Message from our Medical Director on the COVID-19 Pandemic

MD_Turkey2

In the face of the COVID-19 pandemic, D.med Healthcare Turkey is committed to ensuring the health and safety of our patients, partners, and staff.

First of all, we made sure to get accurate information on the outbreak from reliable sources and kept all of our staff well informed.

Additionally, we provided personal protective equipment to our staff we prepared them for this situation to avoid any panic reactions or a misunderstanding of our hygiene plans.

Also, to manage anxiety disorders that may be caused by the epidemiological situation in the country and the rest of the world, we have provided a psychological support program for all employees. Here, I would like to thank the management team of D.med Healthcare Turkey for their full support.

As with the rest of the world, Turkey is going through strenuous days associated with COVID-19. We are aware that this virus poses a high risk to our dialysis patients. Therefore, as workers on the front lines of COVID-19, we are taking every precaution to ensure the safety of our entire dialysis chain in Turkey. The well-being of our patients and staff is our priority.

Today, I have full confidence that we will overcome these difficult days by sticking to our hygiene plans and instructions and always remembering that the epidemic is not over yet.

Finally, I am grateful for the dedication of our frontline health workers who selflessly give themselves to others. You are true heroes!

Notice to our Patients & their Families

We have taken all the necessary measures to protect our patients and to provide safe dialysis treatments. Please carefully check our regulations designed for:

People accompanying the patient

Due to the Coronavirus outbreak, we have taken a series of preventative measures to ensure the safety of our patients, our patients’ relatives, and our staff. Dialysis patients have the right to bring a companion during their dialysis treatment. However, if you are a companion of one of our patients, please refrain from assisting said patient unless the clinic responsible deems it appropriate. Our dialysis patients are in good hands. Our clinic staff regularly receives up-to-date training on COVID-19 infection control practices.

The waiting room

  • While staying in the waiting room, remember to maintain social distancing with others.
  • Review the “Patient Information Flyer” that will be available for you in the waiting area and take care to comply with the specified rules.
  • Use the protective equipment that will be provided to you by our personnel at the center.
  • Wash and disinfect your hands frequently as per our hygiene plans displayed at the center.
  • Only enter the treatment room once you have explicit permission from our personnel in charge.
  • Avoid physical contact with people as much as possible.
  • When sneezing and coughing, be sure to cover your nose/mouth with your elbow or tissue.

The dialysis center

  • Our medical team will check visitors for symptoms of COVID-19 at the entrance of our dialysis centers.
  • If you have a fever and respiratory difficulties, please inform your doctor at the dialysis center.
  • Try as much as possible to avoid direct contact with door handles, elevator buttons, and surfaces.
  • To lower the infection risk, we paused our meal service at the clinic. We suggest eating something before receiving your dialysis treatment.
  • Both at the arrival and when leaving the dialysis center, make sure to wash/disinfect your hands and fistula as per our displayed hygiene plans.

The patients receiving their dialysis at home

  • Track your supplies and medicines and give us a call as your provisions decrease.
  • Plan your exams and clinic visits by contacting the dialysis center with ample time beforehand.
  • Remember, even when at home, it is critical to continue social distancing of at least 1.5 meters during deliveries and other visitors.
  • Pay attention to your nutritional routine and physical activity.
  • Perform simple exercises with the advice of your doctor.
  • If you have any questions, please don’t hesitate to call the clinic at any time.

Q&A

The virus that causes COVID-19 most commonly spreads between people who are in close contact with one another (within about 6 feet, or 2 arm lengths).

It spreads through respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes.

  • These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads.
  • Droplets can also land on surfaces and objects and be transferred by touch. A person may get COVID-19 by touching the surface or object that has the virus on it and then touching their own mouth, nose, or eyes. Spread from touching surfaces is not thought to be the main way the virus spreads.

It is possible that COVID-19 may spread through the droplets and airborne particles that are formed when a person who has COVID-19 coughs, sneezes, sings, talks, or breathes. There is growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes). In general, indoor environments without good ventilation increase this risk.

COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in many affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected. (European Centre for Disease Prevention and Control).

The incubation period indicates the time from infection to the beginning of the disease. The mean incubation time (median) is given in most studies with 5-6 days. In various studies it was calculated at what time 95% of infected people had developed symptoms, with the 95th percentile of the incubation time being 10-14 days. (Robert-Koch-Institut).

People with COVID-19 have reported a wide range of symptoms – from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. If you have fever, cough, or other symptoms, you might have COVID-19. (European Centre for Disease Prevention and Control)

Rapid antigen tests (sometimes known as a rapid diagnostic test – RDT) detect viral proteins (known as antigens). Samples are collected from the nose and/or throat with a swab. These tests are cheaper than PCR and will offer results more quickly, although they are generally less accurate. These tests perform best when there is more virus circulating in the community and when sampled from an individual during the time they are most infectious. (WHO)

Currently, a variety of antigen tests for the detection of SARS-CoV-2 are offered (Robert-Koch-Institut)

To limit the risks of getting COVID-19 follow these basic precautions:

 

  • Follow local guidance. Check to see what national, regional and local authorities are advising so you have the most relevant information for where you are.
  • Stay at least 1 metre away from others, even if they don’t appear to be sick.
  • Wear a mask, especially when you can’t physically distance.
  • Manage your risks by thinking about location and setting of the event, proximity to others and time you will be at the event. In other words, consider where you are going, how close you will be to other people and how long you will be there. Avoid crowded places and events, poorly ventilated indoor locations and prolonged contact with others.
  • Open windows when indoors to increase the amount of outdoor air.
  • Avoid touching surfaces, especially in public settings, because someone with COVID-19 could have touched them before. Clean surfaces regularly with standard disinfectants.
  • Frequently clean your hands with soap and water, or an alcohol-based hand rub. If you can, carry alcohol-based rub with you and use it often.
  • Cover your coughs and sneezes with a bent elbow or tissue, throwing used tissues into a closed bin right away. Then wash your hands or use an alcohol-based hand rub (WHO).

Scientists around the world are working to find and develop treatments for COVID-19.

 

  • Optimal supportive care includes oxygen for severely ill patients and those who are at risk for severe disease and more advanced respiratory support such as ventilation for patients who are critically ill.
  • Dexamethasone is a corticosteroid that can help reduce the length of time on a ventilator and save lives of patients with severe and critical illness. Read our dexamethasone Q&A for more information.
  • Results from the WHO’s Solidarity Trial indicated that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appear to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
  • Hydroxychloroquine has not been shown to offer any benefit for treatment of COVID-19.

 

WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19. WHO is coordinating efforts to develop treatments for COVID-19 and will continue to provide new information as it becomes available (WHO)

Researchers are currently working on more than 200 potential vaccine candidates, with more than 40 vaccines already in clinical trials in healthy volunteers. All vaccine candidates are based on the basic principle of presenting parts (antigens) of SARS-CoV-2 to our immune system so that immunity to the pathogen can be built up. The different candidates use very different antigen parts and approaches. There are three main lines of development: Live vaccines with vector viruses, dead vaccines with virus proteins or mRNA/DNA vaccines. (Federal Ministry of Health)

 

Two manufacturers are currently applying for vaccine approval, Modena and Biontech/Pfizer.

People at increased risk include:

  • Older adults
  • People of all ages with certain underlying medical conditions
  • Pregnant people might also be at increased risk of severe illness from COVID-19.

(European Centre for Disease Prevention and Control).

Most people who get COVID-19 will be able to recover at home. CDC has directions for people who are recovering at home and their caregivers, including:

  • Stay home when you are sick, except to get medical care.
  • Use a separate room and bathroom for sick household members (if possible).
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
  • Provide your sick household member with clean disposable facemasks to wear at home, if available, to help prevent spreading COVID-19 to others.
  • Clean the sick room and bathroom, as needed, to avoid unnecessary contact with the sick person.

However, some people may need emergency medical attention. Watch for symptoms and learn when to seek emergency medical attention.

 

When to Seek Emergency Medical Attention:

Look for emergency warning signs for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

A contact is defined as anyone who had direct contact or was within 1 metre for at least 15 minutes with a person infected with the virus that causes COVID-19, even if the person with the confirmed infection did not have symptoms. Contacts should remain in self-quarantine during the 14-day monitoring period to limit the possibility of exposing other people to infection should they become ill.(WHO)

If you are a possible contact, you should first be contacted by phone or in person by health authorities to determine if you meet the contact definition, which is anyone who has had direct contact or was within 1 metre for at least 15 minutes with a person infected with COVID-19. If you are confirmed as a contact, you will then be encouraged and supported to be in quarantine, which means to separate yourself from others, and to monitor your health for any signs of illness. The monitoring ends 14 days you were last into contact with the person infected with COVID-19.

By participating in contact tracing, you are contributing to controlling spread of the virus that causes COVID-19 in your area; vulnerable people will be protected, and more restrictive measures, such as general stay-at-home orders, might be avoided or minimized. This is an act of solidarity for your community. (WHO)

Masks are a key measure to suppress transmission and save lives.

 

Masks should be used as part of a comprehensive ‘Do it all!’ approach including physical distancing, avoiding crowded, closed and close-contact settings, good ventilation, cleaning hands, covering sneezes and coughs, and more.

 

Depending on the type, masks can be used for either protection of healthy persons or to prevent onward transmission.