YEDİ ÜLKENİN COVID-19 TEST SAYILARI VE TEST YAPMA KONUSUNDAKİ YAKLAŞIMLARI

Öz

Bu çalışmada Türkiye, İtalya, Birleşik Krallık, Almanya, Güney Kore, ABD ve İzlanda’nın SARS-CoV-2 test sayılarının ve stratejilerinin incelenmesi, bunun yanı sıra test sayısı ve stratejilerinin salgının seyrine etkisinin değerlendirilmesi ve bu yolla da test uygulamalarının salgın mücadelesindeki olası katkılarının belirlenmesi amaçlanmıştır. Yedi ülkenin gelişmişlik, eşitsizlik, gelir düzeyi, nüfus, sağlık harcaması, sağlık personeli sayısı, sağlık hizmetlerine erişime ilişkin verileri çeşitli veri tabanlarından elde edilmiştir. COVID-19 ile ilgili 15 günlük aralıklarla hesaplanan salgın istatistikleri, 1 Haziran 2020 itibariyle test sayısı, vaka ve ölüm sayılarını yansıtan değişkenler ve test stratejileri kullanılmıştır. Salgının 15., 30., 45. ve 60. günlerinde en fazla toplam vakaya sahip olan ülke Türkiye’dir. Milyon kişiye düşen test sayısı İzlanda’da 15, 30, 45 ve 60. günlerde diğer ülkelerden daha fazladır. Toplam test sayısı içindeki pozitiflik yüzdeleri bakımından Türkiye 15. ve 30. günlerde, İtalya ise 45. ve 60. günlerde birinci sıradadır. Vaka başına test sayısı 15. ve 30. günde Birleşik Krallık’ta, 45.günde Almanya’da, 60. günde ise Güney Kore’de en yüksektir. Güney Kore 1 vaka başına 80 test yapmıştır. Almanya’nın test kapsayıcılığı  tüm bölgeler için geçerli olmasa da diğer ülkelerden daha geniştir. Milyon kişiye düşen toplam test sayısı açısından İzlanda, Birleşik Krallık ve İtalya; vaka başına test sayısı açısından ise Güney Kore, İzlanda ve Almanya daha olumlu bir tablo çizmektedir. Almanya, Birleşik Krallık ve Güney Kore risk gruplarını daha büyük oranda kapsayan test stratejilerini uygulamaktadır. COVID-19’la mücadelede testlerin erken dönemde ve geniş kapsamlı kullanımı başarıyı getiren en önemli faktörlerdendir. Tanı koyma kapasitesi salgın kontrolünün anahtarıdır.

Anahtar Kelimeler

• COVID-19
• test
• sayı
• strateji

COVID-19 TEST NUMBERS AND APPROACHES TO TESTING OF SEVEN COUNTRIES

Öz

In this study, it is aimed to examine the number of SARS-CoV-2 tests and strategies of Turkey, Italy, United Kingdom, Germany, South Korea, the USA and Iceland, as well as to evaluate the impact of the number of tests and strategies on the course of the epidemic, and in this way to determine the possible contribution of test practices to the outbreak. Data of the seven countries on development, inequality, income level, population, health expenditure, number of health personnel, and access to health services were obtained from various databases. Outbreak statistics calculated at 15-day intervals regarding COVID-19, variables that reflect the number of tests, number of cases and deaths as of June 1, 2020 and test strategies were used. Turkey had the most total cases on the 15th, 30th, 45th and 60th days of the outbreak. The number of tests per million people was higher in Iceland than the other countries on the 15th, 30th, 45th and 60th days. In terms of positivity percentages in the total number of tests, Turkey was the first on the 15th and 30th days, while Italy is the first on the 45th and 60th days. The number of tests per case was highest in the UK on the 15th and 30th day, in Germany on the 45th day and in South Korea on the 60th day. South Korea conducted 80 tests per 1 case. The test coverage of Germany was wider than other countries, though not in all regions. In terms of the total number of tests per million people Iceland, the United Kingdom and Italy; in terms of the number of tests per case South Korea, Iceland and Germany seem more positive. Germany, UK and South Korea apply test strategies that cover risk groups to a greater extent. The early and wide-ranging use of tests in the fight against COVID-19 is one of the most important factors that bring success. The capacity to diagnose is the key to outbreak control.

Anahtar Kelimeler

• COVID-19
• test
• number
• strategy

Kaynakça

1. 1. National Health Commission of the People’s Republic of China main website. [cited 2020 Jan 22]; Available from: https://www.nhc.gov.cn
2. 2. Cevik M, Bamford CGG, Ho A. COVID-19 pandemic-a focused review for clinicians. Clin Microbiol Infect 2020;26:842–7. doi:10.1016/j.cmi.2020.04.023
3. 3. Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. International Journal of Infectious Diseases 2020;92:214-7.
4. 4. Wu YC, Chen CS, Chan YJ, Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc 1097;2020; 83(3):217-20.
5. 5. Europa.eu [cited 2020 Sep 22]; Available from: https://www.ecdc.europa.eu/en/geographical-distribution-%202019-ncov-
6. 6. Laboratory testing strategy recommendations for COVID-19. [cited 2020 May 22]; Available from: https://apps.who.int/iris/bitstream/handle/10665/331509/ WHO-COVID-19-lab_testing-2020.1-eng.pdf.
7. 7. World Health Organization [cited 2020 Sep 22]; Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---16-march-2020.
8. 8. Differences between screening and diagnostic tests and case finding. [cited 2020 Jan 22]; Available from: https://www.healthknowledge.org.uk/public-health-textbook/disease-causation-diagnostic/2c-diagnosis-screening/screening-diagnostic-case-finding.

9. 9. Salathé M, Althaus CL, Neher R, Stringhini S, Hodcroft E, Fellay J, et al. COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation. Swiss Med Wkly 2020;150:w20225. doi:10.4414/smw.2020.20225
10. 10. Ai T, Yang Z, Hou H. Correlation of chest CT and RT-PCR testing in coronavirus Disease 2019 (COVID-19) in China: a report of 1014 cases [e-pub ahead of print. Radiology 2020;296(2):E32-40.
11. 11. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, vd. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 2020 Mar 11;323(18):1843–4. doi: 10.1001/jama.2020.3786. Epub ahead of print. PMID: 32159775; PMCID: PMC7066521.
12. 12. Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med. 2020;58(7):1070-6. doi:10.1515/cclm-2020-0285
13. 13. Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St George K, et al. Report from the American society for microbiology COVID-19 international summit, 23 march 2020: Value of diagnostic testing for SARS-CoV-2/COVID-19. MBio 2020;11. https://doi.org/10.1128/mBio.00722-20.e00722-20.
14. 14. Tang YW, Schmitz JE, Persing DH, Stratton CW. Laboratory Diagnosis of COVID-19: Current Issues and Challenges. J Clin Microbiol. 2020;58(6):e00512-20. Published 2020 May 26. doi:10.1128/JCM.00512-20
15. 15. Zhao R, Li M, Song H, Chen J, Ren W, Feng Y et al. Early detection of SARS-CoV-2 antibodies in COVID-19 patients as a serologic marker of infection. [published online ahead of print, 2020 May 1]. Clin Infect Dis. 2020;ciaa523. doi:10.1093/cid/ciaa523
16. 16. Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis [published online ahead of print, 2020 Feb 27]. J Med Virol. 2020;10.1002/jmv.25727. doi:10.1002/jmv.25727
17. 17. Castro R, Luz PM, Wakimoto MD, Veloso VG, Grinsztejn B, Perazzo H. COVID-19: a meta-analysis of diagnostic test accuracy of commercial assays registered in Brazil. Braz J Infect Dis. 2020;24(2):180-7.
18. 18. OECD Health Data [cited 2020 Sep 22];Available from: https://data.oecd.org/
19. 19. World Bank [cited 2020 Sep 22]; Available from: https://data.worldbank.org/
20. 20. United Nations (UN) [cited 2020 Jun 22]; Available from: https://data.un.org/
21. 21. European Centre for Disease Prevention and Control (ECDC) [cited 2020 Jun 22]; Available from: https://www.ecdc.europa.eu/en/covid-19-pandemic
22. 22. WHO Regional Office for Europe, the European Commission, and the European Observatory on Health Systems and Policies. COVID-19 Health System Response Monitor [cited 2020 Jan 22]; Available from: https://www.covid19healthsystem.org/mainpage.aspx
23. 23. T.C. Sağlık Bakanlığı COVID-19 Pandemisinde Normalleşme Döneminde Sağlık Kurumlarında Çalışma Rehberi [cited 2020 Jun 22]; Available from: https://covid19bilgi.saglik.gov.tr/depo/rehberler/normallesmedoneminde-saglik-kurumlarinda-calisma-rehberi
24. 24. Korea Centers for Disease Control and Prevention. KCDC [cited 2020 Jan 22]; Available from: https://www.cdc.go.kr/cdc_eng/
25. 25. United Kingdom Government. Coronavirus (COVID-19): getting tested. [cited 2020 Jun 22]; Available from: https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested#who-can-be-tested
26. 26. Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, et al. Spread of SARS-CoV-2 in the Icelandic population. N. Engl. J. Med. 2020;382:2302–15. doi:10.1056/nejmoa2006100.
27. 27. Government of Iceland. Testing for international arrivals could start in June [cited 2020 Jan 22]; Available from: https://www.government.is/diplomatic-missions/embassy-article/2020/05/12/Testing-forinternational-arrivals-could-start-in-June/
28. 28. Overview of Testing for SARS-CoV-2 CDC [cited 2020 Jun 22]; Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testingoverview.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fclinicalcriteria.htm
29. 29. Robert Koch Institut. Meldung an zuständiges Gesundheitsamt COVID-19 Verdacht: Testkriterien und Maßnahmen Ambulantes Management möglich? [cited 2020 Jun 22]; Available from: h t t p s : / / w w w . r k i . d e / D E / Content/InfAZ/N/Neuartiges_Coronavirus/Massnahmen_ Verdachtsfall_Infografik_DINA3.pdf__blob=publicationFile
30. 30. T.C.Sağlık Bakanlığı COVID-19 Rehberi Genel Bilgiler Epidemiyolojik Ve Tanı Rehberi [cited 2020 Jun 2]; Available from: https://covid19bilgi.saglik.gov.tr/depo/rehberler/covid-19-rehberi/COVID19_REHBERI_GENEL_BILGILER_EPIDEMIYOLOJI_VE_TANI.pdf
31. 31. Aktuelle Daten und Informationen zuInfektionskrankheiten und Public HealthEpidemiologisches Bulletin 17 2020. Robert Koch Institut. [cited 2020 Jun 22]; Available from:https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Ausgaben/17_20.pdf?__blob=publicationFile
32. 32. OECD iLibrary Health at a Glance 2019: OECD Indicators [cited 2020 Jun 22]; Available from:https://www.oecdilibrary.org/social-issues-migration-health/health-at-a-glance-2019_4dd50c09 en;jsessionid=tLg864_ehjy5YNriFJpvKLSg.ip-10-240-5-25.
33. 33. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science (80-) [cited 2020 Jun 22]; Available from: https://science.sciencemag.org/content/368/6490/489.
34. 34. Reis RF, de Melo Quintela B, de Oliveira Campos J, Gomes JM, Rocha BM, Lobosco M, et al. Characterization of the COVID-19 pandemic and the impact of uncertainties, mitigation strategies, and underreporting of cases in South Korea, Italy, and Brazil. Chaos Solitons Fractals 2020;136:109888.
35. 35. Choi JY. COVID-19 in South Korea [Internet]. C. 96, Postgraduate Medical Journal. BMJ Publishing Group; 2020 s. 399–402. [cited 2020 Jun 22]; Available from: http://pmj.bmj.com/
36. 36. Government objectives and actions Iceland's response. [cited 2020 July 18]; Available from:https://www.covid.is/categories/ icelands-response.
37. 37. COVID-19 in the USA: a question of time [Internet]. C. 395, The Lancet. Lancet Publishing Group;s.1229. [cited 2020 Jun 22]; Available from: https://pubmed.ncbi.nlm.nih.gov/32305080/
38. 38. Cheng MP, Papenburg J, Desjardins M, Kanjilal S, Quach C, Libman M, et al. Diagnostic Testing for Severe Acute Respiratory Syndrome–Related Coronavirus 2. Ann Intern Med 172(11):726–34. https://www.acpjournals.org/doi/10.7326/M20-1301
39. 39. Cohen J, Kupferschmidt K. Countries test tactics in 'war' against COVID-19. Science. 2020;367(6484):1287-8. doi:10.1126/science. 367.6484.1287
40. 40. Lorenzoni G, Lanera C, Azzolina D, Berchialla P, Gregori D, COVID19ita Working Group. Is a more aggressive COVID-19 case detection approach mitigating the burden on ICUs? Some reflections from Italy. Crit. Care 2020;24:175.
41. 41. Iacobucci G. Covid-19: What is the UK’s testing strategy? BMJ.;368:m1222. [cited 2020 Jun 22]; Available from: https://pubmed.ncbi.nlm.nih.gov/32217754/
42. 42. Coronavirus (COVID-19) Infection Survey pilot - Office for National Statistics. [cited 2020July22]; Available from: https: //www.ons.gov.uk/peoplepopulationandcomm u n i t y / h e a l t h a n d s o c i a l c a r e /conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/england25june2020/
43. 43. World Health Organization. COVID-19 -virtual press conference - 30 March 2020. [cited 2020 July 22]; Available from:https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-full-30mar2020.pdf?sfvrsn=6b68bc4a_2/
44. 44. Goverment of Iceland. Large scale testing of general population in Iceland underway .[cited 2020 May 22]; Available from: https://www.government.is/diplomatic-missions/embassy-article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/ Erişim Tarihi: 25 Mayıs 2020
45. 45. Ministero della Salute. AGGIORNAMENTO. [cited 2020 May 22]; Available from: http://www.salute.gov.it/imgs/C_17_notizie_4877_0_file.pdf
46. 46. Kwon KT, Ko JH, Shin H , et al. Drive-Through screening center for COVID-19: a safe and efficient screening system against massive community outbreak. J Korean Med Sci 2020;35:e123.doi:10.3346/jkms.2020.35.e123
47. 47. Hyun-tai S. Korea’s evolving virus tests from drive-through to walk-through. [cited 2020 May 29]; Available from: www.koreabiomed.com/news/articleView.html?idxno=7767
48. 48. Watson I, Jeong S. South Korea pioneers coronavirus drive-through testing station. [cited 2020 May 29]; Available from: https://edition.cnn.com/2020/03/02/asia/coronavirus-drive-through-south-korea-hnk-intl/index.html