The four horsemen of the apocalypse and the covid-19 soup

One of the most serious pandemics in human history has occurred in the past three years. The spread of COVID-9 continues, although its ability to cause deadly disease is decreasing. On the other hand, measures related to COVID-19 have been lifted in all countries due to economic, political and social reasons. As people were tired of isolation and wearing masks, they forgot all the precautions with a sudden relief and flocked to crowded environments. Since our immune systems were unprepared after three years of protection, we came across viral upper respiratory tract infections frequently in this period after suddenly re-contacting with microbes.

Winter is ahead and people will spend more time indoors and in crowds. It is a known fact that the spread of infectious diseases in closed and crowded environments is increasing. In recent weeks, World Health Organization President Ghebreyesus and US President’s health adviser Anthony Fauci warned that the epidemic will increase and even more deadly mutations may appear in the coming days.

The newly emerged BQ-1, BQ-1.1, BBX variant in the US has increased twelvefold in the past month. These variants accounted for 20% of COVID-19 patients in NY and New Jersey. For this group of new subvariants of Covid-19-Omicron variants COVID SOUPIt was named (Covid soup) and it is estimated that there will be epidemics with these microbes in the coming winter period.

We have information that the new epidemic has spread to many parts of the world, even to the Antarctic continent. It has been reported that a serious number of virus transmission and deaths have started again in Latin American countries. In China, isolation has begun as a result of the serious spread of Covid in certain regions, including the capital Beijing. It is estimated that the highly contagious BA.5.2 sub-variant of Omicron is effective in the last wave of epidemics in which cases have increased across the country. Here, a total of 13 million people were re-quarantined for a week and retesting was required.

Respiratory syncytial virus (respiratory syncytial virus) in pediatric hospitals in Europe, Canada, and the United States in the past two months RSV A significant increase has been reported in the number of pediatric patients hospitalized with the diagnosis of RSV is a viral upper respiratory tract disease that can cause serious complications in children and individuals over the age of 65. This virus causes the death of around 160,000 people annually in the world, and 100,000 of them are children under the age of five.

H5N1 (bird flu) in England at the end of October influenza epidemic broke out. It is reported that the number of swine flu cases has doubled in the last year compared to the previous year all over the world. It has been reported that influenza epidemics have increased in the last month in many countries, especially in the United States and Latin American countries. It has been determined that approximately 25% of these occur with the H3N2 variant. Because COVID-19 is so current and we have personally experienced the disaster, there is fear of it. But influenza can be much more dangerous, and indeed there have been many deadly influenza pandemics across the globe in the past. It has been determined that 6.6 million people have died due to COVID-19 so far. However, it is estimated that around 40-50 million people died during the 1918 Spanish flu.

The influenza and RSV epidemic started one month earlier than it should have been every year. These outbreaks are more widespread than ever, and it is reported that the disease-causing capacity of existing viruses and hospitalization rates are high. In a recent study, it was reported that the coexistence of two viruses creates a hybrid form and this form can easily get rid of the body’s defense system.

In addition to these, it peaks in winter and spring every year. ADENOVIRUS it started to be seen earlier this year and has been instrumental in increasing the patient density in pediatric outpatient clinics. This virus can affect all systems of the body and cause disease characterized by nausea-vomiting, fever, weakness, sore throat, eye inflammations. Unlike influenza and RSV, both the incubation period and the duration of the disease are twice as long. Especially eye infection can cause very serious and permanent complications.

The increase in influenza (flu), respiratory syncytial virus (RSV) and adenovirus cases with COVID-19, which has increased again in countries QUADRUPLEDEMIC (quadruple epidemic). The common point of all these virus diseases is that their symptoms are almost very close to each other and therefore it is very difficult to distinguish them.



In the early stages of the COVID-19 pandemic, when the vaccine was not available, social distancing, masks and hand hygiene were applied as the first steps to prevent and control the transmission of the disease, and until a vaccine was found, success was achieved to a certain extent.

Especially COVID-19, cold and flu, chickenpox, measles, rubella, mumps, meningitis, diphtheria and tuberculosis are diseases transmitted by airway and droplet. Germs spread through the air during speaking, breathing, coughing and sneezing. During a strong sneeze, droplets or aerosols one hundred times smaller in size are scattered in the air at a distance of 1.5 meters and remain suspended in the air for an average of three hours. In the meantime, the individual being sick after contact with the microbe suspended in the air depends entirely on the immune resistance of his body. In this context, SOCIAL DISTANCE gains importance in closed spaces and crowded environments during the seasons when the risk of infection increases.

Adequate social distancing reduces the transmission of the disease, but in closed environments and crowded areas where adequate social distancing is not possible, such as in hospitals, schools, public transport, restaurants, cafes and elevators, MASK is likely to reduce the spread of virus-laden droplets and airborne aerosols. We have observed in our own practice that the rate of influenza and cold transmission has decreased significantly in the last three years in those who wear face masks to protect against COVID-19. In a study conducted in Japan, it was reported that there was a significant decrease in the incidence of airborne infective diseases during that period in individuals who wore masks during COVID-19 infection.

Studies have shown that the vast majority of infections are transmitted from person to person through hand contact. Therefore, hands are accepted as vectors of infectious diseases. HAND HYGIENE is more important, especially when in communal areas; Avoid touching door handles, faucet handles, toilet seats, hand grips in public transport, elevator buttons and grocery carts, because millions of microbes stick to them and continue to multiply because hundreds of hands touch them in a day. Numerous studies have shown that microbes can survive and multiply on hands for a long time. Proper hand hygiene and not shaking hands significantly reduce the risk of transmission of germs, as dirty hands can easily transmit infections. During the deadly Covid-19 pandemic, handshaking was considered a serious health hazard due to its capacity to spread infection severely and was strongly recommended to be abandoned at that time.

The most effective and rational method in the fight against infectious diseases is to prevent the spread of the disease and to take measures to avoid getting sick. Considering that sick individuals have the potential to transmit the microbe to people around them for about seven days, starting at least one day before the onset of symptoms, it is of unlimited benefit for these people to isolate themselves from the society during this period. In adenovirus infection, this period should be doubled.