Doctors’ union: Testing is key to flatten COVID-19 curve in Turkey

Turkey has reached a critical phase in its struggle with the coronavirus. The country, which recorded its first diagnosed case on March 11, announced the first death of a patient from the illness a week later, and the number of deaths has continued to rise since.

Experts from the Turkish Medical Association (TTB), the trade union representing most of Turkey’s doctors, have voiced their concerns about the deadly virus, but many of their recommendations have gone unheeded, TTB General Secretary Dr. Bülent Nazım Yılmaz told Ahval in an interview.

Instead, the government waited until a late stage to implement a partial lockdown that keeps elderly and vulnerable people at home. But it is still lagging far behind in testing, the key measure it should be taking, said Yılmaz.

What can we say about the current situation of the coronavirus in Turkey?

“We should start by saying that Turkey’s struggle with the virus did not start poorly. It took the necessary precautions at the earliest time. For example, it detected 65 passengers on a plane coming from China as being at risk and quarantined them in Ankara immediately. This was a very significant move.

“Then, the virus spread to Iran. The number of cases there rose, and the deaths started. At this point, Turkey was unfortunately late taking the necessary measures, likely over fears that its trade and other relations could suffer.

“At that stage, from mid-January to February, travel with foreign countries was still continuing.

“The virus first emerged in China in December. We at the TTB kept calling for measures back then, but sadly our calls were ignored. Then, the pandemic spread to European countries.”

What kind of measures could we have taken in January and February?

“At that point we could have imposed tighter controls on the traffic coming to Turkey from European countries, testing people and isolating those who were found to be at risk. But we didn’t, and more importantly, we didn’t take protective measures either.”

Was it only travel from Europe that affected us?

“No. The really hard blow for Turkey came from those returning from Umrah, the religious pilgrimage to Saudi Arabia’s holy cities – especially those who came back before March 8. That was a group of between 8,000 and 10,000 people.”

Weren’t there any precautions taken for these returnees?

“All they did was take their temperatures and ask them to stay at home for 14 days, but they did not sufficiently monitor them. The Health Ministry itself has said as much, in its own way.

“If the pandemic is a risk to Turkey today, the main reason for that is that we lacked sufficient precautions for those thousands who returned from Umrah before March 8.”

So, if those people had been placed in quarantine, the situation today would be under better control?

“That’s what we think, yes. There were likely people suffering from the coronavirus among that group, and since they weren’t placed under quarantine, anyone who came into contact with them may have caught the virus. In other words, the virus’s spread traces, in large part, back to this group.

“If you cannot prevent the spread of this virus, any intervention becomes very difficult. They say that a single person can put 625 people at risk, or more. And the number of people it spreads to rises exponentially.

“This was the same mistake that both Italy and Spain made: They are paying the price for not taking the necessary measures in time.

“But Germany and South Korea have shown the world two success stories on dealing with the virus.

“Germany, for instance, is very disciplined on this. It tested many people and placed many in isolation, halting the spread of the virus from the very beginning. The strength of the country’s health service has played its role in this as well, of course. Then, after the early days, they set limits on social life to prevent the virus from spreading.

“South Korea has been successful in a similar way. Both countries tested large numbers of people in the early days and found people who had the virus, then isolated them to stop it from spreading.”

Does a larger number of tests prevent the virus from spreading?

“It does, because it is very important to identify who is sick and who is carrying the virus early. If you do, and you place them in quarantine, then you will have in large part contained it.

“We have called for more testing centres and for many more people to be tested for almost two months, because you’ll have success if you find the people with the virus.

“The situation that has emerged in Turkey has proven us right. Today alone, we should be testing at least 40,000 people.”

But the number of tests the Health Ministry is administering has been going down…

“The Health Ministry said this week it had conducted around 20,000 tests so far. This is a very low number. You’re talking about 20,000 tests in two weeks since the first diagnosis. This is about half the number of tests we have advised the government to administer in one day. They should test more people as a matter of urgency

“And, another vital thing they should be doing is to stop citizens from going to hospital or healthcare facilities unless they have a serious medical issue. This is both so they do not keep doctors busy and so they do not get sick. Otherwise our health system will not have the capacity to deal with the pandemic.

“People who feel really unwell should not go to hospitals, instead health workers should go to them, but this requires organisation.”

At this stage, who is it most vital to be testing?

“Everyone who has returned from Umrah and everyone who they have been in contact with should be tested and isolated urgently. It is still not too late for this.

“This could be achieved in one or two days. But if there is a further delay in testing these people, it will be much too late.

“So, the next one or two weeks are very important. If the number of people who are tested and isolated does not rise, the situation could get much worse.

“Besides potential patients, health workers too must be tested, because hospitals are where the epidemic spreads and they are the most at risk.

“We need tests quickly and we need to see their results. Then we can get things under control.”

Hasn’t the government listened to your advice?

“We can’t say that. The board that is looking at the coronavirus has paid attention to our advice and shared it, but we did not see any reaction from the officials implementing policy.

“For a long time, the TTB has had very limited links to the Health Ministry, with nothing at the ministerial level, but recently we have had meetings with the ministry, and this is important. At the moment, some of our advice is being implemented, but it is not enough.”

Is a full lockdown necessary?

“You’d be making a mistake to reduce the issue to a lockdown alone. That includes the curfew in place for people over 65, since those who are younger and living with them can still go out. In Spain and Italy, they imposed a lockdown, but we have seen that this has not solved the problem.

“The most important measure we can take is discipline. Who you isolate is important. It will not do if you keep people over 65 years old at home, but you allow those aged 40 or 50 who have come back from Umrah, or from Europe to continue mixing with society without testing them.”

 

© Ahval English

The views expressed in this column are the author’s and do not necessarily reflect those of Ahval.

The opinions expressed in this column are those of the author and do not necessarily reflect those of Ahval.