While gradually toughening measures against the COVID-19 outbreak in Turkey, the government of President Recep Tayyip Erdogan appears bent on opacity in communicating with the public, a policy it has followed since confirming the country’s first case on March 11.
On March 27, Erdogan announced the toughest restrictions yet, canceling all international flights, banning residents from traveling between cities via public transport and planes unless granted permission by local authorities and closing picnic sites on weekends, among other measures.
In what Erdogan described as the “most important point,” he said, “A decision has been enacted to meticulously implement these measures in all of Turkey’s 30 metropolitan cities, chiefly big cities such as Istanbul, Ankara, Izmir and Kocaeli. I’m not mentioning the others but only the 30 metropolitan cities for now.”
He was referring to 30 provinces whose local administrations with the status of “metropolitan municipalities.” Did Erdogan select Istanbul, Ankara, Izmir and Kocaeli because those four provinces are the worst hit by the outbreak? No official data is publicly available to confidently answer this question in the affirmative. One can only piece together hearsay and a few facts to guesstimate that the outbreak has likely reached serious proportions in Istanbul, Ankara, Izmir and Kocaeli. Deduction is the only option here because Erdogan’s government has been pursuing a policy of opacity in which the distribution of infections has been kept from the public as if a state secret.
That Ankara was following such a policy become obvious thanks to a video leaked from a prestigious hospital March 18, when the government's official count of the novel coronavirus pandemic stood at two deaths and 191 infections, a week after it confirmed the first case.
The video, which was taken secretly and quickly went viral on social media, showed a female physician briefing staff at the Ankara University’s Ibni Sina Hospital about the coronavirus outbreak. Deploring Turkey’s response to the pandemic, the physician, who was later identified as Dr. Gule Cinar, said, “It looks like we’ve got off to a bad start. We don’t know how it will go. We hope we don’t become another Italy.… The cases are now in the thousands, not in the hundreds as they say.”
In addition to putting the cases “in the thousands” while the official tally stood at 191, the doctor cited some of the provinces affected by the outbreak. “Istanbul got off to a very awful start, and Ankara, too, got off to an awful start,” she said. “There are cases in the east, in Van, as well as in Kayseri [in central Turkey].”
So, Cinar’s “situation report” — intended only for hospital staff but made public by an anonymous colleague of hers — was significant in not only contradicting the official number of cases, but also in identifying regions where the outbreak is more prevalent.
The leak of Cinar’s remarks was apparently deemed irksome in undermining the government’s policy of opacity, as Ankara University released an apology signed by Cinar on its Twitter account the following day. The statement referred to COVID-19 as an “impending infection epidemic,” suggesting that the cases in Turkey were not yet on the scale of an epidemic as of March 18. Cinar denied using “any rhetoric that is politically motivated and aimed at provoking [public] indignation,” concluding with an apology “to everybody” for “having caused a negative public perception.”
The doctor’s reference to rhetoric “aimed at provoking indignation” was the key element in her apology. The Turkish government has often used “situations that could plunge the public into fear and panic by causing indignation” as an excuse or justification for measures that are hard to defend on legitimate grounds. The same type of governing impulse has been afoot from the start of the coronavirus outbreak.
Remarks made March 24 by Health Minister Fahrettin Koca are a case in point on how this impulse manifests itself. “[The government] has avoided strategies and practices that could lead to panic and cause the [further] spread of the disease and has [thus] narrowed the extent of risk,” he asserted.
Koca did not elaborate on the said strategies and practices, and none of the journalists present asked him about them. Hence, it is up to observers to try to flag what strategies and practices Ankara has shunned in managing the COVID-19 crisis.
The first observation is that the government has avoided informing the public about the regions and provinces where COVID-19 cases and fatalities are on the rise. Similarly, it has withheld information about what measures, if any, are being taken in regard to the social circles of people with confirmed infections.
By keeping the names of the worst-hit cities and regions under wraps, the government shirks to a certain extent its responsibility to fully isolate and quarantine those settlements. Evading lockdowns and quarantines might slow economic damage in the short run, but Ankara's reluctance and procrastination are exacerbating the outbreak’s impact on public health.
Yet, how this opacity can contribute to the spread of the outbreak was recently on full display in Istanbul when tens of thousands of people, in the dark about the gravity of the threat they faced, flocked to the shores of the Bosporus and to picnic sites to enjoy the pleasant weekend weather as they would in normal times, paying little heed to social distancing and probably spreading the virus. Had those people been warned that Istanbul was a focal point of the outbreak, they hardly would have behaved so casually and put their families in danger.
Turkey’s lack of a free media is a great misfortune in the face of the government’s opacity. According to the 2019 Press Freedom Index by Reporters Without Borders, Turkey ranks 157th out of 180 nations, excelling in the category of countries whose media is “not free.” Without a mainstream media that can investigate, question, report and criticize, the government faces few obstacles in “successfully” implementing its policy of opacity, which can be defined as withholding as much information as possible from the public and thus releasing information in equally limited rubrics.
Even this policy, however, has been inconsistent. For instance, in a March 25 address to the nation, Erdogan spoke of 8,554 coronavirus patients receiving treatment in hospitals. Hours later, the health minister put the total number of patients at 2,433 on his Twitter account, which he has used to provide 24-hour updates on the number of new tests, confirmed cases and fatalities since March 11.
According to Sinan Adiyaman, head of the Turkish Medical Association (TTB), Koca’s tally represents only patients who have been tested for the coronavirus and were found to be positive, while Erdogan’s figure denotes “the total number of patients who have been diagnosed with COVID-19 in line with clinical and radiological findings and placed under treatment in hospitals.” It was Erdogan who gave the “true number of patients under treatment with a COVID-19 diagnosis,” Adiyaman said.
Yet Koca’s official update the following day perpetuated the inconsistency. The minister announced 1,196 new diagnoses, bringing the number of patients to 3,629 — still well below Erdogan’s tally. He also announced 16 new fatalities, which put Turkey’s death toll at 75.
While government officials offered no explanation as to why Erdogan and Koca’s figures differed, the TTB in a March 26 statement said that the number cited by the health minister was only the “tip of the iceberg.” Instead of making do with “Twitter messages of limited word count,” the TTB said, the Health Ministry should begin releasing detailed data on its official website, including breakdowns by a patient's city, age, gender and profession. In addition to figures on those who have tested positive for the virus, the ministry should also reveal the number of cases that are clinically and radiologically consistent with COVID-19, regardless of the results of their tests. The TTB warned, “People will remain insufficiently convinced of taking personal precautions, from hand washing to social distancing, unless they are adequately informed on how much the outbreak has spread among the public.”
Suspicions of a cover-up are not actually new. Emrah Altindis, a Turkish-born scholar at Harvard Medical School, for instance, raised such a doubt in an interview published March 21. Asked why Ankara would conceal the actual figures, he said, “A propaganda [campaign] is currently underway that the process is being managed very well. Until recently, the health minister claimed that Turkey had no cases and was boastful about that. They know this affair will have grave economic and political repercussions, so they are laying the ground to be able to say later they did their best. And are those in power doing their best? In my opinion, no.”
In his March 27 statement, Erdogan put the total number of cases at 5,698, matching Koca’s figure for the day. He did not bother to explain how the number had decreased from 8,554, the tally he had given two days prior.