Turkey says rate of coronavirus infection stabilizes

The health minister sees signs the fast-spreading contagion is coming under control as the number of new cases remains steady. But an independent physicians’ group warns the government may be undercounting.

al-monitor Medical staff members applaud patients leaving Dicle University Hospital after recovering from COVID-19 in Diyarbakir, Turkey, April 15, 2020.  Photo by REUTERS/Sertac Kayar.

Apr 15, 2020

ISTANBUL — Turkey’s health minister said the coronavirus infection rate was stabilizing, showing the fast-spreading contagion may be under relative control, while the head of an independent medical group said the scale of the outbreak remained unclear because a majority of virus-related deaths were not being counted.

Turkey experienced its deadliest day so far after 115 people died, pushing the death toll to 1,518, according to a post on Twitter by Health Minister Fahrettin Koca. There were 4,281 new cases, which is roughly in line with or even slightly fewer than the daily cases confirmed since April 8, even as testing has nearly doubled over the week. Total cases now stand at 69,392.

“The rate of the increase in case numbers, as well as patients needing intensive care or respiratory support, is on a stable trajectory,” Koca said in the post. Late on Tuesday, he told a news conference the infection rate was leveling off after Turkey saw its fastest rate of transmission last week, the fourth week of the outbreak. “Under the current conditions, we are in the position of beginning to bring the virus’ transmission rate under control,” Koca said.

However, the World Health Organization warned Tuesday that Turkey and Britain still faced an acceleration in new cases, even as other European countries with large numbers of patients are beginning to see a respite. Turkey confirmed its first case of COVID-19 on March 11.

It was too early to for Turkey to contend it has the outbreak under control, in part because the diagnostic test is a lagging indicator and may only catch about 60% of positive cases, said Sinan Adiyaman, head of the Turkish Medical Association, at an online press conference.

“We receive information based on our members’ observations from across the country that [show] the figures for cases and deaths are far higher,” he said. One reason for the gap is those who died with COVID-19 symptoms but whose polymerase chain reaction (PCR) test was negative are excluded from the death toll. Turkey has opted against using a WHO-recommended code for probable COVID-19 cases with a negative PCR, he said.

“Unfortunately, COVID-19 does not appear as the cause of death on most death certificates” of patients who likely succumbed to the disease, Adiyaman said. “We do not see an ulterior motive, this is a preference. [But] it presents an obstacle for us to see the true scale of the cases [and] make accurate international comparisons.”

Turkey has introduced a slate of measures to curb the spread of the coronavirus, including sealing off entry to densely populated provinces, requiring the elderly and children to remain at home and instituting rolling lockdowns, including a second 48-hour weekend curfew for 31 cities starting at 11:59 p.m. Friday. Separately, the Interior Ministry said today that 227 residential areas across 58 provinces have been quarantined, affecting 251,726 people.

But a decision to keep workplaces open on weekdays makes curbing the outbreak difficult. Construction, which accounts for about 10% of economic output, is one business that has continued, albeit at reduced capacity, despite much of it being nonessential work during a pandemic.

“Workers can go out during the week, work under onerous conditions and the threat of the coronavirus, but sit at home at the weekend. This amounts to a part-time struggle against the coronavirus,” said Saruhan Oluc, deputy chairman of the opposition Peoples’ Democratic Party, who shared his remarks in an email. “In many provinces, workers are forced to continue working side by side, even when positive cases are confirmed.”

President Recep Tayyip Erdogan has said Turkey, which slipped into recession last year, does not have the luxury of cutting production further. Government spending rose by 16% last month, pushing the budget into a record deficit of 43.7 billion liras ($6.3 billion) in March, the Finance Ministry said Wednesday. The Turkish lira has lost 15% of its value against the dollar since the start of the year. 

The government has ruled out borrowing money from the International Monetary Fund, which has offered emergency financing to virus-hit nations. Turkey will likely find a lifeline from a friendly nation or take steps to limit outflows of capital, wrote Jason Tuvey, senior emerging markets economist at Capital Economics in London, in a research note.

“The political backdrop means that [an IMF facility] would almost certainly be a last resort. Policymakers would probably turn to capital controls and bilateral financing first,” he said. Turning to the IMF “would be an enormous loss of face” for Erdogan, who enjoys full control over economic policy and has boasted that Turkey’s cycle of bailouts ended under his rule.

Erdogan issued a decree Tuesday that makes coronavirus testing, protective materials and treatment at public hospitals free of charge, including for patients who have failed to pay state insurance. All legal residents are also entitled to free protective masks.

Turkey has also extended assistance to dozens of other countries battling the outbreak that has claimed more than 133,000 lives worldwide. “Despite our own needs for medical equipment, we have lent a helping hand to 34 countries, including important allies such as Britain, Italy and Spain,” Foreign Minister Mevlut Cavusoglu was quoted as saying at an online forum late Tuesday.

Back at home, the medical association’s Adiyaman lamented that the authorities’ “antidemocratic” stance, which he said predated the health crisis, was now hampering mitigation of the outbreak. A surprise announcement late Friday that nearly 80% of the population would be under a full lockdown over the weekend for the 48-hour curfew triggered tens of thousands of people to rush out out and enter crowded shops to buy food and water. A lack of clear communication from the Health Ministry has “paved the way for a climate of fear and panic, as happened on the night of April 10,” Adiyaman said.

The government has since acknowledged the lack of forewarning was a mistake, and the powerful interior minister briefly resigned over the blunder before Erdogan said the minister would continue in his post. The concentration of power in the presidency in recent years may be undermining the fight against the pandemic in other ways too. The government has excluded the medical association from its coronavirus task force and provincial pandemic councils, and Adiyaman said this imperiled both medical professionals and the public’s health. Municipalities controlled by the opposition are also sidelined.

Inmates began leaving crowded penitentiaries today, with those over the age of 65 the first to depart, according to news reports. Erdogan’s party and its ultranationalist partners voted to parole or commute sentences of about a third of Turkey’s estimated prison population of 300,000 people. Political prisoners and detainees did not benefit from the amnesty.

The ruling party has backed off from another contentious measure. A plan to force large social media networks to follow government decisions on content and turn over information on their users was dropped from a broader economic stimulus bill, newspapers reported.

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