#Turkey has nothing to fear from a second #Coronavirus spike

International news reports have recently emphasised the ‘unexpected’ success of Turkey’s COVID-19 response. But inside of Turkey, the efficacy of our approach comes as no surprise. I’ve not only spent the last 3 months on the front lines of Turkey’s health-care system, but the last 30 years. Take it from me, Turkey’s success in fighting COVID-19 was no accident, writes Professor Dr Zehra Neşe Kavak (pictured, below).

Our response was rooted in two things: readiness and action. In April last year, Turkey’s Health Ministry published a 200-page pandemic action plan, more than 11 months before we recorded our first case of coronavirus. And how prescient that foresight turned out to be, as the plan described precautions against a possible pandemic and ordered official institutions to abide by strict hygiene rules and to implement clear measures in case of a medical epidemic. With proactive, accessible interventions at the heart of our healthcare response, Turkey was able to react to a global pandemic as though we’d already been through one.

The same is true of the way we readied ourselves and wasted no time in putting our healthcare system to work. While countries across Western Europe hesitated and played at a pandemic response, Turkey looked to how China and Iran managed their response and learned from it. In the two weeks following the first COVID-19 case in Turkey, we relied on treatment algorithms from China which were distributed to doctors and hospitals nationwide to ensure a consistent approach while we established our own.

This was only possible because of the investment we have made reshaping our health-care system in Turkey over the past 18 years. Turkey has invested a lot in health care over that time, 80% of the population got the opportunity to receive free treatment. With the large city hospitals that were built, bed capacities were increased by 1.5.

In this pandemic, all test and treatment expenses were being paid by the government, even for private hospitals. This is the social state approach of Turkey. I’ve been on the front line of the medical profession for my whole career, and I’ve taught at Cornell University in New York and Kings College London, and while many healthcare systems are being overwhelmed in the West, nowhere has done more to revive their health system recent years than Turkey.

Even before the pandemic, countless ‘health tourists’ were choosing Istanbul for organ and stem cell transplants, robotics, and fertility. I’ve seen our medical community evolve to mirror a complex watch mechanism, independent and specialist but unified in purpose.

It is partly this centralised model that made Turkey’s strategy so effective. Within days, we structured an approach like a pyramid, drawing together the Presidency, the Ministry of Health and a Committee consisting of the most prestigious scientists in Turkey. And on medical advice the government acted quickly to establish clear rules, clear preventative measures and clear treatment paths. To begin with, we wasted no time introducing an intelligent suppression method which closed all schools, all cafes, bars, restaurants and gyms, introduced travel in and out of Turkey’s 31 largest cities and banned the unnecessary movement of people over 65 and under 20. It was control, without constriction.

Even when cases did inevitably begin to grow, our medical interventions were bold and decisive. We didn’t have time to toy around with the one-step-forward-two-step-back approach adopted in many countries, and instead pushed ahead with a nationwide plan on tracing and treatment. We used a unique filiation method, which is our form of contact tracing, to establish where and from whom infections had resulted, and when infections were even so much as suspected in a patient, we transferred each immediately to hospital.

I believe medical professionals globally are reconsidering the particular approach we have taken. The drug hydroxychloroquine has been widely ridiculed, partly because no single treatment is going to be a miracle cure anywhere and particularly because of President Trump’s advocacy of its use. But in Turkey, as soon as a patient presented symptoms, we administered the standard PCR COVID-19 test, sent each for a CT-scan and started hydroxychloroquine treatment at the very earliest stage and always before transfer to intensive care. Both approaches have their detractors, but the fact is that even at the height of our pandemic, our intensive care units were only ever full to 62% of capacity.

This is just one of the many statistics of which I am proud when it comes to our response in Turkey. Many others have pointed to our mortality rate, which still remains at around 2.8%, compared with 5.9% in the United States, 12% in Spain, and 14% in UK. But the number that gives me greatest pride is 0. That is the number of surgeries that we missed, postponed or cancelled at our hospital in Istanbul due to the intensity of COVID-19. We even helped numerous mothers suffering themselves in the grip of COVID-19 give birth to healthy babies.

Borders and airports are now opening, and fears are circulating that the tourist influx and the winter months ahead will bring us a second spike. But I am confident to say that we have no such fears in Turkey – we were ready once, and we will be ready again. And we are excited to welcome again tourists from all over the world, each taking comfort in the knowledge that in the unlikely event you fall ill, you have the best treatment in Europe on your doorstep.

Professor Dr Zehra Neşe Kavak is one of Turkey’s leading physicians and a renowned medical scholar. She is the founding president of Istanbul Kent University, a visiting professor at Cornell University New York, and currently Chair of the Board of Academic Hospital, Turkey. She has played a leading role in Turkey’s public health response to COVID- 19. She was born in Istanbul and graduated from Cerrahpaşa Medical Faculty in 1986. She worked for St. Thomas's Hospital in London between 1990-1991 and in 1996 became Associate Professor at Marmara University Medical Faculty Hospital in Turkey.

Between 2000-2001, she worked intermittently at King's College Hospital in London before establishing the Perinatology Unit at Marmara University Medical Faculty Hospital where she later became Chief Physician. In 2017, she was appointed by President Recep Tayyip Erdoğan as the Rector of Istanbul Kent University.

Professor Kavak has published 68 papers in international refereed journals, with 82 published in national refereed journals. She is a regular speaker at international meetings related to perinatology and sits on the editorial board of many national and international scientific journals. She is a member of the World Academy of Art and Science, which was founded in the 1950s by a number of scientific luminaries including Albert Einstein and J Robert Oppenheimer, and in 2009 became the first Turkish person ever to be elected to the Academy's Board of Trustees. Professor Kavak is currently Founding President of Istanbul Kent University, Vice President of Turkish Businesswomen Association, and Professor of Gynaecology and Obstetrics and Perinatology.

Share this article: