Turkey's Management of COVID-19: Measures and Strategies of Health Policies.

• Author: Koca, Fahrettin
• Position: COMMENTARY

Throughout human history, pandemics have been, and will be, an important public health problem. Countries have witnessed various pandemics, along with their dramatic sociological, demographic and economic consequences. Some of the major pandemics include the plague in the 14th century, the cholera and influenza pandemics in 1847-1848, the Spanish flu in 1918, the Asian pandemic in 1957, the Hong Kong flu in 1968, H1N1 influenza, SARS, and MERS in 2009. Finally, now, we are all, globally, going through COVID-19 together.

COVID-19, which is an infectious disease caused by a newly discovered coronavirus, became a global pandemic in about two months after an outbreak in Wuhan, China, in December 2019. The COVID-19 pandemic differs from previous pandemics in terms of its impact and prevalence across countries and sectors. Due to easy transportation around the world and the broad communication network, no pandemic has spread so fast or led to such extensive information-sharing. Turkey immediately started to take stringent measures even before the virus was declared a pandemic by the World Health Organization (WHO) and managed to delay the entry of the disease to the country for more than two months. Taking advantage of this opportunity, the Turkish Ministry of Health was prepared for the pandemic, having made the necessary arrangements in hospitals and strengthened the healthcare infrastructure. Turkey tightened measures upon observation of the first COVID-19 case in the country on March 11, 2020. Under the coordination of the Turkish Presidency, all the involved parties adopted stringent policy measures and implemented them dynamically.

Further, unlike many countries, the pandemic did not take the Turkish health system by surprise. The Ministry of Health had been working on plans and preparations for a possible pandemic since 2004. The "National Preparation Plan for Pandemic Influenza" had been prepared and published in 2019. The National Plan came into force under Presidential Executive Order No. 30744, dated April 13, 2019. The plan provides information and a framework to help all public and private individuals, institutions and organizations recognize the influenza pandemic, be prepared and act in coordination in the most appropriate way in order to fulfill their roles and responsibilities in the event of a pandemic.

Within the scope of this plan, the deputy ministers of all the involved ministries, as well as representatives of the Turkish Red Crescent, the Presidency of Disaster and Emergency Management (AFAD), the Council of Higher Education (YOK) and respective departments of the Ministry of Health attend the meetings of the National Coordination Committee for Pandemic. Prepared with a multi-stakeholders approach, the National Preparation Plan formed the basis for Turkey's management of the COVID-19 pandemic.

Long before the occurrence of COVID-19 cases in the country, Turkey acted proactively; starting with the healthcare sector, it took the required measures as a whole for risk and crisis management early in January 2020. One of the steps taken for scientifically managing the pandemic was the formation of an operation center. The center, consisting of 15 experts, was established under the Ministry on January 6, 2020 in order to follow developments related to coronavirus around the world instantaneously. Subsequently, the Scientific Advisory Board on Coronavirus affiliated with the Ministry was formed on January 10, 2020 with the participation of scientists from the leading Turkish universities. The decisions and advice of the Committee serve as a guide in the successful management of the process.

In the management of the COVID-19 pandemic, policies in accordance with the principles of risk and crisis management were developed by considering the emerging conditions in almost all aspects of life, including healthcare, travel, education, economy, tourism, security, international relations and solidarity, agriculture, production, free circulation, logistics and transportation. Turkey has implemented a wide variety of measures such as keeping selected cases in hospitals, the establishment of pandemic hospitals, the isolation of patients who tested positive, contact tracing, measures for quarantine and restriction, the lockdown of children, teenagers and people 65 years old and over, travel bans and restrictions, online education in schools and universities, and cancelling outdoor activities in public places and financial measures.

Turkey's fight against the COVID-19 pandemic may be evaluated in three stages. The protection period (January and February 2020) involved raising public awareness, providing border security and making preparations for healthcare infrastructure. The period of active fight against the disease in the following three months (March, April, May) started with the adoption of a strategy that concentrated on controlling the...