No need to build new pandemic hospitals in Turkey if the footsteps of Germany and South Korea followed

Sinem Sönmez

Countries are racing to slow the spread of the virus by doing lockdowns, testing and treating patients, carrying out contact tracing, and quarantining their citizens.

The global evidence suggests that only if a country does either a complete lockdown and quarantining its citizens, or a combination of aggressive testing and contact tracing, without necessarily doing a lockdown, would a country be able to control the rapid spread of COVID-19 virus. Turkey can learn from any of the countries below in their timely response to the virus, so that it is able to take the necessary measures, before it’s too late, both in terms of saving lives and potentially avoiding a prolonged recession.  

South Korea did not implement a lockdown (partial or full), but it has done aggressive virus testing instead, and imposed fines to those who violate their quarantines.  

In the case of Germany, there was a late stage lockdown (March 22nd) but testing was also done, up to 500,000 people a week, the highest number of any Western nation. Germany is already making plans to gradually reopen its economy next week. 

Singapore has been held up as a role model for its early and decisive response to the threat, avoiding some of the drastic containment measures seen in countries like China, Italy and Spain, such as a lockdown, quarantining their citizens, and mass virus testing. Last week, however, it enforced a partial lockdown as it struggles to contain a sharp rise in coronavirus cases. The semi-lockdown came after Singapore witnessed an a surge in confirmed coronavirus cases, from 106 infections on March 1 to 1,000 on April 1. The figures indicate that most infections were transmitted locally and that a growing number of cases have no known links to confirmed patients. 

What has worked for Singapore in avoiding the surge in deaths has been again contact tracing, done both manually and electronically. In March, the country released TraceTogether, an app that uses Bluetooth technology to help public health officials do contact tracing for mass digital surveillance network. It works by allowing users to log in the app if they test positive for Covid-19 and the tool then anonymously notifies everyone they’ve recently seen in a two-week period.

As in the case of Singapore, Taiwan did not do a lockdown, but it has started doing testing early on (March 6) and did contact tracing to curb the spread of the COVID-19 virus. 

The contact-tracing technology seems to be highly effective in containing the spread of COVID-19 in Taiwan.

Just like Singapore, Taiwan hasn’t done a lockdown, but it has used technology to track the whereabouts of those under quarantine. The government can track people with their phone, which allows them to make sure all individuals who are supposed to go through the mandatory 14-day quarantine do in fact go through it and are not violating the rules by leaving their quarantine locations.

For both Singapore and Taiwan, the death rates have been quite low. Singapore has only 11 deaths and Taiwan has 6 deaths.  

Effective tracking would require mass testing of a broad population to identify who is infected with the new coronavirus, which often doesn’t cause any symptoms, the asymptotic ones. Since most countries are not able to quickly ramp up the production of test kits, location-tracking could serve as an interim measure allowing some level of normal life to resume before either massive testing is done or else a vaccine is available. Contact tracing could help find people and ask them to self-isolate.

Contact tracing is done either through a contracting tracing workforce, i.e., public health officials, or a contact-tracing app. 

Traditionally, contact tracing has required human involvement. When someone tests positive for the virus, public health investigators get in touch with that person, learn about everyone they’ve been in contact within a certain time frame, and then manually track down and notify all those contacts.

Since contact tracing and isolation of quarantined individuals are two of the most important requirements in the effort to limit the spread of coronavirus, Turkey needs to ensure that contact tracing teams (healthcare professionals) are well resourced, in terms of having test kits and the production capacity required for the test kits. Moreover, Turkey can also use its military personnel for the purpose of contact tracing. 

Public-health experts say, location-tracking could serve as an interim measure allowing some level of normal life to resume before a vaccine is available.

Recently, the European Union recommended smartphone tracking apps as part of a roadmap unveiled to help countries ease restrictions that have prompted steep economic downturns across the bloc.

Iceland started mass testing in February and formed a team of “contact tracers” made up mostly of police officers. The country this week released a mobile tracking app, among the first European countries to do so. 

It’s the combination of a lockdown and mass testing that is most effective in controlling the spread of the virus and flattening of the curve (the rate of death per day being lower than the day before). Easing of the restrictions on society from a complete lockdown combined with mass virus testing has been made possible for some countries in as little as 24 days for Germany, 31 days for Spain, 31 days for Austria, 31 days for Czech Republic, and only 22 days for Poland. In the case of Poland, the easing of restrictions was followed by a relatively small number of deaths of 350. 

With the economic cost of a lockdown being prohibitive, officials and scientists in Europe, following the example of South Korea, Singapore and Taiwan, are advocating the new approach of mass virus testing and contact tracing.

If Turkey follows the footsteps of Germany and South Korea by carrying out mass COVID-19 testing to isolate the carriers of this virus, Turkey would not have to build any new hospitals to accommodate any new COVID-19 patients. To contact trace for potential new infections, as did Singapore, Taiwan, and Iceland, Turkey can rely on its vast network of healthcare professionals across the country for manual contact tracing and use a contact-tracing app and require any offenders to face jail time and pay fines, or both. In doing widespread COVID-19 testing and contact tracing, Turkey would be able to contain the spread of the virus and start a gradual reopening of its economy, while enforcing strict social distancing guidelines.

No doubt the path to mass-testing is filled with obstacles, including surveillance and privacy concerns, that would make it hard for people to use a contact tracing app, share their data with the authorities, or to isolate themselves against their will, but the Turkish people’s collective identity and their tradition of rallying behind the government in times of crisis should make it easier for the population to cooperate with the health authorities in sharing their personal data for identifying people who test positive for the virus. 

Author:

Ph.D., Lecturer of Economics, Baruch College, City University of New York.