On Wednesday, the Turkish Health Minister, Fahrettin Koca, announced that his country is experiencing a second peak in its Covid-19 outbreak. Turkey, he acknowledged, is seeing its daily case numbers jump to levels not recorded since mid-May, while fatalities are edging closer to figures that the government released in mid-June. Figures released by the federal government last Saturday night, for instance, showed 1,549 new cases and 39 deaths in the preceding 24 hours.
Second waves and second peaks are to be expected in any country’s experience with this pandemic. The strain of coronavirus that is now causing so much mayhem in the world is highly infectious, difficult to detect without rigorous and widespread testing and presents varying symptoms inconsistently. This is what makes transparency in data and public-health messaging particularly important in the effort to overcome it.
Last Saturday, however, at a virtual meeting of opposition figures, Mansur Yavas, the mayor of Turkey’s capital, Ankara, made a curious observation. On August 18, he noted, city officials in Ankara had recorded 17 coronavirus deaths. The same day, the Turkish federal government reported 22 across the entire country.
The mayor of Istanbul, Ekrem Imamoglu, pointed out at the same meeting that the contemporary data on case numbers for Istanbul “is almost equal with the Turkey data.” He finished his statement with a caveat. “The data that is being given,” he said.
Both mayors, who lead Turkey’s two largest cities, suspect that the Turkish government is significantly under-reporting its case numbers and, by extension, attempting to downplay the impact of the pandemic. Their contentions are reinforced by similar assertions made by local medics’ chambers across Turkey, who say that hospitals are filling up with more cases than official counts suggest.
In many countries where coronavirus cases are assumed to be under-reported, the issue is a lack of widespread testing. Turkey, however, is conducting close to 100,000 tests per day, and testing conducted by city officials is part of what makes the two mayors so suspicious.
Death statistics (from all causes, including, but not limited to coronavirus) in Turkey's major cities show that the government may have been misleading the public on the actual cases in the country as far back as the spring. From March to April, Istanbul recorded 2,100 more deaths than expected based on data from previous years. This was more deaths than the national government recorded for the whole of Turkey at that time. Furthermore, a report in the Lancet said that the Turkish Ministry of Health announced "a mandatory application for permission for research on Covid-19", a move branded as unconstitutional.
Doctors raising the alarm on Covid-19 have been intimidated by authorities. Medical associations in Mardin and Van have been accused of "creating fear and panic among the public". Last month, the Turkish Medical Association issued a warning that there are 10 times more cases than announced by the Ministry of Health.
All of this begs the question, why is Turkey attempting a misinformation campaign at all? The country has the resources, health infrastructure and testing campaigns in place to steer itself through the pandemic. And there is much at stake for the wider region: Turkey shares borders with Iraq and Syria, which are particularly hard hit, and it hosts millions of Syrian and other refugees, who are particularly vulnerable. As one of the largest and wealthiest nations in the region, Turkey ought to be an example of putting public health before short-sighted political interests. Instead, there are widespread concerns about the government's handling of information and statistics.
As Mr Yavas has noted, “What benefit is there to under-reporting the numbers?”
