Test centres for coronavirus insufficient in Turkey, infectious disease expert says

Turkey currently has five centres to handle all testing for the COVID-19 coronavirus, despite the Health Ministry saying it had 25 such laboratories, clinical microbiologist and infectious disease expert Gaye Usluer from the Eskişehir Osmangazi University told Ahval.

“Until the last three-four days, all testing was done in one centre in Ankara,” Usluer said.

Doctors were instructed to send clinical samples from patients to the capital through a specialised transportation network, Usluer said, leading to long waiting times for the test results to come out. A sample sent to neighbouring Eskişehir province would come back after a full 24 hours, she said.

Four testing centres are currently working to cover much of Turkey, with one in Istanbul, one each in Adana and Erzurum provinces, and another in Ankara.

Screening tests may not be feasible for Turkey’s current situation, Usluer said, but if they were to become more widely available, Turkey’s numbers could skyrocket.

Turkish authorities have identified several clusters of coronavirus positive patients as having come into contact with the virus abroad, but the country is not testing for community spread unless the suspected patient shows extreme symptoms.

An early concern before Turkey confirmed its first case was whether the domestically produced test kits were effective.

“As countries manufacture their own test kits, they send the genetic sequences to the World Health Organisation,” Usluer said. “That is a relieving side of the story.”

Test kits manufactured in Turkey have been exported to Bulgaria, Azerbaijan, Iran and Georgia, and if they had been defective, they would not have produced accurate diagnoses, the Turkish government’s argument goes.

The number of confirmed cases in the country increased by 29 on Monday, as more tests were completed. There are 47 confirmed cases in Turkey so far.

The biggest risk group was returning pilgrims, Usluer said. Authorities announced that some 21,000 pilgrims would be returning from Mecca on March 15, but it was later revealed that a majority had already returned some 10 days ago.

The first 15,000 people to return from Mecca were not quarantined, and have not complied with the advice they were given to self-quarantine for 14 days, Usluer said. The last group of 6,000-people have been quarantined though.

“The most important question I have is this; the umrah (pilgrimage) lasts between 11 to 24 days. Who allowed these umrah visits in these last 11 to 24 days?” Usluer asked. “The fact that pilgrimage visits were permitted within the last month, while pandemic measures were being implemented, points to the most risky area for Turkey.”

Another point of concern for Turkey is its neighbour Iran, where testing has been limited leading to a lower than actual reporting of the spread. Turkey’s Iranian border is extremely porous. The coronavirus task force initially focused on that border for the first incoming case, Usluer said, but the first case was discovered in Istanbul with a connection to Italy.

It is not clear whether Turkey’s hospital capacity will prove sufficient for the outbreak, Usluer said. The coronavirus will also test the status and capacity of hospitals and intensive care units, and whether the hospitals are sufficiently staffed, she said.