Germany reluctant to lift travel restrictions on Turkey due to controversial COVID-19 treatment

As Turkey pushes for the swift lifting of travel restrictions from Europe to reduce losses during the peak of the tourism season, Germany’s federal government is concerned that holidaymakers could be at risk due to the country’s controversial COVID-19 treatment, German newspaper Der Spiegel reported on Friday.

One concern for Germany remains Turkey’s treatment regimen, which deviates from the World Heath Organization (WHO)-advised treatments and includes the early use of the disputed anti-malarial drug hydroxychloroquine.

The drug is not approved for use in COVID-19 treatment in Germany and its risks for the patients are unclear, Der Spiegel cited German Foreign Ministry sources as saying.

The German government announced earlier in June that it was extending travel warnings for over 160 countries outside of the EU, including Turkey, until the end of August.

The travel warnings advise against "non-essential tourist travel" due to the risks posed by the COVID-19 coronavirus.

After months of strict measures and weekend curfews, Turkey entered what it called a “normalisation phase” on June 1 as coronavirus cases in the country had been consistently falling.

Case numbers have steadily increased again since then, with more severe rates seen in several provinces including the popular tourist destination Istanbul.

However, the country maintains that its southern provinces, visited by millions of German tourists every year, are ready to receive guests with increased hygiene requirements and special measures put in place in hotels.

But Germany’s federal public health body Robert Koch Institute still lists Turkey among high-risk countries, giving Berlin another reason to retain the travel restrictions.

“On average, more than 50 people per 100,000 inhabitants in Turkey tested positive for Sars-CoV-2,” Der Spiegel said.

As it currently stands, German tourists would have to self-quarantine for 14 days upon their return from Turkey.

On Sunday, Turkish Tourism Minister Mehmet Nuri Ersoy said himself, Foreign Minister Mevlüt Çavuşoğlu, and Health Ministry officials were planning a visit to Berlin for further discussions with German authorities to resolve the issue.

The meeting is expected to take place next Thursday, Der Spiegel said.

The main problem with hydroxychloroquine is that other countries use it too late in the treatment process, Nurettin Yiyit, chief doctor at Turkey’s Şehit Prof. Dr. İlhan Varank public hospital, said in late May.

Medical journal Lancet around the same time published a study associating the anti-malarial drug with increased risk of in-hospital mortality, but the study was later withdrawn due to concerns over the data underlying the paper.

Notably, the specific combination of drugs Turkey uses, hydroxychloroquine and azithromycin, was cited in the retracted study as linked to “extremely high risks of death and arrhythmia”.

Shortly after, the WHO halted trials of the drug over safety concerns.

On June 15, the U.S. Food and Drug Administration revoked the drug’s emergency use authorisation.

Patients who do not wish to take the drug would not be forced to do so, Deutsche Welle Turkish cited a top official from the Turkish Tourism Ministry as saying.

“The Health Ministry poses several protocols to patients, and they receive whichever treatment they choose,” the official said. “We have already shared Turkey’s treatment protocols with Germany, and every other country for that matter.”

There are currently 22,248 active cases of COVID-19 in Turkey, and a total of 5,065 people have lost their lives after contracting the coronavirus, according to Health Minister Fahrettin Koca’s daily twitter briefing on Friday.

Turkey recorded 1,396 cases since Thursday, slowly inching towards mid-May levels of infection. A total of 19 people died within the same timeframe, while the number of intubated patients and patients in intensive care continued to rise.