key: cord-0684896-93o38r0k
authors: Ozaras, Resat; Leblebicioglu, Hakan
title: COVID-19 PANDEMIC And INTERNATIONAL TRAVEL: TURKEY’S EXPERIENCE
date: 2021-01-13
journal: Travel Med Infect Dis
DOI: 10.1016/j.tmaid.2021.101972
sha: 8023685de948b910e95b2b93fd354a84c1a43ccb
doc_id: 684896
cord_uid: 93o38r0k

nan

1-Infectious Diseases Department, Medilife Health Group, Istanbul, Turkey. 2-Infectious Diseases Department, Samsun VM Medicalpark Hospital, Samsun, Turkey.

Dear Editor, Since December 2019, novel coronavirus infection (COVID-19) has spread worldwide leading to a pandemic. Restrictive measures have been shown to constitute an effective way to control the disease and countries have reacted with differing sequence and intensity. Some countries have recorded low numbers of cases with effective and strict strategies. Beside domestic cases, international travellers and returning citizens have the potential to contribute to the pandemic. Turkey has been deeply affected by the pandemic. As of December 5, 533,800 cases with 14,705 deaths were reported. The Ministry of Health (MoH) established a Scientific Board, which published a guideline on January 24 (1). The guideline included general information about the disease, case definitions and management, infection control and isolation procedures, and information for the travelers (1). MoH updates this guideline regularly. The initial recommendation for people travelling abroad was to stay-at-home and not to accept guests for a 14-day period, even if they had no signs of the disease. If they had to leave home, they were advised to use masks. Travellers were warned against entering crowded environments and meeting people showing signs of infection. On January 24, thermal cameras were placed at the airports. The passengers coming from China were further screened. On February 3, Turkey has suspended all flights from China (2) and on February 23, the Iran border was closed and flights were suspended. On February 29, flights from Italy, South Korea, and Iraq were suspended and the Iraqi border was closed. MoH established field hospitals near the borders of Iraq and Iran to provide assistance to returning citizens. The first case was reported on March 10 and the first death was reported on March 17(1). Saudi Arabia announced the first COVID-19 case on March 2 (3). Turkish MoH declared that a pilgrim recently returned from Umrah tested positive on March 14(1) and on March 15, 10,330 returning Umrah pilgrims were quarantined. On March 16, the flight ban was extended to Egypt, England, Ireland, Switzerland, Saudi Arabia and the United Arab Emirates. On March 21, countries with air transport restriction reached 68. On March 27, all overseas flights were terminated, and intercity travel was subject to permission. On March 28, domestic air transportation was restricted. On April 4, obligatory stay-at-home for ≤20 year-old, in/out travel bans for 31 cities; compulsory use of masks in public places were implemented. On April 11, total lock-downs in 31 cities were initiated.

During the pandemic, people abroad tried to return home. However it was not possible for everybody due to travel restrictions. Many countries programmed evacuation acts for their citizens. From January 31-February 1, Turkey evacuated 32 citizens from Wuhan and on March 15, 4821 citizens from several countries (1, 4) . On March 23, 3358 exchange students from several European countries were evacuated. All the evacuated citizens and returning Umrah pilgrims were strictly isolated in single-rooms for 14-day in dormitories free of charge ( Figure  1 ). They were prohibited from meeting others; at the end of the quarantine, a negative PCR test was warranted. They were closely monitored and those exhibiting signs and symptoms of the illness were treated in the hospitals. Border control measures did not prevent the global spread of the disease but most likely slowed it (5) . Considering the asymptomatic incubation period, tracing the contacts and rapid screening of suspected cases are critical for prevention of further human-to-human transmission. Education of the individuals, requesting them to self-report any exposure, self-monitor for symptoms, and voluntarily quarantine if symptoms arise are likely more effective (5) .

What we have learned:

-COVID-19 pandemic showed the fragility and unpreparedness of the communities. Countries needed to use evacuation programs for their citizens.

-Border control measures, including airport screening and travel restrictions may not prevent the spread of the disease but likely slow it.

-Self-report any exposure to the virus, self-monitor for symptoms, and voluntarily quarantine if symptoms arise, and cancelling travel plans are likely more effective; an education program should be planned for travelers.

-14-day quarantine of returning travelers may contribute to the diagnosis of individuals within the incubation period on their arrival.

-Countries may need to use their differing capacities. Dormitories, which are not used during the lockdown, can provide a suitable environment for isolation. It enables close follow-up the returning travelers and provides diagnostics and timely treatment.

Republic of Turkey, Ministry of Health, COVID-19 Information Page

Global threat of COVID 19 and evacuation of the citizens of different countries

Impact of international travel and border control measures on the global spread of the novel 2019 coronavirus outbreak