Istanbul, Turkey – Coming off a 12-hour shift, Eyup says he does not “know how much more depressed I can be”. A doctor at a public hospital in Istanbul, he has been working in its COVID-19 intensive care unit where numbers, he sighs, “are skyrocketing”.
In fact, the surge in infections is pushing the hospital beyond what it can cope with. Although it increased its coronavirus ward and intensive care unit capacity by 50 percent since the spring, it is now “completely packed”, the doctor says.
“We don’t have any spare bed or anything like that,” says Eyup, whose name has been changed to protect his identity. He adds operating rooms have been turned into intensive care units (ICU) to use the beds with intubation machines there too.
“The situation is so dire that we have more patients to look after than our capacity at this point.”
And despite Eyup and his colleagues’ best efforts, the epidemic is taking its toll. “I’m losing about one or two patients that I’m with every night,” he says of the last three weeks.
With many of his patients elderly and with other underlying conditions, once they enter ICU, he explains, “we’re just watching them get worse”.
The fourth highest number of cases globally
Though Istanbul and the rest of western Turkey have been particularly affected, as winter draws in the spread of COVID-19 all over the country has been alarming. For the first time since July, Health Minister Fahrettin Koca announced last week Turkey’s daily number of actual coronavirus cases – previously it only released figures on symptomatic patients.
While opposition figures and the Turkish Medical Association, the national union of doctors, still maintain cases are higher than the government admits, even the official numbers place Turkey’s second wave of coronavirus among the most serious in the world, much worse than its first peak in the spring.
In the latest figures on Thursday, Turkey reported a record 31,923 new cases and 193 deaths. The total death toll in the country rose to 14,129. Only the United States, Brazil and India – countries with far larger populations than Turkey’s 80 million – had more daily cases.
It has left President Recep Tayyip Erdogan, in his own words, “no choice but to minimise human mobility to reduce the negative impact of the pandemic”.
On Monday, he announced new measures to stop the spread of infection, such as a nightly curfew on weekdays, a mandatory stay-at-home order covering the entire weekend, a limiting of weddings and funerals to 30 people, and a ban on the use of public transport for over-65s and under-20s.
Most workplaces, however, are still open, as are communal prayers, which had been suspended earlier in the year. In justifying the new regulations, Erdogan explained: “We are taking steps carefully not to turn the health crisis into a full-blown economic and social crisis.”
The new steps strengthen initial precautions introduced two weeks ago, which included a partial curfew over the weekend, as well as moving back to online schooling for students, and restricting cafes and restaurants to takeaway service only.
Twenty healthcare workers are reported to have died from COVID in the past week [Sedat Suna/EPA-EFE] ‘Save your whole arm’
Just a few kilometres away from the hospital where Eyup works, Kemal told Al Jazeera those restrictions forced him to close his own restaurant down. Offering customers mostly bread and soup, a takeaway service simply was not viable.
With no work to go to or café to visit, he stood smoking on the street in Zeytinburnu, a district just beyond the old city walls, which since the summer has recorded some of Istanbul’s highest rates of COVID-19. Despite the effect on his own business, he is supportive of the government’s new steps.
“It’s like with an infection, sometimes you have to cut your finger off to save your whole arm,” says Kemal, who only gave his first name.
Asked why he thinks the pandemic is spreading so intensely, he shrugs, “it’s happening everywhere in the world”.
A local official involved in contact tracing in the district shared with Al Jazeera his own explanation. Though mask-wearing is good – “98 percent of people wear them”, he says – the peak has been caused by “weddings, funerals and celebrations for boys about to leave for their military service”.
Throughout November both Erdogan and Health Minister Fahrettin Koca repeatedly bemoaned a lack of care among citizens regarding coronavirus. Last week, the president warned as long as masks were not worn and social distance not maintained, an increase in cases in Turkey’s biggest cities was “inevitable”.
Yet the Turkish Medical Association has criticised this approach and its focus on individual behaviour. As one of its board members put it at a recent meeting, “a mentality that puts all the blame on citizens and all the responsibility on health workers couldn’t have succeeded – and it didn’t”.
In Zeytinburnu, for example, one member of the contact tracing team also cited other reasons for high rates of infection. It was a district, he explained, with a large number of immigrants living in crowded housing, and working in textile factories across the city that has been disproportionately hit by the virus.
The Turkish Medical Association, for its part, has called for a four-week lockdown of all non-essential activities and workplaces since mid-November. It has also highlighted the heavy burden carried by its members during the pandemic. Twenty healthcare workers are reported to have died from COVID in the past week.
From his hospital in Istanbul, Eyup shares much the same concerns having noticed two trends among recent admissions: Elderly patients living in the same house as working relatives; and an increased number of his fellow health professionals needing treatment too.
In the medium-term at least, the government has offered some relief, announcing last week it signed a contract to buy 50 million doses of the Chinese Sinovav Biotech COVID vaccine, with healthcare workers to start receiving vaccinations this month.
But the pandemic may get worse before that relief arrives. If the numbers keep increasing, Eyup says, his hospital simply will not have enough ventilators for patients that desperately need them to survive.
“We all fear if it comes to that in a week’s time – which we probably will – deciding who lives and who doesn’t live. I don’t want to do that. Nobody wants to do that game.”