Policy responses for Turkey - HSRM

Turkey


Policy responses for Turkey

1.2 Physical distancing

Gradual relief in the physical distancing measures restrictions started to be applied after the month of Ramadan (April/May 2020):
The Vice President prepared a 4-stage normalization plan to exit the restrictions put in place due to the COVID-19 pandemic. According to the plan, the first phase begins on May 11, 2020; the second occurs between May 27-August 31, the third stage occurs in September 1-December 31, and the fourth stage is planned for January 1 and beyond, when a vaccine is expected.

Tourism:
The ministry of tourism defined rules for operating hotels and accommodation for tourism from May, 2020 (first phase). Accommodation facilities complying with these rules must be certified by the Ministry and the institutions they designate in order to operate (Circular “Controlled Normalization Process in Accommodation Facilities”, published by the Directorate of Controllers Board of the General Directorate of Investments and Enterprises on May 5, 2020.) https://yigm.ktb.gov.tr/Eklenti/72764,genelgepdf.pdf?0

Worship:
On May 5, 2020 Head of Religious Affairs presidency reopened mosques to pray with the community. Together with the Ministry of Health and the Ministry of Internal Affairs, they worked on a reopening plan, that started to be implemented on June, 12.
Since May 29, Friday prayers can be performed in the open air, while maintaining social distance, by bringing everyone their own prayer rugs. https://www.icisleri.gov.tr/cami-ve-mescitlerde-cemaatle-ibadet-edilmesi-genelgesi

Commerce:
On May 9, 2020, the Ministry of Health allowed reopening shopping malls according to regulations published on its website: “Measures to be taken in shopping centers and shops in the shopping centers”. Malls reopened under physical distance measures such as mask usage, and restrictions on the number of people per area.
Hairdressers, Barbers and Beauty Salons were also allowed to reopen on May 9, 2020, subject to regulations by the General Directorate of Occupational Health and Safety. The regulations determined that hairdressers should work only by appointment, receive a limited number of customers at the same time, face masks are mandatory; all the regulations  are listed on a document called “Considerations for Effective Fighting with the New Type of Coronavirus in Hairdressers, Barbers and Beauty Salons”:  https://www.icisleri.gov.tr/berberguzellik-salonukuaforlerin-acilmasi-genelgesi
Small businesses such as small markets, opticians, car mechanics, toy stores, commercial taxi stops, dry cleaners are also subject to special guidelines:  https://covid19bilgi.saglik.gov.tr/tr/calisma-rehberi-afisleri.html 

Education:
It was reported on May 11, 2020 that the final exams and other exams of this academic year will not be carried out face to face in universities but will be carried out by using “digital possibilities” or “alternative methods such as homework and projects” to be preferred by university competent boards.

Curfew:
During the pandemic, curfews were imposed on individuals  over 65 and under 20. The Curfew started in early March and individuals aged less than 20 or over 65 were not allowed to leave home (except for necessary shops and healthcare) on weekends and holidays in order to avoid mass gatherings.
From March, 21, the curfew was extended and became permanent for individuals under 18 years old and over 65, i.e. they were not allowed to leave home.
In May, the curfew was partially lifted: individuals aged less than 18 could leave home on Wednesdays and Fridays for 4 hours (between 11AM and 3PM). Individuals aged 65 and more, are allowed to leave home on Sundays between 12PM and 4PM.
Curfew was completely lifted for individuals aged 19 and 20, and they are free to circulate anytime.
On June 1st, the curfew for people over 65 years old was lifted and they can circulate freely anytime.
Since June 1st children under the age of 18 can leave home, but must be accompanied by their families.


Social services:
On May 12, 2020 the Minister of Family, Labour and Social Services stated a series of measures to alleviate disabled and chronically ill individuals:
Disability pensions and home care assistance were extended,
Prescriptions can be given in three months period (instead of one month before the pandemic)
The fees of private nursing homes and disabled care centers for the disabled people who need care in an official care center will be paid by the Ministry.

On May 12, 2020 the Minister of Justice stated that the notary publics started their normal working period and Forensic Medicine Institute has started their work again.

Minister of Health made a statement on May 13, 2020:
Health tourism (that was put on hold during the pandemic), was resumed from May 20th.
During the pandemic health personnel were not allowed to take annual leaves, but from May 13th, they can go on annual leave upon approval of their supervisors.
Thesis defense and specialty exams can be made according to the Regulation on Specialization Training in Medicine and Dentistry, but should take place according to physical distance rules.


May 11, 2020: The President made a statement after the Presidential Cabinet meeting:
Citizens should definitely not perceive the steps of normalizing life as returning before the first case was seen,
Until that day due to the threat of pandemic, 412 settlements were quarantined, quarantine was finished in 300 of them and still 112 of them are quarantined.
During the pandemic, the sale of masks was banned, and the state gave it to its citizens free of charge. After this announcement, the sale was called free, with an upper price limit determined by government.
The Ministry of Interior stated that as of May 11, the city travels restrictions in Adana, Denizli, Diyarbakır, Kahramanmaraş, Mardin, Ordu, Şanlıurfa, Tekirdağ and Trabzon provinces were lifted as of May 11, 2020.


Measures in other sectors:

Turkish Airlines (THY) declared that flights will resume on June 1 for domestic, and June 10 for international flights due to the COVID-19 outbreak.
On May 15, 2020, the measures taken against the penal institutions due to the COVID-19 pandemic were extended until May 30 within the scope of the recommendations of the COVID-19 Scientific Advisory Board.
Turkish Standards Institute (TSE) has determined and published standards for washable cloth masks. Turkey thus joined the world standard in this area.

June 1st, the second stage of the transition plan:
Since June 1st, as part of its normalization plan, Turkey lifted most of the restrictions introduced to curb the spread of coronavirus. The Health Minister described this new period as “controlled social life” and urges individuals to abide by measures which include wearing masks, keeping physical distance and hand hygiene. The following activities resumed on June, 1st unless otherwise stated:
Wearing masks is mandatory everywhere outside home in 42 provinces. In the rest of the provinces wearing masks is mandatory in public transportation, malls, markets, and shops except streets.
Restaurants, cafes, patisseries, coffee shops, and similar venues are allowed to open daily until 10.00 p.m.
Parks, gardens, picnic and recreational areas, hiking and fishing, as well as beaches are available effective June 1, while outdoor barbecues will remain restricted.
Swimming pools, hot springs, Turkish baths, saunas and spas resumed services within certain precautionary rules, while sports centers and facilities can be open until midnight.
Certain restrictions will remain on entertainment venues, including board games and hookah-smoking.
Live music activities, dancing and games are still prohibited to prevent direct contact at public recreation and entertainment venues.
Permits are no longer required for intercity public transportation vehicles.
Entry and exit restrictions among the country's 15 provinces were lifted on May, 31st.
Intercity travel by airplane, rail and bus must be done with the mobile app [Hayat Eve Sığar – HES or Life Fits Home] to track passengers and contact them in case an infected individual is identified in the same transportation vehicle. Tracking is done with an electronic follow system for all passengers. Passengers are notified in case they travelled in a vehicle where an infected patient was identified, and are called to self-quarantine.
Civil servants returned to their normal job routine, except those with chronic diseases, who are analyzed by their ministries.
Beaches, swimming pools, hot springs, parks, gardens, driving courses, museums, archaeological sites, sports facilities, libraries, youth centres and camps, daycare centres and kindergartens also reopened.
Restrictions on individual sports, sea tourism, fishing, and sea transportation were lifted.
Coronavirus guide updated on June 1. (https://covid19bilgi.saglik.gov.tr/tr/covid-19-rehberi.html)
Outdoor concerts resumed.
Hippodromes reopened on June 10.
Since June, 16th, it is compulsory to wear a mask while going out on the streets in 42 provinces.


Newly opened hospitals specific for COVID19 patients:

Prof. Feriha Öz Emergency hospital was opened on May, 29th in the Asian side of Istanbul, Sancaktepe, It consists of an important contribution to the health system with its 1008 bed capacity. Each room can be transformed into intensive care, if needed. It has a total area of 125 thousand square meters and a closed area of 75 thousand square meters.
On May 31, Dr. Murat Dilmener hospital was opened for the treatment of patients with COVID 19, having the same features on the European side of Istanbul. This hospital was built within 45 days.

Professor Dr. Murat Dilmener and Prof. Dr. Feriha Öz lost their lives due to Covid 19 disease.

Also, a historical hospital dating back 128 years, Dr. İsmail Niyazi Kurtulmus Hospital was restructured and opened for the treatment of COVID19 patients. It is located in the district of Hadımköy in Istanbul, has 23 thousand square meters of land and has a covered area of 4,500 square meters. The hospital will serve with 101 beds, 59 of which are intensive care units.
 
Ismail Niyazi Kurtulmuş Hospital, located in the district of Hadımköy in Istanbul, has 23 thousand square meters of land and has a covered area of 4,500 square meters. The hospital will serve with 101 beds, 59 of which are intensive care units. The health facility 16 operating rooms, as well as 432 intensive care beds, 36 emergency observation beds, 8 triage, 2 CRP, 4 tomography, 4 MR, 2 X-ray rooms.

20.7.2020
• The use of masks is mandatory in 58 cities on 23 June.
• Around 2 million youngsters are supposed to take university entrance exams every year. They usually come with their families, and gather next to the exam venues. In order to avoid this mass gatherings,  the Interior Ministry imposed a partial curfew  across all Turkey's provinces during  the university entrance exams, i.e. between 9:30 a.m. and 3:00 p.m. on June 27, and between 9:30 a.m. and 6.30 p.m. on June 28. During the lockdown, bakeries, hospitals, pharmacies and workplaces deemed essential will continue to operate. Markets, grocery stores, greengrocers, and butchers will continue to operate.
• A circular on “Inspections within the Scope of Covid-19 Measures” was sent to 81 Provincial Governorships. In the circular, the measures to be taken for each line of business, as well as the rules of cleaning, mask and distance, were determined separately, and it was expressed to ensure that the activities were continued within the framework of these rules and measures. 81 Provincial Governorships will be regularly inspected whether the responsibilities regarding the rules and precautions to be taken in the guides published and determined by the Coronavirus Scientific Committee are being fulfilled. https://www.icisleri.gov.tr/tum-turkiyede-valiler-koronavirus-tedbirleri-denetimi-yapacak

15.7.2020 - Relaxation of physical distancing restrictions
• Education: Schools in Turkey will reopen at the end of August under strict rules laid out in a guide the country’s Health Ministry has released.
• Worship: Head of religious affairs announced that since June, 22 all mosques can open to public as long as worshippers abide the face mask and physical distance rules https://www.aa.com.tr/en/turkey/turkey-reopens-mosques-for-prayers-/1887526 
• The Milas-Bodrum Airport in Mugla resumed international flights as of June 26.

• Tourism:
“Safe Tourism Certification" for all accommodation facilities with a capacity of 50 rooms or more is mandatory. According to the Culture and Tourism Ministry, Turkey has safe tourism facilities compared to those in Europe. More than 727 hotels and about 900 restaurants applied for a “Safe Tourism Certification” that would indicate they had taken standard measures to prevent COVID-19 infections, and most get the certificate.
As the number of confirmed coronavirus cases has slowed and the tourism season has started, the Interior Ministry allows senior citizens aged 65 years and over to travel for tourism purposes.

• Cultural events and venues:
Theatres, wedding halls, internet cafes, and electronic game rooms can reopen on July 1st. The Ministry of Culture and Tourism announced the measures that must be taken at culture and art facilities in order to open and function:  There must be hand sanitizers at the entrance so visitors can sanitize their hands before entering facilities. Temperature must be checked for the staff and artists with a thermal camera. To inform visitors about Covid-19 measures, visual/written information boards will be hung at the entrance of the facility and in places that can be easily seen.

• Welfare Allowances: cash aid to low-income families would also be extended for a month. He said TL 18 billion ($2.6 billion) had been disbursed so far under the two programs. Ministry of Family, Labor and Social Services announced family consultation services will be provided face to face, starting from 1 July 2020. These centers provide guidance and psychosocial support for families to overcome problems in the marriage or during divorce.

06 July 2020
• The number of COVID-19 positive diagnosed cases has increased since June. İstanbul and Ankara are among the seven provinces that have seen the sharpest increases, followed by Gaziantep, Mardin and Diyarbakır, Konya, and Bursa.
• The office of the Ankara Governor has declared a 15-day ban of any sort of mass meetings and demonstrations after Health Minister informed that the number of new coronavirus cases in the capital city has shown an increase.

Lifting of additional physical distancing measures

On July 21, 2020, the Turkish government began allowing cafes, restaurants, and similar businesses to go back to normal work hours again. 
    
Regulations for operation of businesses and public spaces during COVID-19 pandemic:
In May, when the rules for hotels were announced, hotels who wanted to could apply for the “Healthy Tourism Certification" and those who took action to comply with the regulations would be certified. However, since July 2, this certificate is mandatory for hotels with 50 rooms or more, otherwise their license is revoked.

Carrots and sticks tor businesses and public services to comply with COVID-19 regulations:                                               
Businesses, public transportation drivers and taxis that successfully prove to implement COVID-19 preventive measures over three consecutive official inspections will earn a badge of "Safe Space". Inspections will be carried out by the police, the Gendarmerie (army) and coast guard personnel.

Heavier sanctions are imposed for businesses and companies that do not comply with the COVID-19 regulations:
Sanctions to COVID-19 violators are not new, yet from July 2020 they became heavier. Until July, businesses and companies that did not comply with the regulations were fined. Since then, businesses that do not comply with these regulations face heavier penalties, such as closure. They will be given a warning for the first violation, an administrative fine for the second violation, a 1-day suspension of activity for the third violation, and a 3-day suspension of activity for the fourth violation. Apart from expert inspection teams, an audit will also be carried out by civilian personnel or public employee officials (in civilian clothes) to determine whether the measures have been respected.

New policy regarding entrance and exit at Istanbul airport for international passengers:
Turkey’s testing centre for COVID-19 in Istanbul airport is ready to operate in August. The test is intended for International passengers entering and exiting Istanbul. The swab samples taken from passengers' throats and noses are processed and examined in the laboratories located at the airport terminal, and results of the PCR tests are delivered to passengers within two hours.
Passengers undergo PCR tests prior to departure and after arrival. The test results are sent via email in Turkish and English language, and hard copies can be provided to passengers who are travelling abroad or are returning to Turkey. The center has the capacity of conducting up to 40,000 tests per day.

Resuming the education system:
The new school year will commence nationwide on August 31, with classes held remotely. Schools will reopen for presence-based learning on September 21 for students in grades 8 and 12 (who will take high school and university entrance exams at the end of the year). A plan for the reopening of the education system includes the distribution of masks in schools and a creation of epidemic boards in every school for the daily cleaning of schools and school buses. Additionally, over 2,000 inspectors have been checking the COVID-19 safety standards of schools ahead of the planned reopening. Private schools may start online classes from August 17. 

On August 17, people who are 65 years of age and older or are suffering from chronic diseases in the Bursa, Kutahya, Manisa, Batman, Kirikkale, Sivas, Kayseri, Siirt, Yalova, Antep, Bartin and Ankara provinces were restricted from attending weddings, funerals, market places and social activities where large gatherings of people occur.

On September 8, The Interior Ministry distributed a circular to all 81 of Turkey’s provinces that citizens are obliged to wear masks without exceptions in all areas of the country, excluding residences but including public outdoor space and places of work. Standing passengers will not be allowed in public transportation vehicles where physical distance rules cannot be applied (i.e., in any bus with small seating capacity). In public transportation vehicles such as trains, trams and larger buses, the number or ratio of standing passengers permitted will be determined by provincial or district public sanitation boards in ways that are not contrary to the physical distancing rules. Furthermore, signs are to be hung in a way that all can see and the places where standing passengers may stand are to be physically marked.

The Ministry of Interior announced increased and comprehensive inspections starting September 10: 
o The inspections are concentrated in city and intercity public transportation vehicles, food and entertainment venues such as diners, cafes and restaurants, accommodation facilities, shopping malls, bazaars, hair salons,  parks and all other public areas (beaches, for example). Inspection teams consist of representatives of relevant public institutions and organizations:
o Law enforcement and local administrations (such as provincial or district directorates)
o Village and neighborhood mukhtars
o Members of professional associations

o During the inspections, special attention is paid to whether the rules surrounding hygiene, mask use and physical distancing are followed during any special events (wedding ceremonies, funerals, etc.) and in public places (beaches, avenues, parking areas, etc.) where residents may come together in crowds.
o First violations come in the form of warnings,  while second violations result in administrative fines. For businesses, taxis and public transportation vehicles, a the third violation means a 1-day ban of operations, while a fourth violation levies a 3-day ban of operations and suggestions for further steps will be submitted to the local administrative authority.
o For violations that pose a serious risk to public health and acts against the measures, the penalties are to be determined by District General Hygiene Boards and are to be applied by the local administrative authorities.
o The coordination between local administrations, general law enforcement agencies, public institutions and organizations, village and neighborhood mukhtars and professional assoications by the governors and district governor is meant to ensure that necessary planning has been made and no problems will arise in the implementation.


Sources:
https://www.hurriyetdailynews.com/cafes-restaurants-go-back-to-normal-working-hours-156748  
https://www.aa.com.tr/tr/koronavirus/icisleri-bakanligindan-kovid-19-tedbirleri-konulu-ek-genelge/1931574  
https://www.sabah.com.tr/ekonomi/2020/07/01/istanbul-havalimanindan-bir-ilk-koronavirus-test-merkezi-kuruldu-2-saatte-sonuc-verecek
https://www.aa.com.tr/en/education/turkey-to-reopen-schools-from-sept-21/1939774
https://www.icisleri.gov.tr/ulke-genelinde-kapsamli-koronavirus-denetimi-gerceklestirilecek-09-09-20
https://www.aa.com.tr/en/health/turkey-mandates-mask-wearing-in-all-public-areas/1966671
https://www.icisleri.gov.tr/81-il-valiligine-koronavirus-tedbirleri-konulu-ek-genelge-gonderildi-08-09-20
https://dokuz8haber.net/gundem/turkiye-geneli-tedbirler-yogunlasiyor-bircok-ilde-yeni-kisitlamalar-geldi/

Physical distancing measures have been put in place relatively early in Turkey. Initial isolation measures were carried during February:
23 Feb 2020: Individuals entering Turkey with an epidemiological history in Qom or Mashhad, or with a history of patient contact or patient visit are monitored for 14 days in designated hospitals near the border. Those without symptoms are followed at home for 14 days.

Irregular migrants that show COVID-19 symptoms are isolated in the hospital and their samples are taken. Those who do not have symptoms will be followed up for 14 days in temporary shelter camps.

28 Feb 2020: Citizens returning from Umrah without symptoms are informed about COVID-19 and “Information and Consent Form of Follow-up at Home” is signed, (14 days stay-at-home, apply to the hospital if symptoms occur, do not accept visitors, if it is mandatory that going out of home or sharing in the same environment with other people, use a mask). Citizens returning from Public Republic of China without symptoms are kept 14 days stay-at-home or in the places which provincial health directorates defined. Country-wide permission implementation has started for travel by road and airline.

On March 12, 2020, two days after the first case was identified, the Government shut-down schools from March 16 for until May 30, with distance-learning options. On March 26, it was announced that universities will be closed for the spring term. 
On March 9, the Minister of Health announced that individuals coming from abroad should self-quarantine for 14 days; quarantine is also possible in designated observation centres like dormitories and hotels. Visits to hospitals would be limited, and only be allowed after working hours and limited to one visitor. Visits to patients in intensive care and palliative care services was forbidden on March, 13.

As of March 22 2020, civil servants and other workers from essential services, were called to work from home, and allowed flexible work hours, telecommuting. Those who cannot work from home (because they provide services in site) work in shifts with the same employees in order to reduce the contact among workers.
On March 27, it was announced that both private and public sectors should move to flexible work schedules with minimal staff. The government has strongly recommended physical distancing and launched "stay at home" campaigns. In addition, the president called Turkey's 83 million citizens to implement a "voluntary quarantine" and to leave their homes only for basic and emergency needs. On that day, 12 towns and villages were quarantined, and five areas in the Rize province confirmed the lockdown. The Han district of Çaldıran town (located at the Turkish-Iranian border) in the Van province have been quarantined, sub-governor’s office announced.
On March, 30, the Ministry of Interior announced that 39 residential areas in 18 provinces were put under quarantine to prevent the spread of the highly contagious coronavirus (COVID-19).
On March, 31 2020, another 11 villages in Sivas, Yozgat, Çanakkale, Gümüşhane, Giresun, Çankırı and Kütahya provinces, and 2 neighbourhoods in Malatya province were quarantined.
From April 6, many individuals and entire buildings were quarantined due to close contact with COVID-19 cases. As of April 9, about 138,000 Turkish citizens had been quarantined. On April, 15, Turkey further imposed quarantine on 227 residential areas in 58 provinces.

- Special measures for special populations

Concerning special populations, the Turkish government gradually applied special measures, particularly in order to protect the most vulnerable population. It has attempted as to reach individuals outside the main population such as soldiers, refugees and immigrants.
On March, 14, pregnant women and women on breast-feeding leave, people with disabilities and older than 60, except managers, would be allowed 12 days of paid leave for self-isolation.
As of March 17, COVID information brochures and material has been translated and distributed to Arabic for display in refugee health centres. Materials also translated to different languages (Farsi, French, Urdu) and MoH started to distribute them to relevant areas where refugees and migrants frequently use.
On March 22, the movement of individuals aged 65 and up and those chronically ill were restricted, and they were urged not to leave their homes, go to parks and recreational areas.
All legal courts were suspended, except the urgent ones; by the time of writing (May, 5) legal processes are suspended.
As of March 27, soldiers are subjected to a 14-day quarantine during their admission and dismissal from the army. On April, 17, a presidential decree extended the conscription of approximately 66,000 soldiers for one month in order to prevent the spread of the COVID-19 outbreak in the Turkish Armed Forces (TSK).
On 1 April 2020, the President announced curfew for people under the age of 20.
On April, 14, the Turkish parliament ratified a penal reform bill aiming to reduce sentences of thousands of prisoners, paving the way for their release in a bid to ease overcrowding and protect them from the coronavirus. On April, 16 the Turkish penal institutions started releasing inmates, and it is estimated that about 90.000 inmates were released.
17 April 2020: Announcement of suggestions on the protection of seasonal agricultural workers from disease including travel rules; rules to be followed in the city/district of arrival; points to consider during accommodation in arrival city/district.

- Restrictions on non-essential businesses, on mass gatherings and public places

Turkey gradually closed all its non-essential businesses, banned mass gatherings and restricted movement and use of public places just a week after the first case was identified. Bars, night clubs, movie theatres, gyms, wedding halls were closed on March, 16 and nearly 150,000 non-essential businesses across Turkey have suspended their operations by March 20.  On March 22, hairdressers, barber shops and beautify salons were closed until further notice; restaurants and patisseries were allowed to offer only take away and food delivery services. Banks reduced their working hours for client reception. On the following day, grocery stores limited their working hours to 09:00-21:00 and imposed a limited capacity of people at one time, depending on the size of the store. Post workers, cashier, cash collector and other professionals who are in constant contact with clients should wear personal protective gear (gloves and masks). On March 26, the Ministry of Interior announced that in marketplaces (bazar) offering staple foods or cleaning materials, the sale of non-essential items is not allowed and fresh vegetables and fruits must be packed by sellers, avoiding customer contact with the items. The sale of non-essential items such as clothing, toys, ornaments and bags were temporarily suspended as of March 27. Stalls should be separated at least three meters apart, and only a limited number of clients are allowed.

20 March 2020: National and international organizations, meetings, activities were postponed.

From March 21, public transportation was allowed to carry only half their capacity and wearing protective masks is mandatory.
Mass gatherings were banned on March 26: all sport events with spectators were cancelled; mosques mass-worships were postponed; picnics and barbeques at national parks, forests and parks that are managed by the Ministry of Forestry and Agriculture were banned.

On March 31, the Turkish parliament extended an entry ban on visitors at least until the end of April. From the first of April it is mandatory to wear face masks in public spaces, including supermarkets, marketplaces, workplaces and public transportation.

22 April 2020: There will be no iftar/fast breaking meal and sahur organizations and tents during Ramadan. Tomb visits will be restricted during the month of Ramadan.