COVID-19 Outbreak in Istanbul.

OBJECTIVE: The COVID-19 pandemic has demonstrated that the social determinants of health play a fundamental role in the course of the pandemic. This article aims to reveal the class dynamics of the COVID-19 epidemic in Istanbul, Turkey. MATERIAL AND METHODS: Spatial analysis and geographic information system data provided by Istanbul Metropolitan Municipality for March and April 2020 were used. Public transport mobility and turnstile data were analyzed. The data obtained were collated into thematic maps. RESULTS: Between March 16 and 24, 2020, the use of public transportation declined with the tightening of movement restrictions. However, despite the restrictions, an increase in transportation density was observed between 6 and 9 am and between 5 and 7 pm. Although the overall mobility toward outside the city has fallen due to travel restrictions, it has been observed that exit mobility continued between Gebze and Kocaeli, both industrial centers where blue-collar jobs dominate. Most of the mobility in the city is observed in Avcilar, Bahçelievler, Esenyurt, and Küçükçekmece, which are mostly blue-collar residential districts. On the Asian side, activity was observed in Kurtköy, Pendik, Samandira, Ümraniye, and Tuzla, areas where blue-collar workers predominantly reside. From March 25 to April 7, 2020, it was determined that the most intense activity areas of the blue-collar workers were Avcilar, Bahçelievler, Bagcilar, Çekmeköy, Esenyurt, Küçükçekmece, Ümraniye, and D-100 highway line. CONCLUSION: The density in the use of public transportation rose during the hours corresponding to the working hours of the workers who had to continue working despite the pandemic. In addition, the physical movement of blue-collar workers continued despite the travel restrictions imposed along the city borders where they worked and resided. Our data point to the importance of social protection measures for workers in general, and blue-collar workers in particular, for the management of the pandemic.

COVID-19 mortality in Istanbul in association with air pollution and socioeconomic status: an ecological study.

This study aims to reveal the relationship between the COVID-19 mortality indicators and socioeconomic status (SES) and air pollution. In this ecological study, the focus was put on the relationship between COVID-19 mortality and both air quality and socioeconomic status at the district level in Istanbul. The mortality variables of the study are the excess deaths due to the pandemic, the proportion of deaths due to the pandemic among all deaths, COVID-19 mortality rate (per 100,000), and the proportion of COVID-19 deaths among older people (above the age of 65). The daily air quality measurements of PM10, SO2, NO2, and NOx of the pre-pandemic term were included in the research to avoid bias due to decreasing traffic burden during the pandemic. Partial correlation was applied to analyze the relationship between air quality and mortality measures by controlling socioeconomic status, the percentage of the older population, and household size. Every 20% deterioration in the SES stratum has contributed to a 4% increase in excess mortality at the district level. The elderly population ratio of over 10% in the districts was found to increase the COVID-19 deaths in the total population by 35% and the deaths in the population over 65 years old by 3%. Average household size was correlated with COVID-19 deaths in the population over 65. A moderate correlation was found between the COVID-19 mortality rate per 100,000 population and PM10, SO2, and NO2 (r = 0.413, 0.421, and 0.431, respectively). Mortality during the COVID-19 pandemic in Istanbul is related to an interaction of socioeconomic characteristics and air pollution as an environmental issue.

EVALUATION OF THE MEASURES TAKEN IN NURSING HOMES OF THE ISTANBUL METROPOLITAN MUNICIPALITY DURING THE COVID-19 PANDEMIC

Introduction: This research investigates the effectiveness of measures taken against the COVID-19 pandemic in nursing homes under the responsibility of the Istanbul Metropolitan Municipality. Materials and Method: Documents, decisions, and statistical data from the Istanbul Hospice gathered between March 1 and May 31. Results: The average age of the nursing home residents was 70.2. Among them, 29.0% were capable of self-care, while 31.4% were fully dependent on others for care. Visitor restrictions, social function cancellations, fever and complaint follow-up, institutional disinfection, the use of personal protective equipment, placarding, new employee shifts, short stays and isolation areas, personnel services, employees and resident screening tests, cargo limitations, and psychologist-sociologist support were implemented in the home to help deal with the pandemic. In all, 14 of 930 employees tested positive for the virus when given a COVID-19 PCR test. A total of 104 bed-dependent residents received PCR screening tests, and none were positive for the virus. There were 23 deaths in total (3.3%). There were no definite COVID-19-related deaths. The probable case-related mortality rate was 0.5%. Conclusion: Our research shows that the measures taken to address the COVID-19 pandemic in the nursing homes run by the Istanbul Hospice were timely and effective. Our data indicates that, if the finance and service structures of the nursing homes are met, and local authorities have control over the administrative organization, there will be no fatal outbreaks associated with COVID-19.

COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society.

It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.