The Turkish Medical Association (TTB) on Wednesday said Turkey’s health ministry was not reporting COVID-19 deaths in line with World Health Organization (WHO) standards, citing a discrepancy between confirmed cases and the death toll.
“The number of deaths announced over the past few days are not in tune with epidemiological distributions, and there are no parallels between the confirmed cases and the death toll,” the TTB said in a written statement.
“While the lack of increase in the number of deaths is an undoubtedly welcome situation, it noteworthy that it does not correspond to the pattern seen in other countries around the world.”
The statement also included a graph showing new case confirmations and deaths on a daily basis, marking the relative stability in the daily death toll compared to the ongoing surge in new cases.
The TTB said it had received notices from member doctors that patients whose polymerize chain reaction (PCR) tests were not positive are not recorded as COVID-19 deaths when they pass away, even though clinical findings and cat scans point to a high likelihood. Instead, the records show causes of death such as “viral pneumonia,” “infectious disease” or simply that they died of natural causes.
The TTB quoted WHO advisories suggesting the use of a specific code, U07.2, for probable or suspected cases of COVID-19 where clinical and epidemiological findings point to COVID-19 but the diagnosis could not be confirmed through laboratory tests.
The association said the code corresponds to avian influenza infections in Turkey’s death documents, inconsistent with WHO guidelines.
“It is an issue of concern why the Ministry of Health does not use the codes advised by the WHO,” the statement read. “The US Center for Disease Control (CDC) says that we should avoid broader and nonspecific definitions such as viral pneumonia.”
The TTB said the ministry’s choice implies an underreporting of deaths during the COVID-19 pandemic, possibly leading to an inability to consider the real size of the problem and to take adequate public health measures.
The association urged the ministry to adopt WHO-suggested COVID-19 codes and to review the death toll since February.
Turkey confirmed its first COVID-19 case on March 11. As of April 9, it had nearly 40,000 confirmed cases with a death toll of 812.