In the early months of encountering COVID-19, there was a sense of anxiety and fear across all segments of society, including the healthcare community. Since the beginning of 2020, when COVID-19 started to impact Turkey, it has introduced many new terms into our vocabulary. Today, the entire society is familiar with words such as pandemic, PCR, filiation, and mutation.
As a country, Turkey set an example to the world in the fight against COVID-19 with the establishment of the Scientific Advisory Board by the Ministry of Health and the effective implementation of filiation practices.
All healthcare institutions—public, university, and private hospitals—were caught off guard by the pandemic. This was a global phenomenon. Basic medical supplies such as gloves, masks, and caps, which were once considered ordinary and readily available in hospitals, suddenly became scarce. No one could have imagined a time when masks would be rationed and distributed to healthcare personnel with strict records. There were days when hospital staff hid hand sanitizers, medical suppliers turned into black-market traders, and even cologne disappeared from store shelves for months.
Hospitals Were in a Difficult Situation
Many hospitals found themselves in dire straits, with barely a week's worth of stock. While private hospitals had to reduce their staff, public and university hospitals faced significant shortages due to childcare responsibilities, health concerns, and other valid reasons. Those who remained on duty hesitated to enter patient areas. Each healthcare worker had their own fears. Some rented separate accommodations and avoided going home, while others stayed in dormitories. Many sent their spouses and children to their hometowns and went months without seeing them. These were difficult times, filled with countless personal sacrifices from healthcare workers.
A Grueling Process
Although there were action plans on paper, since no one had firsthand experience managing a pandemic, the reality of the situation proved to be incredibly exhausting and challenging. Despite filiation efforts, setbacks were inevitable due to factors such as public anxiety, lack of resources, insufficient personnel, and gaps in education. At the onset of the pandemic, district and private hospitals were initially excluded from COVID-19 care. However, as the burden on central and fully equipped hospitals grew and resources became scarce, all hospitals—both public and private—had to be incorporated into the response.
A New Era in Hospitals
No hospital had a pre-existing action plan or physical structure to isolate patients effectively. Protective measures for personnel and strategies to ensure seamless healthcare services for both COVID and non-COVID patients were inadequate. Central hospitals had to continue serving non-COVID patients as well. Emergency cases, trauma patients, forensic cases, and specialized medical units still required uninterrupted services.
Public response to the crisis was unpredictable; suddenly, the number of patients visiting emergency departments plummeted, and only true emergency cases arrived at hospitals. Outpatient clinic visits declined, and patient visits ceased entirely. It was even observed that some people no longer wanted to accompany their hospitalized relatives.
During the first peak of the pandemic, patients were accommodated in single rooms. However, as hospital bed availability became strained, patients were placed in double-occupancy rooms while maintaining the required distancing measures. This posed risks not only for patients but also for healthcare personnel, adding another layer of anxiety.
It is painful to recall, but there were instances where even spouses and mothers and sons refused to stay in the same room. People had begun to fear one another.
Striving to Maintain Comfort
Efforts were made to ensure patient comfort at the highest level. Meal services, in-room televisions, room cleaning, and tele-information services were enhanced. However, there were also unusual incidents, such as isolated patients smoking in their hospital rooms. Some patients resisted treatment, leading to confrontations with security personnel and law enforcement. Others even attempted to escape from hospitals.
Thus, hospital services took on a new dimension—beyond providing medical care, they had to function as hotel services while addressing psychological and social challenges.
As cases decreased due to various measures, a sense of complacency led to new abuses, and during the second peak of the pandemic, the patient profile and disease severity changed. The number of patients requiring hospitalization and intensive care increased significantly. As a result, central and fully equipped hospitals once again bore the brunt of the crisis. Temporary intensive care units were established, and mechanical ventilators were used in hospital wards as resources became even more strained.
Healthcare Workers Pushed Their Limits
By the time all available resources had been exhausted and the pandemic was expected to subside, a new peak caused by mutated virus strains emerged. Unlike previous peaks, this time the burden on hospitals was even greater. In the early stages of the pandemic, people avoided hospitals out of fear of contracting the virus. However, during this phase, patients no longer wanted to delay their treatments.
This meant hospitals had to care for both COVID and non-COVID patients simultaneously, with every facility and unit adapted to strict isolation protocols. There was no retreat—patients needed care, and services had to continue despite physical and personnel limitations. Pandemic measures had to be maintained at the highest level.
There were significant logistical challenges. The number of ambulances available to transport isolated patients was insufficient. The vehicles and personnel required for patient transfers and post-treatment isolation were also inadequate. In summary, all hospitals faced the same level of restrictions.
But the undeniable reality was this: a pandemic was unfolding, and healthcare workers were at the heart of it, ensuring that healthcare services continued without interruption.
Countless dramatic stories emerged—healthcare workers dancing to cheer up patients, sharing their food and drinks, returning to the hospital hours after their shifts ended just to check on a patient, celebrating recoveries with heartfelt ceremonies, and shedding tears beside critically ill patients. These courageous, selfless, and hardworking healthcare professionals have left us with inspiring stories of resilience.
We are immensely proud of our dedicated healthcare workers, who served as if defying the pandemic itself, risking their own lives in the process. We honor them with deep respect and gratitude.
We also remember with sorrow the colleagues we lost during the pandemic and extend our heartfelt condolences to them.
Prof. Dr. Ahmet Şen
Anesthesiology and Reanimation Specialist
