The coronavirus outbreak is bearing down on Turkey despite strict measures and restrictions. Health Minister Fahrettin Koca singled out the southern province of Adana and the northern provinces of Samsun and Ordu as places with a 100% rise in cases in the past two weeks, while the western province of Izmir and the central province of Konya registered a 50% increase in cases in the same period.

"Health care staff and hospitals in those provinces are under a heavy burden," Koca tweeted late Wednesday after a meeting with local health authorities. "Our test of sacrifice continues in the fight against the outbreak," Koca said.

The autumn has been particularly devastating so far for the country, which is going through what experts call a second wave of the outbreak. The total number of patients exceeded 513,000, while fatalities rose to 14,129. Some 414,141 patients have recovered since the outbreak made its foray into Turkey in March. The country also increased the number of tests to more than 18.9 million.

Turkey rolled out a series of measures in the past weeks, including a partial weekend curfew that was extended to a full weekend lockdown this week. On weekdays, a curfew was imposed between 9 p.m. and 5 a.m. Schools, restaurants, cafes and several businesses were ordered to shut down. Local pandemic boards in each of the 81 provinces also started introducing new restrictions like limited access to crowded streets and squares.

Samsun Gov. Zülkif Dağlı said in a written statement Wednesday that they were concerned with the current outlook. "It appears that the caseload on hospitals is heading toward an unbearable point. We increased intensive care unit bed capacities and plan to use hospitals in small districts more actively. If the current trends continue and people ignore the rules, we will have serious problems soon," he warned.

Samsun Metropolitan Municipality Mayor Mustafa Demir said the city has long recorded new patients below the country's average but faces a new rise in the number. "It appears that it is related to the secretly infectious," Demir told Demirören News Agency (DHA) on Thursday, referring to asymptomatic cases. "We repeatedly warn citizens and hope numbers will drop again," Demir said. He noted that some 40 people working for the municipality tested positive and another 40 were in quarantine for coming into contact with infected people.

The mayor also linked the rise to Samsun’s location as a main hub of transportation in the wider Black Sea region which receives a large number of visitors from other regions. "We also see high infection rate among people from the same families and relatives," he pointed out.

In Adana, sights of people not wearing protective masks are still common although the province struggles to fight against the outbreak by expanding intensive care services, and long lines are seen outside hospitals for COVID-19 tests. Local authorities repeatedly issue warnings from loudspeakers at mosques, calling on the public to adhere to mask, social distancing and hygiene rules.

VACCINE ROAD MAP

Authorities now largely rely on the public’s compliance with measures. Masks and social distancing are mandatory and law enforcement officers routinely conduct patrols to issue warnings and fines to violators. For now, a vaccine remains the best hope of the country to get rid of the pandemic.

The government unveiled a four-stage vaccination plan late Wednesday, which is set to start after Dec. 11. In the first stage, health care workers, senior citizens, people with disabilities and people living in crowded environments will be inoculated. In the second stage, people working in crucial jobs like law enforcement, those living in high-risk environments and people above the age of 50 who have at least one chronic disease will be vaccinated. The rest of the population will be vaccinated in the subsequent stages based on the grade of risk they are exposed to.

Turkey will receive at least 10 million doses of the vaccine this month, and the number will increase gradually in the following months. Although authorities did not disclose the name of the vaccine, the country had previously made an agreement with China to purchase 50 million vaccine doses. The Chinese vaccine will be free for everyone, while vaccines from other companies and countries are being considered to be sold at pharmacies. Koca announced earlier that Turkey was in talks with Germany to purchase 25 million doses.

After the vaccination plan was announced, Koca said in a written statement that an agreement was signed for the acquisition of an inactive vaccine and talks were underway for a messenger ribonucleid acid (Mrna) vaccine. He said the vaccines would be subject to efficacy tests for their approval by health authorities and final approval would be given after early results of their Phase 3 trials. China-based Sinovac’s CoronaVac and a vaccine developed by U.S.-based Pfizer and Germany-based BioNtech are currently in human trials in the country. Health care workers have volunteered first for the vaccines, while the CoronaVac trial was opened later for other volunteers.

Ateş Kara, a member of the Health Ministry’s Coronavirus Scientific Advisory Board, told the Sabah newspaper on Thursday that CoronaVac appears to have more efficacy. "It is developed with old, reliable methods. The Mrna vaccine is relatively new. Mrna vaccines were studied in the 1990s against vaccine and had no prevalent use. Authorities will check data on their safety before inoculation, and three-month and six-month data regarding trials and efficacy will be examined," he said.

An "inactive" vaccine is a vaccine consisting of virus particles, bacteria or other pathogens that have been grown in cultures and lost their disease-producing capacity. They are alternately called "dead vaccines" in contrast to live vaccines that use pathogens that are still alive.