Is it possible to determine exactly when the outbreak started?

Aim: The outbreak of the COVID-19 pandemic, which first appeared in late 2019, has undoubtedly affected the global health system. In this study, we tried to investigate whether this disease was seen before the first case in our country with clinical diagnoses. Methods: This study is a cross-sectional, observational, descriptive study conducted in a pediatric emergency department. The data of the cases were accessed from the hospital automation system. The number of patients who were admitted, the number of hospitalization or intensive care unit, the number of patients who were diagnosed with respiratory tract infection, the triage codes they received in the emergency department, and the viral antigen results obtained from airway swabs are the independent variables of the study. Results: 46 525 patients were admitted to the pediatric emergency department between 01/12/2018-28/04/2019 and 44 532 patients between 01/12/2020-29/02/2020. (T = 0.8 and P = 0.4) During the 2019 period, 1316 cases were admitted to the ward, and 130 cases to the intensive care unit. During the 2020 period, 1246 cases were admitted to the ward, and 142 cases were admitted to the intensive care unit. (P = 0.06 T = 1.8) During the 2019 period, 12 cases resulted in death, while in the 2020 period, 11 cases of exitus were observed. (P = 0.4) Conclusion: The fact that more upper respiratory tract diseases were diagnosed compared to the same period of the previous year makes us think that the outbreak may have started in our country before the first diagnosis.