Foreign Policy

Afghanistan is inundated by the third wave of COVID-19

KABUL, Afghanistan – After months of hesitation over the past year by the Afghan government to respond to the looming pandemic, the country is now in the midst of its third wave of COVID-19, with the government still deeply denying the severity of the disease. Its numbers are widely mocked, with deaths and infections believed to be much higher than reported.

Figures from the Afghan Ministry of Health show that number of positive cases on the rise: 1,582 new cases on Monday with 56 reported deaths versus 1,379 new cases on Sunday. A health economist who refused to be identified said the real number was likely twice that published by the ministry. Kabul’s Ministry of Health said A total of 80,615 people have been infected with the coronavirus since the first report on February 11, 2020; 3,195 people died, it said.

However, health experts said few Afghans report their illness in hospitals and many sick have died in their homes, suggesting that the official COVID-19 numbers in Afghanistan belittle the severity and widespread nature of the ongoing outbreak. On a day last week when 36 deaths were officially reported nationwide, a doctor at a public hospital in Kabul who did not want to be named estimated the deaths in the capital alone at more than 500 deaths per day.

The government argued that Kabul’s cemeteries were underutilized, proving that deaths from COVID-19 are minimal. But most of Kabul’s residents are returned to their villages for funerals, where the high attendance at funerals is a sign of their status (and an additional disease vector) and further tarnishes confidence in government officials.

“The problem is, no one can prove it [government information] right or wrong, ”said Ahmad Abid Humayun, executive director of the Sanayee Development Organization.

While the cabinet is considering reverting to a nationwide lockdown, with schools and universities being taught online again due to rising infection rates, the government has ignored requests from non-governmental organizations to ban travel to and from Iran and Pakistan, both countries with high levels Infection Rates and Porous Boundaries. Flights to Kabul from India, which has become the epicenter of the disease, are full as Afghans flee home, a senior official said. COVID-19 negative tests are said to be easily purchased for around $ 45.

Afghan nationals make their way across the Pakistan-Afghanistan border to Torkham, Afghanistan from Peshawar, Pakistan, on May 5.ABDUL MAJEED / AFP via Getty Images

COVID-19’s rooting in Afghanistan owes a lot to the mistakes made in the first three months of the outbreak last year, prompting medical authorities to transfer the response to international and local charities. By then, according to frontline health workers, it was too late to reverse the spread of the pandemic. And those early mistakes were made worse by corruption and greed, which has caused the prices of basic health equipment to skyrocket while ventilators ordered overseas disappear before they reach the hospitals that desperately need them. The government failed to respond accusations that funds for COVID-19 have been misappropriated or misused as public anger grows over the government’s inability to contain the spread of the virus and reduce the number of deaths.

“The government says it has spent $ 200 million fighting COVID, but there is no adequate public information campaign so no one knows how or where to get vaccinated,” said a Kabul businessman. “There is no doubt that a large part of this money has gone into the deep pockets of the officials.”

Afghanistan’s efforts to address the public health crisis are being hampered not only by endemic corruption and distrust of the government, but also by the rapid withdrawal of U.S. and international forces who have served Afghan security forces for nearly 20 years support against insurgents. The Taliban, who are fighting to oust the government of Afghan President Ashraf Ghani, hold considerable territory amid a nationwide surge in violence. Embassies are reducing their staff, recommending their nationals to leave the country or even closing because the Australian did at the end of last month.

Men wait for a dose of the Covishield vaccine for COVID-19 at a vaccination center in Kabul, Afghanistan on April 26. VICE KOHSAR / AFP via Getty Images

And then there’s all the damage that rumors, superstitions, and misinformation from religious leaders do, Humayun said. In the absence of public information campaigns, awareness and acceptance of vaccines are low, and millions of doses expire before they can be used. Health workers beg their friends and co-workers to get vaccinated. Some, like Sanayee, visit people in their homes and ask them to invite relatives, friends, and co-workers to get vaccinated together to use the vaccines before they expire.

A now firmly entrenched belief that infection with COVID-19 causes infertility means that people who test positive refuse to participate in test-and-trace programs. “They just disappear, refusing to answer the phone,” said Humayun, whose organization supplies the provinces of Kabul, Zabul and Faryab with up to 7 million people.

Religious leaders have told their followers that “good Muslims” do not infect COVID-19, Humayun said. Charlatans have emerged Peddling Opium-infused potions that are touted as remedies. “It gave it out for free and people felt better,” a government official said of herbalist Hakim Alokozai’s free COVID-19 cure.

As a result, Afghanistan was only able to vaccinate a, despite numerous vaccines Small amount of its population. The Johns Hopkins University School of Medicine Coronavirus Resource Center said only 0.38 percent of the Afghan population are fully vaccinated, or 144,600 people with 630,305 doses administered.

A local gardener receives his first round of vaccination on May 25th from an employee of the Sanayee Development Organization in Kabul, Afghanistan. Massoud Hossaini for Foreign Policy

Most of these vaccines were given to members of the Afghan security forces, which amounted to up to half a million first and second doses. Vaccinations race to give civilians a second dose before the supply runs out and miss many who wish to get vaccinated as the crisis worsens.

The only factor Afghanistan seems to have on its side is its Youth of the population: Around 70 percent of the estimated 40 million inhabitants of the country are younger than 30 years and more than 40 percent are younger than 15 years. With older Afghans at lower risk, the overall death rate is likely to stay near the global figure of 1 to 2 percent, Humayun said.

But even that is a deadly pandemic. In arbitrary conversations with Afghans, most say that at least one, often several, close relatives have died of the disease. They tell anecdotal stories of hospitals and clinics overwhelmed by patients – there is a lack of staff, expertise, equipment and oxygen to treat COVID-19 sufferers. And it is likely to get worse and worse. Few people in Kabul wear masks in public and there is little evidence that advice against crowds is being followed. Even during last year’s lockdowns, most Afghans admitted that it was an excuse for large meetings at home while devastating the economy.

Vaccination is so often avoided by the public – despite the government promising to vaccinate most of the country by the end of next year – that huge amounts will have to be destroyed as they will expire unused. In the meantime it is costs basic health equipment has skyrocketed. A simple box of masks that cost $ 1 for 100 masks a year ago is now about $ 15. Everything from simple items like thermometers to high-end devices like ventilators have apparently been diverted to the black market – all of which threaten to jeopardize the means of controlling COVID-19 beyond the reach of many Afghans.

A Sanayee Development Organization employee shows a bottle of the vaccine (left) and a gardener shows his vaccination card after being vaccinated in Kabul, Afghanistan, May 25. Massoud Hossaini for Foreign Policy

Afghanistan’s Acting Minister for Public Health, Wahid Majrooh, has pleaded the public to wear masks as it warns of an impending “disaster” amid severe oxygen shortages in hospitals across the country. When the pandemic broke out, local media reported reported Afghanistan only had 400 ventilators. School girls had found a way to make cheap versions out of auto parts.

Northern Balkh Province Health Ministry head Gul Ahmad Ayubi said 179 oxygen balloons disappeared from the province’s main hospital after reports that local strong men were confiscating oxygen supplies for their own use.

With the situation expected to deteriorate, a Kabul businessman reiterated the concerns of many Afghans when he rejected the government’s desperate requests for caution. “There are worse things here that will kill you.”

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