Delta variant fuels Covid-19 surge in largely unvaccinated Middle East nations

Health systems in Tunisia and Lebanon ‘brought to their knees’ amid political and economic upheaval

A Tunisian medic provides care for Covid-19 patients at Charles Nicole hospital's emergency room in the capital Tunis. AFP

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A surge in cases of the Delta variant of Covid-19d, combined with low vaccination rates, is fuelling a public health emergency and a sharp increase in deaths across the Eastern Mediterranean region, the World Health Organisation reported on Monday.

“As we work hard to take steps to control the Covid-19 pandemic, the virus continues to mutate and spread faster and more aggressively across the region, with severe public health consequences,” said Dr Rana Hajjeh, director of programme management at WHO/EMRO.

Among the countries hardest hit are Lebanon and Tunisia, which are embroiled in political and economic upheaval as their health services are under significant strain.

“Both countries are facing a concerning increase in the numbers of cases and deaths, and their health systems have been brought to their knees, leaving health care workers overwhelmed, and critical shortages in medical supplies,” Dr Hajjeh said.

The WHO defines the Eastern Mediterranean as an area of its operations extending through the Middle East and North Africa to include Pakistan and Afghanistan, covering a total population of nearly 679 million people.

The highly infectious Delta variant, first detected in India and now in 132 countries, has been reported in 15 countries in the region.

An average of 363,000 new cases and 4,300 deaths a week were reported across the region over the past four weeks, a 67 per cent and 24 per cent increase on last month.

More than 12.6 million cases and 237,000 deaths have been reported in the region since the pandemic began.

Countries reporting a substantial increase in cases and deaths over the past month include Iran, Iraq, Lebanon, Libya, Morocco, Pakistan, Somalia and Tunisia.

“A few countries in the region are experiencing a significant rise in cases and deaths as a result of the Delta variant, which is being reported mainly among unvaccinated people,” Dr Hajjeh said.

“This makes it even more critical that all countries must receive enough vaccine doses quickly, and that people take the vaccine at the first opportunity they are offered it.”

The Delta variant, which will soon become the dominant variant globally, is almost 60 per cent more transmissible than the original virus, said Dr Abdinasir Abubakar, infectious hazards manager at WHO/EMRO.

Research shows the risk of hospital admission for people infected with the Delta variant is on average 120 per cent higher, and the risk of death 137 per cent higher. Those infected by the Delta variant are on average 287 per cent more likely to be admitted to intensive care.

Emergency rooms have been overwhelmed, ICUs have been saturated beyond 95 per cent and the need for medical oxygen has increased eightfold

Dr Yves Souteyrand,
WHO representative in Tunisia

Across the region, 132 million vaccine doses have been administered and only 44 million people – less than 6 per cent of the population – are fully vaccinated.

In Tunisia, more than 90 per cent of all reported infections are due to the Delta variant, which was detected in the country on June 24.

“This is being fuelled by low adherence to public health and social measures, as well as low vaccination coverage,” Dr Hajjeh said.

About 8 per cent of Tunisia's 11.8 million population is fully vaccinated. It has reported more than 595,000 cases and more than 20,000 deaths.

“Emergency rooms have been overwhelmed, ICUs have been saturated beyond 95 per cent and the need for medical oxygen has increased eightfold,” said Dr Yves Souteyrand, the WHO representative in Tunisia.

“Swift public health measures have been implemented at the national level, including full lockdown in governorates with the highest incident rate."

At the same time, the country is dealing with political uncertainty following the Tunisian President Kais Saied’s decision to suspend Parliament and dismiss his prime minister last week.

Coronavirus around the world - in pictures

A National Health Service worker prepares for patients at a pop-up vaccination centre during a four-day Covid-19 vaccine festival in Langdon Park, east London.

Young people line up to receive shots of Sinovac's Covid-19 vaccine at the Phnom Penh Thmey Health Centre, in Phnom Penh, Cambodia.

People wearing face masks as a precaution against the coronavirus pray during a service at the Chogyesa temple in Seoul, South Korea.

Passengers wearing face masks wait in the outbound queue at Frankfurt airport, in Germany.

Demonstrators clash with police at the end of a national day of protest against French legislation making a Covid-19 health pass compulsory to visit a cafe, board a plane or travel on an inter-city train, in Paris.

A woman takes a selfie while receiving the first dose of the Moderna vaccine against Covid-19, during the vaccination day called 'Vacunaton', which aims to immunise 50,000 Hondurans aged over 35 in the National Stadium, in Tegucigalpa.

A volunteer holds up a sign to remind people to adhere to Covid-19 protocols during round 4 of the men’s golf individual stroke play during the Tokyo 2020 Olympic Games at the Kasumigaseki Country Club in Kawagoe.

A man with a notice walks around people wearing face masks as a precaution against the coronavirus during a service at the Chogyesa temple in Seoul, South Korea.

A demonstrator kicks away a smoking teargas shell during a national day of protest against compulsory Covid-19 vaccinations for certain workers and the compulsory use of health passes, in Paris.

A health worker, right, administers the Sinovac vaccine during a mass vaccination drive against the Covid-19 coronavirus outbreak in Jakarta.

Dr Souteyrand said the political situation was “not ideal for the efforts provided by the Ministry of Health to tackle the Covid-19 crisis”.

However, “the emergency committee that was established by the government a few days ago will reap fruit soon”, he said.

On the positive side, Tunisia received several large shipments of vaccines, including one million doses of the Moderna vaccine from the US on Friday.

In Lebanon, which detected the Delta variant on July 2, about 12 per cent of its population of 6.8 million is fully vaccinated.

The Delta variant is now the dominant strain in the country and the Covid-19 positive test rate is at 5.7 per cent, compared to less than 1 per cent one and a half months ago, said Dr Iman Shankiti, the WHO representative in Lebanon.

About 93 per cent of new cases are people who are either unvaccinated or have received only one dose, she said.

Lebanon’s political and economic crisis is due to decades of corruption and mismanagement, combined with a lack of foreign currency reserves that has left half of the population below the poverty line.

The resulting problems in the health sector include a shortage of medications, a brain drain of health professionals, poor infrastructure and lack of affordability.

Around 2,000 doctors and 1,500 registered nurses have left the country, the medical syndicate said.

“Hospitals are right now at 50 per cent capacity because of the lack of fuel, electricity, water, sanitation and transportation,” Dr Shankiti said.

“I hope we don’t get to a place where we cannot serve those who need an ICU bed.”

Health care hit by Beirut blast

This week also marks one year since the Beirut port blast killed 200 people, injured 6,000 and displaced 300,000.

“The aftermath of the explosion saw cases of Covid-19 skyrocket, including among health care workers, and the impact of this continues to be seen today, as the health system continues to struggle with limited resources amid the worst economic and social crisis in recent history,” Dr Hajjeh said.

She urged wealthier countries to donate vaccine doses to low and middle-income countries, and appealed to individuals to continue using preventative measures.

“Unfortunately, there is still a worrying inequity in the distributions of vaccines, with many countries in our region severely impacted,” she said.