In the Middle East, Covid-19 optimism risks fading

After a slow start, most countries in the region are struggling with major waves of the virus

In the early weeks and months of the coronavirus pandemic, it looked like the Middle East may, for once, be a lucky exception.

There was a frightening and accelerating outbreak in Iran, but the virus did not take hold in any of the countries that shared borders or had close ties with it early on. There was no major spike in cases in Lebanon or Iraq, or any of the Gulf states. Turkey was late in recording cases, but the rapid rise in infections there was brought under control relatively quickly through a mix of lockdowns, widely available masks and protective equipment, and an effective public health system. Even hotspots like Libya, Yemen and Syria reported few official cases. Few places were as badly hit as China, Italy, Spain, the UK, or the US.

There were many attempted explanations as to why the virus did not take hold in the Middle East, such as speculation that the hot weather may inhibit its spread, genetic variations in the population, and early lockdown measures. But there was no definitive explanation because we still did not know much about the virus. Perhaps, some speculated, the wave simply hadn’t arrived yet.

Fast forward to now, and most of the explanations above seem to have been entirely too optimistic. Almost every country in the Middle East is now struggling with major waves of the virus, highlighting how war devastated communities and made them vulnerable to the pandemic, the catastrophe of decrepit public health infrastructure in many countries in the region, and the need for great vigilance in the weeks and months ahead as schools and universities reopen.

Let us look at where things stand.

In countries riven by war, the virus has spread unchecked. Libya now has nearly 15,000 cases, a sudden increase that mostly took place in the past two months. The country is divided between loyalists of the Tripoli-based government and the eastern part, a stalemate that inhibits the easy flow of medical and humanitarian aid. Vaccines for other diseases were already in short supply as the current outbreak picked up steam.

Yemen has had a relatively low number of officially reported cases with 2,000 infections, but media reports and humanitarian workers reckon the figures are much higher based on the testimony of gravediggers and data in local registers. And at any rate, even a small outbreak is likely to be catastrophic in a country with 20 million people in need of assistance and which has recurrent cholera outbreaks.

The pandemic is also picking up steam in Syria, which has reported nearly 3,000 cases in government, rebel and Kurdish-controlled areas, and estimates there are also believed to be much lower than the real figures. Iraq now has nearly a quarter of a million recorded cases, with over 7,000 deaths.

Lebanon, already reeling from a collapsing economy and hyperinflation, as well as popular unrest following the enormous explosion last month in Beirut, is also struggling with a major spike in cases. More than 17,000 have been recorded after months of just a few dozen cases, and hospitals devastated in the explosion are ill-equipped to deal with them. There are also over 23,000 cases now in Gaza and the West Bank – the former went into lockdown last week after cases were reported in the blockaded strip.

Nor are more functional countries in the region faring a lot better. Morocco has had over 63,000 cases, Egypt is officially at 100,000 but government officials said it likely exceeded that at least two months ago, and Saudi Arabia has recorded more than 300,000 cases and nearly 4,000 deaths as of Tuesday.

A number of Gulf countries generally have suffered a high rate of infection per capita. Out of a population of nearly three million, Qatar has had 119,000 infections. Kuwait has fared a little better, with 86,000 cases out of four million.

Arab countries are still doing much better than the hardest-hit countries in the world at the moment, such as the US, Brazil and India, as well as those now experiencing second waves of the virus after reopening, such as Spain and France. Nevertheless, there are a few important takeaways from the crisis.

First, the wars and conflicts that have devastated large swathes of the region have exacted a terrible toll on public health. Hospitals were routinely bombed in Syria during the war, for example, making it much harder for the country to deal with the pandemic’s eruption. Protecting such civilian infrastructure is absolutely crucial, and it is important for the international community to reclaim its role in enforcing such norms in warfare, though such a prospect sadly remains improbable in the short term. At the very least, access to medical and humanitarian aid must be maintained – it will save lives on all sides of the conflict.

Second, investments in public health are absolutely crucial. No country has fully defeated the coronavirus, but some have fared better than others. Those that did so managed it through widespread access to testing and high-quality medical care. Public health should be the main priority for investment in the coming months and years, though corruption is likely to hinder such efforts in many Arab countries.

Third, vulnerable communities need immediate protection. In some Arab countries, labourers living in cramped conditions have been particularly vulnerable to infection. Refugees in places such as Idlib living in flimsy, overcrowded tents are also susceptible to outbreaks. The pandemic should prompt broad reform in how we protect the most vulnerable among us, by improving conditions for labourers and refugees. It is the decent thing to do and will serve to protect the entire community.

Finally, these numbers show that we are not out of the woods yet, despite broad pandemic fatigue. The reopening of school and college campuses is already driving spikes in cases around the world. It can only fuel ongoing outbreaks in the region. We must be vigilant for a little while longer. The light at the end of the tunnel is still some ways off.

Kareem Shaheen is a veteran Middle East correspondent in Canada and columnist for The National