Infectious disease experts are expressing concern about Pope Francis’s trip to Iraq this week, given a surge in coronavirus infections there, a fragile healthcare system and the crowds that will come to see him.
No one wants to tell the Pope, 84, to call it off, and the Iraqi government wants to show off its relative stability by welcoming the first pope to the birthplace of Abraham.
The trip, from March 5 to 8, is expected to provide a badly needed spiritual boost to Iraq’s beleaguered Christians and advance the Vatican’s efforts to better connect with the Muslim world.
But health experts say the trip during a pandemic is not advisable and sends a poor public health message.
Their concerns were reinforced with the news on Sunday that the Vatican ambassador to Iraq, who would have escorted Francis to all of his appointments, tested positive for Covid-19 and was in isolation.
Archbishop Mitja Leskovar’s symptoms were mild and he was continuing to prepare for Francis’ visit, the embassy told AP.
Experts said wars, economic crisis and a mass departure of Iraqi professionals have devastated the country’s hospital system.
And studies show most of Iraq’s new Covid-19 infections are the highly contagious variant first identified in Britain.
“I just don’t think it’s a good idea,” said Dr Navid Madani, virologist and founding director of the Centre for Science Health Education in the Mena region at Harvard Medical School.
The Iranian-born Dr Madani co-wrote an article in The Lancet last year on the region's uneven response to Covid-19.
It said Iraq, Syria and Yemen were poorly placed to cope, given that they are still struggling with extremist insurgencies and have 40 million people who need humanitarian aid.
Dr Madani said people in the Middle East were known for their hospitality, and the desire of Iraqis to welcome Francis to a neglected, war-torn part of the world might lead to breaches of virus control measures.
“This could potentially lead to unsafe or super-spreading risks,” she said.
Dr Bharat Pankhania, an infectious disease control expert at the University of Exeter College of Medicine, agreed.
“It’s a perfect storm for generating lots of cases, which you won’t be able to deal with,” Dr Pankhania said.
Organisers promise to enforce the wearing of masks, social distancing and crowd limits, and the possibility of increased testing sites, Iraqi government officials said.
The healthcare protocols are “critical but can be managed,” one official told AP.
And the Vatican has taken its own precautions, with the Pope, his 20-member Vatican entourage and the about 70 journalists on the papal plane vaccinated.
But the Iraqis gathering in the north, centre and south of the country to attend Francis’s indoor and outdoor Masses, hear his speeches and take part in his prayer meetings are not vaccinated.
“We are in the middle of a global pandemic and it is important to get the correct messages out,” Dr Pankhania said.
“The correct messages are: the less interactions with fellow human beings, the better.”
He questioned how it would look, with the Vatican delegation inoculated while Iraqis are not.
“You are all protected from severe disease, so if you get infected, you’re not going to die," he said, referring to Vatican officials and the media. "But the people coming to see you may get infected and may die.
"Is it wise under that circumstance for you to just turn up? And because you turn up, people turn up to see you and they get infected?”
The World Health Organisation said countries should evaluate the risk of such an event spreading the disease, and then decide if it should be postponed.
“It’s all about managing that risk,” said Maria Van Kerkhove, the WHO’s technical lead on Covid-19.
“It’s about looking at the epidemiologic situation in the country and then making sure that if that event is to take place, that it can take place as safely as possible.”
Pope Francis has said he intends to go even if most Iraqis have to watch him on television to avoid infection.
The important thing, he told Catholic News Service, is “they will see that the Pope is there in their country".
He has frequently called for an equitable distribution of vaccines and respect for government health measures, although he tends not to wear face masks.
The Pope has for months avoided even socially distanced public audiences at the Vatican to limit the chance of contagion.
Dr Michael Head, senior research fellow in global health at the University of Southampton’s medical faculty, said the number of new daily cases in Iraq is “increasing significantly at the moment”.
The Iraqi Health Ministry is reporting about 4,000 cases a day, close to the height of its first wave in September.
Dr Head said for any event in Iraq, measures such as wearing masks, washing hands, social distancing and good ventilation indoors must be enforced.
“Hopefully we will see proactive approaches to infection control in place during the pope’s visit to Baghdad,” he said.
The Iraqi government imposed a modified lockdown and curfew in mid-February amid a new surge in cases, closing schools and mosques and leaving restaurants and cafes only open for takeout.
But the government decided against a full shutdown because of the difficulty of enforcing it and the financial effect on Iraq’s battered economy.
Many Iraqis remain lax in using masks and some doubt the severity of the virus.
Dr Madani urged trip organisers to let science and data guide their decisions.
Rescheduling or postponing the papal trip, or moving it online would have a significant effect “from a global leadership standpoint”, she said.
“It would signal prioritising the safety of Iraq’s public,” Dr Madani said.
