On Thursday, April 2, 2020, the "General Assembly to Fight Coronavirus Crisis in Herat" which is recently established by the Afghan Institute for Strategic Studies (AISS) with more than 30 members held an online launching ceremony of the paper "Impact of Non-Pharmaceutical Interventions to Reduce #COVID19 Mortality". This article was written by Imperial College COVID-19 Response Team and translated into Farsi/Dari by AISS.
Abdul Qadir Salehi, General Assembly to Fight Coronavirus Crisis coordinator in Herat; Dr. Khawja Mir Islam Saeed, Advisor to the Field Epidemiology Program at the Afghanistan National Public Health Institute; and, Dr. Khushal Nabizada, Public Health Specialist and Country Director of Action For Development, were the speakers of the program. The event was moderated by Abdul Basir Azimi, AISS Fellow and former Deputy Minister of Energy and Water.
At the beginning of the program, Abdul Qadir Salehi pointed out that if non-pharmaceutical interventions scenarios mentioned in this article, implement a crackdown strategy, it will pose serious economic, social and security challenges; and unfortunately the current political problems in the country further intensify these challenges. The worldwide incidences have increased 9-fold over the past 14 days; although the mortality rate has been 7%, but it is good for Afghanistan that the use of the virus suppression scenario has been reduced, he added. Mr. Salehi suggested that multilateral efforts and co-operation be sought between all active currents in Afghanistan; particularly Taliban and the Afghanistan government that have defined Coronavirus as a common enemy, and both have taken action.
Dr. Khushal Nabizada presented the key findings of the paper. Having non-pharmaceutical interventions, unwanted outcomes of the epidemic; it also can minimize the economic burden of the epidemic for the [public] health system, he asserted. He also added that countries like United States and United Kingdom have designed their response to this pandemic based on the findings of this paper. This report focuses on two strategies: 1) To mitigate the effect of the virus; and 2) To suppress the outbreak of the virus. In the mitigation strategy, the goal is to minimize the speed of which the virus spreads. According to this strategy, to create a herd immunity from the virus, people who have a higher [mortality] risk should be protected [from contact to potential carriers of the virus]; in the meantime, attention should be given to people who need intensive care. In the suppression strategy, the goal is to completely stop or significantly control the spread of the virus.
Dr. Khawja Mir Islam Saeed stated that non-pharmaceutical intervention mechanisms to control the epidemics has not changed in the last century; however, pharmaceutical interventions have dramatically changed, and this has significantly minimized mortality rate. Non-pharmaceutical interventions include isolating and quarantining infected cases either in their homes or at hospitals, and prohibiting gatherings, he added. According to Dr. Saeed, strategies can be outlined and implemented based on a society’s economic, social and cultural norms; and 95% of Afghanistan’s population are under the age of 60, and only 5% are above this age. Meanwhile, half of Afghanistan’s population live under the poverty line; thus, before implementing any strategy, different aspects should be widely discussed. Non-pharmaceutical interventions are not sufficient alone, therefore, different mechanisms should be considered, Sayed believes. At the end, he Mr. Saeed added that although the suppression strategy has been successful in China and South Korea, it will be difficult in Afghanistan due to differences it has, because it is hard to economically compare Afghanistan with these two countries.