By Zohra Rasekh
An effective prevention of COVID-19 was stopping the virus from reaching and spreading inside Afghanistan. This was an action that the Afghan government needed to take three months earlier when Afghanistan’s next door neighbors, China and Iran, were hit hard by corona virus. That opportunity is gone. At this moment handling of the pandemic is best done through reducing the spread of the virus among people, and mitigating the suffering, mortality and morbidity from COVID-19.
The new corona virus causes an upper respiratory infection and mostly attacks the lungs. A vast majority of infected people will recover from the illness, but in some people with existing health problems the lung infection can be fatal. In Afghanistan where many people already suffer from upper respiratory problems such as asthma, COPD, chronic allergies, etc., due to air pollution, corona virus can be fatal for many with preexisting health conditions.
Given the highly contagious nature of corona virus, fast spread among people in crowded cities like Herat, Kabul and other parts of the country is inevitable. Therefore, protecting the vulnerable population from getting infected is a strategic imperative. A coordinated response needs to focus on maintenance of situational awareness, public health messaging, reduction of transmission, and care for and treatment of the very ill.
For better preparation, different elements of the Afghan government need to be united for the long fight against an enemy much smarter and sneakier than the Taliban. A national taskforce and a comprehensive corona virus national strategic plan that include every relevant government agencies, businesses and private sectors should be formed immediately. The task force must assign roles to government agencies, businesses, civil society and community-based organizations, individuals, and families for pandemic prevention and control. In the absence of pharmaceutical remedies, i.e., medications and vaccines, the only effective strategy at this point is keeping transmission at a slow rate through social distancing and lock down of crowded cities.
This method will prevent the healthcare system from being overwhelmed by a surge of sick people with covid-19 all at one time. Given the low capacity of the healthcare system in Afghanistan, if a hospital is overwhelmed by Covid-19 cases, very sick patients will have a lower chance of surviving than they would if they became ill when the hospital’s patient load was more manageable. For example, people in suicide bomb attacks or car accidents, people with heart attacks and storks, pregnant women with complications during delivery all would be at risk of getting less care when hospitals are trying to cope with the chaos of COVID-19 patients.
The entire purpose of slowing the rate of transmission is to buy time for the hospitals to treat the very ill, and prevent burnout of the healthcare workers from overwork. The weak healthcare system of Afghanistan is at a high risk of falling apart if the virus spreads too quickly and too many people start showing up at the emergency room at any given time. Therefore, serious measure to slow down spread of corona virus among people is crucial and must be immediately implemented.
While we are a long way from a pharmaceutical intervention including a vaccine for COVID-19, the only measures that are proved to be effective against spread of corona virus is the universally adapted old method of keeping distances, quarantining, and disinfecting hands and surfaces.
How practical all of these measures would be in the conflict affected Afghan society? Social distancing in Afghanistan would be a challenge due to the culture of social closeness, as well as the dependency of a vast majority of the poor people on working on a daily basis to put food on the table. Therefore shutting down the city would be devastating for the poor, whose survival depends on their daily work—driving a taxi, selling goods on the street corner, or begging. This is a big challenge for the government of Afghanistan and more reason for better preparedness to deal not only with the public health, but also with social and economic impacts of corona virus. Afghan businesses need to join the government in formation of a corona virus relief program. There are many wealthy businesses and individuals, including wealthy politicians, in Afghanistan who can help create a corona virus foundation to support the vulnerable population during the pandemic shutdown. The Afghan government cannot solely rely on international support in dealing with this pandemic because international donors are focused on their own population at this time.
Knowing that the ability of Afghanistan healthcare system to scale up the delivery of health interventions during the peak of the outbreak is very limited, planning ahead of the time will help determine the extent to which the existing health system can expand to manage the additional patient load. This includes an inventory of number of hospital beds, medical supplies and equipment such as ventilators, oxygen tanks and personal protective equipments for healthcare workers. It is imperative that the health-care facilities maintain adequate preventive measure to protect health-care workers from contracting the corona virus from sick patients.
Another crucial part of prevention of spread of corona virus is exchanging relevant information with the public. Given the different believes and perceptions associated with corona pandemic, communication strategies should include frequent, transparent, and proactive information exchange with the public, including the vulnerable people such as internally displaced who have no access to social media, TV or radio.
Afghanistan must use the listens learned from its neighboring countries, specifically Iran and China, as well as other countries in fight against this invisible enemy.
Ms. Zohra Rasekh is the former Director of the Human Rights and Women’s Affairs Department at the Ministry of Foreign Affair of Afghanistan. Currently she is the President of Global Watch Group a health and human rights watch organization based in Washington DC.
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