What effect does COVID-19 have on the health care system?
United Nations Children’s Fund (UNICEF), Prospects for children in 2022 A Global Outlook, July 2022
"COVID-19 has dramatically increased the number of food insecure people around the world with 45 million people now on the brink of famine. Food insecurity is greatest in conflict zones such as parts of Ethiopia, Yemen and Afghanistan, where children are disproportionately affected. Ongoing supply chain disruptions and the potential for further droughts in major breadbaskets could even trigger a food crisis at a global scale."
"While children living in rich countries can expect to emerge from the COVID-19 crisis earlier than those in poor countries, children living in humanitarian situations face a more permanent crisis. Record humanitarian needs are forecast in 2022, reflecting both long-standing conflicts as well as rapidly escalating emergencies from Afghanistan to Ethiopia to Myanmar. As climate change grows in severity each year, it will trigger new disasters, fuel instability, and exacerbate communities’ existing vulnerabilities in health, nutrition, sanitation and their susceptibility to displacement and violence. If the global response to COVID-19 reveals the ill-health of multilateralism, conflict and climate change serve as a reminder that the deterioration of multilateralism has occurred when it is needed more keenly than ever."
“Since the beginning of the pandemic in Feb 2020, a total of 583,722 samples have been tested for COVID-19 through the public laboratories in the country. In week19-2022, 4,356 samples were tested in public labs, of which 283 samples tested positive for COVID-19 (percent positivity 6) and 6 new death was reported. This represents 192% and 200% increase in cases and deaths, respectively, compared to week 18 2022, (Table 1). Reduction in different figures during week18 coincided with long Eid holidays following the month of Ramadan. Although all COVID-19 labs were functional during the week18 but most of the mild/moderate cases were not willing to go to the lab for testing, in addition to delayed reporting in the system due to Eid holidays. Cumulatively, 179,279 confirmed cases (overall percent positivity 30.7) of COVID-19 with 7,691 associated deaths (case fatality ratio = 4.28%) have been reported in Afghanistan since Feb 2020. As of 14th May 2022, 90.4 %, cases have recovered. In week 19, 2022, the highest numbers of COVID-19 cases were reported in the Central East and East regions (69 and 55 cases, respectively) (Table 2). The top five provinces that reported positive cases included Kabul (43 cases), Nangarhar (43 cases), Parwan (28 cases), Kunduz (19 cases), and Zabul (19 cases). The WHO supported building the in-country capacity for genome sequencing, after training of two national staff on sequencing techniques in Dubai (December 2021). The WHO supported the procurement of the Oxford Nanopore Sequencer with the reagents and consumables. Initially, the plan is to conduct genome sequencing for COVID-19, with a plan to expand it to include other high-threat pathogens. The team is currently working on processing the COVID-19 samples for sequencing, the results will be shared when available.”
Ava Press, Chloroquine cannot treat Covid-19: Medical experts, 28 April 2022
“Chloroquine is for primary used for treatment of malaria, however, due to different types of malaria, the drug is used together with other medicines.
Claim: Chloroquinecan treat coronavirus.
Verdict: Health experts say chloroquine cannot only treat coronavirus, but the drug is harmful to the infected
person. […] Ahmad Shoaib, doctor in Taimani area of Kabul, said that chloroquine, or the malaria medicine, is more commonly used in warmer regions but not used in Kabul due to its cold climate. He said that the use of the drug recently increased for treatment of coronavirus because the tests of the virus showed a sign of inflammatory disease (malaria) and it was treated with the same drug with some good results. He said that the cases of coronavirus have decreased and the weather got cold, the use of the drug is now decreased to zero. The use of these drugs was high at the time of the outbreak of the coronavirus, and people would arbitrary use it during the time even if they were healthy, he said. He said that during the outbreak of the virus, the use of the drug had increased so much that all pharmacies ran out of it and its price jumped from 50 afghanis to 1,000 afghanis.
Health experts
Dr. Abdul Bayes Ahadpur, a specialist of internal medicine, told Pajhwok that in the first days of Covid-19 virus, some researches were conducted on the effect of this drug for the treatment of the disease. […] He said that in June 2020 announced that the use of the drug is ineffective to treat coronavirus and the latest statement by the US Food and Drug Administration (FDA) and WHO warned about the use of chloroquine for Covid-19 patients due to severe side effects such as heart disease, liver and kidney disease. […] Ahadpur said that majority of drugs such as Chloroquine and Remdesivir, which were initially recommended for the treatment and reduction of the virus, were found to be ineffective with serious side effects in later studies. He recommended that people should follow preventive methods to secure themselves against the virus and if anyone infected, they should not use drugs that worsen the illness.”
United Nations World Health Organisation (Afghanistan), UNICEF and WHO warn of perfect storm of conditions for measles outbreaks, affecting children, 27 April 2022
"Pandemic-related disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunization are leaving too many children without protection against measles and other vaccine-
preventable diseases. “Measles is more than a dangerous and potentially deadly disease. It is also an early indication that there are gaps in our global immunization coverage, gaps vulnerable children cannot afford,” said Catherine Russell, UNICEF Executive Director. “It is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities. But doing so in places where children are not receiving routine vaccination creates the perfect storm for the spread of a disease like measles.” In 2020, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.
Countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan and Ethiopia. Insufficient measles vaccine coverage is the major reason for outbreaks, wherever they occur.
“The COVID-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. For many other diseases, the impact of these disruptions to immunization services will be felt for decades to come,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Now is the moment to get essential immunization back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.” Coverage at or above 95% with 2 doses of the safe and effective measles vaccine can protect children against measles. However, COVID-19 pandemic related disruptions have delayed the introduction of the second dose of the measles vaccine in many countries."
“Another wave of Covid-19 struck Afghanistan early in 2022 with doctors throughout the country reporting a rise in cases from January onwards. The devastation suffered by the Afghan health system since the suspension of most foreign aid following the Taleban takeover left it wholly unprepared to deal with the wave. While cases are now tailing off, AAN’s Rohullah Sorush and Thomas Ruttig (with input from Sayed Asad Sadat and Sayeda Rahimi) examine the impact of Taleban rule on Covid-19 reporting, assess the progress of vaccination campaigns and testing, and look at the many problems facing the Ministry of Public Health (MoPH) as a result of the suspension of aid.”
AVA Press, Health Sector Faces Oxygen Shortage Amid COVID-19 Surge, 12 February 2022
“Doctors at the Afghan-Japan Hospital say despite the rapid spread of COVID-19 in Afghanistan, there is no provision of world aid, nor omicron diagnostic kits, and that oxygen shortages have become a serious problem. The emergency department of the Afghan-Japan Hospital is once again full of COVID-19 patients these days, which includes youth and children. [...] “Our hospital has the capacity of 100 beds, but now we have 85 to 90 patients.
Numbers are increasing day by day. The Ministry of Public Health must be prepared because we have not yet reached the peak stage of the disease. Perhaps in the coming weeks the situation will become more critical and the previous -19 private hospitals will be reactivated,” said Heshmatullah Faizi, a doctor at the -Japan Hospital. [...] Meanwhile, the doctors at the hospital say that it has been five months since they have received their salaries.
According to them, they also face severe shortages of hygienic substances. “Right now, we only have oxygen for our patients for just one more day, but after that we will face a lack of oxygen,” said Ebadullah Ebad, head of the Afghan-Japan hospital's infectious diseases department. “The oxygen generating machine has the capacity to produce oxygen for 60 patients and is not enough for us.””
TOLO News, 21 COVID-19 Centers Closed in Last 6 Months, Infections Rising, 7 February 2022
“At least 21 COVID-19 care centers have been closed across the country within the past six months due to financial issues, the Ministry of Public Health (MoPH) said on Monday. [...] According to Hajir, 36 COVID-19 care centers were active before the fall of the former government, but at least 21 of them are closed now because of a lack of equipment and financial issues. The MoPH also reported 479 cases recorded in 16 of 34 provinces over the last 24 hours. The Afghan-Japan Hospital, the main COVID-19 treatment center, said the number of patients it recorded within the past week increased by 80 percent compared to the previous week.”
AVA Press, Health officials raise concern over sharp increase in COVID-19 cases, 7 February 2022
“Ministry of Public Health officials said Sunday that in the past week 800 new cases of COVID-19 have been recorded, with Kabul, Kapisa and Maidan Wardak provinces registering the highest number of new infections.
[…] Hashmat , the head of the intensive care unit at the Afghan-Japan hospital said they had seen a sharp increase in the number of cases recently. He also said the hospital is struggling financially and has appealed to the international community for help.”
ANI, Afghanistan sees sharp spike in Covid cases, 28 January 2022
“Kabul [...] Airing concern over the sharp increase of patients infected by COVID-19, the doctors on Thursday said that the number of reported patients showing the symptoms of the new COVID-19 variant has risen by 70 per cent within the past week compared to the week before.”
Global Shelter Cluster (Afghanistan), Afghanistan - Joint Winterization Plan 2021-22, 20 January 2022
“The outbreak of COVID-19 has also touched every facet of life for the people of Afghanistan, in many cases exacerbating existing humanitarian and development needs. Between April 2020 and 08 July 2021, a total of 131,586 people was infected with COVID-19 with the deaths of 5,561. Since the beginning of the third wave in June 2021, there has been an exponential increase in the number of cases, with an average of over 2,000 new cases and 100 deaths per day. As of 29 July 2021, only 0.6% of the population received fully vaccination (two doses); and only 2% of the population received the first dose. Presidential decrees (2020) was issued to avoid large crowds and upscale hand-hygiene, and Ministry of Interior Affairs (MoI) banned large gatherings, sporting and entertainment events. According to IOM and UNHCR, cross-border movement from Iran and Pakistan will remain a key challenge in 2021, primarily due to reduced employment opportunities amid the economic crisis partially caused by COVID-19.
Even before COVID-19, an estimated ninety three percent (93%) of people were living on less than $2 per person per day. [...] The winter month’s season brings with it a rise in respiratory infection outbreaks. WoAA reported that there is constant increase in hospitalizations, morbidity and mortality during winter months. The exposure to cold has often been associated with increased incidence and severity of respiratory tract infections and dying from them. The longer the duration of exposure the higher the risk of infection. Some 25% to 30% of deaths in children below five years are due to respiratory tract infections, 90% of these deaths are due to pneumonia. Furthermore, in many parts of the country, major roads are blocked during the winter months limiting the provision of timely and sufficient life-saving medical supplies to communities isolated during the winter
months.”
Avapress, Taliban Awaits Global Assistance to Counter the COVID-19 Threat, 19 January 2022
“Kabul resident Nisar Ahmad Hooshmand says that although the country’s doctors and health staff are professionally trained, the lack of facilities, including the lack of diagnostic kits for omicrons, lack of oxygen, and medicine, is worrying.
Reporters are also concerned that no data has been available on the prevalence of Covid-19 in Afghanistan in the past five months. Merajuddin, a reporter and presenter of Ayna TV, said: “It has been five months since the daily publication of coronavirus statistics was stopped and, no one is aware of the current situation and possible
dangers.” [...]
In an interview with Hasht-e Subh, Morteza Samimi, a journalist from Balkh province, said that the lack of access to new statistics on the coronavirus in the country was worrying. According to him, secrecy can lead us to an undelightful fate. [...]
Meanwhile, some doctors and medical staff are also worried about not treating patients due to the lack of facilities. The Taliban Ministry of Public Health is currently unable to determine the type of coronavirus. [...] the means to deal with the virus were limited and that trained medical staff had been laid off since August.
Mostamandyar also said that there is no human resources capacity in the country in the fight against Corona. For example, there are no omicron detectors in Kabul and Bamiyan provinces. [...]
Mahboob Ahmadi, a doctor working in the field of coronavirus infection, says that he has left his job due to the lack of facilities to save the lives of medical staff. Ahmadi added that the safety of the medical staff, even though they were at the forefront of the fight against the Coronavirus, was not observed because the facilities were very limited. As a former medical staff, he noted that the problem is not in the specialization of the medical staff, but following the recent developments and the bankruptcy of the country’s health system in terms of facilities, the success possibility against the fourth wave of Corona is lower.”
Ariana News, Afghanistan unable to detect omicron variant: health ministry, 17 January 2022
“Public Health Ministry officials said Monday that Afghanistan’s health sector does not have the medical equipment needed to detect the newly mutated version of the coronavirus and as such, they have no idea how many people are infected with the omicron variant.
While the case number in Afghanistan is lower compared to neighboring countries, the ministry of health says the latest data put the number of cases at 40. However, it’s not known how many have the omicron variant.
“We have problems to identify the new variant of COVID-19. We call on the international community to help us. They vowed that they will continues their help,” said Javid Hazher, spokesman for the ministry of public health. Meanwhile, staff at the Afghan-Japan Hospital, the main COVID-19 treatment center in Kabul, said that between 15 and 20 patients seek treatment at the hospital daily, however they are not able to detect the variant.
“So far, the mutated type of COVID-19 has not been identified because we have not received the diagnostic device and we have asked the Ministry of Health to make the device available as soon as possible,” said Mohammad Anil, HR director of the hospital.”
Al Jazeera, Afghanistan healthcare ‘on brink of collapse’ amid Omicron scare, 16 December 2021
“Without outside help, “we are not ready for Omicron. A disaster will be here,” said Dr Shereen Agha, the 38-year- old head of the hospital’s intensive care unit. The hospital was short even of basic supplies like examination gloves, he said, and its two ambulances sit idle for lack of fuel.”
TOLO News, 34 COVID-19 Centers Close Across Afghanistan, 17 November 2021
“In the meantime, citizens are deeply worried about the closure of COVID-19 centers, and ask other countries to support Afghanistan’s health sector. Health officials said that thirty-four hospitals and centers treating COVID-19 patients have been closed after international aid was cut off in Afghanistan. [...]
This comes as the Afghan-Japan Hospital officials and staff announced on November 10 that the center will be closed if the medical staff does not receive five months' worth of unpaid wages within the week.
Officials and medical staff of the Afghan-Japan Hospital began their strike last Tuesday, claiming the hospital faces a lack of medicine and medical equipment.”
UK Foreign, Commonwealth & Development Office (FCO), Foreign Travel Advice: Afghanistan - Coronavirus, Last updated: 5 November 2021
“There is no guarantee that any local health care will be available in the current security situation.
Healthcare in Afghanistan is very limited. Medical facilities, including those in Kabul, do not have the capacity or capability to effectively deal with the COVID-19 outbreak. The supply of ICU beds and ventilators remains low. There are areas which have no medical facilities with ICU beds and ventilators. COVID-19 treatment centres in Afghanistan are experiencing severe shortages of commodities and drugs. The vaccination programme only recently resumed and is operating at a very low level.”
AVA Press, Officials warn of possible 4th wave of COVID-19 in Afghanistan, 27 October 2021
“Afghanistan’s health officials on Tuesday warned of a possible 4th wave of COVID-19 in the county, adding that treatment possibilities have been minimized recently. [...]
“There is no medical equipment such as drugs and other (necessities) to fight the 4th wave of COVID-19 in Afghanistan,” said Qayamuddin, a doctor at the hospital. This comes after the WHO said that 1.6 million doses of the in Afghanistan will expire if it is not used.”
Landinfo, Afghanistan: En humanitær krise, 13 October 2021
“Like the rest of the world, Afghanistan is also affected by the Covid-19 pandemic. To what extent we do not know.
There is great underreporting and unreliable data on the number of infected and dead as a result of the pandemic. Neither before nor after the Taliban took power has the health service had the capacity to test on a large scale.
There are no records of deaths (Essar et al. 2021, p. 1).
At the end of September 2021, Covid-19 was registered as the cause of death in approximately 7,200 cases, while about 155,000 people had been diagnosed with the infection. On nationwide, only 750,000 of a population of about 33 million are tested. About 4 percent of the population is vaccinated. The vaccination rate is particularly low in rural areas (OCHA 2021, p. 5; Reuters 2021).
Afghanistan has had three waves of infection, the third with a peak in June / July 2021. The infectious delta variant dominated the country. The hospitals were full, there was a lack of oxygen and many died (Sarwar 2021; Essar et al. 2021).”
Original excerpt in Norwegian [translated using Google translate]
“I likhet med resten av verden, er også Afghanistan rammet av Covid-19- pandemien. I hvor stor grad vet vi ikke. Det er stor underrapportering og upålitelige data om antallet smittede og døde som følge av pandemien. Verken før eller etter Talibans maktovertakelse har helsevesenet hatt kapasitet til å teste i stor skala. Det finnes ikke registre over dødsfall (Essar et al. 2021, s. 1).
Ved utgangen av september 2021 er Covid-19 registrert som dødsårsak i cirka 7200 tilfeller, mens om lag 155 000 personer hadde fått påvist smitte. På landsbasis er kun 750 000 av en befolkning på om lag 33 millioner testet.
Rundt 4 prosent av befolkningen er vaksinert. Vaksinasjonsgraden er særlig lav på landsbygda (OCHA 2021, s. 5; Reuters 2021).
Afghanistan har hatt tre smittebølger, den tredje med topp i juni/juli 2021. Den smittsomme deltavarianten dominerte i landet. Sykehusene var fulle, det var mangel på oksygen og mange døde (Sarwar 2021; Essar et al. 2021).”