Afghanistan is battling a brutal surge in COVID-19 infections as health officials plead for vaccines, only to be told by the World Health Organization that the three million doses the country expected to receive by April will not be delivered until August.
“We are in the middle of a crisis,” health ministry spokesman Ghulam Dastagir Nazari said this week, expressing deep frustration at the global vaccine distribution that has left poor countries scrambling to find supplies for their people.
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Nazari has knocked on the door of several embassies, and so far, “I’ve gotten diplomatic answers” but no vaccine doses, he said.
Over the past month, the escalating pace of new cases has threatened to overwhelm Afghanistan’s health system, already struggling under the weight of relentless conflict. In part, the increase has been blamed on uninterrupted travel with India, bringing the highly contagious Delta variant which was first identified there.
Also, most Afghans still question the reality of the virus or believe their faith will protect them and rarely wear masks or socially distance, often mocking those who do. Until just a week ago, the government was allowing unrestricted mass gatherings.
The Delta variant has helped send Afghanistan’s infection rate soaring, hitting 16 provinces and the capital, Kabul, the hardest. This week, the rate of registered new cases reached as many as 1,500 a day, compared to 178 a day on May 1.
Hospital beds are full, and it is feared rapidly dwindling oxygen supplies will run out. Afghan ambassadors have been ordered to seek out emergency oxygen supplies in nearby countries, the foreign minister, Haneef Atmar, said in a tweet on Friday.
By official figures, Afghanistan has seen a total of 78,000 cases and more than 3,000 deaths from the pandemic. But those figures are likely a massive undercount, registering only deaths in hospitals, not the far greater numbers who die at home.
Testing is woefully inadequate. In only the past month, the percentage of positive COVID tests has jumped from about eight percent to 60 percent in some parts of the country. By WHO recommendations, anything higher than five percent shows officials are not testing widely enough, allowing the virus to spread unchecked.
At most, only 3,000 tests a day are carried out, as Afghans resist testing, even after the country dramatically ramped up its capabilities to 25,000 a day.
Only recently, the government tried to take steps to clamp down to contain the surge. It closed schools, universities and colleges for two weeks. It also shut down wedding halls, which had been operating unhindered throughout the pandemic.
But it is rare to see anyone wearing a mask in the streets, and even where masks are mandatory, like in government offices, the rule is rarely enforced. As many as 10 flights arrive daily from India, packed with Afghans, particularly students and people who had gone to India for medical treatment.
Nazari said banning flights was not an option since many Afghans cannot afford to be stranded in India and the government cannot prevent citizens from re-entering their own country.
Relies on donation
For vaccines, Afghanistan so far has relied on a donation of AstraZeneca doses from India and then purchases of Sinopharm from China.
About 600,000 people have had at least one dose, about 1.6 percent of the population of 36 million. But the number to have received a second dose is minute – “so few I couldn’t even say any percentage,” Nazari said.
Last month, the ministry received a letter from the WHO saying the expected shipment of three million vaccine doses will not arrive until August due to supply problems, Nazari said.
With just 35,000 vaccine doses remaining in the country, the authorities were forced to stop giving first jabs to use remaining supplies to give second jabs, he said.
Poor countries around the world have been pleading for vaccines even as developed nations have been able to inoculate significant portions of their populations.
COVAX, set up with United Nations help to try to prevent vaccine inequities, has struggled to fill the gap. It faced a major setback when its biggest supplier, the Serum Institute of India, announced last month that it would not export any vaccines until the end of the year because of the surge in that country.
“Honestly speaking, I lost my faith in COVAX,” Nazari said.
“Unfortunately, there are countries who vaccinated more than their 50 percent or 60 percent of the population … and there are countries who did not receive vaccines to even vaccinate one percent of their population.”
On Thursday, the administration of United States President Joe Biden announced its plans to share with the world a stockpile of 25 million unused COVID-19 vaccine doses. The UN-backed COVAX global vaccine sharing programme will receive 75 percent of those doses, while the rest will go directly to US allies.
More than 63 percent of adults in the US have received at least one dose of the vaccine.
At the Afghan-Japan Communicable Disease Hospital, Kabul’s only hospital dedicated solely to COVID treatment, all 174 beds are full. The health ministry opened roughly 350 more beds for coronavirus patients in another three hospitals, but they too quickly filled up. This week, people were being turned away.
Each day three or four people die of COVID at the Afghan-Japan Hospital, said hospital administrator Dr Zalmai Rishteen.
Doctors say they are struggling with the public’s refusal to take precautions and follow safety protocols. “Our people believe it is fake, especially in the countryside,” Rishteen said. “Or they are religious and believe God will save them.”
In the hospital’s intensive care unit, Dr Rahman Mohtazir said that only makes it more dangerous for him as he does his job. “I am afraid I will catch it, but I am here to help,” he said. “I listen to people and they say it’s fake. Then they come here.”
The health ministry has recruited prominent religious leaders and local elders to encourage vaccination and anti-coronavirus precautions.
The worsening COVID situation prompted the US embassy on Thursday to issue a health alert warning of shortages of supplies, oxygen and beds at hospitals and urging American citizens to “to leave Afghanistan as soon as possible”.