By Nadia Hussain
After a surge in international outbreaks, public health authorities across the Middle East are scrambling to contain the spread of the novel coronavirus (COVID-19). Outside of China, there are believed to be three sources for the contagion: South Korea, Italy, and Iran. Unsurprisingly, the outbreak in Iran poses significant challenges to health authorities in the Middle East, a region with extensive transnational connectivity and a reputation for high volumes of tourists from all around the world.
There are 6,566 confirmed COVID-19 cases in Iran and 194 deaths. Alarmingly, there is strong evidence to suggest that Iran’s outbreak is even worse than the official figures indicate. According to leaked patient data from Tehran’s major hospitals, the Iranian government is actively suppressing the country’s real number of COVID-19 cases, thereby compromising public health responses at a domestic, regional, and international level.
When these data sets were presented to Ashleigh Tuite, an infectious disease epidemiologist and adjunct lecturer at the University of Toronto, she was convinced enough to adjust her projection for COVID-19 cases in Iran. After raising her estimate to 28,000 cases, Professor Tuite also told the Washington Post: “I suspect these numbers to keep going up.”
Iran Has Already Failed Its COVID-19 Pressure Test
Contrary to popular belief, Iran actually has one of the more robust healthcare programs in the Middle East. With thousands of primary, secondary, and tertiary medical centers across the country, Iran’s public health authorities had the infrastructure in place to proactively identify and quarantine emerging COVID-19 outbreaks. However, when cases began spiking, Iran’s public health response was hamstrung by bureaucratic indecision, political cover-ups, and general incompetency.
Tehran’s first failure was its decision not to immediately impose travel restrictions on China when the outbreak breached Hubei Province. As a result, thousands of high-risk pilgrims, businessmen, and tourists were able to cross Iran’s borders and disperse across the country. The Iranian government’s second failure is its continued stance against quarantining the city of Qum - the site of Iran’s initial COVID-19 Shackled by political quagmire, Iran’s public health authorities have done what they can, disinfecting public transport carriages, shuttering schools, limiting social gatherings, and cancelling high-risk prayer services. Unfortunately, these limited measures have not been enough, and Qum remains a local epicenter for COVID-19 transmission within Iran.
Because of governmental inaction, Iran is now battling a country-wide contagion—there are now COVID-19 outbreaks in all of Iran’s 31 provinces—instead of more easily traceable and quarantinable infection pockets. Iran’s official response to this nascent epidemic has been astonishing to say the least. One week after denying allegations of under-reporting COVID-19 cases, Iraj Harirchi, Iran’s Deputy Minister of Health, was quarantined after testing positive for the disease. Since then, three other senior Iranian political figures have died from COVID-19. Even as their colleagues passed away, Iranian officials, with the help of state-owned broadcasters, continued to disseminate government reports stating that the lethality and contagiousness of COVID-19 were being hyped by the U.S. in an effort to limit voter turnout in Tehran’s sham elections. Facing mounting public anxiety, the Iranian government is reportedly considering tighter travel and quarantine measures, weeks after such measures should have been put in place.
COVID-19 Responses across the Middle East
Across the Gulf in the United Arab Emirates, things have turned out remarkably different. Unlike Iran, the UAE’s public officials have not been blind to the considerable responsibility the country holds as the Middle East’s foremost gateway to the international community. Remember, within the Middle East, Dubai operates as a hub for commercial activity and international travel transfers—a function that has made the UAE, which accommodates more than 90 million travelers in transit every year, especially vulnerable to untraceable COVID-19 outbreaks.
To avert a generalized outbreak, UAE public health authorities swiftly rolled out a suite of proactive public health measures, with initial priority given to the early evacuation and testing of UAE citizens and foreign nationals in China. The UAE was also one of the first countries to begin quarantining and treating infected individuals in negative air pressure hospital rooms. In addition to refining the quarantine process, UAE public health officials have fast-tracked a range of other infection minimization strategies, such as shifting to remote schooling programs and ordering the mass installation of sanitizer stations in high-traffic transit areas. To preserve governance channels, in-person communications between ministers and public officials have also been substituted for telephone or video calls.
The UAE’s flag carrier, Emirates Airlines, halted all flights to Iran several weeks ago over fears that onboard contamination would spread the virus further. At the same time its neighboring airline, Qatar, kept flying to Iran prompting concern that those planes used to fly to the Islamic Republic have now created new infections in Europe.
Although the regional situation remains dire, the UAE’s COVID-19 counter-measures seem to have been highly successful. There are only 45 confirmed COVID-19 cases there to date.
Elsewhere in the Middle East, the Saudi-led Gulf Cooperation Council (GCC) has introduced temporary bans on entry for citizens travelling into the country from high-risk locations. The Kingdom has also announced additional precautions at border crossings as well as publishing extensive travel advisements. In spite of these measures, the Kingdom was still unable to prevent a limited outbreak in the Qatif region, prompting a local quarantine of the eastern Qatif municipality.
Outside of the GCC, communicative disease experts are extremely apprehensive about the ability of resource-strapped states like Yemen or Afghanistan, both of which are awfully exposed to cross-border infection from Iran, to identify and respond to domestic COVID-19 outbreaks.
Regionally speaking, the success of the UAE’s COVID-19 response seems to be the exception rather than the norm. From what we can gather at this stage, the UAE’s heightened resilience appears to be due to its robust public healthcare system and preventative public health responses. Even though neighboring public health authorities are finally following Dubai’s lead, the window of opportunity for tighter restrictions is rapidly slipping away—if it hasn’t already.
Nadia Hussain is political analyst and researcher based in Norway
"The views expressed in this article do not necessarily reflect those of Al Bawaba News"
