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Afghanistan COVID-19 Multi-Sectoral Response | Operational Situation Report | 12 November 2020

HIGHLIGHTS

  • According to MOPH data as of 12 November, 42,795 people in Afghanistan have tested positive for COVID-19; 1,591 have died and 35,024 have recovered.
  • Since the start of March, partners have medically screened 519,023 people at points-of-entry, provided 301,126 people with psychosocial support to cope with the mental health effects of COVID-19 and distributed more than 5.1 million bars of soap in 349 districts across the country.
  • Since the start of the pandemic, almost 1.3 million PPE items have been delivered to the Ministry of Public Health and frontline NGO workers in Afghanistan.

SITUATION OVERVIEW

MOPH Figures: MoPH data shows that as of 12 November, 42,795 people across all 34 provinces in Afghanistan are now confirmed to have COVID-19. Some 35,024 people have recovered, and 1,591 people have died - 79 of whom are healthcare workers. 127,882 people out of a population of 37.6 million have been tested. Afghanistan has a test-positivity-rate – positive tests as a percentage of total tests – of more than 33 per cent, suggesting overall under-testing of potential cases. The majority of recorded deaths were men between the ages of 50 and 79. Men account for more than 69 per cent of the total COVID-19 confirmed cases in the MOPH data, although this may be the result of over-representation of men in testing. Due to limited public health resources and testing capacity, testing criteria, lack of people coming forward for testing, as well as the absence of a national death register, confirmed cases of and deaths from COVID-19 are likely to be under-reported overall in Afghanistan. Stigma is considered a major factor in people choosing not to get tests and risk communications work is critical to turning this around. WHO notes that the official numbers reported by MOPH are likely not capturing the full scale of the situation since testing remains limited to only the most severe cases. WHO warns that widespread complacency and failure to follow public health advice is creating grave risks in the community with people generally not observing physical distancing or mask wearing protocols. 

Second Wave: Following two months of consistently lower confirmed COVID-19 cases, MoPH tracking data is beginning to reflect anecdotal reports of a recent uptick in cases, with 186 new COVID-19 cases recorded over the past 24 hours and 981 over the past week. As the winter months approach, the spike in new cases suggest a second wave of the pandemic is either looming or has already begun. While the official numbers are not yet at a similar level as the May/June peak, when taken together with reports of increased hospitalisations for COVID-19-like symptoms, the need for vigilance should be reinforced. The rollout of the annual influenza vaccination across Afghanistan will be more important than ever to help the health system manage the rise in COVID-19 cases. Increasing influenza vaccine coverage can reduce the strain on the health care system and free-up limited health resources to focus on treating more severe cases of COVID-19. Public health experts strongly urge the public to follow advice on physical distancing, mask wearing, good hygiene, hand washing and other proven strategies that mitigate the risk of COVID-19 transmission amid this second wave.

Health Services: Hospitals and clinics continue to report challenges maintaining or expanding their facilities’ capacity to treat patients with COVID-19, as well as maintaining essential health services, especially in areas of active conflict. WHO stresses the need to balance the demands of responding directly to COVID-19, with simultaneously engaging in strategic planning and coordinated action to maintain essential health service delivery, mitigating against the risk of system collapse.

9 per cent of the total confirmed COVID-19 cases are among healthcare staff. Health facilities across the country continue to report shortfalls in PPE, medical supplies and equipment, further challenging their capacity to treat COVID-19 patients. In support of the Government, humanitarian partners have provided hundreds of thousands of pieces of PPE and several thousand items of life-saving medical equipment to the Ministry of Public Health. Additionally, frontline NGO workers are set to receive new deliveries of PPE – including both surgical and N95 masks, face shields and shoe covers – from WHO over the coming weeks. Since the start of the pandemic, through support of the European Commission Humanitarian Aid Office (ECHO), WHO has delivered more than 520,000 PPE items to frontline NGO workers in Afghanistan. With a second wave of the gathering pace globally, there is an urgent need to ensure a rapid distribution of medical and protective equipment to all corners of the country.

While 14 laboratories are now operating in Afghanistan, the capacity of these facilities remains limited and stocks of supplies have periodically run out. Moreover, the national capacity for COVID-19 testing has topped 5,500 a day, but according to WHO, lack of demand means that fewer than 400 tests are actually being conducted daily. Humanitarian partners urge the Government to ensure laboratories are appropriately equipped and that procured supplies go to under-resourced health centres in a transparent manner, so that life-saving support can be delivered to those most in need.

Socio-economic impacts: The socio-economic impacts of COVID-19 are translating into a dramatic impact on food insecurity with levels now similar to those seen during the 2018 drought. An estimated 16.9 million people are in crisis or emergency food insecurity from November to March, 5.5 million of whom are in ‘emergency’ level food insecurity (IPC 4). According to WFP’s market monitoring, the average wheat flour price (low price and high price) increased by 10 per cent between 14 March and 11 November, while the cost of pulses, sugar, cooking oil and rice (low quality) increased by 21 per cent, 18 per cent, 31 per cent, and 20 per cent, respectively, over the same period. This price increase is accompanied by a declining purchasing power of casual labourers and pastoralists – which have deteriorated by over 9 per cent and 14 per cent respectively (compared to 14 March). These factors, combined with COVID-19 related interruptions to informal employment, are driving people into crippling debt. Data from the Whole of Afghanistan Assessment shows that household debt is rapidly escalating in terms of both the number of people in debt and the scale of that debt. Average household debt is now 46,299 AFS/US$602, up from 9,813 AFS/US$128 in 2019. Of displaced households in debt, the primary reason for taking on this debt was to pay for food (53 per cent).

Given this situation, there is an urgent need for additional funding for winterisation support to help struggling households survive the harsh weather ahead. 4.8 million people are in urgent need of support to survive the winter season. The ICCT’s $138m Winterisation Plan remains woefully underfunded with only $64m received. Support from the Government towards this plan is urgently needed.

Ongoing needs: While implementing activities to mitigate the spread of COVID-19, humanitarian partners also continue to respond to other ongoing and emerging humanitarian needs, including in response to recent fighting in the country’s south. During the reporting period, 9,923 women received antenatal and postnatal care through midwives deployed in Mobile Health Teams (MHTs). 1,923 people were treated for trauma care and 1,203 children under the age of 5 years received routine immunisation through MHTs. 3,344 children aged 6-59 months received treatment for Severe Acute Malnutrition (SAM) and 75,620 children aged 6-59 months received treatment for Moderate Acute Malnutrition (MAM). 7,696 nutritionally at-risk children under the age of 5 years received blanket supplementary feeding. 40,148 pregnant and lactating women (PLW) received assistance through targeted supplementary feeding programmes (TSFP), while 2,532 nutritionally at-risk PLWs also received blanket supplementary food. 40,567 caregivers received Infant and Young Child Feeding (IYCF) and maternal counselling during the reporting period, while 9,449 community members received Maternal, Infant and Young Child Nutrition (MIYCN) counselling. 133 Gender-Based Violence (GBV) cases across 5 provinces were identified and referred to Family Protection Centres (FPCs) for case management. 2,602 dignity kits were distributed to women and girls across Hirat, Faryab and Kunduz provinces. 567 children and adolescents with protection needs were supported with case management through referrals to multi-sector services across 9 provinces. As part of its regular programming, WFP distributed 5,325 metric tons (mt) of food between 29 October and 4 November.[1] Humanitarian partners are also mobilising to respond to  needs in southern Afghanistan where tens of thousands of people have been displaced by conflict placing them at greater COVID-19 risk and where there has been a surge in trauma cases. Ongoing fighting has also forced the closure of a number of health facilities, interrupting access to critical health services which in turn has directly impacted more than 130,000 people. Assessment teams are currently verifying the immediate needs of affected families and organising assistance.

[1] The tonnage of weekly dispatched fluctuates regularly based on programme needs, use of commercial transporters versus WFP’s own fleet, capacities to distribute in the field and other factors. Weekly figures are regularly consolidated and analysed as part of WFP’s overall rolling implementation plan that ranges from two to four months.

Operation(s)/ Webspace(s): 
Organization(s): 
United Nations Office for the Coordination of Humanitarian Affairs
World Health Organization
Cluster(s)/Sector(s): 
Original Publication Date: 
12 Nov 2020
Document type: 
Situation Report
Coordination hub(s): 
National Level Coordination