Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 101 | 15 July 2021
Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 101 | 15 July 2021
MoPH Figures: As of 14 July, MoPH data shows that 136,643 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19 since the start of the pandemic. An additional 16,427 people have tested positive since the last update two weeks ago. Of the total cases since the start of the pandemic, some 83,849 people have recovered, and 5,923 people have died – at least 93 of the fatalities have been healthcare workers. Since the start of the pandemic, only 664,045 tests have been conducted for a population of 40.4 million.
The number of cases remain at alarming levels over the post-Eid al-Fitr period. The daily average number of new cases now far surpasses figures seen during the peak of the first and second waves last year. In week the last week, some 8,674 new cases and 508 new deaths were reported. This is a 15 per cent decrease in the number of cases and 8 per cent decrease in deaths compared to week prior.
Overseas testing has confirmed the presence of the variants in Afghanistan. While Afghanistan lacks in-country facilities to test for the Delta variant, concern over the variant’s spread remains high. Afghanistan now has a daily test-positivity-rate – positive tests as a percentage of total tests – of 48 per cent as of 14 July, suggesting overall under-testing of potential cases. With a testing capacity of 8,700 tests per day, 35 laboratories are now operating in and there are plans to establish 9 more by the end of August. Due to limited public health resources, 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.
Health partners continue to support the health system in case management and infection prevention and control. Since the outset of the pandemic in the country, around 7,434 health professionals have been trained in response to COVID-19 at national and provincial level on subjects such as critical and severe case management, using of BIPAP, CiPAP, ventilator, nursing care, anesthesia, intubation and infection prevention and control.
WHO warns that despite the new surge, widespread complacency and failure to follow public health advice in Afghanistan is creating grave risks in the community with people generally not observing physical distancing or mask-wearing protocols. There is particular concern about the upcoming Eid al-Adha period and the need to promote personal protection measures during this holiday. Health partners have worked with MoPH to develop specific messages for the upcoming Eid holidays. These will be widely circulated. Given the rapid rise in cases, the Government of Afghanistan has extended closure of all schools, universities and training courses that started on 29 May. The school closure will be in effect across 16 provinces, including Kabul. Most government offices have moved to essential staff because of the outbreak. The Government has also announced other preventative measures across these 16 provinces, including the banning of mass gatherings and weddings. No other nation-wide lockdown measures are currently in place.
Vaccination: Since 8 March, Afghanistan has received 3,068,000 doses of COVID-19 vaccines – 468,000 from the COVAX facility, 500,000 directly from the Government of India, 700,000 from the government of the People's Republic of China and 1,400,000 from USA. Some 2,192,000 additional doses of vaccines are expected to arrive to the country this month as well.
COVID-19 vaccinations through MoPH are open to all those above 18 years of age. Vaccination is currently available in select health facilities and through mobile vaccination teams. People are reminded that mixing of vaccines between doses is not recommended.
Some 989,015 individuals have been vaccinated against COVID-19 as of 14 July 2021. Of this, 753,277 individuals have received the first dose of the vaccine, and 235,738 have received the second dose. Of the total people vaccinated, 62.2 per cent are males and 37.8 per cent are females, 138,101 (14.2 per cent) are health care workers, 95,682 (9.7 per cent) are teachers, 14,231 (1.4 per cent) are those living in IDP camps, and 7,081 (0.7 per cent) are returnees from neighboring countries.
According to a recent public perception survey on COVID-19 vaccines in Afghanistan conducted by the Afghanistan National Public Health Institute (ANPHI) and UNICEF, 71 per cent of respondents reported that they are yet to receive the COVID-19 vaccine. However, some 69 per cent of all respondents noted that they wish to be vaccinated if given the opportunity, compared to just 17 per cent who said they do not want to be vaccinated. Around 14 per cent did not respond to the question. The majority of all respondents listed the radio, masjids and religious leaders, TV and health care providers as the most trusted means of communication for COVID-19 information.
Overall, there remains strong concern regarding equitable access to vaccines for Afghans, especially vulnerable groups such as IDPs, returnees and nomadic populations and people living in hard-to-reach areas. IOM continues to report that vaccination coverage is extremely limited among all migrant populations due to negative perceptions and barriers to accessing care. Greater focus is needed to ensure mobile populations are vaccinated on pace with settled populations given the impact mobility has as a vector for transmission, especially with the more contagious viral variants present in neighbouring countries. Additional efforts are also needed to reach women and people living in non-government-controlled areas with vaccines. Risk communication and community engagement efforts are needed to ensure high-risk populations and frontline staff understand the benefits of the vaccine and can effectively dispel misinformation. Countering negative rumours about the vaccine is a priority as well as promotion of preventative measures during the upcoming Eid holiday.
Health partners are very concerned about the exponential increase in hostilities across the country. Health Cluster partners have recorded a total of 30 incidents in 18 districts of 8 provinces impacting health facilities and personnel in the first six months of 2021 in which 13 health facilities were affected, 29 health care workers were severely affected (12 killed, 10 injured 7 detained), and 6 patients were severely affected (1 injured, 5 killed). As health facilities and resources are increasingly stretched due to both COVID and escalating conflict, all parties to the conflict are reminded of their obligations to respect and protect health care under IHL.
Socio-economic impacts: In addition to pre-existing challenges, the socio-economic impacts of COVID-19 and drought have translated into a food insecurity crisis. The recently released IPC analysis estimates that 12.2 million people – almost one third of the population - are in crisis or emergency levels of food insecurity. Food prices are already higher than normal due to COVID-19 may increase further in some places due to conflict, disruptions at the border, and water scarcity. Water scarcity is already being seen in a number of areas and a significantly reduced wheat harvest is expected.
The Afghan Government, UN and humanitarian partners held a joint appeal on 11 July to highlight the worsening humanitarian situation due to COVID, conflict, and the drought. The appeal highlighted the urgency of the humanitarian situation, the current gap in funding for the HRP and the Government’s plan to resource existing National Priority Programmes in response to the drought.
Border Crossings: Since 29 April, the Iranian Government has imposed an indefinite lockdown with border closures. The border remains open only to commercial traffic and movement of documented nationals returning home to Afghanistan. According to the Border Monitoring Team of the Directorate of Refugees and Repatriation (DoRR), a total of 16,957 Afghanistan nationals returned from Iran through the Milak and Islam Qala border crossing sites between 2nd and 8th July. Of these, 7,103 people returned voluntarily and 9,854 were deported. Since the start of the year, a historically significant influx of 621,133 people returned to Afghanistan from Iran sparking new concerns about transmission of COVID-19 variants and overall absorption capacity of existing health resources. A sharp drop in remittances to Afghanistan has also been observed.
Between 2nd and 8th July 2021, a total of 22 undocumented Afghans voluntarily returned from Pakistan through the Torkham and Spin Boldak borders. The total humanitarian returns from Pakistan in 2021 remains low with 6,846 total undocumented and refugee returns.
The rapid escalation of conflict across Afghanistan has also had a pronounced impact on border crossing points. Humanitarian partners’ operations at the Spin Boldak and Islam Qala borders have been impacted by recent fighting and are temporarily suspended. IOM is exploring resumption as early as possible to ensure continued delivery of humanitarian assistance to returning Afghans. Similarly, the recent escalation of conflict in Spin Boldak crossing point has affected humanitarian partners’ operations at the border.