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Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 80 | 08 October 2020

Situation Overview: UPDATED

MOPH Figures: MoPH data shows that 39,616 people across all 34 provinces in Afghanistan are now confirmed to have COVID-19. Some 33,058 people have recovered, and 1,470 people have died - 76 of whom are healthcare workers. 113,392 people out of a population of 37.6 million have been tested. The majority of the recorded deaths were men between the ages of 50 and 79. Men account for more than 70 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, 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. 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 protocols.

Second Wave: With a fragile health system, a developing economy and underlying vulnerabilities, the people of Afghanistan are facing extreme consequences from the COVID-19 pandemic. While data suggests that the first wave seemed to peak in June, a new rise in cases is being closely monitored. Doctors are warning that the second wave of COVID-19 may be deadlier than the first if people do not follow health advice. This dangerous second wave of the virus comes at a time of increased conflict and political uncertainty and reduced community adherence to prevention measures. Limited access to water and sanitation, widespread food insecurity and high rates of malnutrition are all additional complicating factors for Afghanistan. Resourcing community engagement, surveillance, and contact tracing remains critical to supporting the COVID-19 response and preventing unnecessary suffering. Effective awareness raising, rumour management, adoption of safety measures, and identification of people with COVID-19 requires substantial investment in community-informed communication and engagement.                                      

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. A WHO comparison of HMIS health data from Q2 2019 with Q2 2020 shows that the utilisation of health services has dramatically decreased during the pandemic.

The drop in the utilisation of health services indicates that many of the severe medical cases that required hospital care have been unable to receive treatment during the COVID-19 pandemic as a result of a variety of factors including health staff falling ill with COVID-19, overwhelmed health facilities focused on COVID-19 response, patients’ unwillingness to attend health facilities, movement restrictions. These unaddressed medical conditions will likely to result in increased mortality and increased needs in the second half of the year and into 2021. WHO notes that when health systems are under stress, as is being seen in Afghanistan, both direct mortality from the outbreak and indirect mortality from vaccine-preventable and treatable conditions increase dramatically. WHO emphasises that infection prevention and control need to be improved in health facilities to encourage people to return to health services safely. 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.

Around 10 per cent of the total confirmed COVID-19 cases are among healthcare staff. Health facilities across the country are reporting 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 tens of thousands of pieces of PPE and several thousand items of life-saving medical equipment to the Ministry of Public Health. 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 13 laboratories are now operating in Afghanistan, laboratory capacity in Afghanistan remains limited. Humanitarian partners urge the Government of Afghanistan 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.

Accountability to Affected People: A recent study was carried out by BBC Media Action and WHO to understand how communities in Afghanistan are experiencing COVID-19, their main current concerns, their knowledge of COVID-19 as well as their sources of information. The study found that people interviewed are aware of COVID-19 and accept it is a disease as opposed to a conspiracy. However, only women and some men in urban areas say they still follow health guidelines to stop spread of the virus (such as frequent handwashing with soap). Perceptions about COVID-19 are still dominated by rumours. Men, especially those living in rural areas, believe that COVID-19 has been eliminated in Afghanistan. Interviewees report that media has been the main source of information about COVID-19; mullahs and community leaders are also engaged in providing information in rural areas. TV is most trusted source of information among those who have access to it. According to the report, most people now want to know when, where and how they can access COVID-19 vaccine.

Socio-economic impacts: Afghanistan is facing an ongoing food security crisis that is being compounded by the economic shock of COVID-19. Over the past 5 years, the food security situation in Afghanistan has steadily deteriorated as the percentage of food insecure people has almost doubled. A new Integrated Food Security Phase Classification (IPC) analysis for 2020-2021 is just being finalised and is expected to show this situation has further deteriorated during COVID-19 with worrying implications for the winter season ahead. This comes alongside preliminary data from the Whole of Afghanistan Assessment showing that household debt is spiralling in terms of both the number of people in debt and the scale of that debt. At the same time, average prices for key commodities remain elevated above pre-COVID levels while purchasing power has diminished. According to WFP’s market monitoring, the average wheat flour price (low price and high price) increased by almost 9 per cent between 14 March and 7 October, while the cost of pulses, sugar, cooking oil and rice (low quality) increased by 25 per cent, 18 per cent, 26 per cent, and 17 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 6 per cent and 10 per cent respectively (compared to 14 March)

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