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Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 97 | 20 May 2021

Situation Overview: UPDATED

Global Update: According to John Hopkins University, more than 3.4 million people across the world have now died due to COVID-19. As of 20 May, the pandemic is affecting 192 countries with some 164 million confirmed cases globally. WHO reports that in the past week, the number of new cases and deaths continued to decrease with just over 4.8 million new cases and just under 86,000 new deaths reported; a 12% and 5% decrease respectively compared to the previous week. Despite a declining trend over the past three weeks, the incidence of cases remains at some of the highest levels since the start of the pandemic. WHO is closely investigating the new variants of the virus and emphasises that public health and social measures, diagnostics, therapeutics and vaccines remain effective against the new variants.

MOPH Figures: As of 20 May, MoPH data shows that 64,532 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 55,529 people have recovered, and 2,772 people have died – at least 91 of whom are healthcare workers. Since the start of the pandemic, only 434,506 tests have been conducted for a population of 40.4 million. While numbers currently remain below those seen during the peak of the first and second waves, recent official MOPH figures indicate a deterioration of the situation, potentially signalling a third wave. Afghanistan now has a test-positivity-rate – positive tests as a percentage of total tests – of 15 per cent, suggesting overall under-testing of potential cases. The majority of confirmed cases were men between the ages of 15 and 30, whereas the majority of recorded deaths were men between the ages of 50 and 79. Men account for more than 66 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, 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 warns that 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. WHO Afghanistan remains concerned about mutations of the virus, cases of which have been confirmed in Afghanistan. There is a significant increase in cases of the new, more infectious variant in neighbouring Pakistan and Iran. MOPH is preparing for a third wave including scaling-up surveillance at borders and improved testing.

More than 7 per cent of the total confirmed COVID-19 cases are among healthcare staff and ensuring these groups are vaccinated is of critical importance. Among the provinces, Hirat, Kabul, Nangarhar and Balkh reported the highest number of cases among healthcare workers. There is an urgent need to ensure continued distribution of medical and protective equipment to frontline workers all corners of the country. 26 laboratories are now operating in Afghanistan – with plans to scale-up to at least one laboratory per province by June 2021. National laboratories are testing 7,500 samples a day. WHO reports that laboratories have capacity to test up to 8,500 samples but low demand means technicians are currently working reduced hours.

Vaccination: The first batch of 468,000 COVID-19 vaccination doses through the COVAX facility arrived in Afghanistan on 8 March. In total, Afghanistan has received 968,000 doses of the vaccine – 468,000 from the COVAX facility and 500,000 directly from the government of India -- enabling the vaccination for some 484,000 people. COVID-19 vaccination through MOPH has now been opened to all those above 18 years of age. Vaccination is currently available in select health facilities and through mobile vaccination teams. More than 497,400 have been vaccinated in Afghanistan through the MOPH programme to date, including some 108,511 health workers, 66,741 teachers, 25,000 people with co-morbidities and 23,900 prisoners. Of those vaccinated, 65 per cent were men and 35 per cent women. Around 11 per cent of those vaccinated have received both doses of the COVID-19 vaccine.

Overall, however, there remains some concern around low demand among healthcare workers and 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 reports that vaccination coverage is extremely limited among all migrant populations due to negative perceptions and barriers to accessing care. Much more focus is needed to ensure migrants are vaccinated on pace with settled populations given the impact mobility has as a vector for transmission, especially with the more contagious viral variants now in Afghanistan. Additional efforts are also needed to reach women and people living in non-government-controlled areas with vaccines. Vaccine uptake remains slow and continued 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 cases increase, humanitarian partners continue to urge the Government to ensure laboratories and frontline staff are appropriately equipped and that procured supplies – including vaccines – go to under-resourced health centres across the entire country in a transparent manner, so that life-saving support can be delivered to those most in need. WHO reports that additional deliveries from the COVAX facility will likely be delayed due to global shortages. However, additional vaccines may become available through bilateral channels.

The UN has received 5,000 doses of the AstraZeneca vaccine for personnel so they can continue to deliver life-saving services to people in Afghanistan. Eligible groups include UN and INGO staff. In order to access the UN vaccination scheme, eligible individuals must register on the UN COVID-19 vaccine portal. In order to access the portal, INGOs are requested to develop a sponsorship agreement with their main UN partner. NNGO staff are able to be vaccinated through the Government’s vaccination scheme. Please see the UN COVID-19 Vaccination page for more information. Vaccinations under the UN scheme began in Afghanistan on 13 April.

Response update: According to the last WHO COVID-19 Response Update, 945 health workers have received training on ICU care and 1,702 health workers have been trained on case management by WHO between 29 April 2021 and March 2020. Since the start of the pandemic, WHO has further provided MOPH with almost 500,000 PCR tests, more than 5.7 million surgical masks, over 1,000 oxygen concentrators and 179 hospital beds – with an additional 3,433 hospital beds in the pipeline. Close to 300 laboratory staff have been trained on PCR testing. Almost 300,000 health workers (including polio workers), NGO and government staff have been trained on COVID-19 surveillance and some 250,000 health workers and mobilisers have been oriented on delivering preventative COVID-19 messages. Since the start of March 2020, WHO has medically screened almost 11 million people at points-of-entry.

Socio-economic impacts: The socio-economic impacts of COVID-19 in addition to other factors have translated into a dramatic deterioration in food insecurity. The recently released updated IPC analysis estimates that 14.1 million people – more than one third of the population - are in crisis or emergency levels of food insecurity. Cumulative precipitation has been below average over the wet season with reduced precipitation and higher temperatures likely to affect farmers and pastoralists, as well as water availability over the next few months. Food prices are already higher than normal due to COVID-19 and are likely to increase further given the dry spell’s likely impact on first and second crops in 2021. These factors, combined with COVID-19 related interruptions to informal employment and decreased remittances, are driving people into crippling debt. Data from the 2020 Whole of Afghanistan Assessment showed that the primary reason for taking on this debt last year was to pay for food (53 per cent).

Operation(s)/ Webspace(s): 
United Nations Office for the Coordination of Humanitarian Affairs
World Health Organization
Original Publication Date: 
20 May 2021
Document type: 
Situation Report
Coordination hub(s): 
National Level Coordination