This report is produced by OCHA Afghanistan in collaboration with humanitarian partners via clusters. It covers activities carried out between 9 November and 13 December 2020. The next Operational Situation Report will be released on 14 January and cover activities carried out between 14 December and 10 January.
According to MOPH data as of 20 December, 50,677 people in Afghanistan have tested positive for COVID-19; 2,110 have died and 39,158 have recovered.
Since the start of March, partners have medically screened 536,363 people at points-of-entry, provided 310,026 people with psychosocial support to cope with the mental health effects of COVID-19 and distributed more than 5.4 million bars of soap in 376 districts across the country.
Since the start of the pandemic, more than 1.3 million PPE items have been delivered to the Ministry of Public Health and frontline NGO workers in Afghanistan.
MOPH Figures: MoPH data shows that as of 20 December, 50,677 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 39,158 people have recovered, and 2,110 people have died – at least 86 of whom are healthcare workers. Only 189,385 people out of a population of 36.7 million have been tested. Afghanistan now has a test-positivity-rate – positive tests as a percentage of total tests – of 28 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 68 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, 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. This is supported by the results of an early seropositivity study by MoPH, Johns Hopkins and WHO that estimated 30 per cent of the population had been exposed to COVID-19 by June 2020. 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 is creating grave risks in the community with people generally not observing physical distancing or mask wearing protocols.
Second Wave: The MoPH has confirmed that Afghanistan is in a second wave of the COVID-19 pandemic. Following two months of consistently lower confirmed COVID-19 cases, MoPH tracking data is starting to reflect an uptick in cases, with 141 new COVID-19 cases recorded in the last 24 hours. Furthermore, suspected and confirmed cases of COVID-19 are again rising in the western part of the country in particular. According to WHO, the Hirat Regional Hospital is currently operating at full capacity. The hospital has now expanded its bed capacity from 100 to 130 beds, all of which are now filled with COVID-19 patients. Other COVID-19 hospitals in Kandahar and Nangarhar are also operating at full capacity. While the official numbers across the country are not yet at the same 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 health 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.
More than 8 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. 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 15 laboratories are now operating in Afghanistan, the capacity of these facilities remains limited and stocks of supplies have periodically run out. National capacity for COVID-19 testing has topped at 5,800 a day. Humanitarian partners urge the Government to ensure laboratories are appropriately equipped, staff receive timely renumeration 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.
Vaccination: The Government of Afghanistan and the UN have initiated a number of steps to prepare for the rollout of a COVID-19 vaccine across the country, including the establishment of a dedicated National Technical Working Group (TWG) for COVID-19 response within the MoPH. The TWG will focus on operations, cold chain, communication, surveillance, training and monitoring and evaluation/data and will complement the existing Vice Presidential COVID-19 Task Force. The COVID-19 vaccine is expected to be available in Afghanistan in 2021 through the COVAX Advanced Market Commitment (AMC) facility. While COVAX will sponsor vaccine costs for up to 20 per cent of the population, the vaccine presentation, dosage, costs and cold chain requirements are not yet known. A plan to vaccinate the remaining 80 per cent of the population is currently being developed.
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 11 per cent between 14 March and 2 December, while the cost of pulses, sugar, cooking oil and rice (low quality) increased by 21 per cent, 19 per cent, 36 per cent, and 21 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 13 per cent and 16 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. For displaced households in debt, the primary reason for taking on this debt was to pay for food (53 per cent).
Winterisation support: Afghanistan is facing a grim winter ahead as people struggle to keep themselves warm amid soaring poverty driven by the economic shock of COVID-19. Given this situation, there is an urgent need for additional funding for winterisation support from both the Government and donors to help struggling households survive the harsh weather ahead. The ICCT’s $138m winterisation plan aims to reach 2.5m people over the winter months with a range of life-saving support including cash and in-kind heating assistance for households and classrooms, warm clothes, seasonal food support, nutrition treatment, and health services for winter sickness. To date, about half of the funds needed have been committed by donors and the Government ($67m), leaving a gap of $71m.
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. During the reporting period, 10,236 women received antenatal and postnatal care through midwives deployed in Mobile Health Teams (MHTs). 2,353 people were treated for trauma care and 1,634 children under the age of 5 years received routine immunisation through MHTs. 672 children aged 6-59 months received treatment for Severe Acute Malnutrition (SAM) and 1,187 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. 669 pregnant and lactating women (PLW) received assistance through targeted supplementary feeding programmes (TSFP), while 1,918 caregivers received Infant and Young Child Feeding (IYCF) and 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. As part of its regular programming, WFP distributed 2,211 metric tons (mt) of food between 10 and 16 December.
- UN Office for the Coordination of Humanitarian Affairs
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