Afghanistan Flash Update: Daily Brief: COVID-19, No. 4 (1 March 2020)

Key Messages:

• Confirmed case: 1

• Suspected cases: 17

• Negative cases: 38

• Key concern: border crossing areas in the country’s west

Basic principles to reduce the general risk of transmission of acute respiratory infections include:

• Avoiding close contact with people suffering from acute respiratory infections.

• Frequent hand-washing, especially after direct contact with ill people or their environment.

• Avoiding unprotected contact with farm or wild animals.

• People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).

• In case of symptoms suggestive of respiratory illness either during or after travel, travelers are encouraged to seek medical attention and share their travel history with their health care provider.

Situation Overview:

As of 1 March 2020, a total of 86,927 cases of COVID-19 have been confirmed and 2,976 fatalities have been reported across 59 countries. Based on current data, 81 per cent of cases seem to have a mild case of the disease, about 14 per cent appear to progress to severe disease, and some 5 per cent are critical. While the daily number of confirmed cases in China has been stabilising in the last few days, since 26 February more cases have been reported outside China. Furthermore, the increasing spread of the virus from and within Italy, Iran and South Korea remains a concern. Travel restrictions by countries are changing rapidly and should be monitored on daily basis.

On 24 February, Afghanistan’s Ministry of Public Health (MoPH) reported one suspected case had been confirmed in the western province of Hirat. The person had recently travelled from Qom, the Islamic Republic of Iran. It is reported that all schools in Hirat are closed and public gatherings banned until further notice. As of 1 March, MoPH is investigating 17 suspected cases. The clinical conditions of the confirmed and non-confirmed cases are good. All 17 suspected cases are being kept in isolation wards.

Response

The focus of activities in Afghanistan is now on both preparedness and containment. MoPH is working closely with WHO, Health Cluster partners, IOM and other relevant stakeholders to rapidly expand in-country preparedness and containment capacity, to strengthen detection and surveillance capacity at points-of-entry into Afghanistan, such as airports and border-crossing sites (especially in the west), and to continue the training of medical staff on casemanagement, risk communication and community engagement. The level of support and activities in all key areas will need to be expanded rapidly to manage the further spread of the disease.

Additionally, MoPH has recently established five committees for the surveillance of COVID-19 at the national and provincial level: Points of Entry Committee; Population Surveillance Committee; Data Management Committee; National COVID-19 Contact Tracing Committee; and the Lab Surveillance Committee.

Cross Border Concerns

As of 1 March, there are four confirmed cases of COVID-19 in Pakistan. Air travel between Pakistan and China is ongoing with no stoppages. In Iran, health officials have reported 593 cases and 43 deaths as of 1 March.

On 1 March, the Spin Boldak border crossing was closed by both Afghan and Pakistani border police, reportedly in connection with COVID-19. The border will remain closed for seven days. However, Pakistan’s main border crossing with Afghanistan - the Torkham border crossing - remains open.

IOM reports that there have been a higher return of spontaneous returnees (citizens of Afghanistan) from Iran during recent days as many labour camps have been closed due to the rapid spread of COVID-19. Reaction to COVID-19 has been significant amongst the general population with confusion widespread. Awareness raising and evidence-based sensitisation on COVID-19 facts remains a key gap and requires further strengthening.

IOM and WHO are actively supporting response activities with MoPH to address preparedness and emergency coordination actions in the border provinces with Iran and Pakistan (Nangarhar, Kandahar, Nimroz and Hirat).

Support includes: secondment of staff for cross border surveillance; material support; publication of MoPH and WHO Information, Education and Communication (IEC) materials; billboards; community level awareness raising and sensitisation efforts through health education sessions and Displacement Tracking Matrix focus group discussions; and use of IOM transit facilities as temporary isolation/quarantine spaces.

Education

The Ministry of Education is working closely with MoPH to develop IEC posters for hygiene and sanitation promotion to be distributed in schools across the country. Similarly, the Education in Emergencies Working Group (EiEWG) is currently working on developing public information campaigns on preventive measures against COVID19 to be distributed through schools, community shuras, parents’ associations and teachers. All schools in Hirat – including temporarily learning spaces (TLS) and community-based education (CBE) – are suspended until further notice to help contain the spread of the COVID-19 outbreak (although public schools and universities are currently closed for winter break and will resume on 22 March).