Afghanistan: Strategic Situation Report: COVID-19, No. 82 (28 October 2020)

Situation Overview:

MOPH Figures: MoPH data shows that 41,032 people across all 34 provinces in Afghanistan are now confirmed to have COVID19. Some 34,217 people have recovered, and 1,523 people have died - 76 of whom are healthcare workers. 120,914 people out of a population of 37.6 million have been tested. The majority of recorded deaths were men between the ages of 50 and 79. Men account for more than 69 per cent of the total COVID-19 confirmed cases in the MOPH data, although this may be the result of overrepresentation 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 or mask wearing protocols.

Second Wave: Following two months of consistently lower confirmed COVID-19 cases, MoPH tracking data is beginning to reflect previously anecdotal reports of a recent uptick in cases, with 166 cases recorded on the 21 October 2020, the highest daily figure recorded since the mid-July peak. As the winter months approach, the spike in new cases suggest a second wave of the pandemic is either looming or has already begun. While the numbers are not yet at the same level as the May/June peak, when taken together with reports of an increased number of hospital admittances of people with COVID-19-like symptoms, the need for vigilance should be reinforced. Furthermore, WHO notes that the official numbers report by MOPH are not likely to be capturing the full scale of the situation since testing remains limited to only the most severe cases. Public health experts strongly urge the public to adhere to physical distancing, mask wearing, good hygiene, hand washing and other proven strategies that mitigate the risk of COVID-19 transmission.

Protection of Civilians: The number of civilians killed and injured in the conflict in Afghanistan has failed to slow since the start of intra-Afghan peace talks, although the overall civilian casualty figure for the first 9 months of 2020 dropped by around 30 per cent compared to the same period in 2019, according to a new report released on 29 October by the UN Assistance Mission in Afghanistan (UNAMA). The Mission’s latest quarterly report documented 5,939 civilian casualties (2,117 killed and 3,822 injured) from 1 January to 30 September. High levels of violence continue with a devastating impact on civilians, with Afghanistan remaining among the deadliest places in the world to be a civilian.

UNAMA supports the renewed call by UN Secretary-General Antonio Guterres for a global humanitarian ceasefire to be put in place before the end of the year. Such a pause to the conflict in Afghanistan would help the fight against COVID19 and reinforce critical efforts to prepare humanitarian assistance before winter sets in for millions of the most vulnerable.

Ongoing Needs: At the same time as responding to COVID-19, humanitarian partners are also mobilising to respond to needs in southern Afghanistan where at least 11,00 people are so far confirmed as being displaced as a result of conflict and there has been a surge in trauma cases. The violence has stretched hospitals in Lashkargah to capacity.

Furthermore, attacks on health facilities during fighting are particularly worrying with WHO reporting that 12 health facilities have been targeted. The closure of health clinics in the area due to insecurity is directly affecting more than 55,000 people. COVID-19 awareness raising and community engagement work is being incorporated into this response due to the increased risks facing people who are displaced and living in crowded conditions without proper access to hygiene facilities. For more information, please see the latest OCHA Flash Update.

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 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 also 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.