Coronavirus in the Middle East: everything you need to know about Covid-19

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Hind Al Soulia - Riyadh - Middle East countries continue to report higher numbers of confirmed cases of the novel coronavirus known as Covid-19, with Iran as the centre.

Countries in the Gulf have taken unprecedented moves, and elsewhere in the Middle East there have also been border closures, travel restrictions and lockdowns. Jordan has ordered some of the most extreme measures - a complete three-day lockdown and limited movement even between governorates in order to contain the disease.

The World Health Organisation have urged Middle Eastern states to give them more information on their number of infections amid accusations that some countries were not reporting all their cases. Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean, said the regional approach to fighting the coronavirus had so far been "uneven" and that much more should be done.

This weekend was Mother’s Day in the Middle East, and many took to social media to lament the fact that they would not be able to visit family members. Others thanked mothers who spent the holiday working as doctors or nurses at hospitals. One popular online greeting card praised mothers as the original advocates of hand-washing.

Since Covid-19 was detected in Hubei province, China, in January, it has spread to more than 100 countries, infecting around 307,000 people and killing more than 13,000.

How many cases in the Middle East?

How is each country managing the crisis?

Iran

Iran is the worst affected country in the Middle East, with 20,610 confirmed cases and 1,556 deaths. The health ministry spokesman said last week that one person is killed every ten minutes.

Roughly nine out of 10 cases in the Middle East come from the Islamic Republic. Days of denials gave the virus time to spread as the country marked the 41st anniversary of its 1979 Islamic Revolution with mass demonstrations and then held a parliamentary election in which authorities desperately sought to boost turnout. But authorities appear unable or unwilling to stop travel between major cities as local towns affected by the virus threaten to set up their own checkpoints to turn away or even attack outsiders.

Iran’s death rate from the virus is now higher than in other hard-hit nations. That could be from the initial lack of testing kits and facilities, but it has also been alleged that Iran was previously hiding the true number of infections and deaths.

Read more: Coronavirus and Ibuprofen: What you need to know

Iraq

Iraq has reported 193 cases and 14 deaths from the coronavirus, and is still battling remnants of ISIS. It imposed a weeklong curfew last week, with fines for breaking it, and flights were suspended from Baghdad’s international airport. Several governorates also closed their borders.

Over the weekend, the government was forced to deploy troops after hundreds of thousands of people defied restrictions and attempted to visit a shrine sacred to Shiite Muslims to the north of the country’s capital Baghdad.

Lebanon

Lebanese Prime Minister Hassan Diab asked the security forces on Saturday to enforce stricter measures to keep people at home and prevent gatherings to rein in the coronavirus outbreak. He said this would include patrols and checkpoints and called on residents to go out only if absolutely necessary.

The health ministry recorded on Saturday a 29 per cent rise in cases from the day before, bringing the total to 230. Four people have died in the past month.

Lebanon's government declared a medical state of emergency earlier this week and ordered most of the country closed, including the airports. Experts warn the country's healthcare system is ill-prepared, as a financial crisis and dollar shortages have for months drained it of critical supplies.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

Syrian volunteer group The White Helmets have been disinfecting schools in the Aleppo countryside as part of efforts to contain coronavirus. Courtesy: The White Helmets.

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Syria

Syria is yet to record any cases with the United Nations' World Health Organisation, yet there is some doubt that the country is being transparent. Volunteer group the White Helmets has been working to disinfect busy areas in north-western Syria, particularly at risk due to the current displacement crisis in Idlib. Aid groups are working to raise awareness and mitigate risks, and the military said it was distributing masks and gloves to soldiers. On-sight testing will begin when kits arrive some time next week.

More on Syria: Syria's stretched aid groups working '25/7' to prevent Idlib outbreak

Jordan

Air raid sirens echoed across Jordan’s capital this weekend to mark the start of a three-day curfew. In one of the strictest measures yet, Jordan has ordered all shops to close and all people to stay off the streets until at least Tuesday, when it plans to announce specific times for shopping. Authorities have already arrested 392 people accused of violating the curfew. It has 99 confirmed cases and no deaths, the United Nations has reported that some refugees have been infected with the virus.

Turkey

Turkey imposed a curfew on Saturday for its senior citizens and banned restaurants from serving at tables, extending measures against the coronavirus outbreak as the death toll more than doubled to 21. The number of confirmed cases rose to 947, and 2,953 tests have been conducted in the last 24 hours.

The interior ministry announced late on Saturday that all restaurants, pastry shops, and other similar food-service establishments can only offer takeaway service and delivery. Flights from 46 more countries, and including northern Cyprus, are suspended and picnics and barbecues are banned. It had earlier closed schools, cafes and bars, banned mass prayers and indefinitely postponed matches in its main sports leagues.

More on Turkey: Vinegar gargles and sheep's head soup – Turkey's strange coronavirus remedies

Egypt

Egypt has reported 285 cases and eight deaths, and there are increasing calls for a curfew. The most populous Arab nation is home to more than 100 million people. Cairo, the capital, is one of the most densely populated cities on earth, with more than 20 million residents.

So far, it has announced that all museums and archaeological sites, including the famed pyramids at Giza, would be closed from Monday until the end of March. Authorities said they would sterilise all sites during the closure.

Egypt also announced the temporary suspension of Friday prayers and other congregations in all mosques. The Coptic Orthodox Church canceled all services and wedding parties, and said funeral processions would be limited to family members of the deceased.

A man wearing a protective face mask takes a selfie photo by his mobile phone after attending the Friday prayers inside Al Azhar mosque. Reuters

A man wearing a protective mask attends Friday prayers outside Abdel Rahman Mosque in the Cairo neighborhood Maadi, Reuters

A man wearing a protective mask at the Al Rahman mosque. Reuters

A member of a medical team sprays disinfectant at a church in Cairo. EPA

A member of a medical team sprays disinfectant at a church in Cairo. EPA

A member of a medical team sprays disinfectant at a church in Cairo. EPA

An volunteer ties a mask onto an Egyptian man in a street in Cairo. AFP

An Egyptian worker sprays disinfectant at Cairo's Ramses railway station. AFP

Egypt ordered the overnight closure of cafes, restaurants, nightclubs and sporting clubs to fight the spread of coronavirus. AFP

Volunteers distribute masks and gloves to a sanitation worker in a Cairo street. AFP

Egypt's Muslim religious authorities decided to put Friday prayers on hold. AFP

An Egyptian worker sprays disinfectant inside a train at Cairo's Ramses railway station. AFP

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Libya

Libya is yet to record a case, and the United Nations and nine countries have called on the country's warring parties to cease hostilities to allow health authorities to fight against the new virus.

In a joint statement, the ambassadors of Algeria, France, Germany, Italy, the Netherlands, the UK and the US, as well as the European Union delegation to Libya and the governments of Tunisia and the United Arab Emirates, called for a "humanitarian truce".

Authorities in eastern Libya suspended all public transportation and ordered the closure of nonessential businesses. The government in the west declared a nightly curfew starting on Sunday in areas under its control, including the capital Tripoli. It announced all mosques, educational facilities and shops would be closed and banned wedding parties, funerals and public transportation.

Coronavirus in the Gulf: everything you need to know about Covid-19 in the GCC

Algeria

Algeria, which has had 15 deaths despite only reporting 139 cases, has suspend all international and domestic travel and postponed all international sports events. Cultural and political gatherings have also been called off and a ban was ordered on mass street demonstrations, scuppering the country's year-long anti-government protest movement. They have also closed mosques, cafes and restaurants and told half of state employees to stay at home to try to limit the spread of the virus.

Morocco

Sea and land links with European countries, Algeria and China are suspended, and international flights have been grounded. Sporting events are off and schools and universities are closed. There is a ban on gatherings of more than 50 people.

Morocco’s Interior Ministry declared a health emergency late on Thursday, barring anyone from being outside except to go to work or to shop at grocery stores or pharmacies. The restriction also requires people to present to police documents justifying their reasons for being out.

In its latest figures, Morocco reported 96 confirmed coronavirus cases, including three deaths.

Tunisia

Tunisian, which has 60 cases and one death, on Friday ordered a general lockdown, restricting public movement to counter the spread of the virus. The majority of people have been asked to stay at home and movement between cities has been stopped.

Coronavirus: everything you need to know about Covid-19 in the UAE

Yemen

So far Yemen has no infections. But doctors in war-torn countries with no cases believe the virus has arrived and fear that a lack of disease surveillance systems — shortages of tests, basic supplies and properly trained professionals — is allowing an invisible pandemic to spawn.

Israel

Israel reported another 178 infections, bringing its total to 883, the second highest number in the region behind Iran. But that appears to be the result of stepped-up testing. Israel’s Health Ministry has only reported one fatality and says only 15 patients are seriously ill. The ministry says it has tested more than 17,000 people.

Palestinian health workers wearing a protective facemask in the courtyard of a United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) school at Al Shati refugee camp in Gaza City. AFP

Palestinian health workers wearing a protective facemask in the courtyard of a United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) school at Al Shati refugee camp in Gaza City. AFP

A Palestinian health worker wearing a protective facemask checks the body temperature of a child at a UNRWA school at Al Shati refugee camp in Gaza City. AFP

Palestinian health workers wearing a protective facemask in the courtyard of a United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) school at Al Shati refugee camp in Gaza City. AFP

Angham Abu Abed, a Palestinian web developer, works at Gaza Sky Geeks office in Gaza City. Reuters

A Palestinian woman wearing a mask looks out of a car upon her return from abroad at Rafah border crossing in the southern Gaza Strip. Reuters

A Palestinian health worker sprays disinfectant as a precaution against the coronavirus in a gymnasium in Gaza City. AP

A bakery worker wears a facemask during his work at the family bakery as a precaution against the spread of the Covid-19 coronavirus in Gaza City. EPA

A bakery worker wears a facemask during his work at the family bakery as a precaution against the spread of the Covid-19 coronavirus in Gaza City. EPA

A bakery worker wears a facemask during his work at the family bakery as a precaution against the spread of the Covid-19 coronavirus in Gaza City. EPA

A Palestinian barber wears protective a facemasks and hand gloves as a precaution against the spread of the Covid-19 coronavirus. EPA

Palestinian municipality workers and Health Ministry personnel stand at the construction site of a field hospital to house coronavirus patients in Rafah in the southern Gaza Strip. AFP

Palestinians, wearing protective masks amid fears of the spread of the novel coronavirus, take part in a protest in solidarity with Palestinian prisoners in Israeli jails outside the UN High Commissioner's offices in Rafah. AFP

Palestinian volunteers spray disinfectant a street at Al Shati refugee camp in Gaza City. AFP

Palestinian volunteers spray disinfectant a street at Al Shati refugee camp in Gaza City. AFP

Palestinian volunteers spray disinfectant a street at Al Shati refugee camp in Gaza City. AFP

Palestinian volunteers sprays disinfectant a street at Al Shati refugee camp in Gaza City . AFP

Palestinian volunteers sprays disinfectant a street at Al Shati refugee camp in Gaza City . AFP

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Palestine

The Gaza Strip confirmed its first two cases of coronavirus on Sunday. The development added to fears of a potential outbreak in crowded Gaza, which has an overstretched health care system after years of an Israeli-Egyptian blockade, cross-border conflicts with Israel and Palestinian political division.

In the Israeli-occupied West Bank, Palestinian security forces arrested 20 Muslim preachers for allegedly violating a ban on holding Friday prayers. The Palestinian Authority, which governs parts of the West Bank, has closed mosques and barred all group prayers. It has reported 52 confirmed cases, including 17 who recovered.

How is this affecting the region?

Iran's supreme leader accuses US of creating outbreak

US-led coalition forces in Iraq reposition amid pandemic and Iran threat

Lebanon calls in army to enforce lockdown

Gazans fear widespread coronavirus outbreak over sub-par quarantine centres

A tale of two cities: Cairo's residents split on coronavirus response

Is Turkey’s coronavirus 'success' story all it seems?

Israel: limited numbers and 'distancing' at Al Aqsa

UN urges Yemeni authorities to release ‘conflict related’ prisoners amid fears of Covid-19 outbreak

What is coronavirus and how is it spread?

Coronaviruses are a large family of viruses which may cause illness in animals or humans. Covid-19 is only the most recently discovered strain.

In humans, seven coronaviruses are known to cause respiratory infections, including the common cold and more severe diseases such as Middle East respiratory syndrome (Mers) – first recorded in Saudi Arabia in 2012 – and severe acute respiratory syndrome (Sars) which swept through southern China and Hong Kong in 2002 and 2003.

Covid-19 has affected far more people.

But it is far less deadly, with a mortality rate which is believed to be around 3.5 per cent, according to an estimate by the World Health Organisation, compared with about 10 per cent in Sars and 34 per cent in Mers.

The most common symptoms of Covid-19 are fever, tiredness and a dry cough. Some patients may have aches and pains, nasal congestion, sore throat or diarrhoea and, rarely, a runny nose.

Read more: What to do if you think you have coronavirus?

The elderly, and those with underlying medical problems such as high blood pressure, heart problems or diabetes, are more likely to develop serious illness.

According to a doctor who fought the outbreak in Wuhan, high blood pressure is a major risk factor. Out of a group of 170 patients who died in January in Wuhan – in the first wave of casualties caused by the pathogen – about half had hypertension.

A study of 44,000 patients by the Chinese Centres of Disease Control found only 0.2 per cent of children and teenagers died, compared with almost 15 per cent of people above the age of 80.

What should you do if you have symptoms?

The first thing you should do if you feel unwell and suspect you may have Covid-19 is pick up the phone and call the hospital you intend to visit ahead of time.

That way, doctors will be able to assess the risk you pose to staff and other patients. Public transport should be avoided at all costs to avoid spreading the virus further.

If you are identified as a possible carrier, the hospital will likely send an ambulance staffed with paramedics in protective clothing to pick you up.

Anyone suspected of suffering from Covid-19 will be isolated immediately.

A swab is then taken from the patient's nose and throat which is taken in a vial to a laboratory.

Results take between 24 to 36 hours, during which time the patient will remain isolated in the hospital.

How does this compare to the global picture?

One statistic that can give Gulf residents cause for optimism is that, as of mid-March, there has only been one reported death in the region out of nearly 8,000 worldwide fatalities.

The highest death toll has been reported in China, which has suffered more than 3,000 deaths, followed by Italy and Iran. Spain, France and the United States have all suffered more than 100 deaths. So the outlook in the Gulf in terms of suffering caused by the virus is much lower than that witnessed elsewhere in the world.

Experts have put that down to countermeasures taken early on in the crisis, unlike a country like Iran, which was accused of underplaying the crisis and not taking the appropriate restrictive measures to prevent the virus spreading far and overwhelming the country’s health system.

Updated: March 22, 2020 01:42 PM

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