Health system may not cope with another COVID-19 outbreak: KRG Health Minister

KRG Health Minister Dr. Saman Barzanji told Rudaw’s Sangar Abdulrahman on Monday that there is fear of another wave of COVID-19 given the ease of lockdown measures and waning commitment to public health advice.

Barzanji said his health ministry conducts 1,200 to 1,300 tests on a daily basis and that they expect the daily tests will increase because of the surge in new cases. 

The minister warned that there is growing mistrust among the public in the Kurdistan Region  and urged people to take the disease seriously, adding that the Region's health system will not be able to cope with another outbreak.

Speaking of the existing curfew, he added there has not been any decision by the government to extend it beyond the Eid al-Fitr.  

The minister also highlighted that the Region continues to need medical support from NGOs and foreign countries.

Rudaw: I would like to start off by asking why there is currently a surge in the number of coronavirus cases in the Kurdistan Region. Over the past 24 hours, 20 new cases were recorded.

There has been a  growing number of coronavirus cases in recent days, according to figures from the Ministry of Health. We consider it a surge but it stills falls within the first and same wave of Covid-19. The factors are internal and external. In some Middle Eastern countries the numbers are rising. It has risen in Iraq as well. Unfortunately, on an individual level, the easing of some of the measures has led to large crowds,  making people less committed to the health advice. Though self-protection mainly protects the individual themselves, it also helps contribute to protect the public as well.

A large number of patients tested positive after presenting symptoms at the hospital. Others who tested positive in Duhok province had returned from Baghdad with travel permits. 

Are the sources of infection clear to you? Sometimes you state in your announcements that some of the cases can’t be traced. Did those who have recently tested positive come into contact with many other people?

For some of those who have been hospitalized, it is unclear from whom or where they have been infected. We have not been able to learn where they have transmitted the disease so we could limit its spread. For others in Erbil and those who have returned from Baghdad to Duhok, the source is clear. Some transmitted the disease from a family member or a colleague.

The steady increase in cases worries us given that there has not been a full lockdown or curfew in place recently. There is a lot of physical contact between people as public places are open and people gather in crowds. At the same time, people are unfortunately not committed to the health regulations and instructions not wearing masks or gloves and not following the social distancing advice. All these reasons largely contributed to the surge. 

There are two important dimensions that we should not take for granted; first, people may ask why the disease is dangerous since the infected are in good health and that there is very low death rate. I would like to make one clarification to the public: the whole world is terrified by the outbreak.  The number of cases could be in the dozens in the next few days. The death tally will most probably grow among the elderly, too. If we have a large number of infections, our health system may not  be able to cope given that the infected will need intensive care. 

Secondly,  it takes time for symptoms to show. Cases we announced yesterday or the day before yesterday were the result of gatherings in the past two to three weeks that we repeatedly expressed worry about.
 
How many tests you conduct on a daily basis? Has the number increased or decreased compared to the past months?

It differs. These days, we conduct more than 1,200. The number of tests  decreased recently  as the rate of infection dropped. In the beginning, we used to conduct 2,000 tests. The number of the tests is usually contingent upon the number of those put in quarantine or when there is a flight back to the Kurdistan Region or those who return from Baghdad including police, guards and soldiers. When there is an infected case in a certain place, we test all those who have come into contact with them. Therefore, the number of tests has increased in the past three days.
 
What are your testing capacities and other resources to treat the Covid-19 patients?

Since early March the Kurdistan Regional Government (KRG) has allocated a budget to the Health Ministry to help with medical needs. The government tries to help the health department to boost testing capacities and provide preventative equipment and treatment. We have adequate medical resources for the existing number of cases. In the  meantime, we are working to assess the situation. If a very large number of people are infected, we will have to provide a maximum number of medical supplies in terms of tests and protective  equipment.

Although some charities and organizations help, it’s not enough for us to rely on by itself.
 
What about foreign countries? Do they provide you with medical assistance?

Countries contribute assistance to the WHO, who has so far brought aid twice to the Kurdistan Region. The amount aid was very good the second time. The first time, they only provided  testing kits. China has provided us with masks and some medical needs three times. Some companies and NGOs provided medical supplies and we distributed them to the health departments across the provinces, districts and sub-districts. This aid should continue because most of the equipment can only be used once, including masks and gowns. According to the plan and strategy we have laid out, we will continue to need medical assistance in the fight against coronavirus.

We have said it time and again that if we are expecting to receive a new wave of coronavirus and, we must prepare now to test more people and make space for new patients. 

To some extent, there is now less commitment to the health instructions given that people are recently not taking the pandemic serious. Are we facing a real danger of another outbreak?

It is very unfortunate that our people downplay the seriousness of this disease. Coronavirus has brought life, social relations, trade, and the economy to a standstill. Every country is suffering from coronavirus.

There may be a set of reasons contributing to mistrust about coronavirus among our people. The main reason is that there is a heavy economic burden across the globe, and the Kurdistan Region is not exempt.  This financial crisis may have created problems for the individuals and the families leading to make people have wrong perceptions about the pandemic. Another factor could be a low number of coronavirus death-related cases as well as few infections here in Kurdistan. Maybe people will therefore believe that actually there are few or even no cases in Kurdistan.

Unfortunately, a number of media outlets and social media have misled people into believing that coronavirus does not exist here. Some [people] are intentionally trying to undermine the efforts of the KRG. At the end of the day, this is not in the interests of our people. The health of our people must not be mingled with political issues.  

The Ministry of the Interior most of the time set out regulations and measures on the basis of your reports to them. As you know, the curfew will expire tomorrow. If the interior ministry approach to ask whether or not extend the curfew, what would your response be?

The curfew has been designed only for the three days of Eid al-Fitr. In the beginning there was a full lockdown in place, which made it easier for health workers. Now we will have to balance between keeping the self-protection measures and returning to normal life. It will be difficult to protect ourselves  if the number of cases grow. Therefore, in any assessment we make, the priority will go to public health. 

Translated by Zhelwan Z.Wali