The Silent Spread: Afghanistan's Hidden Coronavirus Crisis

Afghanistan has been impacted by the COVID-19 pandemic, with the first case of the virus being reported in the country on 24 February 2020. As of May 2024, there have been over 233,000 confirmed cases and nearly 8,000 deaths. Kabul Province has had the highest number of cases, with other areas such as Herat and Balkh also being heavily affected. The pandemic has had wide-ranging impacts in Afghanistan, including on healthcare, travel, education, and the economy.

The first case of COVID-19 in Afghanistan was confirmed on 24 February 2020

On 24 February 2020, Afghanistan confirmed its first case of COVID-19. The patient was a 35-year-old man from Herat who had recently returned from Qom, Iran. He had been in contact with employees from the shoe company that supplied his shop. The man returned to Afghanistan on 15 February 2020 and spent time with his family and friends without taking any precautions.

On 16 February, the patient began experiencing symptoms including fever, headache, cough, and dyspnoea. Five days later, he decided to visit a private clinic as his concerns grew. He was suspected of having COVID-19 due to his recent travel history and was referred to a governmental hospital for further investigation.

Upon admission to the hospital on 22 February, the patient reported a headache and appeared stressed. A physical examination revealed no fever, with a pulse of 85 beats per minute, blood pressure of 110/70 mm Hg, oxygen saturation at ambient air of 98%, and a respiratory rate of 25 breaths per minute accompanied by wheezing. A mild crepitation was heard beneath the lungs upon auscultation. No other abnormalities were found.

Molecular assays were conducted, and the COVID-19 diagnosis was confirmed three days after the patient's admission to the hospital. All individuals who had been in close contact with the patient were quarantined at home, and accommodations and vehicles related to the patient were disinfected. The patient received treatment, including ceftriaxone, oseltamivir, and terbutaline, and was in good health 17 days after admission. As of 28 February 2020, all close contacts of the patient appeared asymptomatic.

Kabul Province has had the highest number of COVID-19 cases in Afghanistan

Afghanistan has been affected by the COVID-19 pandemic, with the virus reaching the country in February 2020. Kabul Province has had the highest number of COVID-19 cases in Afghanistan, with 18,896 cases as of May 2024. This is followed by Herat with 9,343 cases, and Balkh with 3,431.

The first case of COVID-19 in Afghanistan was confirmed in Herat on 24 February 2020. The virus spread across the country, with cases being reported in various provinces. Kabul, as the capital and largest city, became a hotspot for the virus, with a high number of cases.

The Afghan government implemented various measures to control the spread of the virus, including lockdowns, social distancing, and the establishment of testing and treatment centres. Despite these efforts, Kabul Province continued to have the highest number of cases in the country.

As of May 2024, there have been over 233,000 confirmed positive cases and nearly 8,000 deaths in Afghanistan. The true number of cases and deaths is likely higher due to limited testing and reporting. The pandemic has had significant impacts on the country, including economic difficulties and losses of jobs.

Healthcare in Afghanistan is very limited

Afghanistan's healthcare system has been steadily improving over the last two decades, but it is still very limited compared to its neighbouring countries. The country has over 3,000 health facilities, including the first neurosurgery hospital, and more than 17,000 health posts. There are also over 100 government-run and private or internationally-administered hospitals. Despite these improvements, many challenges remain.

Limited Access to Healthcare

Afghanistan's healthcare system has been described as dysfunctional, with widespread poverty and restrictions on women's access to education and employment being key barriers to accessing healthcare. People in rural areas often have to travel vast distances to reach a health facility, and even then, they may not be able to afford treatment. This is especially true for women, who, according to tradition, must be accompanied by a male relative when leaving the home. This restriction can impede their ability to reach hospitals, whether as patients, caregivers, or humanitarian workers.

Lack of Resources

Afghanistan's healthcare system suffers from a lack of resources, including medical equipment, medicines, and healthcare workers. Many hospitals lack basic amenities such as clean water, electricity, and heating. The average pay for doctors in government hospitals is also very low, ranging from $700 to $2,367 per month, which has led to doctors taking on additional work at private clinics.

High Mortality Rates

Afghanistan has one of the highest infant mortality rates in the world, and thousands of Afghan women die every year from pregnancy-related causes, many of which are preventable. The maternal mortality rate is currently 396 deaths per 100,000 live births, and the infant mortality rate is 66 to 1112.8 deaths per 1,000 live births.

Impact of COVID-19

The COVID-19 pandemic has further exacerbated the challenges faced by Afghanistan's healthcare system. Hospitals have struggled to cope with the influx of patients, and there have been shortages of medical supplies and equipment. The pandemic has also disrupted immunization programs and other health services, making it difficult to control the spread of infectious diseases.

The Taliban spread awareness of the coronavirus in insurgent-controlled areas of Afghanistan

The Taliban's approach to the COVID-19 pandemic in Afghanistan was markedly different from other terrorist groups such as ISIS and al Qaeda, who deemed the virus a "divine retribution". The Taliban instead chose to cooperate with health workers and spread awareness of the virus in insurgent-controlled areas of Afghanistan.

In March 2020, the Taliban started a public awareness campaign in Jowzjan and Logar provinces, where they offered safe passage to health workers treating coronavirus patients. They also enforced lockdowns in affected districts and quarantined suspected COVID-19 cases.

In April 2020, the Taliban took further steps to limit the spread of the virus in areas under its control. They declared a ceasefire, distributed medical equipment, and set up quarantine centres. They also cancelled public events and instructed people to pray at home instead of gathering at mosques. The Taliban also lifted a ban on the World Health Organisation (WHO) and the Red Cross, allowing them to operate in its territories.

The Taliban's pragmatic approach to the pandemic may have been driven by the fact that several top members of the group had contracted the virus. The virus sweeping through the upper echelons of the Taliban left a leadership vacuum and affected their approach to the intra-Afghan dialogue and military operations.

The Taliban's efforts to raise awareness and facilitate health work were publicly praised by the U.S. government and the Afghan health ministry. However, the Taliban continued to carry out attacks on Afghan forces, and their increased offensive in the winter of 2020 signalled that their approach to the pandemic may have been a strategy to gain legitimacy and acceptance as a legitimate and responsible actor.

The number of confirmed cases is lower than the true number of infections due to limited testing

Afghanistan has been severely impacted by the COVID-19 pandemic, with the virus reaching the country in February 2020. The country's healthcare system is extremely limited, with a shortage of medical facilities, ICU beds, and ventilators. This has resulted in a lack of testing capacity, which has led to the number of confirmed cases being lower than the true number of infections.

In March 2020, U.S. military officials reported that there was "no availability of testing for COVID-19" for U.S. troops deployed in Afghanistan, particularly those stationed near Iran. This highlights the challenges in accessing testing resources in the country.

The Afghan government has faced difficulties in managing the outbreak due to limited resources and infrastructure. By March 2020, the Afghan government had spent $25 million to tackle the outbreak, which included $7 million in aid packages. They established testing centers and quarantine facilities, but the capacity to process tests remained low.

According to Deputy Health Minister Feda Mohammad Paikan, the ministry could only process 1,300 to 1,500 samples per day out of around 20,000 collected, due to limited equipment and processing facilities. This resulted in a backlog of untested samples stored in freezers. The low testing capacity had a significant impact on the country's ability to accurately track and contain the spread of the virus.

The World Health Organization (WHO) reported that as of December 13, 2023, there had been 229,289 confirmed cases of COVID-19 in Afghanistan, with 7,965 deaths. However, these numbers likely underestimate the true extent of the outbreak due to limited testing. An official survey from the Ministry of Public Health in August 2020 estimated that approximately a third of the country's population, or roughly 10 million people, had been infected with COVID-19.

The COVID-19 pandemic has severely impacted Afghanistan, and the limited testing capacity has made it challenging to accurately track and contain the spread of the virus. The true number of infections is likely significantly higher than the number of confirmed cases reported.

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