|Year : 2021 | Volume
| Issue : 4 | Page : 1534-1539
Perspective of Covid-19 pandemic in Middle East countries
Nouf Alabdulkarim1, Nouf Altwaijri1, Fahad Alsultan2, Raidah S Albaradie3, Shahid Bashir3
1 College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 Prince Sultan Military Medical City; King Saud Medical City, Riyadh, Saudi Arabia
3 Neuroscience Center, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
|Date of Submission||01-Oct-2020|
|Date of Decision||03-Dec-2020|
|Date of Acceptance||17-Dec-2020|
|Date of Web Publication||29-Apr-2021|
Dr. Shahid Bashir
Neuroscience Center, King Fahad Specialist Hospital – Dammam
Source of Support: None, Conflict of Interest: None
COVID-19 has emerged as the world's biggest challenge that has not only threatened human lives but also had an immense impact on the economy, safety and religious practices. The situation has worsened due to the lack of proper guidelines for fighting the sudden unexpected outbreaks. The world was not prepared for this situation. This review highlights some important steps the Middle East countries is taking and their impact on controlling the COVID-19 outbreak. We also discuss some hypothetical predictions for the coming months.
Keywords: Covid-19, Middle East, pandemic, Saudi Arabia
|How to cite this article:|
Alabdulkarim N, Altwaijri N, Alsultan F, Albaradie RS, Bashir S. Perspective of Covid-19 pandemic in Middle East countries. J Family Med Prim Care 2021;10:1534-9
|How to cite this URL:|
Alabdulkarim N, Altwaijri N, Alsultan F, Albaradie RS, Bashir S. Perspective of Covid-19 pandemic in Middle East countries. J Family Med Prim Care [serial online] 2021 [cited 2021 May 16];10:1534-9. Available from: https://www.jfmpc.com/text.asp?2021/10/4/1534/314915
| Introduction|| |
Since the rise of novel coronavirus (Covid-19) in Wuhan city of China in December 2019, every other country of the world remained concerned about its entry and spread in their own territories by taking various preventive measures. Despite all barriers, the outbreak gradually spread to all six continents of the globe while it hit hard some specific countries of Europe, Asia and North America. Recently, its epicenter from china has shifted to other countries such as Italy, Spain, and USA. The exponential infectious rate of Covid-19 has posed a major threat to the economy and the international health system. Middle Eastern countries include 18 countries (13 out of 18) are part of the Arab world with population of 371 million. As of this writing, no definitive treatment or vaccination has been established. On March 11, 2020, the novel coronavirus disease (COVID-19) was declared by the World Health Organization (WHO) to be a global pandemic. It is vital for primary care physicians to know where COVID-19 is most prevalent and how countries managed this pandemic in order to direct their patients if they needed to travel, on the extra precautions they might need to take [Figure 1]. In addition, this paper can help other physicians tackle COVID-19 in the event of an outbreak, given that each response in clarified and highlighted it makes it easy for physicians to ensure the most important precautions to follow.
The government of Saudi Arabia released multiple statements and measures to control the COVID-19 pandemic, starting with suspension of Umrah, a religious duty done in the city of Makkah., Later in 2nd of March the first confirmed case in Saudi Arabia was reported of a citizen arriving to Qatif from Iran through Bahrain. Furthermore, all passengers coming from countries stricken by COVID-19 outbreak were to be screened. During the 7th of March, the total confirmed cases in Saudi Arabia was 7, all in Qatif city. Ergo, the statement: “suspension of schools and universities in Qatif” was released. A few days later centry into and exit from Qatif was temporarily suspended.
Further along, the minister of education declared the suspension of all schools and universities in Saudi Arabia. All social events were suspended, Attendance at workplaces in government agencies and private sectors were suspended as well. Prayer in all mosques was suspended as well., Consequently, as the confirmed cases number started to increase drastically, curfew in all cities from 7 p.m. to 6 a.m.
On the 15th of March, 12 cases were confirmed to have the corona virus, all have been tested upon their arrived in the United Arab Emirates. The ministry of health has made it very clear to the public that they are set and ready to combat the corona virus with all necessary requirements and supplies within their medical facilities to provide adequate care for the patients of COVID-19. In addition, the ministry has urged people to follow the precautions and awareness material available on the official channels. On the 17th of March, the health authorities of the United Arab Emirates have started to mobilize action plans coordinating with all other authorities in an effort to stop the outbreak. On the 21st of March, it was announced that all non-essential establishment will be closed until further notice, including parks, public and private beaches, swimming pools, sport halls and movie theaters for 2 weeks. However, delivery of food from restaurants and cafes can continue whilst having only 20% seating capacity within their establishment to ensure 2 meters distance between people., On the 25th of March, the ministry confirmed that essential establishments like pharmacies and grocery stores will remain open for 24 hours a day.,
On January 10th, a “Corona virus scientific Advisory Board” have been issued by the Turkish Ministry of Health. Where the sole purpose of this board is to come up with the guidelines needed to combat the corona virus by the public, and the treatment measures needed to be followed by healthcare professionals., On the 1st of February, all flights to China and Iran have been stopped in an effort to stop the transmission. On the 29th of February, Turkey has announced closing flights from multiple countries including Italy, South Korea and Iraq. Not too long after that, the borders with Iraq have been closed as well. In March, Turkey has started a process of disinfecting the public places and public transportation. Turkey has over 3000 cases as of April 5th, the government has issued multiple regulations, starting with the closure of schools by the beginning of March 16. The first death of corona virus has occurred in Turkey on the 18th of March.
On March 15, the government has urged people to stay at home, they have issued a lockdown that will last until April 26th at least. And have announced a state of medical emergency. The government has ordered any non-essential institutions whether they were private or public to close. The exceptions for this order are the vital places like pharmacies, supermarkets, banks and so on that meet people's needs. On March 18, the government announced that it will suspend all travel from countries with COVID-19 outbreaks, including Syria. Thereafter, the government had closed all borders, sea, air and land. On March 26th, the government has announced a curfew from 7 pm to 5 am that has only limited exceptions. They have also implemented a curfew for multiple municipalities with Syrian refugees on the 19th of March, prohibiting them from having visitors or leaving their homes under any circumstances in order to stop the spread of the corona virus.
On the 26th of January, all flights to china have been suspended. Egypt had its first case of the corona virus on the 14th of February, they have taken every preventative measure to decelerate the spread of the virus by contacting WHO and quarantining and isolating the patient. 27 hospitals have been identified by the ministry, whose sole job is to conduct essential tests, diagnose patients and quarantine suspected cases until a final diagnosis is made. On the 28th of February, Qatar has stopped all flights from Egypt as a cautionary measure, which was later on followed by another action taken by Kuwait on the 2nd of March, in which they have announced they will test anyone coming from Egypt. On the 19th on March, the minister of aviation shut down all airports and suspended all air travel as a cautionary measure. On the 21st of March, all prayers have been suspended in the mosques of Egypt in an effort to stop the spread of the corona virus. Not too long after that, Coptic Orthodox Church followed in the same footsteps by suspending all religious and gathering activities. On the 31st of march, a decision to close all non-essential establishments like restaurants, nightclubs, cafes and other public places from 7pm to 6am was made by the government, which excluded essential places like pharmacies, places that sell food and delivery services.
Palestine had its first case on the 5th of March, which in turn, marked the beginning of the corona virus crisis. It was evident that the reason was due to a couple of Greek tourists visiting the area, which in turn, led the Palestinian government to forbid tourists from coming into the country immediately on the same day, they have also acted fairly quickly by stopping schools, universities, churches and mosques for one month in the area of the diagnosed cases, which was the West Bank. On the 7th of March, Israeli military has imposed a lockdown on the West bank that was, according to them, in coordination with Palestinian authorities. On the 16th of March, the prime minister has confirmed that Kuwait has indeed contributed around 5 million dollars to help Palestinian combat the corona virus. On the 22nd of March, after a meeting concerning the National Emergency, a ban for 2 more weeks on the movement between and inside the cities was announced by the prime minister, except for essential facilities like health, pharmacies, grocery stores and bakeries.
Kuwait-instated several measures to tackle the COVID-19 pandemic. On the 13th of March all commercial flights were suspended. Friday prayers were suspended. Educational institutions were suspended from 1 to 12 of March, then extended until 29th of March, and later on to 4th of August. All passengers arriving from countries stricken by COVID-19 to Kuwait were quarantined for 14 days. On March 22, the Kuwait government decided to impose a nationwide curfew.
Oman established several measures to slow the progression of the COVID-19 epidemic. Early on, The Ministry of Health in Oman ordered all shopping malls and supermarkets to install hand sanitizers. All schools and universities were suspended on March 15th for 30 days. Movements between regions was restricted by installing entry and exit checkpoints on the streets. By the end of March, the Supreme Court decided that all flights from and to the country were suspended.
Israel has acted fairly quickly to contain COVID 19. On January 24th, the ministry of health has advised to avoid non-essential travel to Wuhan, China, on the 25th of January the ministry has released a statement confirming that it is ready to tackle COVID-19, with an ongoing contact with WHO, in addition, it has released multiple instructions for people noticing any respiratory disease. On March 14, schools were closed and on March 19, Israel closed its borders and implemented multiple measures to stop the spread of the virus, starting with social distancing, 14-day quarantine for people arriving into the country or have been exposed to a COVID-19 patient, movement restriction to only a 100 meters from home, where the only exception to that rule is the need to go grocery shopping, go to the pharmacy or to and from work. They have also banned gatherings of more than 10 people and have also banned all houses or worship. In addition, no more than 10 people are allowed in a supermarket at any certain time, and all should keep a distance of at least 2 meters from any non-relative. Finally, any nonessential establishment is either closed or delivery-only, for example restaurants.
On the 8th of March, the government of Qatar has banned travel to several countries including India, Thailand, South Korea, Sri Lanka, Syria, Bangladesh, China, Nepal, Iran, Iraq, Lebanon and Pakistan in an effort to stop the spread of the corona virus. In addition, Qatar airways has also announced it would temporarily suspend all travel to Italy due to the current outbreak happening there. Also, Qatar Airways have suspended any stopover services in Doha in an effort to contain this outbreak. On the 9th of March, the announcement of closure of all school and universities have been made by Qatar authorities until further notice. On the 11th of March, the number of cases confirmed in one day suddenly jumped to around 200 after being within 1-5 a day, as confirmed by the Qatari ministry of health. On the 23rd of march, volunteers were needed to combat the corona virus outbreak by the Qatari Ministry of health.
On the 22nd of January, Bahrain has started to increase the preventative measures in order to protect its citizens from the outbreak, also announcing there are no suspected cases at the time. On the 30th of January, the ministry of health has set up a preventative plan to stop the spread of corona virus. On the 12th of February, Bahrain has started supporting China by providing them with much needed face masks. In addition, total ban on all travelers whom have visited China in the past two weeks was implemented by the interior ministry. On the 21st of January, the kingdom of Bahrain has banned all foreign travelers coming from Iran, Singapore, Thailand, Malaysia and South Korea in the past 14 days to enter the kingdom of Bahrain and any Bahraini or GCC citizen will be subjected to quarantine and undergo testing procedures in order to limit the spread of corona if they have visited any of the mentioned countries within 2 weeks of their arrival. On the 29th of February, the ministry of interior has urged people to avoid any public gatherings. And on the 18th of March they have released guidelines for the public to help them with disinfecting their homes and guidelines for the workplace.
In Iran, the start of COVID-19 pandemic was with a case of a merchant who traveled to China. In response to the rising epidemic, Iran government established several preventative measurements. Case in point, closing the schools, the universities, malls, holy shrines. Later on, following a dramatic rise in the number of cases a travel ban was officially announced between the cities. Ministry of Health and Medical Education requested to minimize the number of pilgrims in Fatima Masumeh Shrine and all religious sites. In spite of that, the Shia shrines in Qom were still open for the pilgrims. As a result to the drastic increase in Iran's COVID-19 cases, several surrounding countries closed the border they share with Iran. Several other countries banned all flights from and to Iran. In the middle of March Iran's cases made up 90% of all COVID-19 cases in the Middle East. By the 5th of April, Iran reported 58 thousand confirmed cases and 3.6 thousand deaths. Iran is the eighth highest country in COVID-19 cases around the world and is the worst affected middle east country.
The first case on Iraq was of an Iranian student In response to the epidemic, a number of measures were undertaken. Such as the complete lockdown including shops, except for a few selected pharmacies working through delivery., All schools and universities were closed for 10 days. The government announced that all flights to and from Baghdad airport were suspended for a week 17-24 March. Additionally, Curfew was instated in the Baghdad, the capital over the same period. Religious gatherings were suspended but not strictly until the 4th of Aril when it was found that 2 funerals were held in the city of Erbil and resulted in third of all the cases in that city. By the 5th of April Iraq has 961 confirmed cases and 61 deaths.
The Minister of Health of Syria revealed the first case of COVID-19 on the 22nd of March. The Autonomous Administration of North and East Syria took various measures to halt the progression of the COVID-19 epidemic in Syria, like instating a region-wide curfew and the suspension pf all non-essential businesses. Not only that, but schools and universities were suspended as well. Syria is particularly liable to the epidemic for the reason of the ongoing civil war. By April 5th Syria has 19 confirmed cases and 2 deaths.
The kingdom of Jordan undertook several measures to combat the epidemic like the other countries. The kingdom started with banning all people from entering from China, South Korea, and Iran. All people entering through the Jordanian border and airports were thoroughly screened. All malls and commercial centers were closed. Quarantine camps were set for people arriving to Jordan. A state of emergency was declared by the Jordanian Government on March 19th, and warranting a Curfew on the 21st. The government launched a website for citizens to apply for permits allowing them to exit their homes for urgent matters. Total cases in Jordan by 5th of April is 323 and 5 deaths.
Cyprus reported their first two COVID-19 cases of 25-year-old man coming back from Italy, and a 64-year-old arriving from The United Kingdom. Cyprus shutdown their border for 15 days as a precautionary measure. Furthermore, entry to Cyprus was only granted to whoever presented a medical report of being tested for COVID-19. The Minister of Communications and Works, issued a decree suspending flights for 14 days. By the 5th of April Cyprus had 426 cases and 11 deaths.
| Conclusion|| |
To conclude, all countries have made all the efforts they possibly could with the resources they have to ensure the safety and wellbeing of their people. Furthermore, all countries issued guidelines for the general public to follow and have requested everyone to abide. Contributions and cooperation between authorities have aided in this ongoing fight against the corona virus. However, the numbers of confirmed cases in the Middle East is increasing steeply.
The closure of borders throughout the middle east helped in stopping the spread of COVID-19 to and from each country to the other. Also, the strict precautions, guidelines or lockdown implemented by these countries depending on their resources was a key factor in flattening the curve and keeping their citizens from acquiring the disease.
Ethical approval: It was not required for this paper
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
World Health Organization. 2020. Coronavirus disease 2019 (COVID-19) situation report – 65. Geneva, Switzerland.
Yezli S, Khan A. COVID-19 social distancing in the Kingdom of Saudi Arabia: Bold measures in the face of political, economic, social and religious challenges [published online ahead of print, 2020 Apr 21]. Travel Med Infect Dis 2020;37:101692. doi: 10.1016/j.tmaid. 2020.101692.
Ebrahim SH, Memish ZA. Saudi Arabia's measures to curb the COVID-19 outbreak: Temporary suspension of the Umrah pilgrimage. J Trav Med 2020;27:taaa029. doi: 10.1093/jtm/taaa029.
Ahmed QA, Memish ZA. The cancellation of mass gatherings (MGs)? Decision making in the time of COVID-19. Travel Med Infect Dis 2020;34:101631. doi: 10.1016/j.tmaid. 2020.101631.
Khan Z, Karataş Y. COVID-19 in Turkey: An urgent need for the implementation of preparedness and response strategies. Health Sci Rep 2020;3:e153.
Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci 2020;50:489-94.
Kattan C, Badreddine H, Rassy E, Kourie HR, Kattan J. The impact of the coronavirus pandemic on the management of cancer patients in Lebanon: A single institutional experience. Future Oncol 2020;16:1157-60.
Khoury R, Karam G. Impact of COVID-19 on mental healthcare of older adults: Insights from Lebanon (Middle East) [published online ahead of print, 2020 Apr 24]. Int Psychogeriatr 2020;1-4. doi: 10.1017/S104161022000068X.
Hassany M, Abdel-Razek W, Asem N, AbdAllah M, Zaid H. Estimation of COVID-19 burden in Egypt. Lancet Infect Dis 2020;20:896-7.
Tuite AR, Ng V, Rees E. Estimation of the COVID-19 burden in Egypt through exported case detection. Lancet Infect Dis 2020;20:894.
Muhareb R, Giacaman R. Tracking COVID-19 responsibly [published online ahead of print, 2020 Mar 27]. Lancet 2020;S0140-6736(20)30693-0. doi: 10.1016/S0140-6736 (20) 30693-0.
Clarfield AM, Dwolatzky T, Brill S, Press Y, Glick S, Shvartzman P, et al
. Israel Ad Hoc COVID-19 Committee: Guidelines for care of older persons during a pandemic. J Am Geriatr Soc 2020;68:1370-5.
Gesser-Edelsburg A, Cohen R, Hijazi R, Abed Elhadi Shahbari N. Analysis of public perception of the Israeli Government's early emergency instructions regarding COVID-19: Online survey study. J Med Internet Res 2020;22:e19370.
”Qatar announces closure of schools, universities over coronavirus”. 09 March 2020. Retrieved 09 March 2020.
Major S, Sawan L, Vognsen J, Jabre M. COVID-19 pandemic prompts the development of a Web-OSCE using Zoom teleconferencing to resume medical students' clinical skills training at Weill Cornell Medicine-Qatar. BMJ Simul Technol Enhanc Learn 2020;bmjstel-2020-000629. doi: 10.1136/bmjstel-2020-000629.
Al-Muharraqi MA. Testing recommendation for COVID-19 (SARS-CoV-2) in patients planned for surgery-continuing the service and 'suppressing' the pandemic. Br J Oral Maxillofac Surg 2020;58:503-5.
Abdi M. Coronavirus disease 2019 (COVID-19) outbreak in Iran: Actions and problems. Infect Control Hosp Epidemiol 2020;41:754-5.
Nikpouraghdam M, Jalali Farahani A, Alishiri G, Heydari S, Ebrahimnia M, Samadinia H, et al
. Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study. J Clin Virol 2020;127:104378. doi: 10.1016/j.jcv. 2020.104378.
Iraq announces 1st
case of COVID-19 in Najaf-World-Chinadaily.com.cn [Internet]. [cited 2020 Apr 15]. Available from:https://www.chinadaily.com.cn/a/202002/24/WS5e53adb8a310128217279e69.html.
New death raises Iraq's COVID-19 fatalities to 12 [Internet]. [cited 2020 Apr 16]. Available from:https://www.aa.com.tr/en/latest-on-coronavirus-outbreak/new-death-raises-iraqs-covid-19-fatalities-to-12/1770631.
Health Minister: First case of Coronavirus registered in Syria in patient who had come from abroad, appropriate measures have been taken to deal with the case – Syrian Arab News Agency [Internet]. [cited 2020 Apr 16]. Available from: https://www.sana.sy/en/?p=188671
Alqutob R, Al Nsour M, Tarawneh MR, Ajlouni M, Khader Y, Aqel I, et al
. COVID-19 crisis in Jordan: Response, scenarios, strategies, and recommendations [published online ahead of print, 2020 May 13]. JMIR Public Health Surveill 2020;10.2196/19332. doi: 10.2196/19332.
Al-Tawfiq JA, Memish ZA. COVID-19 in the Eastern Mediterranean Region and Saudi Arabia: Prevention and therapeutic strategies. Int J Antimicrob Agents 2020;55:105968. doi: 10.1016/j.ijantimicag. 2020.105968.
Wilder-Smith A, Chiew CJ, Lee VJ. Can we contain the COVID-19 outbreak with the same measures as for SARS? Lancet Infect Dis 2020. doi: 10.1016/S1473-3099 (20) 30129-8.