Middle East faces rise in Covid-19 deaths between now and November, expert says

Iraq, Yemen and Egypt among regional countries where death tolls could reach five figures by winter

A top Middle East epidemiologist is warning that there could be sharp increases in the number of coronavirus deaths between now and November, and said more movement restrictions across the region may be necessary.

At an online briefing on Monday, Dr Ali Mokdad, director of Middle Eastern Initiatives at the University of Washington’s Institute for Health Metrics and Evaluation, predicted that the region’s worst-hit countries would have 160,000 Covid-19 deaths by November 1.

The institute’s projections say Iran’s death toll would grow from about 13,000 to 62,000 by November, while Egypt’s fatalities would rise from about 4,000 to more than 50,000.

The Middle East’s other hot spots are also projected to post significant death tolls by then, with Saudi Arabia’s toll expected to rise from 2,000 to 20,000, Iraq’s to grow from 3,500 to 16,000, and Yemen’s to increase from about 500 to 12,000.

“These projections are scary in many ways but what I want people to know is we can prevent that mortality,” Dr Mokdad, who has worked with the US Centres for Disease Control and Prevention, told an online event held by the Atlantic Council think tank.

Movement restrictions, social distancing and near-universal mask wearing could slow the pathogen’s spread and reduce death rates, he said. Widespread use of masks would keep Egypt’s death toll down to 14,000, by his projection.

Dr Mokdad said government stay-at-home measures across the region starting in March had been effective.

But since then, people have been “letting down their guard” and spreading the virus by socialising without wearing masks.

“We have to be ready for another lockdown and we have to prepare the public for that scenario, basically telling people to be ready with two weeks of necessities at home, so that if we have to lock down, we can do it effectively,” Dr Mokdad said.

Iran’s President Hassan Rouhani on Saturday called for weddings, funerals and other big gatherings to be banned as a sharp rise in infections emerged since officials in midApril began relaxing the country’s lockdown.

Saudi Arabia has said it will hold a limited Hajj later this month, with only those living in the kingdom allowed to take part.

Dr Mokdad said the Yemeni government had been overwhelmed by the virus while the Iran-backed Houthi rebel administration in the north was “not acknowledging there is even a Covid-19 problem”.

He said that policymakers in some countries had been hiding the true numbers of coronavirus infection rates and death tolls when they should have been building trust among their people.

“Be realistic. Level with your public,” Dr Mokdad said. “Tell them what you’re dealing with. Tell them what they need to do. They will do it.”

Dr Lina AbiRafeh, executive director of the Arab Institute for Women, a rights organisation, told the session that women and girls throughout the Middle East were being hit hard by the pandemic.

During movement restrictions, women with violent partners were forced to spend more time at home.

They often struggled to see doctors, while incidents of trafficking, child marriage and female genital mutilation had all shot up.

“We’re talking about something that has amplified all of the problems that we’ve had before, which we just brushed under the table and never adequately addressed,” said Dr AbiRafeh, whose group is part of the Lebanese American University.

As the number of Covid-19 cases grew across the Middle East, the International Monetary Fund on Monday projected a deeper recession for a region that has been hit hard by falling oil prices and reductions in foreign investment.

The IMF now predicts the economies of the Middle East and Central Asia will shrink by 4.7 per cent this year – two percentage points lower than its forecast in April.

Dr Mokdad’s coronavirus projections for the Middle East were released amid growing concerns that, while coronavirus was being beaten back in some regions, infection rates continued to rise steadily in others.

On Monday, the World Health Organisation’s director general, Dr Tedros Adhanom Ghebreyesus, said healthcare guidelines were being ignored and that “too many countries are headed in the wrong direction”.

“If basics are not followed, the only way this pandemic is going to go – it is going to get worse and worse and worse,” Dr Tedros said.

Global infections yesterday were at more than 13.3 million, with more than 577,000 deaths.

These projections are scary in many ways but what I want people to know is we can prevent that mortality DR ALI MOKDAD Epidemiologist