Chicago Tribune (Sunday)

Iraqis believe they’re immune from the virus

- By Jane Arraf

BAGHDAD — In the upscale shisha lounge of one of Baghdad’s new restaurant­s, customers puffing on fragrant fruit-scented tobacco sit at gold-rimmed tables flanked by a giant video screen and views of the Tigris River.

It’s a weekday night, but the Dawa restaurant’s Sky Lounge is crowded with people partying like it’s 2019: no masks, no distancing, no problem.

“I live the lifestyle of 2019 before the coronaviru­s,” said Ali al-Khateeb, 37, a businessma­n, as he sat at a green velvet chair pulling smoke from a gold-embossed glass water pipe. “As Iraqis we don’t have a fear of death. It’s a psychologi­cal factor that can strengthen a human being’s immunity.”

His friend, Rami Riadh, 34, also a businessma­n, said he threw away his mask at the airport when he returned to Baghdad from Amman, Jordan, a week ago.

“It feels like we live in another world here,” he said.

As coronaviru­s rates have fallen, Iraqis are flouting the recommende­d virus precaution­s en masse, many subscribin­g to a dubious belief in their own immunity. That conviction, derided by scientists, has been publicly endorsed by regional and local health officials and some religious leaders.

“We have reached a type of herd immunity,” one of Baghdad’s senior health officials, Dr. Jasib al-Hijami wrote in a Facebook post in December.

Reached by phone this week, he said he still stood by those comments.

Such misconcept­ions, and the widespread disregard for virus safety they have engendered even as more contagious new variants of the virus are coursing around the globe, are laying the groundwork for a major new outbreak, public health experts fear.

Iraq’s reported infection

rate has been steadily falling from more than 3,000 new cases a day in November to fewer than 800 on most days in January. The decline has contribute­d to what experts say is a false sense of security.

“Honestly, it’s the calm before the storm,” said Ali Mokdad, director of Middle East Initiative­s at the University of Washington’s Institute of Health Metrics and Evaluation. “There is a potential wave coming on unless Iraqis are vaccinated or taking social distancing measures.”

Mokdad said the drop in infection rates can be explained in part by Iraq’s temperate winter, in which windows are kept open. The relative youth of Iraq’s population could explain lower deaths and hospitaliz­ations.

Other experts suspect that the real number of coronaviru­s cases in Iraq is likely to be double to triple the reported number.

At the height of the pandemic last year, Iraq

closed mosques, schools and restaurant­s as its decrepit health care system struggled to cope. Those restrictio­ns were loosened last fall as infection rates dropped.

Now the government is waging a losing public relations battle to persuade Iraqis to wear masks and to stop shaking hands and kissing cheeks, the common samesex greeting in Iraq.

The campaign has been undermined by local and provincial health officials who have claimed that the rate has fallen because enough Iraqis have been exposed to the virus to achieve herd immunity.

But public health experts doubt Iraq is anywhere close.

Herd immunity is believed to occur when 70% or more of a population has been infected or vaccinated. That offers a virus fewer potential hosts and provides the population with some resistance to an outbreak.

Mokdad said that Iraq

does not conduct the random testing that would allow it to determine accurate infection rates, but that the best estimate is about 20% of the population.

“For educated Iraqis and officials to come and say ‘we are immune’ or have a different strain is unacceptab­le because it gives a false sense of security,” he said.

At mosques, some preachers have been telling worshipper­s they should not fear the virus as long as they follow God.

Even Iraq’s health minister, Dr. Hassan al-Tamimi, has not tried to directly correct the misinforma­tion.

Asked about herd immunity, he neither endorsed nor rebutted the notion. In an interview, he responded by crediting the fall in mortality rates to the country’s increased ability to treat COVID-19 cases and the decline in infection rates to divine protection.

“The main factor is the

mercy of God,” al-Tamimi said.

He has expressed concerns about the highly contagious variant of the virus recently identified in Britain, and the government has taken steps to try to prevent infection coming from abroad.

Last week, the government banned entry for most non-Iraqi travelers from 20 countries with high infection rates, including those with the variant. But the restrictio­n leaves wide gaps for people to come from other countries where the variant has been identified.

Dr. Riyadh Lafta, an epidemiolo­gy professor at Al Mustansiri­yah University in Baghdad, said he expected another, more severe wave to hit by March or April, endangerin­g not just those with compromise­d immunity but also healthy younger people.

“We are afraid of another wave like what happened in Europe,” he said. “So this is the risk and threat that we are waiting for. Unfortunat­ely many people are not very aware of it yet.”

Iraq, a country of 40 million people, is ill-prepared for a second wave.

A damaged infrastruc­ture, a system of awarding control of ministries to political factions on the basis of loyalty, and rampant corruption has devastated the country’s health care system. Last summer, shortages of oxygen cylinders prompted riots at some hospitals among relatives forced to try to procure lifesaving equipment on their own.

Al-Tamimi said that Iraq had opened 47 new plants to make or refill oxygen cylinders and added 14,000 new beds and 63 new hospitals to help deal with the pandemic. The number of hospitals could not be immediatel­y independen­tly verified. Another public health official said the number was fewer than 25.

Iraq has reserved 1.5 million doses of the Pfizer vaccine, he said, and is procuring ultracold freezers to store them for a vaccinatio­n campaign it expects to start by the beginning of March.

But Lafta and other public health experts said they doubted that enough Iraqis would agree to be vaccinated for the campaign to succeed.

“People here don’t like vaccines,” he said. “We were struggling very much in the past year just to convince them to vaccinate their children for polio and measles.”

He said given the widespread poverty that prevents many Iraqis from social distancing, he was not surprised that they would choose to believe they were immune rather than accept that they were at risk.

“It’s about making a living,” he said. “Because social distancing means that poor people don’t go to work; they don’t go out in the street to sell their goods. They feel if they worried about the coronaviru­s, they would die of hunger.”

 ?? IVOR PRICKETT/THE NEW YORK TIMES ?? In Iraq’s capital city, many believe they enjoy a herd immunity from COVID-19, which has infected almost 100 million people and killed more than 2 million worldwide. Above, a busy street Jan. 17 in Baghdad.
IVOR PRICKETT/THE NEW YORK TIMES In Iraq’s capital city, many believe they enjoy a herd immunity from COVID-19, which has infected almost 100 million people and killed more than 2 million worldwide. Above, a busy street Jan. 17 in Baghdad.

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