As of mid-July, Afghanistan had reached 35,000 confirmed cases of COVID-19 with 1,094 deaths but public-health officials warned that actual cases are likely much higher given the government’s low testing capacity.
In addition, COVID-19 has likely pushed Afghanistan into a recession, overwhelmed the country’s basic health-care system and the numbers infected and dead are likely to be vastly undercounted, a new report by the Special Inspector General for Afghanistan Reconstruction (SIGAR) stated this week.
According to the report, released on Thursday, testing remains limited, but nearly 43 percent of samples were testing positive as of July 15, one of the highest rates in the world.
The overwhelming effect of the virus has, as UNAMA head Deborah Lyons put it, cast “a huge shadow” over Afghan daily life.
According to the report, as of July 15, the number of reported deaths remained low at just 1,094, but this figure may vastly undercount the true toll of the virus as not only has the testing capacity remained limited but many Afghans do not have access to medical facilities.
At the end of June, the Asia Foundation’s country director wrote: “I have been unable to keep track of the growing number of deaths among my own acquaintances, relatives, and friends’ families.”
While the governor of Kabul Mohammad Yaqub Haidari said at a press conference in June that the city’s ambulance service had reported an average of approximately 33 deaths per day.
SIGAR reported that commenting on the lack of an accurate death count, the head of a Kabul-based hospital dedicated to treating COVID-19 patients estimated that roughly 75 percent of those who died at the hospital had not been tested.
The report also stated that available COVID-19 data points to rapid spread with undetected infection.
As of early June, Afghanistan’s Ministry of Public Health could test only 2,000 of the 10,000–20,000 samples received daily, according to the International Rescue Committee (IRC), a humanitarian-oriented nongovernmental organization.
“Consequently, up to 90 percent of potential cases are not being tested,” the report read.
Meanwhile, Afghanistan’s positivity rate – or the proportion of tests that return a positive result divided by the total number of tests conducted – was nearly 43 percent, as of July 15.
SIGAR stated that this was one of the highest positivity rates in the world, based on data collected by Johns Hopkins University (JHU) and, separately, by the IRC.
Overall, the IRC said, Afghanistan faced a “humanitarian disaster.”
“The potential for disaster is heightened by the probability that the pandemic will have secondary effects on broader health outcomes,” the report stated.
In addition to this, SIGAR reported that the economic shock of the pandemic – including increased unemployment, food-supply disruptions due to border closures, and rising food prices – has exacerbated Afghans’ food insecurity, already impacted by the ongoing conflict and high poverty levels.
In May, the Integrated Food Security Phase Classification (IPC), a common global scale for classifying the severity and magnitude of food insecurity and malnutrition, warned that about one-third of Afghanistan’s estimated 32.2 million people remain in either a crisis or emergency state of food insecurity and require urgent action.
Another challenge the Afghan government is facing is the lack of public cooperation over public-health recommendations.
SIGAR stated that although information campaigns have been launched to help curb the spread of the virus, Afghans are increasingly moving about in Kabul.
Health officials have warned that the public was not paying sufficient attention to the crisis.
Meanwhile, public-health conditions in areas under Taliban control remain unclear, SIGAR reported.
According to them, the group has released messages and videos as part of a public relations campaign highlighting its COVID-19 response, including enforcing quarantine.
“Yet, as aid officials have argued, it has been difficult to assess the effectiveness of the Taliban’s actions,” the report stated.
In addition to this Afghanistan also lacks the medical equipment necessary to treat patients diagnosed with COVID-19.
SIGAR stated that while the Afghan government approved the purchase of 500 ventilators in April, the country’s hospitals currently have only 300 ventilators to help patients.
“Furthermore, Kabul hospitals have also reported a severe lack of oxygen, resulting in relatives bringing makeshift oxygen balloons to help suffering patients,” the report stated.
The pandemic meanwhile has also had a severe impact on the country’s economy.
The IMF said that Afghanistan had likely entered a recession, forecasting that Afghanistan’s GDP would contract by three percent in 2020.
Projected economic contraction by other experts ranged from three percent to 10 percent.
Describing the outlook as “dire,” the World Bank said South Asia would likely experience its worst economic performance in the last four decades and predicted that Afghanistan would be the worst regional performer in 2020, other than the Maldives.
“The pandemic is inflicting severe economic and social damage, with its depth and duration subject to great uncertainty,” the IMF said.