Yemen: High number of deaths due to COVID-19 signals wider catastrophe in Aden

What we are seeing at Aden’s only COVID-19 treatment center points to need for urgent international action

View of Aden from MSF hospital's rooftop.
Yemen 2018 © Agnes Varraine-Leca/MSF
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NEW YORK/ADEN, MAY 21, 2020—The high number of deaths occurring in the COVID-19 treatment center that Doctors Without Borders/Médecins Sans Frontières (MSF) runs in Aden, Yemen, speaks to a wider catastrophe unfolding in the city, the international medical humanitarian organization said today. The United Nations and donor states must do more to urgently help the response as people continue to die in their homes or arrive to health facilities too late to be saved.

The center that MSF runs in the city is the only dedicated COVID-19 center for all people living in southern Yemen. From April 30 to May 17, the center admitted 173 patients, at least 68 of whom have died. Many patients are arriving at the center already suffering from acute respiratory distress syndrome, suggesting that many more people are sick at home.

“What we are seeing in our COVID-19 treatment center is just the tip of the iceberg in terms of the number of people infected and dying in Aden,” said Caroline Seguin, MSF’s operations manager for Yemen. “People are coming to us too late to save, and we know that many more people are not coming at all: they are just dying at home. It is a heartbreaking situation.”

Al Amal COVID-19 Isolation and treatment center
MSF has been managing the COVID-19 treatment center at the al-Amal hospital in Aden since May 7, 2020. MSF has a team of local and international staff working around the clock at the hospital to provide the best care possible for people sick with COVID-19.
Yemen 2020 © MSF

The fact that people are likely dying at home is reflected in government burial statistics that reveal that as many as 80 people have been dying in the city per day in the past week, up from a pre-outbreak normal of 10. Another indication of just how widespread the outbreak has become is the number of health care professionals MSF is treating in the center. Many members of MSF’s own staff are sick.

“The United Nations and donor states need to do more and do it urgently, not just for Aden but for the whole of Yemen,” Seguin said. “Money to pay health care workers must be found, and supplies of the personal protective equipment necessary to keep them safe need to be organized. The country also badly needs more oxygen concentrators to help sick patients breathe. Local authorities need to do all they can to facilitate the work of international organizations like MSF that are working with them to respond to the virus, ensuring the entry of medical supplies and international staff to reinforce teams on the ground.”

An MSF team is working around-the-clock to provide the best treatment they can at the treatment center in Aden, which MSF has been fully managing since May 7. As in other places around the world, they are witnessing just how deadly this disease can be.

“The high level of mortality we are seeing amongst our patients is equivalent to those of intensive care units in Europe, but the people we see dying are much younger than in France or Italy: mostly men between 40 and 60 years old,” Seguin said.

Prior to the COVID-19 pandemic, Aden was already struggling with a health care system that had collapsed after five years of war in Yemen. Authorities there lack the means to properly respond to the outbreak. There is no money to pay staff, little personal protective equipment, and very few tests for COVID-19, so the exact numbers of cases cannot be known. However, the patients dying clearly have the symptoms of COVID-19. Diseases such as malaria, dengue, and chikungunya are endemic to the city but have never produced so many deaths in such a short period of time.

“Hospitals have had to close elsewhere in the city or are refusing certain types of patients because staff members lack the personal protective equipment to keep them safe, which leaves us very concerned about the knock-on effects of this outbreak on other types of illnesses,” Seguin said.

MSF’s trauma hospital in Aden is still open and has seen an increase in the number of admissions since other hospitals started closing. MSF has instituted triage and other protective measures to keep staff and patients safe at the hospital as much as possible. Any staff member who begins to show symptoms is immediately sent home to self-isolate.

“We are doing all that we can, but we cannot face this virus alone,” Seguin said. “It would be unconscionable for the world to just leave Aden and the rest of Yemen to face this crisis by themselves.”

MSF first worked in Yemen in 1989 and has been continuously present since 2007, working in 12 hospitals and health centers and providing support to more than 20 health facilities across 13 governorates in Yemen in 2019. MSF is also assisting the local authorities in treating patients in a COVID-19 treatment center in Sanaa, as well as offering other elements of support to the authorities in their response at various locations throughout the country, including Hodeidah, Hajja, Haydan, and Khameer.