Iraq: COVID-19 outbreak in Baghdad is "very alarming"

Iraq 2020 © MSF
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The COVID-19 emergency in Iraq continues to escalate,  with the country reporting close to 4,000 new cases a day and approximately 500 deaths a week. In the past month, more than 100,000 cases have been detected in the country, and on September 23, 5,055 new COVID-19 cases were confirmed, representing the highest daily rate in the country since the beginning of the pandemic. Iraq’s capital, Baghdad, is the worst-hit city, with almost 30 percent of the country’s reported cases.

“We’re trying to do our best to support the efforts of Iraqi health authorities in tackling the virus in Baghdad, even though our capacity is limited,” said Gwenola Francois, head of MSF programs in Iraq. “Even with the high number of patients we see at the moment, we are not sure where we are on the epidemiological curve. From what we can see the situation is deeply worrying.” To respond to the escalating emergency and support local health authorities, Doctors Without Borders/Médecins Sans Frontières (MSF) has started working in Al-Kindy hospital in Baghdad. The hospital is receiving large numbers of severe and critical COVID-19 patients. During the past two months, MSF teams have assisted in the respiratory care unit (RCU), providing bedside training for staff, including ventilator use, administration of medication, and implementation of techniques adapted for the treatment of COVID-19.

By the time we have a free bed, patients are in really bad shape.

Dr Pedro Serrano Guajardo, Intensive Care Specialist

Despite efforts to control the spread of the virus, the growing number of severe and critical cases has recently overwhelmed Al-Kindy and other health facilities treating people with COVID-19. The RCU in Al-Kindy hospital is made up of 52 beds, all of which are currently full. Given the high number of patients, MSF will open a new COVID-19 ward in Al-Kindy hospital.

COVID-19 patient in Al-Kindy hospital, Baghdad
A COVID-19 patient receives care in the severe case ward of Al-Kindy hospital.
Iraq 2020 © MSF

“Every moment of every day we’re seeing more and more severe COVID-19 cases in Baghdad,” said Dr. Pedro Serrano Guajardo, a doctor who recently worked with MSF as an intensive care unit specialist. “Many patients stay in the RCU for 15 to 20 days to be treated, meaning that sometimes new patients are put on the waiting list for two, maybe three days, until they can get the treatment they need. By the time we have a free bed, patients are in really bad shape. It is really distressing to watch these people wait for a bed.” The waiting lists and lack of bed capacity are not the only issues in Baghdad. Some people are waiting to come to the hospital when it’s almost too late to seek treatment, said Dr. Guajardo. The teams receive cases in acute respiratory distress, and it is very hard to treat them when they reach that point. 

“Some people in the city do not appreciate the gravity of the situation, and they are not taking prevention measures,” said Dr. Guajardo.

“These people seem to be avoiding treatment due to the heavy social stigma associated with COVID-19 in the community. I think many people sometimes only realize how bad the situation is when they or a loved one is brought to the hospital. They see patients dying, very quickly, every day. Then they realize the reality [of the situation].” 

Iraqi health workers have also been very badly affected, with almost 15,000 cases among this group since the start of the outbreak. This risk to health care workers comes at a time when hospitals in Baghdad are dealing with human resource shortages, further complicating an already critical situation.

 “The most stressful thing is to see a patient dying and know that I don’t have an available ventilator for them,” said Dr. Guajardo.“ When you can see them fade away minute by minute, it is frustrating because I know that if people were taking measures to protect themselves—like wearing a mask when they go out, and washing their hands—or coming to hospital earlier rather than later, then the situation could improve.”

MSF is working across Iraq to help the health system cope with the pandemic. In Mosul, soon after COVID-19 reached Iraq, MSF began supporting the city’s health care system and temporarily transformed part of its 62-bed post-operative care center into a COVID-19 treatment facility.

MSF teams have also been providing training sessions, with a focus on infection prevention control, in various health facilities in Erbil, Dohuk and Ninewa governorates. The organizationhas also set up a 20-bed isolation and treatment facility in Laylan camp in Kirkuk Governorate, in preparation for a potential surge of COVID-19 cases.