BAGHDAD (AP) – In the busy emergency room in Baghdad’s main public hospital, Ali Abbas stood uncovered waiting for his ailing father. Dozens of other patients and their family members mingled without masks.
It is a scene that is confusing health workers in Iraq, warning that the country is entering a new wave of coronavirus cases, partly because many are taking precautions.
“I do not believe in the coronavirus, I believe in God,” said the 21-year-old Abbas in the middle of the hospital floor, challenging the rules of the facility in which masks are required.
On Friday, Iraq was under the first full day of a new evening bell imposed by the government in response to infection figures that shot back after easing last fall. The curfew rule lasts all day Friday to Sunday and the rest of the week from 20:00 to 05:00. Mosques and schools have been closed, large gatherings are banned and the wearing of masks and other protective equipment will be applied, according to a government statement.
A complete exclusion, including the closure of airports and borders, is also being considered, two government officials said on condition of anonymity because they are not authorized to inform the media.
New cases, less than 600 per day just a month ago, increased sharply, reaching 3,896 per day on 18 February, reaching the daily high of September of more than 5,000. The Ministry of Health says that 50% of the new cases come from the new, more contagious strain that first broke out in the UK. More than 657,000 people have been infected by the virus in Iraq and 13,220 have died since February.
Doctors told The Associated Press that they had been seeing the flare-up for weeks. They blame an indifferent public and a government that cannot fully implement virus protocols.
“I am a doctor who fights public ignorance, not the pandemic,” said Mohammed Shahada, a pulmonologist at al-Zahra Hospital in Baghdad.
At al-Zahra Hospital, the year began with just four patients in the 90-bed isolation ward. By early February, it had jumped to 30 serious virus patients. Shahada expects more in the coming weeks.
In his private clinic, some patients walked rather than meet his strict face mask requirement, he said.
Ismail Taher, a doctor at Sheikh Zayed Hospital in Baghdad, estimated that only one in ten people who walk into his hospital wear masks.
The Ministry of Health said earlier this month that a new wave is being driven by religious activities – including Friday prayers and visits to shrines – and large crowds in markets, restaurants, shopping malls and parks, where greetings with handshakes and kisses are the norm.
The ministry also blamed ‘some people who openly question the existence of the pandemic’.
This is a common sentiment.
“It’s just flu,” said Yahya Shammari, a 28-year-old college student. “I went to the hospital twice without a mask and was not infected.”
Rahem Shabib, 32, said he noticed how the infection rates dropped after the Shiite Muslim Arbaeen pilgrimage in October. “So God is stronger than COVID-19,” he said.
The Arbaeen is bringing millions of people from around the world to Iraq for commemorations related to the assassination of Imam Hussein, the grandson of Islam’s prophet Mohammed, in the 7th century. This year, Iraq banned foreign pilgrims from attending, which has significantly reduced the numbers.
Mac Skelton, a medical sociologist at the American University of Iraq in Sulaimaniyah, said the dismissive attitude is not so much rooted in ignorance as in the reality facing Iraqis.
Iraqis have endured so many disasters over the past few decades, including wars, political violence and sanctions, that COVID-19 ‘may not be a major problem’, he said.
Skelton also said the government’s pandemic policy, which is focused on hospitals, does not align with the way Iraq is treating the disease. Amid years of instability, Iraqis had to come up with their own strategies because health care was not available, or they distrusted hospitals, which at the height of sectarian fighting became dangerous places to check.
Therefore, they seek pharmacists, nurses, help from neighbors or even go across borders to treat diseases.
“Most doctors are not so surprised, they know that patients would refuse to go to hospital unless they gasped for air and had no choice,” said Skelton, director of the University’s Institute for Regional and International Studies, said.
It also suggests that Ministry of Health statistics, based on tests at government laboratories, are an understatement, as many Iraqis may test completely and prefer to recover at home.
Iraq’s centralized health care system, which has remained largely unchanged since the 1970s, has been torn down by decades of wars, sanctions and protracted unrest since the 2003 US invasion. Successive governments have invested little in the sector.
The mixing of virus patients with others has also exacerbated the number of cases, doctors said. Shahada’s hospital was once reserved for virus patients only; but no more, and COVID-19 patients and others share rooms where CT scans, MRIs and X-rays are taken, Shahada said.
So far, Iraq has not had shortages of medical supplies or ICU capacity. But that could change as cases increase, doctors said.
The Ministry of Health said they plan to start vaccinating vaccines by the end of March. The government has allocated funds to secure 1.5 million Pzifer vaccines and signed a contract for another 2 million from AstraZeneca. Little has been announced about how the vaccination will go.
Government officials are now more worried than ever that it is difficult to change entrenched habits.
As the restrictions eased after September, life returned to Iraq. In Baghdad, restaurants are crowded and face masks are rarely seen. Further south in Basra, residents go the day as if the pandemic has never reached the southern shores, while sharing meals in busy cafes and shaking hands.
“Changing public awareness is the only way to stop another deadly virus outbreak,” Health Minister Hasan al-Tamimi told the AP on the sidelines of a recent press conference.
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Associated Press author Samya Kullab in Baghdad contributed to this report.