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Pandemic worsens for Iraq as Delta variant and vaccine hesitancy take root

Iraq's covid-19 infection rate has peaked for a third time, to a record high, putting dire pressure on an overloaded health care system.
A special team of the al-Hashid al-Shabi, dedicated to burying victims of the coronavirus, in a desert graveyard outside Najaf. (Source: Ali al-Fahdawi via al-Hashid al-Shabi media office)

Iraq has recorded its highest daily covid-19 case count since the beginning of the pandemic, as the spread of the Delta variant and widespread vaccine hesitancy plunge the country into a third wave of infections.

There were 9,189 new cases recorded on Thursday, according to Ministry of Health figures, building on case numbers that have been rising since mid-May, as social distancing and mask-wearing are largely ignored. There were 31 more deaths, taking the overall toll to 17,444 since the beginning of the pandemic.

Widespread vaccine hesitancy and supply issues mean that as of July 5, just 699,325 people –1.74% of the population – had been fully or partially vaccinated, according to figures compiled by Oxford University’s Oxford Martin School. The number of fully vaccinated individuals was 388,541 – less than one percent of the population.

As the highly-contagious Delta variant spreads through a largely unprotected population, pressure on medical staff and pandemic-related disruptions in Iraq are likely to worsen before they get better.

“People are refusing the vaccine," said a doctor working at a Baghdad hospital that treats coronavirus patients. "Their ignorance will kill them, and kill us with them.”

On Thursday, the Ministry of Health acknowledged the record case load in a statement that blamed the figures on “almost non-existent” preventative measures.

“This wave could be the worst, worse than those that preceded it, and today we recorded the highest number of infections since the beginning of the pandemic,” the statement said. “This is a result of most citizens from all sectors of society not conforming to preventative measures, which have become almost non-existent, especially mask-wearing and social distancing.”

Medical personnel are struggling to cope with the rise in patient numbers, according to three doctors in Najaf and Baghdad.

“Now the Delta variant has arrived, and there are so many cases, most of them critical,” said the Baghdadi doctor. Most wards designated for coronavirus patients in the eastern half of the capital are full, he added.

Two other doctors in Najaf described a sharp rise in coronavirus admissions in recent weeks, including many cases among young people.

“People are sleeping in the [hospital] corridors – there is no space left,” one of the doctors said. Some medical staff who had received the Pfizer or Sinopharm vaccines had later tested positive for covid-19, he added, placing further pressure on health infrastructure.

Although the government has ordered ministries to coordinate with the Ministry of Health to vaccinate staff, the low rates indicate that a large percentage of Iraq’s public sector workers is yet to be inoculated.

The latest surge in cases does not appear to be having any new impact on the oil sector, although low vaccination rates mean that the risk of infection among industry personnel remains high. This week the government issued an order allowing ministries to reduce staffing by half if officials felt it necessary to minimize infection.

In early June, Iraqi health officials said the Delta strain of the coronavirus was not present in Iraq, according to state media reports. But two weeks later, they confirmed that it had arrived, although the origin remains unclear.

Amid criticism over delays, Iraq began its vaccination campaign in March, but authorities have faced reluctance among large sections of the population to take the vaccines.

In March, Iraq’s head of public health told Iraq Oil Report that a 30 percent vaccination rate by the end of 2021 would be “good” – although the current pace means that target appears well out of reach.

The widespread vaccine hesitancy is caused by misinformation spread on social media, distrust of the government, and a general lack of quality information about healthcare, medical workers say.

“Unfortunately, social media sites are now full of anti-vaccine posts,” said the Baghdadi doctor. “There is a saying: ‘People are enemies of what they are ignorant of.’ This is what is happening.”

Dr. Sabah Hawrami, director of Sulaymaniah’s health directorate in the Kurdistan Region of Iraq, said that recent infection and death figures were “concerning”, but not a reason for “panicking.”

“I think the problem is the people and their wrong perceptions about the virus and vaccines,” he said. “We are doing our best to increase the number of tests and improve testing infrastructure. However, there has not been any government decisions regarding partial lockdowns and new restriction measures.”

Iraq is not the only country in the region or worldwide suffering from a spike in cases, as the Delta variant moves around the globe. Neighboring Iran is currently also seeing a spike in cases – around 16,000 per day – and as of late June under 5 percent of its population had received one or more vaccine dose.

Iraqi doctors report higher uptake of the Pfizer vaccine than the widely rejected AstraZeneca and Sinopharm brands, the other two manufacturers who have supplied Iraq. The country has received two batches of AstraZeneca, totalling one million vaccines, through the COVAX facility, an initiative co-organized by the World Health Organization (WHO), an international vaccine alliance known as Gavi, and the Coalition for Epidemic Preparedness Innovations (CEPI), which aims to help countries diversify vaccine sources and even out the access to vaccines between wealthier and poorer nations.

Baghdad has also bought vaccines from Pfizer, and has received Chinese doses as donations from Beijing.

Two Iraqi Ministry of Health officials did not respond to requests for comment on measures to increase vaccine uptake, or when more doses would arrive in the country.

With infections rising, the federal government this week renewed and updated a long list of movement and travel restrictions aimed at preventing the spread of the coronavirus, as well as measures around religious tourists, who normally visit Iraq’s shrines and other holy sites in the millions every year. At present, land, air and sea borders remain open.

The government's new pandemic measures include a renewed nighttime curfew enforced in federal Iraq, although it remains unclear how effective the movement ban is in preventing the spread of coronavirus. There is at present no curfew in the Kurdistan region. The federal orders also include a limit on visas for foreigners entering the country, in accordance with other countries’ treatment of Iraqi visa applicants, excluding diplomatic staff.

Lizzie Porter reported from London. Mohammed Hussein reported from Sulaimaniya. Amir Ali reported from Khanaqin.

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