Coronavirus Slams Broken, Embattled Yemen

Coronavirus Slams Broken, Embattled Yemen

BEIRUT, Lebanon — In northern Yemen, more and more people are falling ill and dying after having trouble breathing, yet the Iran-backed group that controls the region, the Houthis, has acknowledged only a few coronavirus deaths.

In southern Yemen, where two groups that previously fought the Houthis together have turned on each other, mortality rates have more than tripled compared with last year.

The coronavirus appears to have slammed into Yemen, a country already staggering from five years of war, competing power centers, a health care system in ruins, widespread hunger and outbreaks of cholera and other infectious diseases.

But the denial of the outbreak in the Houthi-controlled north, the absence of clear authority in the divided south and the drying-up of aid everywhere have hobbled any hope of limiting the virus’s spread, leaving health care workers and hospitals ill-equipped to cope with it and the public confused and suspicious of efforts to combat it.

Yemen was already facing what has been called the world’s worst humanitarian crisis before the virus hit. The war, in which a Saudi-led military coalition is battling the Houthis, has taken 100,000 lives. Saudi-led airstrikes have killed thousands of civilians and destroyed hospitals and schools, while United Nations officials have accused the Houthis of diverting humanitarian aid.

The pandemic has generated rumors that patients were being euthanized at hospitals, causing many Yemenis to shy away from treatment. Yet when they can no longer avoid the hospital, they are regularly turned away for lack of beds, protective equipment and medical supplies.

The authorities in many places are too weak to prevent large crowds from gathering at prayers, funerals and marketplaces, or residents from traveling within the country.

The confusion and doubt are compounded by the secrecy surrounding the outbreak — officially, the country has only 282 confirmed cases and 61 deaths.

“In Yemen, we think there’s no coronavirus because we don’t trust our own health system,” said Salah Mohammed, a school security guard in the southern port city of Aden. “They talk about a curfew to prevent the spread of the disease. Great. But why do they allow people to move freely around the country if there’s a curfew?”

With little testing available and the government and hospitals in disarray, it is difficult to measure the virus’s true spread in Yemen. What numbers are known, however, are grim.

As of last week, tests had confirmed more than 500 coronavirus cases just in Sana, the Houthi-controlled capital, said a doctor who advises the Health Ministry there. The deputy health minister is among those infected, and a former president of Sana’s flagship university is among the nearly 80 dead.

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Credit…Mohammed Huwais/Agence France-Presse — Getty Images

Yet the Houthi authorities have acknowledged only four cases in their territory, leaving public health officials, health care workers and aid groups to sound the alarm about an outbreak whose severity the authorities are playing down.

Some Health Ministry employees have been pleading with senior officials to make the true numbers public so that emergency medical workers and residents understand the gravity of the threat, said the doctor, who asked to remain anonymous because the authorities had threatened colleagues who had tried to go public.

On Thursday, the Health Ministry in Sana asserted in a statement that other countries’ decisions to publicize their coronavirus case counts had “created a state of fear and anxiety that was more deadly than the disease itself.” The ministry offered no numbers of its own.

“We don’t have to adhere to what the world wants us to,” Yousif al-Hadhiri, a ministry spokesman, said in an interview on Friday. He blamed the World Health Organization and international aid groups for being “lazy” and failing to deal with the outbreak.

The reason for the secrecy is unclear. But one result is that the virus is likely to spread further, analysts said.

“The Houthis aren’t just shooting themselves in the foot,” said Osamah al-Rawhani, the executive director of the Sana’a Center for Strategic Studies, a Beirut-based think tank focused on Yemen. “They’re shooting people. The people who are in power haven’t recognized or revealed the right information to the public. And secrecy makes people do the wrong things because they’ve gotten the wrong message.”

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Credit…Nabil Hasan/Agence France-Presse — Getty Images

The coronavirus is ravaging the other side of the front lines as well, where forces opposed to the Houthis are also reporting dubiously low numbers. There, however, the main problem is not denial, but lack of governance and a health care system in meltdown.

In Aden, which served as the interim seat of Yemen’s internationally recognized government until a separatist group seized it last month, burial data showed that 950 people had died in the city in the first 17 days of this month, more than triple the 306 recorded for all of May 2019, according to an analysis by Abdullah Bin Ghouth, an epidemiology professor at Hadramout Universitywho advises the minister of health in Aden.

The spike in deaths suggests that the official virus death toll is a vast undercount.

At a hospital for coronavirus cases that Doctors Without Borders has set up in Aden, the only dedicated Covid-19 facility in southern Yemen, 173 patients have been admitted, more than 68 of whom have died, the group said.

In other countries, 80 percent of patients did not need hospitalization, suggesting that many more people may be infected than those who went to the hospital.

Yemen’s health care system, already overrun with outbreaks of cholera and other serious diseases, is gasping. Most doctors and nurses have not been paid in years, leading many to leave the public health system. Those who stayed are now being asked to treat coronavirus patients without protective gear.

Azzubair, an emergency room doctor at a hospital in Dhamar Province, south of Sana, said he and his colleagues had been given only cheap, flimsy masks and gowns despite treating an average of six suspected Covid patients a day.

  • Frequently Asked Questions and Advice

    Updated May 28, 2020

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

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      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

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      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

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      More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

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      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

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    • How can I help?

      Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.