If allowed to spread within the war-torn country, the novel coronavirus threatens to become a “catastrophic” disaster in Yemen, according to an official with the World Health Organization (WHO).

“The health system here is already fragile. Should the virus become fully transmissible in Yemen, it will be catastrophic in the country,” Altaf Musani, the WHO Representative and mission chief in Yemen, told Anadolu Agency in an exclusive interview on the latest developments about the virus’s spread in the Middle Eastern country.

Noting that though the country’s health system was starting efforts to prepare for a response to the pandemic, Musani warned that it would never be fully prepared as it had experienced conflict within its borders for the past five years.

“This health system will never be fully prepared, because we’ve had five years of war, and that conflict, that vulnerability, and that fragility has really weakened the health system to deal with routine health matters such as cholera, dengue and malaria.”

Musani said he was “deeply worried” should the country find itself facing coronavirus cases, since the health system would “not be able to manage” the outbreak.

Earlier this week, the Yemeni authorities have confirmed eight COVID-19 death cases and 51 cases in areas under its control. Half of the fatalities and 35 infections were reported in the temporary capital city of Aden alone.

Although the first infection case was declared on April 10 in the southern Hadramaut province of Yemen, Musani said the particular patient has recovered — which was announced on April 13 by the government — but noted that there have been subsequent additional five cases declared by the authorities in Aden.

Musani underlined that the WHO was dealing with both of two different authorities in the country, adding that they were providing capacity to both.

“We have a situation where we deal with two different authorities, the internationally recognized government and Aden as well as the de facto authorities in Sanaa. We have provided capacity to both these entities to make sure that they can test for the virus, trace for the virus, of course isolate and treat,” he said.

Yemen has been beset by violence and chaos since 2014, when Houthi rebels overran much of the country, including Sana’a. The crisis escalated in 2015 when a Saudi-led military coalition launched a devastating air campaign aimed at rolling back Houthi territorial gains.

Since then, tens of thousands of Yemenis, including numerous civilians, are believed to have been killed in the conflict, while another 14 million are at risk of starvation, according to the UN.

Testing facilities

Musani said that testing was available in the city of of Sana’a under the Houthis’ control, while in the south, testing was carried out in Aden, Al-Mukalla and Taiz. He said WHO was making efforts to support the country’s health authorities to launch an additional lab in the southern city of Seiyun, and “hoping to have testing capability” in the coastal province of Al-Hudaydah.

“So that would make six central public health laboratories nationwide that would be capacitated to have the necessary means to run the PCR [Polymerase Chain Reaction] samples,” he said, adding that those six would be further expanded based on the availability of tests.

Testing for COVID-19 requires rapid response teams, Musani said, noting that such teams had been deployed at “almost every district” of Yemen due to a cholera outbreak two years ago.

“These rapid response teams have been further trained and will continue to scale up. They can do the screening at the points of entry, they can do investigation of rumors, and then, the third, and the most important thing they do is they take samples of suspect cases.”

He explained that after a sample, or swab, is taken from the interior of a patient’s nose or the back of their throat, it is transported to one of the six labs across the country. Test results are reported to the country’s Ministry of Public Health, which then reports the figures to WHO as members states are legally required to report any public health emergency of international concern to the organization.

WHO, in turn, provides the “public health advice,” as well as some material operational support, he said.

“We help them with PPE [personal protective equipment], we help them with tests, we help them with swabs, we help them with PCR machines. And then of course, we provide some financial support based on what donors have provided us from COVID-19 response.”

COVID-19 specialized hospitals

The WHO official said that Yemeni health authorities specially equipped 38 out of a total of 369 hospitals to fight against the COVID-19 pandemic with special intensive care units, oxygen therapy, ventilators, clinical experts, barrier materials to manage severe and critical cases.

WHO has shared necessary operational materials with 32 out of the 38 hospitals, Musani said, adding that only 14 of these were functional.

He emphasized that the organization was still working with authorities to make sure that the remaining facilities were fully functional.

Functionality criteria include whether a facility’s staff had the right training, whether it had the right workforce and required equipment, as well as whether the community was aware of these facilities.

‘Stop blaming WHO’

Musani urged the public to stop blaming WHO for the ongoing pandemic, which has killed more than 290,000 people so far out of over 4.2 million who have been infected.

“They must stop attacking and laying blame on the WHO. The WHO is not a government, but WHO is here as a provider of last resort. WHO is here as the technical agency to provide the health authorities with the evidence, with the information, with the material support in order for the authorities to manage the outbreak,” he said.

Musani urged the public to protect the health authorities and defend their humanitarian work.

Last month, US President Donald Trump said he would suspend the country’s funding for WHO, accusing the UN agency of mismanaging and covering up the outbreak due to Chinese pressure.

US-Chinese relations have deteriorated dramatically since Trump’s accusations and branding of COVID-19 “the Chinese virus,” a move his critics say smacks of racism.

Insufficient test numbers

“Based on models that have been developed worldwide and for Yemen, the number of tests that would be required are millions, we don’t have those tests. The amount of PPE [personal protective equipment] that would be required is millions. We don’t have that kind of PPE, and the type and number of hospitals that may have admissions are in the hundreds of thousands,” he explained.

Musani emphasized that so far 10% of hospitals worldwide have been dedicated to combating the coronavirus pandemic.

“We are deeply worried that the amount of PPE, testing kits, labs, healthcare workforce are grossly insufficient in Yemen to manage the outbreak at peak.”

The Yemeni government on Sunday appealed for help from the international community to combat the spread of the pandemic.

On Monday, the government declared the temporary capital, Aden, as a “disaster zone” due to the spread of the coronavirus and other epidemics, according to local media.

Since appearing in Wuhan, China last December, the novel coronavirus has spread to at least 187 countries and regions, according to data compiled by Johns Hopkins University in the US.

More than 4.26 million cases have been reported worldwide, with a death toll surpassing 291,000 and more than 1.49 million recoveries.

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