BAGHDAD (AP) – In the crowded emergency room of Baghdad’s main public hospital, Ali Abbas stood uncovered waiting for his ailing father. Dozens of other patients and their relatives mingled without masks.
It’s a scene that confuses health workers in Iraq, who warn that the country is entering a new wave of coronavirus cases, in part because many are avoiding precautions.
“I don’t believe in the coronavirus, I believe in God,” said 21-year-old Abbas in the middle of the hospital floor, defying the facility’s rules that prescribed masks.
On Friday, Iraq was under the first full day of a new curfew imposed by the government in response to infection rates that rose again after the easing last fall. Curfews run all day Friday to Sunday and from 8:00 PM to 5:00 AM the rest of the week. Mosques and schools are closed, large gatherings are banned, and masks and other protective clothing will be enforced, a government statement said.
A complete shutdown, including closing airports and borders, is also being considered, said two government officials, speaking on the condition of anonymity because they were not authorized to inform the media.
The number of new cases, just below 600 per day a month ago, has risen sharply to 3,896 per day on February 18, approaching the daily high of more than 5,000 in September. The Department of Health says 50% of new cases come from the new, more contagious strain that first broke out in the UK. More than 657,000 people have been infected with the virus in Iraq and 13,220 have died since February.
Doctors told The Associated Press that they’ve been seeing the flare-up coming for weeks. They blame a careless public and a government incapable of fully enforcing virus protocols.
“I am a doctor fighting public ignorance, not the pandemic,” said Mohammed Shahada, a pulmonologist at al-Zahra hospital in Baghdad.
At al-Zahra hospital, the year started with just four patients in the 90-bed isolation ward. At the beginning of February, that number had risen to 30 serious virus patients. Shahada expects more in the coming weeks.
In his private clinic, some patients have run away instead of adhering to 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 wears a mask.
The Ministry of Health said earlier this month that a new wave was driven by religious activities – including Friday prayers and visits to shrines – and large crowds in markets, restaurants, malls and parks, where handshake and kiss greetings are the norm.
The ministry also blamed “some people openly questioning the existence of the pandemic.”
That’s a general feeling.
“It’s just the flu,” said Yahya Shammari, a 28-year-old graduate. “I went to the hospital twice without a mask on and I did not get infected.”
Rahem Shabib, 32, said he noted how the number of infections dropped after the Shia Muslim Arbaeen pilgrimage in October. “So God is stronger than COVID-19,” he said.
The Arbaeen brings millions from around the world to Iraq for commemorations related to the 7th-century assassination of Imam Hussein, the Prophet Muhammad’s grandson of Islam. This year, Iraq has banned foreign pilgrims, which has reduced the number significantly.
Mac Skelton, a medical sociologist at the American University of Iraq in Sulaimaniyah, said the dismissive attitude is rooted not so much in ignorance as in the reality Iraqis face.
Iraqis have faced so many calamities in recent decades, including wars, political violence and sanctions, that COVID-19 “may not be a major problem,” he said.
The government’s pandemic policy, targeting hospitals, is also inconsistent with the way Iraqis deal with disease, Skelton said. In the midst of years of instability, Iraqis had to devise strategies of their own as health care was unavailable or they distrusted hospitals, which became dangerous places to go at the height of sectarian fighting.
So they seek pharmacists, nurses, help from neighbors or even cross the border to treat illness.
“Most doctors are not that surprised, they know that patients would refuse to go to the hospital unless they gasped and had no choice,” said Skelton, director of the university’s Institute of Regional and International Studies.
This also suggests that Ministry of Health statistics, based on tests in government labs, are under-graded, as many Iraqis refrain from testing altogether and choose to recover at home.
Iraq’s centralized health system, largely unchanged since the 1970s, has been undermined by decades of wars, sanctions, and ongoing unrest since the US invasion in 2003. 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 exclusively for virus patients; but no longer, and COVID-19 patients and others share rooms where CT scans, MRIs and X-rays are taken, Shahada said.
So far Iraq has no shortage of medical supplies or ICU capacity. But that could change as cases increase, doctors said.
The health ministry said it plans to start administering vaccines by the end of March. The government has allocated funds to obtain 1.5 million vaccines from Pzifer and has signed a contract for an additional 2 million vaccines from AstraZeneca. Little has been made known about the course of the vaccination.
Government officials are more concerned than ever that it will be difficult to change entrenched habits.
When restrictions were eased after September, life returned to Iraq. In Baghdad, the restaurants are packed and face masks are rarely seen. Further south, in Basra, residents go about their business as if the pandemic never reached the southern shores, sharing meals in busy cafes and shaking hands.
“Changing public consciousness is the only way to stop another deadly virus outbreak,” Health Minister Hasan al-Tamimi told the AP on the sidelines of a recent news conference.
Associated Press writer Samya Kullab in Baghdad contributed to this report.