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BAGHDAD (AP) – In the busy emergency room of Baghdad’s main public hospital, Ali Abbas stood with his face uncovered, waiting for his sick father. Dozens of other patients and their loved ones mingled without a mask.
It’s a scene that confuses health workers in Iraq, who are warning the country is entering a new wave of coronavirus cases, in part because many precautions are slipping away.
“I don’t believe in the coronavirus, I believe in God,” Abbas, 21, said in the middle of the hospital floor, defying the facility’s rules requiring masks.
Iraq was under its first full day on Friday of a new government-imposed curfew in response to infection rates that rebounded after declining last fall. The curfew runs throughout the day from Friday to Sunday and from 8 p.m. to 5 a.m. the rest of the week. Mosques and schools are closed, large gatherings banned and the wearing of masks and other protective equipment will be imposed, according to a government statement.
A full lockdown, including closing airports and borders, is also being considered, two government officials said, speaking on condition of anonymity as they were not authorized to brief the media.
New cases, down from less than 600 per day just a month ago, have risen sharply, reaching 3,896 per day on February 18 and approaching the September daily peak of more than 5,000. The health ministry says that 50% of new cases are from the new, more infectious 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 they had seen the outbreak happen for weeks. They blame a reckless public and a government unable to fully enforce antivirus protocols.
“I am a doctor who fights against public ignorance, not against the pandemic,” said Mohammed Shahada, 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, this figure rose to 30 patients with severe viruses. Shahada expects more in the coming weeks.
In his private clinic, some patients were taken out rather than complying with his strict face mask requirements, he said.
Ismail Taher, a doctor at Sheikh Zayed Hospital in Baghdad, estimated that only one in 10 people entering his hospital wore masks.
The health ministry said earlier this month that a new wave was fueled by religious activities – including Friday prayers and visits to shrines – and large crowds in markets, restaurants, centers shopping malls and parks, where greetings with handshakes and kisses are the norm.
The ministry also accused “some people who openly question the existence of the pandemic”.
It is a common feeling.
“It’s just the flu,” said Yahya Shammari, a 28-year-old college graduate. “I went to the hospital twice without a mask and I was not infected.
Rahem Shabib, 32, said he noticed how infection rates fell after Shia Muslims made a pilgrimage to Arbaeen in October. “So God is stronger than COVID-19,” he says.
The Arbaeen brings millions of people from around the world to Iraq for commemorations related to the 7th century murder of Imam Hussein, the grandson of the Prophet of Islam Muhammad. This year Iraq has banned foreign pilgrims from attending, drastically reducing their numbers.
Mac Skelton, a medical sociologist at the American University of Iraq in Sulaimaniyah, said the disdainful attitude is not so much rooted in ignorance as it is in the realities Iraqis face.
Iraqis have endured so many calamities over the past decades, including wars, political violence, and sanctions, that COVID-19 “cannot be considered a major problem,” he said.
Likewise, the government’s hospital-centric pandemic policies do not match how Iraqis cope with the disease, Skelton said. Amid years of instability, Iraqis had to develop their own strategies as health care was unavailable or they were wary of hospitals which, at the height of sectarian fighting, became dangerous places.
So they look for pharmacists, nurses, help from neighbors or even cross borders to treat diseases.
“Most doctors aren’t that surprised, they know that patients would refuse to go to the hospital unless they gasp and have no choice,” said Skelton, director of the University’s Institute for Regional and International Studies.
It also suggests that the Health Ministry’s statistics, based on tests done in government labs, are underestimated, as many Iraqis may forgo testing entirely and choose to recover at home.
Iraq’s centralized healthcare system, virtually unchanged since the 1970s, has been wiped out by decades of wars, sanctions, and protracted unrest since the 2003 US invasion. Successive governments have invested little in the sector.
The mix of patients infected with the virus has also exacerbated the number of cases, doctors said. Shahada Hospital was once reserved only for patients infected with the virus; but 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 faced shortages of medical supplies or critical care capacity. But that could change if cases skyrocket, doctors said.
The Health Ministry has announced plans to start administering the vaccines by the end of March. The government has allocated funds to obtain 1.5 million vaccines from Pzifer and signed a contract for another 2 million with AstraZeneca. Little has been reported about the course of the inoculation.
More than ever, government officials fear that it will be difficult to change entrenched habits.
With the easing of restrictions after September, life returned to Iraq. In Baghdad, restaurants are crowded and face masks are rarely seen. Further south in Basra, residents spend the day as if the pandemic never reached the southern shores, sharing their meals in crowded cafes and shaking hands.
“Changing public awareness is the only way to stop another deadly virus outbreak,” Health Minister Hasan al-Tamimi told the PA on the sidelines of a recent press conference.
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Associated Press writer Samya Kullab in Baghdad contributed to this report.
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