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COVID-19 in Afghanistan Under Taliban Rule

Alyssa Schmidt, Sam Shames, Jade Patel, Emergency Management, Health, and Hazards (EMH2) Team

Week of Monday, September 27, 2021


COVID-19 Cases in Afghanistan[1]


The Taliban takeover is likely to hinder Afghanistan's COVID-19 response and increase the threat of a fourth virus wave. The country's limited access to virus protection combined with the ongoing humanitarian crisis are likely to lead to a surge in cases making it extremely likely for a sharp increase of fatalities. With Afghanistan's healthcare system on the verge of collapse, a fourth wave is most likely to increase demand, reduce access to treatments, and overwhelm health facilities. The limited international aid is likely to cause medical cases to be prioritized and leave thousands without medical care, negatively affecting the welfare of the country. If vaccination rates remain low, it is likely that cases and deaths will continue to increase as more people become vulnerable to contracting the virus.


The United States (US) started removing their troops in early 2021 after being stationed in Afghanistan for over 20 years.[2] Whilst underway, the Taliban began insurging and gaining control of Afghanistan's major cities resulting in millions fleeing to the Kabul airport in attempts to flee.[3] On August 15, 2021, the Taliban occupied Kabul, ensuring their authority over the airport.[4] Violence occurred as the Taliban seized power and international countries facilitated evacuations of their citizens and Afghan refugees. Unfolding conflict is likely to have sidestepped Afghanistan progress in controlling COVID-19, resulting in the country dealing with two major issues simultaneously. The chaos caused by the insurgency is likely to have accelerated the threat of the virus and is likely to result in delays to vaccinations and a potential fourth COVID-19 wave.


The month following the insurgency, resources that were previously distributed from larger countries such as the US were paused, leaving millions of people without access to basic necessities.[5] The ongoing humanitarian crisis is extremely likely to worsen without alternative aid, and is likely to lead to a surge in fatalities from impoverished circumstances. The World Health Organization (WHO) has been working to send medical supplies to Afghanistan, but it is not enough to supply the population that is in need of medical treatment, likely leaving millions vulnerable to contracting and transmitting the virus.


As of September 24th 2021, there are at least 154,000 cases of COVID-19 in Afghanistan and 7,000 deaths.[6] Global comparison shows that these statistics are average but with multiple points of conflict within the country, it is very likely that cases and deaths will increase throughout 2021 and in the early months of 2022, unless greater preventatives are implemented. Despite the Taliban’s views on previous health emergencies such as the poliovirus outbreak, the group is being more cooperative with COVID-19 guidelines by promoting face masks and social distancing.[7] Workshops have also been created to educate Afghans on how to limit the spread of the virus.[8] It is also highly likely that COVID-19 guidelines will not be actively enforced due to excessive overcrowding at hospitals and shelters for internally displaced people (IDP).[9] If individuals in highly populated areas contract the virus, it is extremely likely that super-spreader events will occur, meaning the virus will contract easier and quicker. It is highly likely that contact tracing is limited due to the lack of resources available. Healthcare facilities and workers have been directly impacted by the violence, causing some medical professionals to move to more secure places.[10] This is likely to hinder the already struggling hospitals that are trying to handle treating patients with a lack of appropriate resources. The resources to maintain these practices are likely diminishing, which causes concern regarding future transmission. Without ongoing virus prevention practices combined with the country's instability, it is extremely likely that a fourth wave will occur. Whilst the government is being established, a severe increase in cases will likely send Afghanistan into a state of emergency.


Afghanistan has experienced an 80% decrease in vaccinations since the Taliban’s rise to power.[11] With only 2 million of the 39 million population vaccinated, even a single dose of the vaccine is not as effective as receiving both, likely leaving many without full protection from the virus.[12] With limited resources and civil unrest, access to vaccination is unlikely to be achieved within all regions of the country, creating areas of high virus vulnerability. Many people, likely unvaccinated, have left their region to seek safety which will likely cause the virus to spread at an increased rate. Vaccines available for the country have been expiring because people are prioritizing their immediate health and safety over virus protection.[13] With people traveling around the country and individuals living in hard to reach communities, it is likely that millions may not have access to health clinics in order to obtain the vaccine. Without making vaccines available in all regions, people will continue to miss the opportunity to receive a vaccination and could be time pressured if more bans are implemented across the country. The Taliban’s opposition towards vaccines, in the past with polio and currently with COVID-19, causes concern for the future of the pandemic. Without advocating for the vaccine, this is extremely likely to influence further virus outbreaks throughout the country.[14] Current misinformation campaigns and anti-vaccination propaganda is likely being used as a fear tactic, although vaccination bans have begun in the Paktia Province.[15] If anti-vaccination propaganda is being dissmetined around Afghanistan, it is very likely that more regions will invoke similar bans. Without people receiving the vaccine, this will likely speed virus transmission rates as well as impact the severity of the virus for the infected individual. It is also extremely likely that populations in Afghanistan may have undiagnosed or untreated underlying illnesses that make them more susceptible to the virus.


Limited international aid is likely to have caused disruptions in the surveillance, testing, and vaccination methods.[16] PCR testing is available for the community but it is unknown how often tests are being administered as they do not have a robust track-and-trace system. Mistrust in medical systems will likely cause underreporting and avoidance of medical facilities, especially as many of the trained and educated individuals from Afghanistan have fled the country. It is also likely that public health records may be outdated and are likely inaccurate, especially if the majority remaining medical professionals are focused on assisting the patients.


The Taliban’s ideology regarding gender is causing many women to feel in danger; as a result, they refuse to leave their homes with the exception of emergencies.[17] Women are likely to not get vaccinated to limit the threat, leaving them vulnerable to COVID-19 if transmitted from others. When the Taliban previously gained control of Afghanistan, women’s rights such as their healthcare access and education were stripped. If women are left without healthcare during this crisis, their welfare will likely be greatly impacted. Women will likely push off medical treatment until immediately necessary, which is likely to result in more severe problems in the future. As COVID-19 is more severe for immunocompromised and unvaccinated individuals, this could make women in danger. Women may be hesitant to return to work until the threat to their safety is gone which may impact their individual financial stability. Lack of workers will likely cause businesses to be understaffed and could lead to closures if they are incapable of successfully completing their day to day activities. Children will most likely be more susceptible to the COVID-19 because vaccines are not available to them. Due to current unrest, it is likely that parents will keep their children inside to protect them from the conflict as well as the virus. This could impact younger children’s social skills and education, as well as their overall health. The oppression that women are dealing with may inhibit their ability to care for their children, as their physical and mental health are likely to suffer from the complete isolation and lack of access to healthcare. The long-term effects of living in fear and isolation due to medical necessity and the Taliban takeover are highly likely to severely affect future generations, as precautionary conservative mannerisms and social responses become increasingly ingrained.


Disruptions at the airport have impacted the distribution of medical supplies as well as the travel for individuals fleeing. A lack of transportation could make it increasingly difficult to find the medical care needed; without proper care, individuals may have to seek treatment elsewhere which could cause future issues or they may push off receiving treatment until it is extremely necessary. Afghanistan has also had a severe drought that has been impacting the food and water supply of the country.[18] Consuming contaminated water could lead to further medical problems that could make them susceptible to other diseases. Malnourished and immunosuppressed individuals have a more difficult time fighting off illnesses, and COVID-19 is likely to cause fatalities if outbreaks occur throughout this population. As there have been many hazards going on throughout the world alongside COVID-19, humanitarian organizations may have limited resources. If international aid is sourced, it is highly likely that the resources will be distributed towards necessities such as food and water rather than vaccinations. Aid workers are still allowed to help in Afghanistan however it is unclear whether the Taliban will continue to accept them into their country.



The overall situation in Afghanistan is extremely likely to result in a severe humanitarian crisis. With unpredictable COVID-19 prevention, growing food insecurity, drought, and violence, it is crucial that international assistance is revised and resources are made available to Afghanistan. It is recommended that humanitarian access is negotiated and granted to reduce mass fatalities within the country. These events in tandem are highly likely to cause political unrest which are likely to cause more violence and disrupt emergency management. Emergency aid should be made accessible where possible to all regions of Afghanistan to decrease the prevailing situation. As chaos continues in the country, international cooperation should be considered, and humanitarian organizations may likely revise actionable plans to assist in ensuring citizen safety.


The Counterterrorism Group (CTG) works to detect, deter, and defeat threats of terrorism around the world. The Emergency Management, Health, and Hazards (EMH2) Team continuously monitors worldwide major health and hazard concerns such as COVID-19, specifically health developments that may affect emergency response. Future implications of the unfolding situation in Afghanistan will continue to be monitored by multiple CTG teams, including the CENTCOM and EMH2 team. Recommendations are aimed towards government officials and humanitarian organizations that may be able to assist in mediating the situation. The EMH2 team will continue to monitor the ongoing Afghanistan crisis and the transmission of the virus within the country and throughout the world.

 

[2] The Taliban in Afghanistan, Council on Foreign Relations, September 2021, https://www.cfr.org/backgrounder/taliban-afghanistan

[3] Timeline: The Taliban's rapid advance across Afghanistan, Reuters, August 2021, https://www.reuters.com/world/timeline-talibans-rapid-advance-across-afghanistan-2021-08-15/

[4] Ibid

[5] The Taliban Could Soon Face A Cash Crunch As Countries Cut Off Funding To Afghanistan, NPR, August 2021, https://www.npr.org/2021/08/19/1029437836/the-taliban-could-soon-face-a-cash-crunch-as-countries-cut-off-funding-to-afghan

[7] Taliban ban on jabs may trigger COVID-19 spike, SciDev Net, August 2021, https://www.scidev.net/global/news/taliban-ban-on-jabs-may-trigger-covid-19-spike/

[8] Fact check: What we know about COVID-19 precautions, deaths in Afghanistan, USA Today, September 2021, https://www.usatoday.com/story/news/factcheck/2021/09/10/fact-check-afghanistan-taliban-havent-been-spared-covid-19/5769960001/

[9] Taliban ban on jabs may trigger COVID-19 spike, SciDev Net, August 2021, https://www.scidev.net/global/news/taliban-ban-on-jabs-may-trigger-covid-19-spike/

[10] For the Taliban, the Pandemic Is a Ladder, Foreign Policy, May 2020, https://foreignpolicy.com/2020/05/06/taliban-afghanistan-coronavirus-pandemic/

[11] During chaos of Taliban takeover, Covid-19 vaccinations in Afghanistan decline 80%, CNN, August 2021, https://www.cnn.com/world/live-news/afghanistan-news-taliban-refugees-08-25-21/h_eb5ab01c7ac87958157fcc356bb34ec9?cid=external-feeds_iluminar_newsbreak

[13] Ibid

[14] Taliban ban on jabs may trigger COVID-19 spike, SciDev Net, August 2021, https://www.scidev.net/global/news/taliban-ban-on-jabs-may-trigger-covid-19-spike/

[15] Fact check: What we know about COVID-19 precautions, deaths in Afghanistan, USA Today, September 2021, https://www.usatoday.com/story/news/factcheck/2021/09/10/fact-check-afghanistan-taliban-havent-been-spared-covid-19/5769960001/

[16] Acute health needs in Afghanistan must be urgently addressed and health gains protected, World Health Organization, September 2021, https://www.who.int/news/item/22-09-2021-acute-health-needs-in-afghanistan-must-be-urgently-addressed-and-health-gains-protected

[17] Statement by the WHO Representative in Afghanistan, World Health Organization, August 2021, http://www.emro.who.int/afg/afghanistan-news/statement-by-the-who-representative-on-afghanistan.html

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