Copy of 2020-06-01T165334Z_657585441_RC2G0H9XNM8H_RTRMADP_3_HEALTH-CORONAVAIRUS-SAUDI-REOPENING-1591536379543
Women wear face masks as they walk at the Hayat mall after restaurants and malls reopened as the government eases the coronavirus lockdown restrictions, in Riyadh, Saudi Arabia June 1, 2020. Image Credit: REUTERS

Riyadh: Saudi Arabia had barely inaugurated a slogan for loosening its coronavirus restrictions - “Return carefully” - when health officials looking at the numbers started to threaten another lockdown.

The number of COVID-19 patients in critical condition in the kingdom has tripled over the past week. Just days after the economy reopened, health-care workers are also falling ill, hospitals are filling up and some intensive care units are near capacity, according to interviews with nearly a dozen medical workers in Riyadh and Jeddah, who spoke on condition of anonymity. The fatality rate, still low, is rising.

Countries across the Middle East are grappling with what appears to be a new surge in coronavirus cases - offering a cautionary tale for a world gradually reopening to a new normal. Iran, the epicentre of the Mideast outbreak, is back to reporting record numbers of daily infections after relaxing restrictions over the past two months. Egypt said it expects a significant rise in cases over coming weeks. In Israel, where restaurants and bars got the go-ahead to start seating customers last week, an uptick in cases since the reopening has forced cancellation of events including meetings of parliament.

Some states in the region appear to be doing better. In the UAE, the number of new cases reported has fallen steadily in the past week, despite a recent easing of movement restrictions. Case rates in Kuwait and Qatar have held steady.

‘Normal life’

But Saudi Arabia’s example shows how quickly a country’s control over the novel coronavirus can start to slip. The nation of 34 million has reported one of the lowest death rates in the world, even as the virus hobbled health care systems in the US and Italy. According to data compiled by Bloomberg from Johns Hopkins University, Saudi Arabia’s mortality rate is around 0.7 per cent, compared with 5.8 per cent in the US and more than 14 per cent in the UK, although a lack of standardised reporting makes country-to-country comparisons difficult.

Part of that may be due to the kingdom’s relatively young population, but Saudi Arabia also acted swiftly - imposing restrictions in March, with the number of cases in the country still under 100. It shut domestic and foreign travel and began quarantining thousands of people in hotels. In April, a 24-hour curfew was announced for major cities - followed by another lock-down in late May during Eid holidays.

Then, last week, the government announced a gradual return to “normal life,” with guidelines for new precautionary measures. Face masks were mandated in public, borders are still closed and an 8pm curfew remains. But mosques opened their doors to the faithful, restaurants began hosting diners and workers went back to their offices in droves.

‘Return carefully’

The government replaced its slogan during the lockdown, “We’re all responsible,” with the new one, and plastered it on billboards across the capital.

“We’re prepared for any situation,” Health Minister Tawfiq Al Rabiah said in an interview with Al Arabiya television last week. “We ensure our capability to absorb any case that reaches us.”

Yet interviews with health-care workers this week suggest that a grave situation was already brewing, and so do official figures. The number of patients in critical condition has spiked from less than 400 last week to 1,412 on Friday.

“These worrying numbers show that there are unhealthy behaviours and activities happening,” health ministry spokesman Mohammed Al -Abdulaali admonished the public on Tuesday.

While some Saudi medical workers told Bloomberg their hospitals have plenty of space, others said that beds are filling up and reported outbreaks among staff - putting much-needed care-givers out of commission.

“I thought we were okay, but we’re not at all,” one nurse said, asking not to be named discussing sensitive information in a country where freedom of speech isn’t protected.

Back home

Days after unshuttering offices, some government agencies have sent employees home after positive cases were discovered, according to internal notices seen by Bloomberg. Several health-care workers said they’re awaiting the coming weeks with dread and expect a surge of cases contracted during the reopening.

Saudi Arabia’s health system has “the capacity to withstand several scenarios, and we prepared several months ago for all possibilities,” the health ministry said in a statement to Bloomberg on Saturday. Healthcare workers “are in good morale and are providing services to all,” it said.

On Friday, authorities re-imposed a 3pm curfew and other restrictions in the second-biggest city, Jeddah, for the next 15 days, citing “high occupancy levels in ICUs.” In a statement, the interior ministry said officials are monitoring the number of critical cases in Riyadh and are “prepared to take the appropriate measure if the increase continues.” The number of daily new cases rose sharply to 2,591, the highest in two weeks.

Israel, like Saudi Arabia, imposed strict precautions early, with a near-total lockdown between mid-March and mid-April; at one point, residents were not allowed further than 100 meters from their residences. The country has lifted restrictions since late April, opening schools and returning workers to offices in stages. The latest green light was given to train services, set to start Monday.

But authorities have also shut schools linked to outbreaks, and some parents are choosing to keep their children home after a recent rise in new cases.

Caucasus, Turkey

Countries adjacent to the Middle East are also struggling with reopening.

Just north of Iran in the landlocked Caucasus nation of Armenia, Prime Minister Nikol Pashinyan announced Monday that he and his family have tested positive for coronavirus. Faced with growing economic hardship, the government largely lifted coronavirus restrictions on May 3, relying on people to wear face masks and adhere to social distancing.

Infections have ballooned since then to 11,221. Yet cafes are still overflowing, and many aren’t wearing masks. On Thursday, Pashinyan warned on Facebook that hospitals were on the verge of being unable to cope.

On Thursday, Turkey said it was lifting pandemic-related restrictions on Iran and allowing traffic through the border gates again. Azerbaijan, another country that borders Iran, said the same day that it was reimposing strict lockdowns in the capital Baku and three other cities after the number of new infections rose following the easing of restrictions.