Afghanistan’s doctors braced for rapid spread of India Covid variant

Doctors in Afghanistan have expressed fears that the Covid-19 variant first discovered in India could now be spreading quickly in the country.

At Kabul’s main Covid hospital, where all 100 beds are occupied, doctors said that many critically ill patients had recently returned from India. Up to 10 people die here every day.

The health ministry reported more than 500 new Covid infections on Friday, but actual numbers are likely to be much higher, as many people continue to recover at home without seeking medical care.

Facilities to test for the B.1.617.2 variant that originated in India are not yet available in Afghanistan, the health ministry’s spokesperson Dastagir Nazari said. He couldn’t officially confirm whether the variant was spreading in the country.

“We’ve seen a steep increase in patients in the last two weeks, many of them needing oxygen, and many having a history of recently returning from India or having been around relatives who returned,” said Dr Qandagha Hassan, who works at the Afghan-Japan hospital for communicable diseases – the main Covid clinic located on Kabul’s western outskirts.

“It’s very concerning, especially after watching the situation unfold in India. We need a lockdown in place and we’ve appealed to the government to stop flights between India and Afghanistan,” he said. Several airlines continue to regularly operate between Kabul and Delhi.

Engineer Fazly Noordin, who takes care of the hospital’s generators and power supply, confirmed that “many of our patients have recently returned from Pakistan and India”.

There are no measures now in place to stop the spread of Covid-19 in Afghanistan, including in Kabul, a densely populated city of six million people.

At the beginning of the pandemic, when Afghanistan announced nationwide lockdowns, the economy suffered and unemployment soared – especially among daily labourers – with many people resorting to begging. In the war-torn country, where security is constantly under threat, and people’s finances and sheer survival are a challenge, Covid has taken a backseat.

At the Afghan-Japan hospital, new patients arrive regularly, some unable to walk, carried by relatives, others brought by ambulance or taxi. The rooms are crowded. It is hectic and chaotic as new beds are prepared while others are moved outside for cleaning once a patient has died.

Most of the patients are now receiving non-invasive ventilation, Hassan said, as hospital staff try to source more oxygen balloons.

The hospital is already running beyond its capacity, he explained, adding that he worried about the coming weeks.

“Even our outpatient department sees over 100 people daily, and more than 60% of them test positive,” he said.

Outside the clinic, tents and temporary housing have been set up for relatives of those trying to recover from Covid. Many families have been there for weeks.

Mohammed Safar, 46, said he had been sleeping in one of the shelters for almost a month, hoping for his mother to recover. “My whole family has come here,” he said. “We visit my mother every day.”

Another relative, Ramazan Surobi, 45, said his family was taking turns staying with his brother’s wife. “The ward is accessible to us, so I’m able to visit her regularly,” Surobi said.

The health ministry’s Nazari admitted that Afghanistan would struggle to help all patients if the B.1.617.2 variant were to spread throughout the country.

“Now we have about 1,500 ICU beds in the country. This could increase to 3,500,” he said.

On the other side of the capital, Al-Hayat hospital – a private clinic – has recently opened a small Covid-19 ward, catering for up to 10 patients. While government healthcare is free, patients here pay between 3,000 and 5,000 Afghanis a day (£27–£45), which, for severe cases, includes ventilation.

Medical director Dr Jawad Noorzai explained that a number of private clinics had taken on Covid-19 cases, with the government “too weak” to manage them all.

“We are witnessing the third wave now,” he said. “Just a few weeks ago, families celebrated the Eid al-Fitr holiday together. We have seen cases rising since.” Many Afghans living abroad – including in India – travelled back to be with their families for the holidays.

Noorzai said oxygen was one of his biggest concerns. “It’s still easily accessible in the market, but I’m concerned by the rise of patients in critical condition,” he said.

“Infection numbers are steeply rising – and casualties are too.”