Coronavirus: nearly 100 healthcare workers have died in Yemen

When it comes to coronavirus, I believe there are certain countries that one has to mourn for more than others. One of those countries is Yemen. This is a country that is in the middle of a civil war with major Middle East powers involved; Saudi Arabia and Iran. Due to the war, the country is in chaos with great need for humanitarian assistance. 

Then came COVID-19. According to Worldometer, the case counts and deaths are not that significant. As I'm writing this, there are only 1,796 confirmed cases and 512 deaths. Those are not significant numbers for a country with a population of 30 million. If we look at countries with populations around that size, we can see that Peru has 464,000 cases, Saudi Arabia has 286,000, and Canada has 119,000. Yet, we know that Yemen's numbers are simply due to a lack of testing and proper accounting of deaths. 

The Independent (Jul 23) provides the perfect reason to know that the COVID-19 deaths are significantly under-counted:

Nearly 100 healthcare workers have died from coronavirus in Yemen, one of the highest figures worldwide for medical staff, according to a new report.

Dr Sahloul cautioned that the high number of health worker deaths in Yemen suggests that the true overall death toll could be 10 times higher than officially recorded.

Now nearly 15 million people are on the brink of famine, a number which the World Food Programme said on Wednesday could swell by at least a million more over the next six months as conditions deteriorate.

Worldometer states that there are 512 deaths of which 97 are healthcare workers (the article mentions the exact number - perhaps at the time this posts, the death count will be over 100). We can venture to say that this is not a proper ratio of deaths of healthcare workers as a percentage of the total deaths. As Dr Sahloul points out, the death count in the country may be over 5,000 just based on the accurate count of deaths among healthcare workers. 

Now looking at deaths among healthcare workers is one way to triangulate how bad it is in a country. Another way that I see used by various articles is to look at hospital utilization. In Yemen, hospitals are being under-utilized so a skeptic of my under-counting argument might say that this is a potential proof that the virus is not destroying the country.  

Devex (Jul 23) explores this:

Hunger and COVID-19 are both spreading across Yemen, but one worrying indicator — hospital admissions — is not keeping pace, according to Caroline Ducarme, head of the Médecins Sans Frontières mission in the country.

Fear of contracting COVID-19 in hospitals and the perceived stigma of catching and spreading the disease are keeping people at home, even if they require medical care, Ducarme said. Only half of the 20 beds reserved for patients with moderate COVID-19 symptoms are currently occupied in one new MSF-supported coronavirus treatment center at Sheikh Zayed Hospital in Sanaa.

. . . Another hospital MSF supports with intensive services for malnourished children typically has a 100% bed occupancy rate. Bed occupancy rates are now below 50%.

To prove the point that one can't argue that COVID-19 is widespread due to a lack of hospital admissions, the article points out that occupancy rates for malnourished children is half of where they should be. 

If COVID-19 isn't enough, The Guardian (Jul 28) brings up another deadly disease that is sweeping through the country: 

The country also suffered the worst cholera outbreak in modern times, with 110,000 cases between January and April this year.

A 50% drop in people seeking treatment for cholera in the past three months has led to concern that tens of thousands of people are avoiding health centres for fear of contracting Covid-19.

. . . That concern has been compounded by the fact that, according to estimates by the World Health Organization, half of those diagnosed with cholera in the country will die from the disease if it is left untreated.

So here's the summary of what is going on in Yemen:

1. A civil war.

2. Half the population is near famine conditions.

3. COVID-19 is much more widespread than what is indicated by Worldometer. Maybe there is well north of 100,000 cases? That would seem totally reasonable.

4. Due to COVID-19, there is a fear of going to a hospital, which likely leads to increased deaths due to malnutrition and cholera.