BEIRUT: Lebanon's limited resources are not being used efficiently to contain the spread of the deadly coronavirus, the crisis-addled country’s leading authority on the disease said Wednesday.
Despite a record high of 9,243 PCR tests being conducted Tuesday, the head of Rafik Hariri University Hospital Dr. Firass Abiad said that authorities are still not providing an accurate picture of the virus’ spread in Lebanon, due to the lack of a coordinated surveillance strategy.
“There is no declared national strategy. There is a combination of private testing and governmental testing, but I don’t think that there is any coordination,” Abiad told The Daily Star. “Testing is effective when it helps you prevent or contain. We are doing more tests, but at the same time the epidemic is spreading even more.”
Abiad explained that the lack of a coordinated testing strategy means that the country’s limited resources are not being used efficiently to inform how the authorities deploy the range of tools available to them to contain the virus, such as lockdowns.
“The question is, do you want to test everybody, only those who are symptomatic and their contacts, or do you want everybody to have their own policy, so to speak?” he said.
Fadi al-Jardali, a public health professor at the American University of Beirut, also criticized the government’s seemingly patchwork approach to handling the public health crisis that has so far seen 9,758 infected and 107 die from coronavirus.
“The challenge is that the authorities are not making prompt and swift decisions as cases increase,” Jardali told The Daily Star.
He added that a strict and complete two-week lockdown was ideally needed to slow the transmission of the virus, and that the authorities should accompany this with “coordination between communities and municipalities in terms of the referral of cases to health care facilities.”
Caretaker Interior Minister Mohammad Fahmi Tuesday announced a two-week lockdown that will start Friday and includes a curfew between 6 p.m. and 6 a.m. However, it contains numerous exceptions that have been put in place to accommodate the multiple, overlapping crises Lebanon is facing – not least the aftermath of the Aug. 4 port explosion that left more than 300,000 people in Beirut temporarily homeless.
“Let’s be clear that this is a partial lockdown. It is clear they didn’t want to cripple whatever is left of the economy; they wanted to give people the opportunity to fix their homes [after the blast], and to be able to go out and buy groceries,” Abiad said.
“If we want to give this loose lockdown a chance to work, people have to do their part ... otherwise nobody should be surprised at the end of these two weeks to find ourselves back where we started.”
But six months after the virus was first detected in Lebanon, many residents have still not received the message. Parties, weddings and funerals have all been taking place, with little to no respect for social distancing or adherence to other preventative measures.
“In the aftermath of the blast ... the challenge is how to influence their behavior and get across that this will really affect everybody if we don’t put certain measures in place,” Jardali said.
Abiad said that Lebanese media could do more to pick up the mantle in this regard.
“How many times have you seen a persistent message trying to convince people about how dangerous COVID-19 is? The absence of this campaign is allowing a lot of fake news to circulate. You would think that more effort should be put into this, especially in far-reaching areas given that the [virus] can cripple the country, which doesn’t have resources to fight this war,” he said.
Lack of public awareness aside, both Jardali and Abiad said that the authorities should come down harder on those who refuse to listen to or abide by the limited precautions already in place.
“There is more and more urgency for the government to take this seriously and to make sure the [prevention] measures are enforced. We’ve seen a lot of decisions before, but there hasn’t been a lot of enforcement,” he said.
Abiad meanwhile said that, while the authorities had made concessions with the lockdown terms, it needed to also punish offenders.
“There has to be a carrot and stick policy. Wearing a face mask has to become some kind of a law, where there is a price if you break it ... You can’t break laws with impunity,” he said.
The government made it mandatory to wear a face mask in May, but this rule is rarely enforced.
Caretaker Health Minister Hamad Hasan warned Monday that Lebanon’s hospitals cannot absorb a further surge in coronavirus cases, explaining in an interview with Voice of Lebanon radio that in Beirut most COVID-19 intensive care units and wards in public hospital are full, and that a similar situation is to be found in “most private hospitals.”
“We are not full, but we are working with high occupancy rates,” Abiad said of RHUH. “The situation is dynamic. We are not at the panic button at the moment, but this is such a treacherous virus that it can really push you there.”
State hospitals have long said that private hospitals should dedicate more of their beds to treating COVID-19. These hospitals, however, are owed millions of dollars in dues from the government, struggle to access hard currency needed to import supplies due to the 80 percent devaluation of the local currency, and several in Beirut sustained substantial damage in the port explosion.
“The private hospitals are right to say ‘we cannot run on empty,’ and they have legitimate concerns,” Abiad said. “But the reason we are panicking is that we have half of our army or more that hasn’t shown up yet, and they really need to do that ... There needs to be a solution to bring that part of our bed capacity into action.”
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