Qatar at the Peak of the Infection, Part 3

Ongoing Efforts to Curb the Coronavirus:

Fear, Frustration, Fatigue, & Family Infections

May Recap:

The month of May saw public health concerns collide with cultural norms associated with Ramadan and the Eid-al-Fitr holiday.  Ramadan began on April 23 with the Eid holiday in Qatar beginning on May 24 and ending on May 30.

Government officials warned people to continue to stay-at-home during this season and avoid any inter-family meals, visits, or celebrations.  It continued to ban congregational prayer at mosques.  While it relaxed the rules on take-a-way meals from restaurants, it continued precautionary measures.  As Eid approached, officials imposed further pre-cautionary measures to curb the spread of the virus.  They required people to wear masks when they left their homes, to install a contact notification app called EHTERAZ to help people learn when they had had close contact with an infected person, and limit the number of persons in vehicles.  They continued to urge people to limit trips away from home and suggested that they exercise for no more than 2 hours outside and to do it close to home. 

In May, Qatari officials:

• built field hospitals;
• established drive-by-testing;
• designated four health centers for testing;
• lifted the quarantine of the Industrial Area, subject to tight protocols;
• apparently quarantine Mekaines Labor City;
• sanctions businesses for violating precautionary measures;
• briefly opened money exchanges;
• set up checkpoints and patrols to monitor compliance with precautionary measures and to educate the public about the requirements;
• kept the death rate low in comparison to other countries (1.4 per 100,000 people);
• revealed that 25 percent of the people tested for the virus were infected;
• adopted a new policy for designating recovered cases;
• helped facilitate expatriation flights to several countries;
• outlined a four-phase plan for re-opening the economy;
• continued most precautionary measures into June, including distance learning, distance working, required mask wearing, stay-at-home requirements, business closures or restricted hours, and use of the EHTERAZ app.

People violating any of the precautionary measures could face 3 years imprisonment, a fine of QR 200,000, or both. 

By May 31, Qatar reported 56,910 infections, 222,069 people tested, 30,29 recovered cases, and daily admissions to ICU running at about 20 per day.

By the end of May, as the death toll crept up to 38 persons, the Ministry of Health revealed that infections doubled because people had held family gatherings, visited between friends and extended families, and ignored the preventive measures recommended by authorities, especially staying at home and maintaining social distance. 

Accordingly, June will be a month where infections associated with the holy month of Ramadan and the Eid holiday manifest among a population showing more stress from months of social isolation.

Social media feeds continue to show the tension between people frightened for themselves and their families and people demanding that the government relax precautions, re-open businesses, and allow people to return to work.

On a more personal note, during my evening walks in The Pearl, I have noticed that 30 to 50 percent of people are not wearing masks or not wearing masks correctly as required by existing orders.  Most people violating this rule are younger men.   This rule violation may show fatigue, defiance, denial, or frustration.  Empirical research may help us understand these responses during a public health event.  

In the meantime,  the US surpassed 100,000 deaths over a long holiday week-end in which the President failed to acknowledge the milestone or show any empathy for families suffering these losses.  

The New York Times listed the names of the US dead on its front page.  See here and here.  People representing that number of deaths would fill some of the largest sports stadiums in the world, including the Lusail Stadium in Qatar designed to hold 80,000 fans. 

Worldwide, countries reported over 6 million infections and over 2 million deaths. 

For an engaging and approachable description of the virus, its impact on us, and the associated science see Monster or Machine?  A Profile of the Coronavirus at 6 Months.

What We Know and Don't Know About the Virus:

In a June 2 article, writers at the New York Times listed what we know about this virus:

• We will live with the virus for a long time.
• You should be wearing a mask.
• Public health infrastructures in many countries need an update.
• Responding the the virus is extraordinarily expensive.
• Many countries do not have a reliable testing protocol in place.
• We can't rely on herd immunity to keep us healthy.
• The virus produces more symptoms than expected.
• We can worry a bit less about infection from surfaces.
• We can also worry less about a mutating virus.
• We cannot rely on warmer weather to defeat the virus.

Another article listed what we don't know:

• How many people are infected.
• How much virus does it take to make you sick.
• Why some people get so much sicker than others.
• The role children play in spreading the disease.
• When or where the new coronavirus started spreading.
• How long you will be immune after infection. 

Qatar's Response to the Pandemic:  The Ongoing Timeline 

What follows is a time-line I created to track mostly Qatar's response to the pandemic,  Tangentially and for comparison, it refers to developments in the West.  For its sourcing, I have relied on The Peninsula Qatar, Gulf News, Gulf Times, Qatar Tribune, Al Jazzera, the New York Times, and the Washington Post.  I often reproduce content from the original source without using quotation marks, but I always include a link to the original source.

I pick-up my daily updates here.   My updates for December 31, 2019 to April 30, 2020, appear in my Part 1 post.  Posts for Part 2, May 1 to May 31, appear here. 

June 1:  Qatar reports 1,523 new cases, bringing total to 58,433.  Officials have tested 225,919 people, with 3,850 tests taken in the last 24 hours.  Recovered cases stand at 33,437.  ICU patients currently number 240, with 22 admissions in the last 24 hours.  Two new deaths occurred: a 50-year old, and a 58-year old.  The death toll stands at 40. 

The Ministry of Public Health states that Qatar is still in the peak phase of the virus outbreak, which is seeing a rise in the number of infections recorded daily, and therefore it is necessary to adhere to, more than ever before, the preventive measures and social measures recommended.

The Al Sadd Pediatric Emergency Center has been designated as a COVID-19 treatment facility for children.  Three to four percent of confirmed COVID-19 positive cases in the country are under the age of 14 years old.

Officials have contracted with a company to provide weekly disinfecting services for 217 government schools over the next 10 weeks.  

Qatar will participate in the Global Vaccine Summit scheduled for June 4. While delegates will discuss a vaccine for COVID-19, they will also discuss vaccines for other diseases.  The goal of the organization is to immunize 300 million children and save up to eight million lives by 2025.  Qatar pledges $20 million to effort. 

The US reports over 1.8 million infections with over 100,000 deaths. 

June 2:  Qatar reports 1,826 new cases, bringing total to 60,259.  Officials have tested 231,098 people, with 5,179 tests taken in the last 24 hours.  Recovered cases stand at 36,036.  ICU patients currently number 239, with 20 admissions in the last 24 hours.  Three new deaths occurred: a  24-year old, a 59-year old, and a 62-year old.  The death toll stands at 43. 

The US reports 105,094 deaths.

Worldwide, at least 6,266,000 people have been infected by the virus and at least 374,000 have died. 

June 3:  Qatar reports 1,901 new cases, bringing total to 62,160.  Officials have tested 233,437 people, with 5,339 tests taken in the last 24 hours.  Recovered cases stand at 37,542.  ICU patients currently number 237, with 15 admissions in the last 24 hours.  Two new deaths occurred: a  48-year old and a 53-year old.  The death toll stands at 45. 

In recent days, official reports are not saying that patients dying of the disease had pre-existing conditions.  This omission could reflect a change in reporting style or it could indicate that the virus is killing people who are not otherwise at a higher risk or death. 

Geneticists have been scouring our DNA for clues. Now, a study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus.  Variations at two spots in the human genome are associated with an increased risk of respiratory failure in patients with Covid-19, the researchers found. One of these spots includes the gene that determines blood types.  Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.  

One scientist also noted that the locus where the blood-type gene is situated also contains a stretch of DNA that acts as an on-off switch for a gene producing a protein that triggers strong immune responses.

The coronavirus triggers an overreaction of the immune system in some people, leading to massive inflammation and lung damage — the so-called cytokine storm. It is theoretically possible that genetic variations influence that response.  A second locus, on Chromosome 3, shows an even stronger link to Covid-19, Dr. Franke and his colleagues found. But that spot is home to six genes, and it is not yet possible to say which of them influences the course of Covid-19.  One of those gene candidates encodes a protein known to interact with ACE2, the cellular receptor needed by the coronavirus to enter host cells. But another gene nearby encodes a potent immune-signaling molecule. It is possible that this immune gene also triggers an overreaction that leads to respiratory failure.

In mid-July 2020, new studies indicated that persons with Type A blood type are not at greater risk form the virus. Two studies — one at the Massachusetts General Hospital and the other at Columbia Presbyterian Hospital in New York — did not find that Type A blood increases the odds that people will be infected with Covid-19.  The new reports do find evidence that people with Type O blood may be slightly less likely to be infected. But the effect is so small that people shouldn’t count on it.

An international team of scientists, including a prominent researcher at the Wuhan Institute of Virology, has analyzed all known coronaviruses in Chinese bats and used genetic analysis to trace the likely origin of the novel coronavirus to horseshoe bats.  In their report, posted online Sunday, they also point to the great variety of these viruses in southern and southwestern China and urge closer monitoring of bat viruses in the area and greater efforts to change human behavior as ways of decreasing the chances of future pandemics.  None of the bat viruses are close enough to the novel coronavirus to suggest that it jumped from bats to humans. The immediate progenitor of the new virus has not been found, and may have been present in bats or another animal. Pangolins were initially suspected, although more recent analysis of pangolin coronaviruses suggests that although they probably have played a part in the new virus’s evolution, there is no evidence that they were the immediate source.  The new research includes an analysis of bat and viral evolution that strongly supports the suspected origin of the virus in horseshoe bats, but isn’t definitive, largely because a vast amount about such viruses remains unknown.

June 4:  Qatar reports 1,581 new cases, bringing total to 63,741.  Officials have tested 241,086 people, with 4,649 tests taken in the last 24 hours.  Recovered cases stand at 39,468.  ICU patients currently number 239, with 14 admissions in the last 24 hours. The death toll stands at 45. 

Officials state that the pandemic is "stabilizing" in Qatar.

Officials close a retail business for 15 days for violating the precautionary measure against the opening of businesses in a mall. 

The public apparently supports businesses who require people to show their EHTERAZ app before entering a store.  The story recognizes that people without a residency ID or a newer phone cannot use the app.   For more on this entry requirement, see here.  Some banks will require the app as a condition of entry. 

India announces more repatriation flights.  Over 10,000 Indians repatriated using 61 flights. 

Beginning June 4, some businesses and services will be allowed to open from 7 a.m. to 8 p.m.  Essential businesses and operations will continue to have extended hours as established in prior announcements.  Some businesses remain closed, including retail outlets in malls, popular markets, and shopping centers, with the exception of outlets selling food products and pharmacies, and also includes health clubs and centers, barbershops and beauty salons, including those that offer home services.

In addition: 

• People may exercise outside without a mask and more distant from home, but exercisers must continue to avoid gatherings and stay 3 meters from other persons. 
• Officials increased the number of persons allowed in a vehicle to four, including the driver, but families are exempt from this limitation.  
• Busses must remain at 50 percent of capacity.

June 5:  Qatar reports 1,754 new cases, bringing total to 65,495.  Officials have tested 246,362 people, with 5,276 tests taken in the last 24 hours.  Recovered cases stand at 40,935.  ICU patients currently number 238, with 18 admissions in the last 24 hours.  Four new deaths occurred: a 62-year old, a 70-year old, a 80-year old, and a 90-year old.  The deceased all had chronic diseases.  The death toll stands at 49.

Chair of the National Strategic Group on COVID-19 and Head of the Infectious Diseases Division at Hamad Medical Corporation, Dr. Abdullatif Al Khal, said that Qatar has succeeded in flattening the curve and reducing the impact of the virus by 75 percent thanks to the preventive efforts and measures, and the awareness and cooperation of the community.  “We are three months into our COVID-19 outbreak in Qatar. Latest data on new cases and hospital admissions shows a levelling off and the coming week or two will confirm if this will continue to be the trend,” said Dr. Al Khal. 

The authors of two studies linking treatment of ill patients with the anti-malarial drugs chloroquine and hydroxychloroquine to increased rates of death and heart problems withdrew their articles published in The Lancet and The New England Journal of Medicine.  The authors did not get reliable access to the database underlying their research.

Qataris acknowledged the closure on June 5, 2017 of land, sea, and air routes to and from Qatar by four neighboring Arab countries.  Qataris celebrated their resilience and success despite this act of aggression against a sovereign state. 

US reports over 1.8 million infections and 108,187 deaths. 

A WHO report suggests that asymptomatic carriers of the virus are not a significant cause of its spread.  Its report suggests health officials should focus more on people with symptoms.  The report relies on the results of contact tracing data. In contrast, Dr. Avantika Singh, a researcher at Boston Children’s Hospital and co-author of a study on asymptomatic transmission, says that an infected person is most likely to spread the virus in the few days before the onset of symptoms. She said she was “highly curious” to hear more from the W.H.O., and to see the evidence behind Dr. Kerkhove’s statements, which seem to contradict the commonly held belief.  

Later in the week, following concerted pushback from researchers, WHO officials walked back the claim, saying it was a “misunderstanding.”  The W.H.O.’s thinking on asymptomatic transmission does not appear to have changed much since February, when the W.H.O. China Joint Mission reported that “the proportion of truly asymptomatic infections is unclear, but appears to be relatively rare and does not appear to be a major driver of transmission.”  Studies later estimated this number could be as high as 40 percent; the current best estimate from the Centers for Disease Control and Prevention is 35 percent. The research prompted many countries, including the United States, to endorse use of masks by everyone.

Worldwide:  As the pandemic’s global death toll approaches 400,000, known cases of the virus are growing faster than ever, at a rate of more than 100,000 a day. And the surge is concentrated in densely populated, low- and middle-income countries across the Middle East, Latin America, Africa and South Asia.

June 6:  Qatar reports 1,700 new cases, bringing total to 67,195.  Officials have tested 251,391 people, with 5,029 tests taken in the last 24 hours.  Recovered cases stand at 42,527.  Officials did not provide ICU  data, but said admissions had dropped. Two new deaths occurred: both 57-year olds with chronic diseases.  The death toll stands at 51.

June 7:  Qatar reports 1,595 new cases, bringing total to 68,790.  Officials have tested 255,533 people, with 4,142 tests taken in the last 24 hours.  Recovered cases stand at 44,338.  Officials did not provide ICU data, but noted a drop in admissions.  Three new deaths occurred: a 40-year old, and two 68-year olds.  The deceased all had chronic diseases.  The death toll stands at 54.

People without a Qatari ID can now register for the EHTERAZ app with a visa number instead.  This change addresses one of the concerns raised by the more limited availability of the app, which an increasing number of stores and other locations require for admission. 

Mall of Qatar defers rent payments for June.  The mall has offered rent relief since March. 

Worldwide, WHO reports 6,799,713 infections with 397,388 deaths.  

The World Health Organization reported on Monday that the number of new daily cases worldwide had hit a new high on Sunday, a sign that the pandemic appeared to be worsening.  Dr. Tedros Adhanom Ghebreyesus, the organization’s director general, told reporters that more than 100,000 new cases had been reported on nine of the previous 10 days, and that Sunday’s tally — 136,000 cases — was the highest single-day tally so far.

June 8:  Qatar reports 1,368 new cases, bringing total to 70,158.  Officials have tested 259,646 people, with 4,113 tests taken in the last 24 hours.  Recovered cases stand at 45,935.  ICU patients currently number 241, with 19 admissions in the last 24 hours.  Three new deaths occurred: a 50-year old, a 52-year old, and a 65-year old. The death toll stands at 57.

Officials outline the four phases of re-opening beginning on June 15.

 

Officials will allow the limited opening of mosques, with precautionary measures, beginning June 15. People  may pray at mosques, except for Friday prayers, if they (1) make ablution at home before going to mosque because the bathrooms and ablution place of the mosques will be closed; (2) avoid going to the mosques early because they will not open until the call for prayer; (3) avoid crowding inside the mosque; (4) maintain a distance of two meters from others; (5)  avoid shaking hands even if wearing gloves; (6) cover mouth and nose while sneezing and coughing; (7) show the Ehteraz application before entering the mosque; (8) bring their own prayer mat and not share it with others or leave it in the mosque; (9) wear face masks as long as they are in the mosques; and (10) bring their own copy of holy Quran and not share it with others or read it on a mobile phone.  Friday prayers will be allowed in 54 mosques from the third phase, which will begin in August.   The fourth phase (September) will see complete opening of mosques and Friday prayers.

The S&P 500 stock market index climbed back above where it began the year — before the pandemic brought the United States economy to a grinding halt.

June 9:  Qatar reports 1,721 new cases, bringing total to 71,879.  Officials have tested 265,035 people, with 5,389 tests taken in the last 24 hours.  Recovered cases stand at 47,569.  ICU patients currently number 236, with 16 admissions in the last 24 hours.  Five new deaths occurred: a 53-year old, a 62-year old, a 65-year old, a 74-year old, a 78-year old, and a 80-year old. The death toll stands at 62.

Officials provide information about mandatory quarantine for persons returning to Qatar and other flight-related requirements.  Qatar Air is offering packages that include the quarantine hotel reservation. 

Take-a-ways from an interview with Michael Osterholm, PhD, MPH, Director of the US Center for Infectious Disease Research and Policy. He has also served as interim Director of the US Centers for Disease Control.

• 3 months ago, COVID-19 was not even in the top 75 causes of death in the US. Much of the last month, it was the #1 cause of death. This is more remarkable than the 1918 Flu pandemic.
• There is no scientific indication Covid-19 will disappear of its own accord.
• If you’re under age 55, obesity is the #1 risk factor. So, eating the right diet, getting physical activity, and managing stress are some of the most important things you can do to protect yourself from the disease.
• One of the best things we can do for our aging parents is to get them out into the fresh air, while maintaining physical (not social) distancing.
• Wearing a cloth mask does not protect you much if you’re in close contact with someone who is COVID-19 contagious. It may give you 10 minutes, instead of five, to avoid contracting the disease.
• We can expect COVID-19 to infect 60% – 70% of Americans. That’s around 200 million Americans.
• We can expect between 800,000 and 1.6 million Americans to die in the next 18 months if we don’t have a successful vaccine.
• There is no guarantee of an effective vaccination and even if we find one, it may only give short term protection.
• Speeding a vaccination into production carries its own risks.
• 600 health care workers in the US died of COVID-19.
• The darkest days are still ahead of us. We need moral leadership, the command leadership that doesn’t minimize what’s before us but allows everyone to see that we’re going to get through it.

June 10: Qatar reports 1,716 new cases, bringing total to 73,595.  Officials have tested 269,964 people, with 4,929 tests taken in the last 24 hours.  Recovered cases stand at 49,413.  ICU patients currently number 226, with 15 admissions in the last 24 hours.  Four new deaths occurred: a 54-year old, a 56-year old, and a 74-year old with chronic conditions, and a 66-year old without chronic conditions. The death toll stands at 66.

Officials have amended work hours for employees in the government sector to 7 hours per day from 7 am until 2 pm, as of Sunday June 14, 2020 and allowed changes medical services offered in health facilities as of Monday, June 15.

Hamad International Aiport will require all passengers to wear masks, carry hand sanitizer, and practice physicl distancing. Passengers will undergo thermal screening, should not travel if they have any symptons of illness, and arrive 3 hours before the scheduled flight. The airport is using robots and thermal screening helmets as part of its precautionary measures. 

June 11:  Qatar reports 1,476 new cases, bringing total to 75.071.  Officials have tested 274,793 people, with 4,829 tests taken in the last 24 hours.  Recovered cases stand at 51,331.  ICU patients currently number 230, with 17 admissions in the last 24 hours.  Three new deaths occurred: a 41-year old, a 51-year old, and a 70-year old. The death toll stands at 69.

The Ministry of Awqaf and Islamic Affairs has issued the list of mosques which are going to reopen in phase one (June 15).  The list includes 500 mosques listing number and location of mosques. Nine mosques were decided to reopen in Aslata Al Jadeeha, eight mosques in Abu Hamour, 12 mosques in Azghawa, six mosques in Umm Sanim, 19 mosques in Umm Salal, four mosques in Bu Sidra, 13 mosques in Bani Hajar.

The Ministry of Finance instructed government ministries, institutions, and entities funded by the state to reduce monthly costs for non-Qatari employees by 30% from June 1, either by cutting salaries or laying off workers with a two-month notice, according to a letter seen by Bloomberg. 

June 12: Qatar reports 1,517 new cases, bringing total to 76,588.  Officials have tested 280,665 people, with 5,872 tests taken in the last 24 hours.  Recovered cases stand at 53,296.  ICU patients currently number 229, with 14 admissions in the last 24 hours.  One new death occurred: a 51-year old. The death toll stands at 70.

Qatar imposed the mask requirement on May 17, nearly a month sooner than the recommendation issued by WHO on June 5, 2020.

The government plans to require incoming travelers to wear a bracelet that allows officials to track their compliance with qurantine rules.  The bracelet apparently alerts officials to any person who does not maintian contact with his or her phone and the EHTERAZ app. The braclet technology will roll out in July 2020. 

June 13:  Qatar reports 1,828 new cases, bringing total to 78,416.  Officials have tested 286,830 people, with 6,165 tests taken in the last 24 hours.  Recovered cases stand at 55,252.  ICU patients currently number 232, with 13 admissions in the last 24 hours.  The death toll remains at 70.

Officials will open eight parks for exercise only as part of the Phase 1 re-opening plan. The parks will allow access from 4-9am and from 4-10pm.  The parks are: Al Wakra Public Park, Al Khor Park, Park 66 - Al Qatifia, Al Shamal City Park, Al Sailiya Park - Abu Nakhleh, Al Dafna Park, MIA Park and Al Rayan Park.  People entering will need to show the EHTERAZ app, undergo a temperature check, and engage in other precautionary measures.

Officials have released additional guidelines for the opening of shops in malls and shopping centers on June 15.  Children under age 12 and adults over the age of 60 will not be allowed to enter the malls.  A long list of precuationary requirements exists for shopkeepers, mall owners, and shoppers. 

Cumulative data for Qatar according to the European Center for Disease Prevention and Control:

Certain widely used medications that treat high blood pressure apparently do not add to the danger as earlier feared. Recent studies suggest they don’t make people more susceptible to becoming infected with the coronavirus, nor do they exacerbate the disease. As a result, doctors who care for patients with hypertension have urged them to continue taking the drugs.  “I believe these medications do not make covid-19 worse,” says Karan Desai, a cardiology fellow at the University of Maryland Medical Center. “These medications treat hypertension and heart failure. But if these conditions worsen or go untreated, it will likely make covid-19 more severe if a patient contracts the virus.”  These findings are important because earlier reports raised questions about whether two frequently prescribed classes of blood pressure drugs, ACE inhibitors and angiotensin receptor blockers (ARBs), might actually make people more vulnerable to contracting the virus and cause an infection to become more virulent.

US reports 2,037,000 infections with 112,000 deaths.  The infection and death rate far exceed the number of infections and deaths reported in any other country. Meanwhile, across the South and West, coronavirus cases and hospitalizations are on the rise. In Texas, more than 2,100 people in the state were hospitalized with covid-19 as of Friday, according to state data tracked by The Washington Post, and intensive care units are reportedly at 88 percent capacity in the Houston area. Arkansas reported 731 new cases, the largest since the pandemic began. And in North Carolina, cases topped 40,000 after its highest single-day increase.  These increases are occuring in states that re-opened earlier than other states. 

Cumulative data for US (green line) and Qatar (red line) according to the Eurpean Center for Disease Prevention and Control:

Worldwide, reported cases are 7,657,000 with deaths at 424,000. 

June 14:  Qatar reports 1,186 new cases, bringing total to 79,602.  Officials have tested 290,714 people, with 3,884 tests taken in the last 24 hours.  Recovered cases stand at 56,898.  ICU patients currently number 231, with 13 admissions in the last 24 hours.  Three new deaths occurred: a 42-year old, a 57-year old, and a 84-year old. The death toll stands at 73.

Chinese doctors are seeing the coronavirus manifest differently among patients in its new cluster of cases in the northeast region compared to the original outbreak in Wuhan, suggesting that the pathogen may be changing in unknown ways and complicating efforts to stamp it out.  Patients found in the northern provinces of Jilin and Heilongjiang appear to carry the virus for a longer period of time and take longer to test negative. Patients in the northeast also appear to be taking longer than the one to two weeks observed in Wuhan to develop symptoms after infection, and this delayed onset is making it harder for authorities to catch cases before they spread.

June 15: Qatar reports 1,274 new cases, bringing total to 80,876.  Officials have tested 295,338 people, with 4,624 tests taken in the last 24 hours.  Recovered cases stand at 58,681.  ICU patients currently number 238, with 18 admissions in the last 24 hours.  Three new deaths occurred: a 60-year old, a 62-year old, and a 87-year old. The death toll stands at 76. 

Officials will permit access to the Industrial Area without the need for a permit.

According to a new modeling study, roughly 1.7 billion people around the world — 22 percent of the global population — fall into a category of raised risk for severe disease.  The researchers compiled 11 categories of underlying conditions that may raise the risk of severe Covid-19 — a form of symptomatic disease that warrants hospitalization — using information from the World Health Organization and health agencies in the United States and Britain. The list includes patients who regularly take immunosuppressive drugs, such as those with autoimmune disorders, or are undergoing immunity-weakening treatments like chemotherapy.  The study also estimated that about 4 percent of the world’s population, around 349 million people, would require hospitalization if they became infected. That number includes patients without underlying medical conditions, such as healthy, older adults; and the risk of hospitalization increases with age.

CDC has published a guideline for older adults who are at higher risk to contract COVID-19. 

In the US, 23 of 50 states see a rise in new cases.  

June 16:  Qatar reports 1,201 new cases, bringing total to 82,077.  Officials have tested 300,499 people, with 5,161 tests taken in the last 24 hours.  Recovered cases stand at 60,461.  ICU patients currently number 244, with 19 admissions in the last 24 hours.  Four new deaths occurred: a 43-year old, a 53-year old, and two 61-year olds. The death toll stands at 80.

Officials remind people that even with phased re-openings of the economy, people must adhere to precuationary measures. 

Some shops open in malls and shopping centers. 

Qatari courts will begin in-person litigation sessions with all precuationary measures in place. 

Qatar Airways announces quarantine packages for returning Qatari nationals.  Discover Qatar packages announced, too. 

Shura Council praises the decisions to send medical aid to 20 countries. This praise may intend to counter criticsm following the announcement that government-funded entities must reduce costs by 30 percent through staff cuts, salary cuts, or benefit cuts. 

People with underlying medical conditions such as heart disease and diabetes were hospitalized six times as often as otherwise healthy individuals infected with the novel coronavirus during the first four months of the pandemic, and they died 12 times as often, according to a health report issued by the US CDC.

June 17:  Qatar reports 1,097 new cases, bringing total to 83,174.  Officials have tested 301,801 people, with 4,302 tests taken in the last 24 hours.  Recovered cases stand at 62,172.  ICU patients currently number 240, with 9 admissions in the last 24 hours.  Two new deaths occurred: a 67-year old and a 87-year old. The death toll stands at 82.

Officials publish a circular on the quarantine obligations for any returning passengers with a list of quarantine hotels. file:///C:/Users/py15990/Downloads/Circular%20No.%20(12)%202020%20(1).pdf

US CDC has provided guidelines for safer travel.  For an assessment of the risks of travel by airplane or vehicle, see here.  For advice on how to practice social distancing on an airplane, see here.

Qatar ranked 6th among 63 countries for economic performance in 2020.  It ranked 14th internationally.  Factors considered including strong economic performance as represented by Qatar's low unemployment rate (ranked first), high percentage of gross fixed capital formation, capital investments, and saving to GDP (ranked first for all three), percentage of trade balance to GDP (ranked first), the high overall productivity (ranked first), and low inflation rate (ranked third) whereby other factors had negatively influenced the rank as real GDP growth per capita (rank 58), Office rents (rank 52), business expenditure on R&D % (rank 57).  Experts cite the resiliency of the Qatari economy. 

Officials permit Indian schools to take a shorter summer break, continue distance learning through the end of July, begin the semester on September 1, end the semester in early December and take a month-long winter break. These measures reflect the preferences of parents in the midst of the pandemic and related precautionary measures. 

People can use Metrash 2 to renew visas.

June 18:  Qatar reports 1,267 new cases, bringing total to 84,441.  Officials have tested 309,670 people, with 4,869 tests taken in the last 24 hours.  Recovered cases stand at 63,642.  ICU patients currently number 230, with 11 admissions in the last 24 hours.  Four new deaths occurred: a 41-year old, a 43-year old, a 61-year old, and a 77-year old. The death toll stands at 86.

Officials continue to provide information on the need for precautionary methods, especially in the midst of Phase 1 re-opening.  See here, too.

Does everyone infected with the virus produce antibodies — and if so, how long do they last?  Not very long, suggests a new study published Thursday in Nature Medicine. Antibodies — protective proteins made in response to an infection — may last only two to three months, especially in people who never showed symptoms while they were infected.  The conclusion does not necessarily mean that these people can be infected a second time, several experts cautioned. Even low levels of powerful neutralizing antibodies may still be protective, as are the immune system’s T cells and B cells.  But the results offer a strong note of caution against the idea of “immunity certificates” for people who have recovered from the illness, the authors suggested.  A second paper, published on Thursday in the journal Nature, suggests that even low levels of antibodies might be enough to thwart the virus. “It does appear that even low levels of certain antibodies have potent neutralizing capability,” said Dr. Rasmussen, the Columbia University virologist. “Low antibody titers don’t necessarily determine whether a patient will be protected from reinfection.”

US reports 2,154,000 infections with over 115,000 deaths.

Worldwide, reported cases are at least 8,366,000 with deaths at 447,000. 

June 19:   Qatar reported its highest daily death toll to date, with seven deaths. It reported an ongoing decline in new cases of 1,021, bringing total to 85,462.  Officials have tested 313,501 people, with 3,831 tests taken in the last 24 hours.  Recovered cases stand at 65,409.  ICU patients currently number 230, with 11 admissions in the last 24 hours.  The seven deaths included people aged 34, 40, 64, 65, 69, 71, and 77 years old.  The death toll stands at 93.

Qatar Airways resumes flights to US.

June 20:  Qatar reports 1,026 new cases, bringing total to 86,488.  Officials have tested 317,694 people, with 4,193 tests taken in the last 24 hours.  Recovered cases stand at 66,763.  ICU patients currently number 224, with 14 admissions in the last 24 hours.  One new death occurred: a 42-year old. The death toll stands at 94. 

Officials issue guidelines for praying in mosques.

The World Health Organization (WHO) issued a sobering warning late this week about the status of the coronavirus pandemic, saying that the virus that has killed more than 460,000 people worldwide is still malignant.  "The pandemic is accelerating. More than a 150,000 new cases of COVID-19 were reported [on Thursday], the most in a single day so far," WHO Director-General Tedros Adhanom Ghebreyesus said in a press conference Friday.  He added, "The world is in a new a dangerous phase. The virus is still spreading fast, it is still deadly and most people are still susceptible. We call on all countries and all people to exercise extreme vigilance."

June 21:  Qatar reports 881 new cases, bringing total to 87,369.  Officials have tested 320,792 people, with 3,098 tests taken in the last 24 hours.  Recovered cases stand at 68,319.  ICU patients currently number 221, with 8 admissions in the last 24 hours.  Four new deaths occurred: a 37-year old, a 55-year old, a 61-year old, and a 69-year old. The death toll stands at 98.

Accordingly, new cases are dropping to levels seen during the first week of May.  See here for May 4 (640 new cases);  here for May 5 (951 new cases); and here for May 6 (830 new cases). 

Private health centers may now do COVID-19 testing.   Officials announce lab testing capacity up to 30,000 tests per day by the end of July. 

June 22:  Qatar reported  1,034 new cases, bringing total to 88,403.  Officials have tested 324,570 people, with 3,778 tests taken in the last 24 hours.  Recovered cases stand at 69,956.  ICU patients currently number 219, with 11 admissions in the last 24 hours. A 60-year old died, bring the death toll to 99.

Officials announce schedule for upcoming academic year in government schools.

June 23:  Qatar reported  1,176 new cases, bringing total to 89,579.  Officials have tested 328,941 people, with 4,371 tests taken in the last 24 hours.  Recovered cases stand at 71,501.  ICU patients currently number 225, with 17 admissions in the last 24 hours. The death toll remains at 99.

Officials state that Qatar is past the peak of infection for the pandemic, but new cases exist. 

This chart shows the progress of the pandemic in Qatar and the evidence that it is now past the peak of infection. 

Dr Hamad Al Romaihi, Director of Health Protection and Communicable Disease Control at the Public Health Department and co-chair of the National Pandemic Preparation Committee reminded people of  the need to adhere to precautionary measures, especially among younger people who can be asymptomatic, but create a risk for older family members or members with chronic health conditions.

This article compares the COVID-19 related economic strategies of GCC countries, including stimulus packages, expat job losses, and GDP deficits.  

Saudi Arabia effectively cancels hajj pilgrimage.  It will allow only about 1,000 pilgrims this year — a tiny fraction of the 2.5 million who came last year. Few criticized the decision to limit the event since Saudi Arabia is suffering from one of the largest coronavirus outbreaks in the Middle East, with 161,000 declared infections and more than 1,300 deaths. Epidemiologists have warned that mass gatherings — from concerts to sporting matches — can become so-called super-spreader events.

In the US, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, told members of Congress on Tuesday that the nation does not yet have the coronavirus under control and is seeing a “disturbing surge” of infections in some parts of the country. he said the next two weeks would be critical to controlling the spread of the virus, and he warned of a dangerous situation looming this winter, when the regular flu season will intersect with the coronavirus, producing “two respiratory-borne infections simultaneously confounding each other.”  The doctors testifying all pledged to do more testing, not less, as Trump recently suggested. 

EU may ban travelers from the US because of its poor response to the pandemic. 

June 24: Qatar reported  1,199 new cases, bringing total to 90,778.  Officials have tested 333,172 people, with 4,231 tests taken in the last 24 hours.  Recovered cases stand at 73,083.  ICU patients currently number 219, with 7 admissions in the last 24 hours.  The five deaths included people aged 57, 58, 77, 85, and 93 years old.  The death toll stands at 104.

The Qatar Cabinet will allow government sector agencies to employ 50 percent of employees on-site, while the remaining staff will work remotely.  Private health care facilities may work at 60 percent capacity and offer emergency services.  The changes take effect on July 1. 

June 25:  Qatar reported  1,060 new cases, bringing total to 91,838.  Officials have tested 337,495 people, with 4,324 tests taken in the last 24 hours.  Recovered cases stand at 74,544.  ICU patients currently number 212, with 11 admissions in the last 24 hours.  The two deaths included people aged 57 and 60 years old.  The death toll stands at 106.

Qatar is among 26 countries with a decrease in new cases. 

US has more than 2.3 million cases, with 121,926 deaths.  It reported the highest number of new cases per day, with nearly 37,000 cases.  Florida, Oklahoma, South Carolina and Texas reported their highest single-day totals on Wednesday, but case numbers have been rising in 29 states. New York — along with Connecticut and New Jersey — said it would institute a quarantine for some out-of-state travelers.

In the US, pregnant women infected with the coronavirus are more likely to be hospitalized, admitted to an intensive care unit and put on a ventilator than are infected women who are not pregnant, according to a new government analysis presented to a federal immunization committee on Wednesday.  More on COVID-19 and pregnancy here.

The American Dental Association has made a series of recommendations including advising patients to wear a face covering when they come in, having them wait outside or in their car until the dentist is ready to see them, removing magazines and toys from the waiting area, and placing hand sanitizer throughout the office. Getting the first appointment of the day may also limit risk, though many dentists said they are seeing fewer patients so they have more time to disinfect rooms between visits. Still, other health experts, including dentists, said they were skeptical about going to the dentist for anything that is not urgent, like an abscess, especially in the many parts of the country where coronavirus cases are rising.

In the EU, the number of new coronavirus cases increased last week for the first time in months, the World Health Organization said on Thursday. In 11 countries in particular, “accelerated transmission has led to very significant resurgence,” said Dr. Hans Kluge, the W.H.O.’s regional director for Europe, warning that if left unchecked, the resurgence could “push health systems to the brink once again.” He added that a total of 30 European countries had reported increases in the number of new cases over the previous two weeks.

In Kerala, India, precautions have led to successful containment of virus. 

Worldwide, the virus has infected 9,435,900 people and killed 482,809.  On June 17, more new cases were reported in a single day worldwide than ever before: 166,099. The increase has been driven by emerging hot spots in Latin America, Africa, Asia, and the Middle East.

June 26:  Qatar reported  946 new cases, bringing total to 92,784.  Officials have tested 341,914 people, with 4,418 tests taken in the last 24 hours.  Recovered cases stand at 76,072.  ICU patients currently number 200, with 7 admissions in the last 24 hours.  The three deaths included people aged 45, 59, and 79 years old.  The death toll stands at 109.

The Grand Hyatt announces opening of its beach facilities with proper precautions beginning July 1. 

A study out of Norway indicates it is safe to return to some gym activities if you live in an area with low infection rates and take necessary precautions. 

June 27:  Qatar reported  879 new cases, bringing total to 93,663.  Officials have tested 345,691 people, with 3,777 tests taken in the last 24 hours.  Recovered cases stand at 77,225.  ICU patients currently number 205, with 14 admissions in the last 24 hours.  A 77 year-old died. The death toll stands at 110.

Qatari officials have not yet announced whether the fall semester of schooling will be online or in-person.

Qatar pledged $10 million to the World Health Organization (WHO) to support the finding of testing equipment, treatment, and vaccine for the novel Coronavirus (COVID-19), in addition to its $20 million contribution to the Global Alliance for Vaccines and Immunization (GAVI).

New studies suggest that in many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V.  In May, Dr. Wherry and his colleagues posted online a paper showing a range of immune system defects in severely ill patients, including a loss of virus-fighting T cells in parts of the body.  In a separate study, the investigators identified three patterns of immune defects, and concluded that T cells and B cells, which help orchestrate the immune response, were inactive in roughly 30 percent of the 71 Covid-19 patients they examined. None of the papers have yet been published or peer reviewed.  Researchers in China have reported a similar depletion of T cells in critically ill patients, Dr. Wherry noted. But the emerging data could be difficult to interpret, he said — “like a Rorschach test.”  The theory may also explain why the virus has not affected children at the same rates. Children have highly active thymus glands, the source of new T cells. That may allow them to stay ahead of the virus, making new T cells faster than the virus can destroy them. In older adults, the thymus does not function as well.

In US, younger people are making up a growing percentage of new coronavirus cases in cities and states where the virus is now surging, a trend that has alarmed public health officials and prompted renewed pleas for masks and social distancing.  In Arizona, where drive-up sites are overwhelmed by people seeking coronavirus tests, people ages 20 to 44 account for nearly half of all cases. In Florida, which breaks records for new cases nearly every day, the median age of residents testing positive for the virus has dropped to 35, down from 65 in March.  And in Texas, where the governor paused the reopening process on Thursday as hospitals grow increasingly crowded, young people now account for the majority of new cases in several urban centers. In Cameron County, which includes Brownsville and the tourist town of South Padre Island, people under 40 make up more than half of newly reported cases.

US now reports highest daily rate of new infections at 45,000, and some states are re-closing some activities.  The ICU unit at the largest hospital in Texas is at capacity.  The rolling average of daily new cases in Texas has increased 62 percent from the past week, jumping from 2,610 on June 18 to 4,227 on Thursday, according to data tracked by The Washington Post. The daily count has set a record each day for 13 consecutive days.  Florida reports nearly 9,000 new cases yesterday, a daily high for the state. 

US CDC says infection rate could be ten times higher than reported cases based on antibody tests. The CDC Director said he believes 5 to 8 percent of the population has been infected so far.

June 28: Qatar reported 750 new cases, bringing total to 94,413.  Officials have tested 349,153 people, with 3,462 tests taken in the last 24 hours.  Recovered cases stand at 78,702.  ICU patients currently number 201, with 8 admissions in the last 24 hours.  The death toll stands at 110.

Two small studies link male baldness to a higher-risk for COVID-19.  Male sex hormones seem to play a role in the increasing risk for men. 

US sets single-day record in new cases for fifth consecutive day. 

China has imposed a strict lockdown on around half a million people near Beijing to contain a fresh coronavirus outbreak.

June 29:  Qatar reported  693 new cases, bringing total to 95,106.  Officials have tested 352,659 people, with 3,506 tests taken in the last 24 hours.  Recovered cases stand at 80,170.  ICU patients currently number 203, with 9 admissions in the last 24 hours.  The three deaths included people aged 59, 63, and 81 years old.  The death toll stands at 113.

Officials remind people of the rules governing Phase 2 re-opening on July 1. Phase 2 will include the following:

• The restricted opening of mosques will continue for all 5 prayers with limited capacity as well as the implementation of precautionary requirements.
• Public and private gatherings limited to five people only will be allowed, and violators will be subject to the relevant offenses and penalties. The number has been reduced from 10 to 5 people following the discovery of numerous cases amongst Qatari nationals due to majlis gatherings and family visits, and amongst white-collar expats due to uncontrolled contact with no precautionary measures.
• 50% of public and private sector employees will be allowed at the workplace as needed, provided that employers meet hygienic requirements, implement precautionary measures, and continue to protect vulnerable employees by allowing them to work remotely.
• Families will be allowed to rent boats and yachts in groups not exceeding 10 people.
• All parks and beaches as well as the corniche will be reopened for people of all ages while continuing to practice social distancing. Play areas will remain closed.
• Sports training in open spaces and large halls will be permitted for professional athletes in groups not exceeding 10 people.
• The capacity of private health facilities will be increased to 60% while continuing to provide emergency services.
• Restaurants will be allowed to reopen with limited capacity; the Ministry of Commerce and Industry will issue a comprehensive statement on the matter.
• Libraries and museums will reopen with limited capacity and limited working hours.

June 30:  Qatar reported  982 new cases, bringing total to 96,088.  Officials have tested 356,832 people, with 4,173 tests taken in the last 24 hours.  Recovered cases stand at 81,564.  ICU patients currently number 200, with 9 admissions in the last 24 hours. The death toll stands at 113.

Restaurants in the following tourist areas may open July 1, 2020:  Souq Waqif, Souq Al Wakrah, The Pearl-Qatar, Katara Cultural Village, restaurants and kiosks in sports clubs, Qatar Museums, Al Hazm and Msheireb.  They must follow the following precautionary measures:

• Requiring clients to pre-book before coming to the restaurant.
• Allowing diners into the restaurant only after checking the colour code identifying the individual's health condition in the Ehteraz app. Only green code holders are allowed in.
• Open buffet service is completely prohibited; only pre-defined menus are to be served.
• Serving shisha is prohibited.
• Barring people not wearing a medical mask.
• Checking the body temperature of diners at the entrance, and barring any customer whose temperature is above 38 degrees Celsius.
• Providing hand sanitisers across restaurant facilities.
• Placing safe distance stickers on restaurant floors.
• Redistributing the furniture, leaving no less than two metres between each table.
• Allowing a maximum of five people to sit at each table.
• Reducing the restaurant's capacity to 50% of the maximum number of diners.
• Encouraging customers to pay using credit cards rather than cash.
• Reducing the number of parking spaces available to clients to 50%.
• Barring smoking at the restaurant entrances, and removing all containers designated for cigarette waste.
• Gathering of diners or limousine and taxi drivers at the entrance to the outlet should be prohibited.
• Continuously measure the body temperature of the restaurant's staff, isolate employees who exhibit symptoms, and inform concerned authorities to take the necessary precautions and health measures in this regard.
• Continuously sterilize all of the restaurant's facilities, including administrative offices, warehouses, employee housing, and affiliated transportation facilities.

Officials allow all shops in malls and shopping centers to open as long as they follow precautionary measures. Restaurants in malls and shopping centers may only offer take-away and delivery service. Gaming centres, amusement parks, skateboard arenas, prayer rooms and cinemas will remain closed. 

Studies show that the virus is mutating and apparently making it 10 times more contagious. 

The US reported 2,604,800 people infected, with 126,100 deaths.  43 percent of all US deaths have occurred in nursing homes and long-term care facilities. Overall, new cases increased 76 percent in the last 14-days.  32 of 50 states have an increasing number of cases.  Many states have halted or rolled back plans to reopen. 

The US is now seeing more than 40,000 new infections a day while the European Union, which has more people, is seeing fewer than 6,000. About half the new cases are coming from California, Texas, Florida, and Arizona. Florida’s cases increased by 277 percent in the past two weeks; Texas’s by 184 percent, and Arizona’s by 145 percent . . . . Arizona recently released a new triage scoring system to help healthcare providers decide how to allocate resources if they must make choices about which patients to treat.

Dr. Anthony Fauci, the US's top infectious disease expert, told members of Congress on Tuesday that although he can't predict the ultimate number of infections and deaths related to the coronavirus, "it's going to be very disturbing." I would not be surprised if we go up to 100,000 infections a day if this does not turn around," he told the Senate Committee on Health, Education, Labor and Pensions, which convened to discuss plans for reopening schools and offices that have been shuttered by the deadly coronavirus pandemic. Regarding a potential vaccine, Fauci said that while health officials are hopeful, there's "no guarantee" the U.S. will develop a "safe and effective" vaccine for the coronavirus.  "But we are cautiously optimistic, looking at animal data and the early preliminary data, that we will at least know the extent of efficacy sometime in the winter and early part of next year. Hopefully, there will be doses available by the beginning of next year," he said.

EU has now banned US citizens from traveling into its borders.  Will allow citizens from 14 countries to enter.

Worldwide, 10,278,700 people have been infected, with 504,900 deaths.