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Saudi Arabia – Getting Twitchy About MERS Coronavirus

April 21, 2014

The sacking of Health Minister Abdullah Al-Rabeeah, about whom I wrote a couple of years ago, comes at a difficult time for health services in Saudi Arabia. Whether his dismissal is the result of the sudden spike in new infections by the MERS-CoV coronavirus or for other reasons remains to be seen. It cannot have helped his cause that his ministry issued statements to the effect that it had the virus under control at precisely the time when a number of new cases were reported in Jeddah.

Also, as John Burgess reported in Crossroads Arabia, the statement that experts from a drug company were in discussions with the Saudis about developing a vaccine may be comforting for a worried population, but developing and testing vaccines can take months or even years, depending on the virus. The virus in question is a relative of the common cold and also of the more lethal SARS, which caused 800 deaths and a worldwide scare in 2003. I’m not aware of there being a vaccine for either, despite the cold being responsible of millions of days of absenteeism every year around the world. This is partly because there are so many variants of coronavirus, and also because rapid mutation renders a specific virus a constant moving target.

What is spooking the region about the new MERS-CoV clusters – cases have now been reported in the UAE as well as several population centres in Saudi Arabia – is that whereas previously it tended to attack older people with immune systems compromised by other conditions such as diabetes, its victims are getting younger.

Most people assume that infections move as people move. But there’s another interesting possibility. Because the virus has been identified in camels, is it possible that it’s the camels moving around that are causing the problem. If you drive on the main highway from Dammam to Riyadh you pass a huge camel market. Trade in camels is brisk, not only within Saudi Arabia but across neighbouring borders. I’m sure that the authorities are looking at camel mobility as a contributing factor.

An additional concern is that in October around three million pilgrims will be pouring into Makkah and Madinah for the annual Haj pilgrimage. Many of them will pass through Jeddah, where the new outbreak started. It’s highly likely that the authorities will attempt to prevent the elderly and infirm from travelling to this year’s Haj, but if the virus is now infecting the young and fit, this measure would most likely reduce but not eliminate the risk of mass infection.

This is not the first time that health fears have focused on the Haj. The last time was in 2009, when swine flu was the concern. In that instance the festival took place with no adverse consequences. But that doesn’t mean that mass infections can’t take place in the future. Think of the consequences of an Ebola outbreak, for example. Although the Saudis are making noises about not issuing visas to Haj applicants from Guinea and neighbouring Senegal and Liberia, it would only take two or three infected people to find their way to the Holy Places for the authorities to have a major health emergency on their hands.

However, if there’s one area in which the Saudis have deep and long-standing experience, it’s in the logistics of the Haj. No doubt there are contingency plans in place for dealing with unexpected outbreaks of disease among the pilgrims. But anything that weakens that confidence, particularly on the part of the World Health Organisation, which monitors global disease outbreaks and has strict protocols to which the Kingdom is a signatory, is likely to have weakened the position of the Minister.

Dr Al-Rabeeah is an eminent surgeon whose speciality – separating conjoined twins – has brought him and his country considerable prestige. Even while serving in the government he still practised medicine. Only two weeks ago he supervised the separation of twins from Iraq. He will not be unemployed for long.

As for Adel Fakeih, the Minister of Labor, who has taken over Al-Rabeeah’s duties on a temporary basis, he adds a second sensitive brief to his existing portfolio. His regular job is stressful enough. I hope that he is taking good care of his health in what will be a difficult period for him.



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