'Yo-yo' lockdowns blamed for rising cases and surge in Covid-19 deaths in Lebanon

Lebanon reported a single-day record of 98 Covid-19 deaths on Friday.

The grim milestone came after a sharp increase in number of deaths due to the coronavirus this year, which experts have linked to an easing of health restrictions over the December holiday season.

The country of six million people, including Palestinian and Syrian refugees, recorded 1,627 deaths in January alone, compared with 1,455 over the past year.

With more than 312,000 cases so far, the Covid-19 death rate in Lebanon stood at 1.1 per cent as of Friday, according to statistics compiled by Johns Hopkins University. The per capita death rate was 49.6 per 100,000 people.

Although significantly lower than in many other countries, these figures are still worrying, and completely avoidable, Lebanese experts said.

Lebanon’s caretaker government eased restrictions for the Christmas and New Year period, allowing gatherings, parties and celebrations. This was followed by a surge in Covid-19 cases that overwhelmed the healthcare system.

Firas Abiad, manager of Rafik Hariri University Hospital in Beirut, said the recent increase in Covid-19 deaths was a result of this surge, because people considered critical cases generally die between three to four weeks after infection.

“Early and immediate treatment can help reduce the number of Covid-19 deaths,” Dr Abiad said. “Previously, we had the capacity to take in patients and give them oxygen, saving their lives. Now it takes time to be admitted and find a hospital bed and, by the time they are in, it’s sometimes too late.”

Jade Khalife, a specialist in health systems and epidemiology, said the government was adopting a mitigation strategy in battling the pandemic, which he called a “failed approach”.

"Many countries got away with 0, 5, 10 deaths at most because they adopted a Covid-zero approach," Dr Khalife told The National. "It's the best way to decrease cases and deaths."

He said the approach involves driving down cases as close as possible to zero through strict control measures, such as total lockdown, emergency social safety nets, contract tracing, obligatory isolation and quarantine, and an effective communication plan.

Dr Khalife is a member of the Independent Lebanese Committee for the Elimination of Covid-19, known as zerocovidlb, a group of medical practitioners, scientists and professionals from various disciplines that studied effective strategies adopted in other countries and is calling for similar measures in Lebanon.

He said Lebanon might begin to see a decrease in daily deaths at the beginning of March, after the government imposed a new 25-day lockdown from January 7 and tightened the restrictions a week later, but “we’re still stuck in a loop of tragedy”.

Such intermittent “yo-yo lockdowns” will not be effective when the new highly infectious B117 coronavirus strain, first detected in Britain, becomes the dominant strain in Lebanon in coming months, he said.

“The more you open up, more people will be infected, more people die,” said Dr Khalife. “The best strategy to execute is the Covid-zero strategy, you have nothing to lose.”

Dr Abiad is hopeful that the start of vaccinations, combined with the lockdown, will help to lower the death rate.

Lebanon has secured 2.1 million doses of the Pfizer-BioNTech vaccine, which are expected to be delivered from mid-February over a period of five weeks.

The health ministry has also secured 1.5 million doses of the AstraZeneca vaccine directly from the company and 2.73 million doses through the Covax network to cover an additional 20 per cent of the population, bringing the total number of vaccine doses available to 6.33 million.

For Dr Abiad, no death rate can be considered “low”.

“Even a death rate of 0.1 per cent in a population of six million equates to 6,000 victims, is this acceptable?” he said.

"Patients are not numbers," added Dr Abiad. "We are not numbers."

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