Shunning masks causing unnecessary deaths in Gulf, Riyadh health summit told

Many hundreds of lives could be saved in the Gulf region if more people start wearing masks to prevent the spread of the coronavirus, a regional health conference has heard.

Although the Riyadh Digital Global Health Summit was told that mask wearing in the region is already high by global standards, modelling suggests as many as 1,000 extra deaths could be saved in Saudi Arabia alone this year.

It comes as epidemiologists, grappling with multiple unknowns such as whether a vaccine will be approved or people’s behaviour will change, struggle to forecast how the pandemic will develop.

Addressing the conference remotely, Prof Ali Mokdad, a health metrics specialist at the University of Washington who focuses on the Middle East, said his forecasts suggested Saudi Arabia’s coronavirus death toll would reach about 5,800 by the beginning of December. Until now the Kingdom has registered around 3,200 deaths.

He highlighted the UAE, Oman and Saudi Arabia as countries where much of the population already wears masks, but said many lives could be saved if more people used face coverings.

“Right now mask-wearing is around 75 per cent [in Saudi Arabia], but 1,000 less deaths could be achieved if 95 per cent of people in Saudi Arabia wore masks,” he said.

“For Saudi Arabia, we’re showing how many beds they need. Saudi Arabia will not have a shortage of beds, will not have a shortage of ICUs [intensive care unit beds] or ventilators, because they have a strong medical system.”

Because infection rates in the country are forecast to remain relatively under control, a lockdown is unlikely to become necessary.

However, the conference heard the picture varied significantly across the Middle East, with the situation in Iran forecast to deteriorate dramatically as infection rates increase.

By the beginning of December, the number of deaths in the country is could exceed 71,000, almost four times the current total of just over 18,000.

“We expect it will go into a lockdown some time in October. In Iran we expect that there will be a shortage of beds some time in November in the peak of the second wave,” said Prof Mokdad.

“This wave is staying with us in a roller coaster. They will not have enough beds, they will not have enough ICUs compared to what we’re showing in Saudi Arabia.”

In the United States, where there is resistance among some to wearing masks, the death toll is forecast by Prof Mokdad to grow to about 295,000 by the beginning of December, almost twice what it is now – about 163,000.

However, if 95 per cent of people wore masks outside the home, 66,000 of the additional deaths could be avoided. This represents “a huge difference”, Prof Mokdad said.

Experts acknowledged that projections for death and infection rates are more difficult to make now than at the pandemic’s start, when the initial wave of cases was relatively easy to understand.

“The pandemic is much more unpredictable now,” said Dr Erik Volz, of the School of Public Health at Imperial College London.

“It depends on evolution [of the virus], political considerations, behavioural fatigue and a vaccine.

“We don’t know if we’ll have an effective vaccine and how quickly production can be ramped up. These are giant unknowns and we won’t have greater clarity until later this year.”

One positive he highlighted was that the quality of care for patients with Covid-19 has “improved dramatically” in recent months, especially in developed countries. Drugs such as the antiviral medicine remdesivir are a key reason for higher survival rates.

However, the new coronavirus is likely never to be eliminated, Dr Volz said, even though there is not continued animal-to-human transmission, as is the case with, for example, the coronavirus that causes Middle East Respiratory Syndrome, for which camels act as a “reservoir” and transmit the virus to people.

“We’re probably not going to be able to eradicate this even if we have an effective vaccine. This is of the same order of difficulty as seasonal influenza,” said Dr Volz.

The health summit has brought together health and digital-technology specialists from across the globe, with most participants taking part remotely.

The coronavirus's emergence is the first pandemic of the digital age, and has sparked innovation, such as in contract tracing and symptom checking technology. However, the conference was told there was much room for improvement.

“We have a long journey to ensure the digital transformation of the healthcare sector is accelerated, so as we get through this first pandemic of the digital era, we … take advantage of the digital technologies,” said Bernardo Mariano, the World Health Organisation’s chief information officer.