Fighting COVID- 19 in Jordan, from early declared victory to extreme burden

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By Mahmoud Shorman, MD, FIDSA, MHA

After the reports of the spread of a novel coronavirus in China in the first part of 2020, Jordan was no exception as countries worldwide began putting measures in place to prevent the spread of the virus. By Jan. 26 a protocol designed by Jordan’s Health Ministry with the aid of the National Epidemics Committee was in effect, and focused on designating certain major hospitals in different parts of the country to manage suspected and confirmed COVID-19 cases, with the caveat of preventing all other patients with chronic or acute problems access to these hospitals.

The first recorded case of a returning traveler on March 2 was quarantined at the designated COVID-19 hospital in the capital city. Interviewed by TV and radio stations, he became very famous (so much for HIPAA).

The first complete nationwide lockdown was implemented on March 17 after COVID-19 exposure at a wedding attended by 400 people, with a strictly enforced curfew for four days, during  which people were allowed on foot to buy groceries from 10 am to 6 pm.

The activation of the National Defense Law began the same day, leading to the suspension of schools and universities, preventing prayers at places of worship, banning any large gathering and the complete closure of the borders. The last 5,000 passengers coming through the airport before the closure were quarantined for two weeks at luxury Dead Sea resorts with the escort of the Jordanian army.

For the following six weeks use of cars was banned. Any neighborhood with a proven case was isolated and no travel between cities was allowed. The government issued a mask mandate on May 5 with a hefty fine of up to $70. These measures were successful in limiting the total number of COVID-19 cases with only 1,136 cases as of July 2, 2020, four months after the 1st confirmed case, making contact tracing easy with testing of all contacts and isolation of positive cases. Jordan was the country with the lowest number of cases in the Middle East at the time.

The lockdown measures had major economical effects on the country and decision was made to relax these measures and public gatherings up to 20 people were allowed, while hotels, restaurants and gyms were allowed to reopen with the emphasis on social distancing and wearing masks. The airport was reopened on Sept. 8.

The second wave of COVID-19 started after the ease of the lockdown with the number of cases reaching 13,650 between Sept. 2 and Oct. 2, 2020.  On Nov. 26, 2020 more than 200,000 COVID-19 cases were diagnosed, with deaths due to COVID-19 increasing. The situation worsened despite re-closure of schools and universities, curfew after 7pm daily with total lockdown every Friday. Between Jan. 2021 and April 27, 2021, there have been 704,540 confirmed cases of COVID-19 with 8,660 deaths, reported to the World Health Organization, with only 807,175 vaccine doses  —  about 1% of the population.

The lesson from the Jordan experience of fighting COVID-19 pandemic is despite early success of controlling the pandemic with lockdown, the second wave was inevitable without a plan to vaccinate at risk populations to reach herd immunity.

Dr. Mahmoud Shorman

Dr. Mahmoud Shorman is American board certified in internal medicine, infectious diseases and infection control and has a Master’s in Health care Administration. He is the infectious diseases section chief at University of Tennessee Medical Center and the antimicrobial stewardship program director and an Associate Professor of Internal Medicine and Infectious Diseases.His research focuses on Endocarditis, antimicrobial stewardship, and antimicrobial resistance. He has more than 40 peer reviewed publications and speaks at international conferences on Infectious diseases and Infection Control.

 

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