Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Tag: Jordan

QuikStats: MERS-CoV in the Arabian Peninsula (Nov 2013)

“No to slavery … That is not a world we will accept … Not here. Not overseas. Not anywhere.” Former Prime Minister of Australia, Julia Gillard (8th March 2013) who will be speaking at the 2013 WISE Summit: Reinventing Education for Life in Doha, Qatar (29-31 October 2013)

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***** Please note that this infographic of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was updated with public source information to 1200hrs 20 November 2013 EST *****

The world’s top virology experts have watched the recent Hajj very closely, as has the world’s media since it first came on the scene in April 2012. It initially sprung up in Jordan but was soon exported to Saudi Arabia which has taken the hardest hit from the disease. As I write this blog 125 persons are confirmed to have caught the disease in the Kingdom, with 54 of them dying).

Of concern were the 2-million pilgrims who would be travelling together to the various sites (numbers were down approximately 1/3rd on recent years, possibly due to MERS-CoV). Although sometimes cramped the Hajj is generally well organised and supported including health and vaccination facilities. Some very good writers have expressed doubts about the data coming out of Saudi Arabia but the Hajj is behind us now. It seems that outside of some individual cases, as the possible French case highlights, major concerns about Saudi Arabia and the Hajj might have overblown.

Perhaps those same concerns should be directed at Qatar and the conditions of those who are building the FIFA World Cup stadiums for 2022?

Qatar has a population of just 1.9-million, of which only 15% are Qatari. In 2012, the country’s Gross Domestic Product per capita was the richest in the world at $89,736 (compare that to Australia $62,003, Canada $51,554, US $48,113, KSA $24,116 or Yemen $1,361). Yet a lot of the country is actually populated by very poor foreign workers who make up 94% of its total workforce.

Recently The Guardian newspaper has highlighted the abject conditions of those working on construction sites. In the first article the International Trade Union Confederation has estimated that at current numbers the construction of FIFA World Cup facilities will cost around 4,000-lives mostly via heat related illness or workplace incidents, although the data is sketchy at best (and non-existent at worst).

In another article Revealed: Qatar’s World Cup ‘slaves’ the newspaper investigates and documents multiple cases of workers being abused and living in awful conditions. Excerpt:

According to documents obtained from the Nepalese embassy in Doha, at least 44 workers died between 4 June and 8 August. More than half died of heart attacks, heart failure or workplace accidents.

The investigation also reveals:

  • Evidence of forced labour on a huge World Cup infrastructure project.
  • Some Nepalese men have alleged that they have not been paid for months and have had their salaries retained to stop them running away.
  • Some workers on other sites say employers routinely confiscate passports and refuse to issue ID cards, in effect reducing them to the status of illegal aliens.
  • Some labourers say they have been denied access to free drinking water in the desert heat.
  • About 30 Nepalese sought refuge at their embassy in Doha to escape the brutal conditions of their employment.

And another excerpt which mentions the living conditions:

The Guardian’s investigation also found men throughout the wider Qatari construction industry sleeping 12 to a room in places and getting sick through repulsive conditions in filthy hostels. Some say they have been forced to work without pay and left begging for food.

“We were working on an empty stomach for 24 hours; 12 hours’ work and then no food all night,” said Ram Kumar Mahara, 27. “When I complained, my manager assaulted me, kicked me out of the labour camp I lived in and refused to pay me anything. I had to beg for food from other workers.”

For those working and living in cramped filthy conditions or working long arduous days without proper food or hydration would be more at risk to just a seasonal flu. What about the practice of going to work when ill or ‘presenteeism’? How many of the 85% of non-Qatari’s in the monarchy have access to decent medical help.

With 44 Nepalese dying in just 66-days and a further 82 Indians dying in the first five months of this year in work related incidents it seems trite to concern ourselves with a relatively small outbreak of a disease which only caused two deaths in 2013.

As I write this post in late October MERS-CoV has been confirmed in just seven cases in Qatar with two onsets in recent weeks.

I’m not trying to suggest that all migrant workers in that country are going to get the virus it does seem a more likely vector than the better organised and supported Hajj pilgrimage.

As I did with the recent MERS-CoV infographics I’ll keep the infographic updated as new information comes to hand through to the end of November. Here is a copy of the original infographic posted with data to 29 October 2013:

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Acknowledgements: Data for this infographic was sourced largely from CIDRAP, H5N1, FluTrackers and the WHO. Background reading supplied mainly via Pandemic Information News, Ian at Virology Down Under and Helen Branswell.

Updates

30 Oct 2013 – Via H5N1Oman: Sultanate reports first MERS case;

1 Nov 2013 – Via H5N1: Dr. Mackay reflects on the latest MERS cases;

3 Nov 2013 – Amendments to infographic as suggested by Crawford Kilian (detailing methodology);

7 Nov 2013 – Via H5N1: Dr. Mackay has questions about the Spanish MERS case;

8 Nov 2013 – Via CIDRAP: UAE, Saudi Arabia report 3 more MERS cases;

9 Nov 2013 – Via H5N1: Qatar: New MERS case is an expatriate;

11 Nov 2013 – Via H5N1: Oman reports first MERS death;

12 Nov 2013 – Via GulfNews.com: Omani visitor dies from Mers virus in Abu Dhabi emirate (h/t Helen Branswell);

17 Nov 2013 – Via H5N1: CIDRAP: MERS death toll rises as WHO confirms 2 cases and Kuwait: Some details on the second MERS case;

20 Nov 2013 – Via H5N1: CIDRAP: Saudi Arabia reports 2 more MERS cases;

QuikStats: MERS-CoV (September 2013)

“I think the take-home message is: MERS is not SARS” (Zaid Memish, Deputy Health Minister, Kingdom of Saudi Arabia, 30th August 2013).

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***** Please note that this infographic of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was updated with public source information to 1200hrs 1 October 2013 EST *****

The above infographic shows the distribution of MERS-CoV by onset country. The Kingdom of Saudi Arabia (KSA) has had the most cases and the numbers are reflective of the latest KSA Ministry of Health figures. The most recent fatality outside of the KSA that I have included in my data was from Tunisia. Some countries, such as France and the UK have had fatalities that are not shown above due to the fact that the onset occurred elsewhere in the Middle East. The Tunisia index case seems to have occurred in Qatar or the KSA but at this time is still included under that countries flag. Italy initially reported two cases but these were later amended to probably by WHO due to testing issues. A number of fatalities are not shown as their details have not been made public.

Ian M. Mackay, via his VDU blog has been discussing the spike in case numbers during the month of September. To emphasise his point here is the index chart that I published on the 4th September 2013 (110-cases & 50-deaths).

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Data can be many things to many people. For health investigators it is a critical resource to build a story about new or emerging diseases, for medical professionals it is a tool to inform while for the public it is a way to tell a complex epidemiological story in a more manageable format.

It has its drawbacks though. Data alone often tells a non-contextual story only.

Reading the back story on MERS-CoV I couldn’t help but reflect on the story of Abid Hussain (case number 10). Abid had travelled to his former home of Pakistan then visited Mecca to pray for his 39-year old son who had been diagnosed with cancer and was in the process of receiving chemotherapy. Upon his return to the UK he became unwell with severe flu like symptoms and either prior to being hospitalised or during his hospitalisation managed to pass on the disease to both of his adult children. The daughter only showed mild symptoms, did not require hospital admission and made a full recovery. The son, Khalid, a father of two and in the battle of his life could not stop a second assault on his system by MERS-CoV and succumbed to the disease just eight days after being admitted to hospital.

What terrible luck.

Acknowledgements: Data for this infographic was sourced largely from CIDRAP, H5N1, FluTrackers and the WHO. Background reading supplied mainly via Pandemic Information News, Ian at Virology Down Under and Helen Branswell.

Updates

  • Case numbers and fatalities have been updated regularly by multiple agencies. Here are the CIDRAP daily overviews which included case updates for the 3rd – 4th – 6th – 9th – 11th – 17th18th – 20th and the 30th of September 2013.