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| Desperate for Any Coronavirus Care, Afghans Flock to Herbalist’s ‘Vaccine’ | Desperate for Any Coronavirus Care, Afghans Flock to Herbalist’s ‘Vaccine’ |
| (7 days later) | |
| KABUL, Afghanistan — Every day, thousands of people swarmed Hakeem Alokozai’s herbal clinic in Kabul seeking their three drops of his Covid-19 “vaccine.” Some carried IV drips, others oxygen cylinders. Some were brought in ambulances, others in the back of Toyota station wagons. They were laborers, officers of the security forces and even lawmakers in the country’s Parliament. | KABUL, Afghanistan — Every day, thousands of people swarmed Hakeem Alokozai’s herbal clinic in Kabul seeking their three drops of his Covid-19 “vaccine.” Some carried IV drips, others oxygen cylinders. Some were brought in ambulances, others in the back of Toyota station wagons. They were laborers, officers of the security forces and even lawmakers in the country’s Parliament. |
| When the Afghan Health Ministry first tried to shut down Mr. Alokozai’s operation several weeks ago, residents were furious — they protested, blocking roads and burning tires. Even after laboratory tests showed that his concoction was nothing but several types of narcotics, the response was: So what? The government has since forced him to leave the city. | When the Afghan Health Ministry first tried to shut down Mr. Alokozai’s operation several weeks ago, residents were furious — they protested, blocking roads and burning tires. Even after laboratory tests showed that his concoction was nothing but several types of narcotics, the response was: So what? The government has since forced him to leave the city. |
| The rush on the herbalist in Kabul nonetheless points to Afghans’ rising desperation as the coronavirus overwhelms their country’s struggling health system amid a bloody war with the Taliban. | The rush on the herbalist in Kabul nonetheless points to Afghans’ rising desperation as the coronavirus overwhelms their country’s struggling health system amid a bloody war with the Taliban. |
| As the virus spreads and the death toll climbs, Afghan officials have said they simply do not have the capacity to test and contain the pandemic. President Ashraf Ghani’s administration, which is largely dependent on aid from donor countries that are themselves grappling with the pandemic, is trying to manage daily violence and focus on averting a famine that officials fear could grip a country where 80 percent of the population lives right around the poverty line. | As the virus spreads and the death toll climbs, Afghan officials have said they simply do not have the capacity to test and contain the pandemic. President Ashraf Ghani’s administration, which is largely dependent on aid from donor countries that are themselves grappling with the pandemic, is trying to manage daily violence and focus on averting a famine that officials fear could grip a country where 80 percent of the population lives right around the poverty line. |
| The Health Ministry said on Sunday that about 55 percent of the roughly 1,200 coronavirus tests conducted in the past 24 hours were positive, bringing the number of official cases to about 25,000. The recorded death toll stands just below 500. | The Health Ministry said on Sunday that about 55 percent of the roughly 1,200 coronavirus tests conducted in the past 24 hours were positive, bringing the number of official cases to about 25,000. The recorded death toll stands just below 500. |
| But health experts openly warn that the official figures are at best an indication of a catastrophic picture, not an accurate count. The Afghan health minister, Ahmad Jawad Usmani, said that about 20,000 samples were being taken across the country each day, but that there was capacity to test only about 2,000. | But health experts openly warn that the official figures are at best an indication of a catastrophic picture, not an accurate count. The Afghan health minister, Ahmad Jawad Usmani, said that about 20,000 samples were being taken across the country each day, but that there was capacity to test only about 2,000. |
| The governor of Kabul, Mohammad Yaqub Haidari, said at a recent news conference that the city’s ambulance service had told him there were about 33 deaths a day. He said his phone rang constantly with news of the dead needing burial, and that those thought to be victims of the virus were being buried in the dark of night. | The governor of Kabul, Mohammad Yaqub Haidari, said at a recent news conference that the city’s ambulance service had told him there were about 33 deaths a day. He said his phone rang constantly with news of the dead needing burial, and that those thought to be victims of the virus were being buried in the dark of night. |
| “The number of infected is higher than the picture we have,” Mr. Haidari said, adding, “In Kabul, it is likely more than a million people.” | “The number of infected is higher than the picture we have,” Mr. Haidari said, adding, “In Kabul, it is likely more than a million people.” |
| Mohammed Dawood Danish, the head of one of the two government hospitals in Kabul that has been dedicated to coronavirus treatments, said that many patients died before they could be tested. | Mohammed Dawood Danish, the head of one of the two government hospitals in Kabul that has been dedicated to coronavirus treatments, said that many patients died before they could be tested. |
| “Last week, on average, we had eight deaths a day at our hospital,” Mr. Danish said. “Maybe two of them would be tested, while six others who had symptoms died before testing.” | “Last week, on average, we had eight deaths a day at our hospital,” Mr. Danish said. “Maybe two of them would be tested, while six others who had symptoms died before testing.” |
| Over the past two decades, Afghanistan’s health system has been largely dependent on subcontracting services to small nongovernmental organizations and reliant on foreign donations for health spending of roughly $5 per person. | Over the past two decades, Afghanistan’s health system has been largely dependent on subcontracting services to small nongovernmental organizations and reliant on foreign donations for health spending of roughly $5 per person. |
| The Afghan government sought to make the fight against Covid-19 a demonstration of its competence. Amrullah Saleh, one of the country two vice presidents, said in April that his government had been a “role model of management in the third world” and that it did not “need W.H.O. to come show my nation how to wash their hands.” | The Afghan government sought to make the fight against Covid-19 a demonstration of its competence. Amrullah Saleh, one of the country two vice presidents, said in April that his government had been a “role model of management in the third world” and that it did not “need W.H.O. to come show my nation how to wash their hands.” |
| But hospitals across the country were soon overwhelmed. In Kabul, there were widespread complaints of a lack of oxygen cylinders. In Herat, the center of the country’s first outbreak, front-line medical workers resigned en masse, saying that they had not been paid for months. | But hospitals across the country were soon overwhelmed. In Kabul, there were widespread complaints of a lack of oxygen cylinders. In Herat, the center of the country’s first outbreak, front-line medical workers resigned en masse, saying that they had not been paid for months. |
| In Kandahar’s main hospital, coronavirus tests were positive for about 100 of 900 staff members. Basic health services in the restive region could barely be delivered, and the hospital was forced to stop receiving the roughly 2,000 people needing daily outpatient services, admitting only the most seriously ill patients. | In Kandahar’s main hospital, coronavirus tests were positive for about 100 of 900 staff members. Basic health services in the restive region could barely be delivered, and the hospital was forced to stop receiving the roughly 2,000 people needing daily outpatient services, admitting only the most seriously ill patients. |
| At the main regional hospital in the northern province of Kunduz, 83 of 361 staff members came down with the virus. | At the main regional hospital in the northern province of Kunduz, 83 of 361 staff members came down with the virus. |
| “I am resting at home, because I am infected — so are my wife and four daughters,” said Dr. Mohamed Naeem Mangal, the director of the hospital. | “I am resting at home, because I am infected — so are my wife and four daughters,” said Dr. Mohamed Naeem Mangal, the director of the hospital. |
| Updated June 22, 2020 | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| Dr. Mangal said he had called the Covid-19 testing facility in Kunduz to arrange tests for his daughters, who were gravely ill, and was told that there was no testing and that they should just stay home and self-medicate. | |
| “The problem now is that the virus has spread to the families of our staff,” Dr. Mangal said. | |
| In the early weeks of the outbreak, the government tried to enforce partial lockdowns in urban centers. It bought some time by distributing bread to the most needy. But without a social safety net, many people soon left their homes to return to work. Infections mounted last month after markets were flooded with people shopping for Eid al-Fitr, the Muslim festival that ends the holy month of Ramadan. | |
| In the weeks that followed, hospitals were quickly overwhelmed. People hoarded oxygen cylinders at home, exacerbating the state of panic at health facilities. Death notices flooded social media, few mentioning the cause. Crowded funerals followed. In private conversations, families would admit that deceased loved ones had shown symptoms. | In the weeks that followed, hospitals were quickly overwhelmed. People hoarded oxygen cylinders at home, exacerbating the state of panic at health facilities. Death notices flooded social media, few mentioning the cause. Crowded funerals followed. In private conversations, families would admit that deceased loved ones had shown symptoms. |
| So when news spread that Mr. Alokozai, the herbalist, had “a vaccine,” people rushed to his clinic. | So when news spread that Mr. Alokozai, the herbalist, had “a vaccine,” people rushed to his clinic. |
| Mr. Alokozai has been making herbal medicine for 25 years, his brother Mohammad Khamas said. They first started distributing the concoction in Kandahar with a partner, before bringing it to Kabul on a scale where some days as many as 5,000 people were given three drops of it for no charge. | Mr. Alokozai has been making herbal medicine for 25 years, his brother Mohammad Khamas said. They first started distributing the concoction in Kandahar with a partner, before bringing it to Kabul on a scale where some days as many as 5,000 people were given three drops of it for no charge. |
| “The rush was such that sometimes people brought blankets and slept on the road the night before to be first in line the next morning,” said Sediqullah Nekzad, a tailor next door to the clinic. “Hundred percent, it worked — one time they brought a patient in an ambulance who was plugged into oxygen. An hour later, I swear to god, he walked on his own feet. I saw it with my own eyes.” | “The rush was such that sometimes people brought blankets and slept on the road the night before to be first in line the next morning,” said Sediqullah Nekzad, a tailor next door to the clinic. “Hundred percent, it worked — one time they brought a patient in an ambulance who was plugged into oxygen. An hour later, I swear to god, he walked on his own feet. I saw it with my own eyes.” |
| When its warnings were ignored, the Health Ministry published the result of its tests on the so-called vaccine. Tests found several types of opiates — opium, morphine, papaverine, codeine — mixed with a few herbs. The pressure grew, and Mr. Alokozai’s big-ticket supporters quietly backed off. The clinic in Kabul was closed. | When its warnings were ignored, the Health Ministry published the result of its tests on the so-called vaccine. Tests found several types of opiates — opium, morphine, papaverine, codeine — mixed with a few herbs. The pressure grew, and Mr. Alokozai’s big-ticket supporters quietly backed off. The clinic in Kabul was closed. |
| Mr. Alokozai appears to be in hiding, with reports of a warrant for his arrest, but his brother said they continued to distribute his drops to about 3,000 people in Kandahar each day. | Mr. Alokozai appears to be in hiding, with reports of a warrant for his arrest, but his brother said they continued to distribute his drops to about 3,000 people in Kandahar each day. |
| Mr. Alokozai has split with one of his first partners in Kandahar, who had been distributing the concoction on his behalf. | Mr. Alokozai has split with one of his first partners in Kandahar, who had been distributing the concoction on his behalf. |
| The former partner, Nisar Ahmad Ehsan, said Mr. Alokozai had stopped sending them drops — which people drink in a glass of water or tea — after demand rose in Kandahar. So he left to make his own “vaccine.” | The former partner, Nisar Ahmad Ehsan, said Mr. Alokozai had stopped sending them drops — which people drink in a glass of water or tea — after demand rose in Kandahar. So he left to make his own “vaccine.” |
| “Our drop is better than Alokozai’s — his took 30 minutes to an hour to kick in, ours takes only five to 10 minutes,” Mr. Ehsan said. “Alokozai is not a herbalist — he is an addict. I don’t know where he got his formula from.” | “Our drop is better than Alokozai’s — his took 30 minutes to an hour to kick in, ours takes only five to 10 minutes,” Mr. Ehsan said. “Alokozai is not a herbalist — he is an addict. I don’t know where he got his formula from.” |
| Mujib Mashal, Fatima Faizi, and Najim Rahim reported from Kabul, and Taimoor Shah from Kandahar, Afghanistan. Asadullah Timory contributed reporting from Herat, Afghanistan. | Mujib Mashal, Fatima Faizi, and Najim Rahim reported from Kabul, and Taimoor Shah from Kandahar, Afghanistan. Asadullah Timory contributed reporting from Herat, Afghanistan. |