Why were there maggots ? because the GNA (government in the Western side of Libya) had imposed a 5 day full lockdown for Eid Adha festivities. If you are a follower of Libyan affairs, you realise that this is a tragedy, because the country is plagued by a civil war since 2011 and rubbish collection is low on its priority scale. Also Libya has the largest number and variety of deadly foreign intervention and proxy wars on its soil and in its skies and waters in this century.
Now let's get back to the hideous olfactory experience.
It was a powerful catalyst to my fears about the future in Libya and in the world. I watch with concern as the USA, allegedly the most powerful, advanced nation on earth crumbles under the impact of Covid19 virus and as the
WHO, makes increasingly alarming announcements, literally stating that there is no "silver bullet" in sight.
Media bombards us with numbers of cases on a daily basis but every week I check the dashboard of the Libya website of the Libyan NCDC or National Centre for Disease Control, and the numbers though small compared to the rest of the world are worrisome to me especially when they surpassed the 1000 confirmed cases. But the strange part wast that it took until the first week of July to reach 1000 cases. Today we stand at 9707 positive tests and are looking at an abyss. If we look at the numbers: by August 2 we were almost 4000, at this rate it looks like before the end of August we would have reached the 10,000 mark! ( We actually reached it on August 21 as I was writing this post).
What on earth happened?
As a lingering pursuit from my previous background and interest in clinical pharmacology and healthcare, I have been following @Muaaddio on Twitter. Muaad is a Libyan medical student who has been tweeting about public healthcare in Libya for a while and collates the news from various sources. This builds an image of what is actually taking place in the country, better than the local news sites as he combs through them all. Naturally he started compiling the data on Covid19 as provided by the NCDC but translating it in English but also with raw data from contacts and personal resources.
I have been expecting a disaster after Ramadan as social media filled up my inbox with people celebrating Eid El Fitr with zero social distancing or masks in various cities across Libya. I was proven right when the spike started rising right about a week later.
But how did we get to this?
Libya's airports fly a limited number of routes and with an ongoing conflict, our tourism sector is basically defunct. In this article I will attempt to retrace the steps of Covid19 in Libya that have led us to what I can only see as a tragedy on a grand scale if unchecked. This is not a scientific paper, this is not a thesis for a degree nor even investigative journalism. It is simply a story to recount from memory and to try to bring the different threads in the pantomime together before we get buried in more details and forget what happened in Libya.
The wider news about the corona virus started to filter to us around December last year as some form SARS-COV2 breaking out in China. In our lifetime we have seen many diseases, Mad Cow diseases, SARS, Mexican flu, Ziza virus, bird flu, Ebola, mouth and feet you name it. Periodically we have a scare that flares up somewhere in the world and we beat it by paying attention and restricting travel a little bit or curtailing the activity that was causing it in the first place. But it is always contained in some way. We always knew the fact that disease can be carried by travellers back to their countries or from their countries to other destinations since the great travels of Columbus at least. Having travelled through Asia, I am very familiar with people wearing medical face masks on public transport, airports and streets. This is done for protection from viruses or pollution or if they have the flu as a courtesy to others. So when I think that we are in a particularly dangerous time of the year during my travels I try to wear a mask.
Around mid December 2019, my 16 year old niece became very ill. She had a continuous cough that she could not clear, chest pain, difficulty breathing, loss of smell, sore throat, lethargy and coughing her lungs out. Her fever was continuous and when the usual flu remedies of , vitamins C, Nurofen or Panadol, lozenges for the sore throat, soup etc... were not working and she started using her asthma SOS inhalers almost constantly we went to hospital. The ER ward at that time was busy with the wounded from the frontline, but the young doctor managed to check her and by listening to her chest he asked for an x-ray. When the results came out a corner in lungs was not ok. I was appalled and felt guilty how can a young, healthy teenagers, who eats well and is well taken care off get pneumonia !!! How can her "normal flu" deteriorate so fast to this situation where her life was in danger? She was given oxygen and prescribed antibiotics but it was not working as a few days her fever did not drop but rose even higher. So I took her to another hospital thinking they would have more time for her since it was farther from the frontline. There in the outpatient ward we has some tests and she was prescribed with very potent IV antibiotics. I call them the munitions of last resort. She was also given panadol in IV form. I was seriously panicked. What if she gets worse, how can we treat her in a war zone. But I also noticed another thing that most beds in the ER where filled with men and women who were getting the same injection and had more or less the same symptoms. They were also given oxygen. I simply assumed that this years flu strain was more vicious than before. Still we both had masks on because it is easy to catch more viruses in hospitals. I spent a week taking her for her daily dose of injection. The patients at the two hospitals I had seen were either young men wounded at the frontline or people who had, flu like symptoms, chest issues and fever that needed, oxygen and strong antibiotics. In that same week I discovered one evening my 80 year old father inanimate in the living room and burning hot with fever. He had mild flu symptoms a few days ago and I was cursing at the war and whoever was responsible for it, that had damaged our infrastructure and caused us to feel cold in our own homes due to long hours of power cuts. Which meant we were prone to getting sick and others illnesses. I had never seen my father unconscious. So it was terrifying to have a child burning with fever in one room and choking on her own breath and my father who had heart disease and a string of other chronic issues helpless in front of me. I did first aid and changed him and tried to bring down his fever. I was unable to move him on my own, and when he regained a bit of consciousness later he refused to go to hospital. So I brought him antibiotics, as he chest was definitely making weird sounds. That week was a nightmare. All in all my niece was severely ill for 20 days and convalescing until February. My father fared better, he was prompt on his feet in about 10 days.
At the end of January I travelled to Turkey. At that time we had already heard about Covid19 but not many people were taking precautions. I am an OCD in terms of cleaning my personal space on a plane but I noticed a few of the travellers with disinfectant gels and masks something I never did before. I was seated next to a young man and the middle seat was empty between us. This suited me fine. There is no inflight movie on Libyan flights but you could follow the flight progress on the map on your screen. My neighbour was doing that during the journey. He did not hesitate to ask for one of my wet wipes when the meal was served. Then at some point over the Mediterranean Sea he observed that it was strange that we were not passing over Greece in our route. I was curious so I asked why is that a problem? he said that usually we fly a bit over it on our way to Istanbul and that the same thing happened when we was returning from China, the pilot had deviated slightly from the usual route. I won't get here today about Greek part, nor the China change of route. But when I heard that he had been in China, I remembered that he was sneezing earlier. I did not ask him when was he in China.. But for the rest of the trip I covered my whole face with my scarf not just my mask. This was the 29 of January.
China is a popular destination for young Libyan men, as they bring a lot of goods to sell in Libya from there. Electronics, monogrammed luxury leathers, brand clothes or just other business. We also have a good sized diaspora there since 2011 and many students who are on scholarships from the Chinese government. About 100 per annum.
On February 3rd, my fever started rising and my throat closing and my nose was stuffy. I was very tired and started losing my voice. I was breathless and by the next day had a dry unproductive cough which I could not stop. I lay down for most of the week, feeling miserable, sweaty, coughing, choking, with a fever going up and down. Fears of Covid19 started plaguing me. So by the end of the week I went to hospital, telling myself that if I had something, I would immediately be kept there. My doctor did a thorough examinations and decided that I had a viral infection of the vocal chords and asked me to shut up for 5 days. He only gave me Advil and something to soothe my throat. Two days later I wore my mask and returned home to Libya. I was choking most of the time like having asthma attack. I took a panadol before boarding so I would not raise any alarms because by the time we established that I have no Covid it be too long.
When I got home, I isolated myself in my room because I did not want my family to have another bout of flu, since they just recovered if you recall. My brain was burning like mush and my cough was not getting better, though it became very productive now. So when I saw yellowish colour from my nose and throat I realised it was no longer viral throat but probably some kind of bacterial infection. It was the morning I woke up with yellow pus coming out of my eyes and I was unable to open them that I realised this was serious. I donned a mask and got my own meds, antibiotic tablets but also antibiotic eye drops and nasal solutions the whole lot. About 24hrs later I started improving. A week later I felt human again, though I was still having difficulty breathing.
In February if you were traveling to Tunisia or Turkey you had to fill some forms on arrival for contact tracing, while if you arrived in Tripoli, Libya your temperature was taken at the airport. I left the country again on February 28 and arrived in Canada on March 1st. I got another sore throat on March 2 and was ill, coughing etc... until March 10, had to take antibiotics again. The doctor said it was not Covid19.
My point is that perhaps Covid 19 was introduced in Libya early on by the Libyan travellers who came from China back in 2019? It is a popular destination. Why was there such a high number of pneumonia cases? There are many anecdotes.
Sewage testing in a number of countries shows that the virus was present in Europe since December 2019 most likely but also as far back as March 2019 ( yes you read that right !) even before China announced the first cases on December 31st, 2019. So does that mean it could be present in Libya too ? How can we find out ?
Could we have herd immunity ? Apparently it is possible . But if we did in Libya, why are the numbers ONLY now rising drastically ? are these new mutations? or is it because we increased testing?
All I know is that around the 10th of March, Libya woke up from its slumber and decided to do something drastic. The GNA side closed flights on 15 March without any previous warning while the eastern government told its citizens they had until the 19 March to get to Benghazi. Of course people in southern Libya used either western or eastern airports to get home. At the same time many countries were closing their borders and imposing quarantine such as Tunisia.
When you know that most of your travellers are people going for treatment or people who have meetings overseas and some small business entrepreneurs who cannot afford to stay long outside, or simple young men gone to withdraw some foreign currency from the ATMs to resell back home and combine with it the visa challenges facing Libyans you would imagine the mess that can happen. The Libyans who became stranded abroad was a tragedy on its own. Because many Libyans spend everything before the day they go to the airport. Travellers had left families and jobs in Libya, while others had finished or not finished treatment. Others were dead and their family wanted to return their remains. In short It was a completed mess. I should know I was one of those stranded in Istanbul as a result of the dumbest decree on earth.Why was it dumb ? because while it stopped travel for ordinary Libyans those who has "waste" still were able to board one way or another a flight back home on the so called "cargo flights" or Air Ambulance flights or even private jets or even by special exemptions from a minister. I used to see their Facebook posts boasted that they made it home... Additionally all these non publicly documented returnees did NOT undergo quarantine or even self isolate. Libya had no Covid19 confirmation until March 24.
In early March, the multiple Libyan governments had all announced sets of budgets to combat Covid19, by building hospitals ( now ? ) and testing plans etc...In addition to the state of emergency the GNA announced "half a billion dinars to fight the virus." Also all the governments put some measures. There was no lack of advocacy on line, on social media, radio, TV, billboards. Tripoli residents were on lockdown for two months. Schools closed etc... Masks were encouraged not mandatory.
In April 75 million LYD was supposedly finally allocated to municipalities from the initial half a billion. The EU contribute 18 million Euro in May and a further 110 million Euro in July, further mobilising 20 million Euro in August. By May the United States had confirmed over 12 million USD of support to Libya's anti-Covid19 efforts.
All the above is a lot of money ! WHERE did it go? Is anyone keeping track of this ?
The Libyan health sector crashed, testing kits are always not available, PPE as well, as for ventilators and spaces in hospital ..... in Tripoli the hospitals were targeted by the LNA so probably some contamination took place when people ran out or others ran in to help? The water has been cut for months, the electricity is a non-ending saga. The oil blockade has not helped with paying bills and the government undertook a very late and expensive scenario to repatriate travellers. Put them in hotels at its expenses abroad and quarantine them + Covid tests before returning home. At some point it became unsustainable and people are now quarantined locally. It does not mean that those who stranded brought it with them, no I can vouch that between March 16 and May 15 those that were quarantined in Istanbul did not see even the street until they were put on the planes, but as I mentioned above there were some slips and also those that had returned to Libya and to their communities between March 10 and 19 and those that were brought by private jets, also let's not forget all the foreign combatants, planeloads after planeloads were descending in a number of Libya cities in the east and the west. So many factors went wrong that must be laid at the feet of those who had crowned themselves responsible for us but also to our own stubborness and Libyan macho psyche that we are invincible and this is just the flu.
At the end of May Libyans threw caution to the wind due to the enormous economic suffering and also they got fed up and emerged from lockdown and the numbers started rising. Now in the past two weeks while the spike has gone up drastically and everyone knows someone who died from the virus or suffered from it, people are increasingly finally wearing masks and having a modicum of social distancing. However, to this day, weddings/funerals have not abated. We also have to contend with protests. The war on Tripoli ended but all the rest of miserable circumstances did not stop.
I believe that we must have had our first wave in early 2020 and we are now riding the second wave due to the botched up measures.
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