MERS cases drop in KSA; alarm over medics becoming carriers

May 19, 2014

MERS cases dropNew York, May 19: The biggest risk that Middle East Respiratory Syndrome (MERS) will become a global epidemic, ironically, may lie with globe-trotting health care workers.

“This is how MERS might spread around the world,” said infectious disease expert Dr. Amesh Adalja of the University of Pittsburgh Medical Center.

It can take five to 14 days for someone infected with MERS to show symptoms, more than enough time for a contagious person to fly to the other side of the world without being detectable.

Health care workers “are at extremely high risk of contracting MERS compared to the general public,” Adalja said.

The threat has attracted new attention with the confirmation of the first two MERS cases in the United States. Both are health care workers who fell ill shortly after leaving their work in Saudi hospitals and boarding planes bound west.

About one-third of the MERS cases treated in hospitals in Jeddah were health care workers, according to the World Health Organization (WHO).

The Ministry of Health's counted 529 MERS infections since September 2012, of which 168 patients died as of May 17, 2014.

Despite the risk, few of the health care workers now in, or planning to go to, Saudi Arabia are having second thoughts about working there, according to nurses, doctors and recruiters interviewed by Reuters.

Michelle Tatro, 28, leaves next week for the kingdom, where she will work as an open-heart-surgery nurse. Tatro, who typically does 13-week stints at hospitals around the United States, said her family had sent her articles about MERS, but she wasn’t worried.

“I was so glad to get this job,” she told Reuters. “Travel is my number one passion.”

So far, international health authorities have not publicly expressed concern about the flow of expatriate medical workers to and from Saudi Arabia.

“There is not much public health authorities or border agents can do,” said infectious disease expert Dr. Michael Osterholm of the University of Minnesota. “Sure, they can ask people, ‘did you work in a health care facility in Saudi Arabia,’ but if the answer is yes, then what?“

Health care workers are best placed to understand the MERS risk, Osterholm said, and “there should be a heightened awareness among them of possible MERS symptoms.”

Neither the Centers for Disease Control and Prevention nor the Department of Homeland Security responded to questions about whether they were considering monitoring health care workers returning to the United States.

Soaring demand

In the last few years, the number of expatriates working in Saudi Arabia has soared, said Suleiman Arabie, managing director of Houston, Texas-based recruiting firm SA International, with thousands now working in the kingdom.

The Saudi government is building hundreds of hospitals and offering private companies interest-free loans to help build new facilities.

About 15 percent of physicians working in the Kingdom are American or European, and some 40 percent of nurses are Filipino or Malaysian, according to estimates by recruiters and people who have worked in hospitals there.

The majority of US-trained medical staff are on one- or two-year contracts, which results in significant churn as workers rotate in and out of Saudi medical facilities.

Arabie’s firm is trying to fill positions at two dozen medical facilities in Saudi Arabia for pulmonologists, a director of nursing, a chief of physiotherapy and scores more.

Doctors in lucrative, in-demand specialties such as cardiology and oncology can make $1 million for a two-year contract, recruiters said.

Nurses’ pay depends on their home country, with those from the United States and Canada earning around $60,000 a year while those from the Philippines get about $12,000, recruiters said. That typically comes with free transportation home, housing, and 10 weeks of paid vacation each year. For Americans, any income under about $100,000 earned abroad is tax-free, adding to the appeal of a Saudi posting.

Undaunted

One Filipino nurse, who spoke anonymously so as not to hurt her job prospects, told Reuters that she was “willing to go to Saudi Arabia because I don’t get enough pay here.” In a private hospital in Manila, she made 800 pesos (about $18) a day.

“I know the risks abroad but I’d rather take it than stay here,” she said. “I am not worried about MERS virus. I know how to take care of myself and I have the proper training.”

None of Arabie’s potential candidates “have expressed any concern” about MERS. Only one of the hundreds of professionals placed by Toronto-based medical staffing firm Helen Ziegler & Associates Inc. decided to return to the United States because of MERS, it said, and one decided not to accept a job in Jeddah she had been hired for.

Recruitment agencies in Manila have also continued to send nurses to the kingdom since the MERS outbreak, said Hans Leo Cacdac, the head of the Philippine Overseas Employment Administration. The government advises that returning workers be screened for MERS, Labor and Employment Secretary Rosalinda Baldoz said this week.

Expat health care workers now working in Saudi Arabia feel confident local authorities are taking the necessary steps to combat the spread of MERS in hospitals.

“Just today they came and put up giant posters in our hospital on MERS,” said Dr. Taher Kagalwala, a pediatrician originally from Mumbai who works at Al Moweh General Hospital in a town about 120 miles from Taif city in western Saudi Arabia.

“I have not heard of or seen any health care workers looking to leave their jobs or return to their countries because of the MERS panic. If it was happening, there would have been gossip very soon.”

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March 16,2020

Cairo, Mar 16: Saudi crown prince Mohammed bin Salman said G20 summit will work to combat coronavirus and coordinate efforts to ease its economic burdens, state news agency SPA said on Sunday.

In a phone call with British Prime Minister Boris Johnson, Salman discussed international efforts to fight the flu-like disease, saying the next G20 summit, which will be hosted by the Kingdom, will work on finding medical solutions, SPA added.

The G20 Summit is an annual gathering of representatives of the world's largest economies.

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News Network
July 1,2020

Riyadh, Jul 1: Saudis braced Wednesday for a tripling in value added tax, another unpopular austerity measure after the twin shocks of coronavirus and an oil price slump triggered the kingdom's worst economic decline in decades.

Retailers in the country reported a sharp uptick in sales this week of everything from gold and electronics to cars and building materials, as shoppers sought to stock up before VAT is raised to 15 percent.

The hike could stir public resentment as it weighs on household incomes, pushing up inflation and depressing consumer spending as the kingdom emerges from a three-month coronavirus lockdown.

"Cuts, cuts, cuts everywhere," a Saudi teacher in Riyadh told AFP, bemoaning vanishing subsidies as salaries remain stagnant.

"Air conditioner, television, electronic items," he said, rattling off a list of items he bought last week ahead of the VAT hike.

"I can't afford these things from Wednesday."

With its vast oil wealth funding the Arab world's biggest economy, the kingdom had for decades been able to fund massive spending with no taxes at all.

It only introduced VAT in 2018, as part of a push to reduce its dependence on crude revenues.

Then, seeking to shore up state finances battered by sliding oil prices and the coronavirus crisis, it announced in May that it would triple VAT and halt a cost-of-living monthly allowance to citizens.

The austerity push underscores how Saudi Arabia's once-lavish spending is becoming a thing of the past, with the erosion of the welfare system leaving a mostly young population to cope with reduced incomes and a lifestyle downgrade.

That could pile strain on a decades-old social contract whereby citizens were given generous subsidies and handouts in exchange for loyalty to the absolute monarchy.

The rising cost of living may prompt many to ask why state funds are being lavished on multi-billion-dollar projects and overseas assets, including the proposed purchase of English football club Newcastle United.

Shopping malls in the kingdom have drawn large crowds in recent days as retailers offered "pre-VAT sales" and discounts before the hike kicks in.

A gold shop in Riyadh told AFP it saw a 70 percent jump in sales in recent weeks, while a car dealership saw them tick up by 15 percent.

Once the new rate is in place, businesses are predicting depressed sales of everything from cars to cosmetics and home appliances.

Capital Economics forecast inflation will jump up to six percent year-on-year in July, from 1.1 percent in May, as a result.

"The government ended the country's lockdown (in June) and there are signs that economic activity has started to recover," Capital Economics said in a report.

"Nonetheless, we expect the recovery to be slow-going as fiscal austerity measures bite."

The kingdom also risks losing its edge against other Gulf states, including its principal ally the United Arab Emirates, which introduced VAT at the same time but has so far refrained from raising it beyond five percent.

"Saudi Arabia is taking massive risks with contractionary fiscal policies," said Tarek Fadlallah, chief executive officer of the Middle East unit of Nomura Asset Management.

But the kingdom has few choices as oil revenue declines.

Its finances have taken another blow as authorities massively scaled back this year's hajj pilgrimage, from 2.5 million pilgrims last year to around a thousand already inside the country, and suspended the lesser umrah because of coronavirus.

Together the rites rake in some $12 billion annually.

The International Monetary Fund warned the kingdom's GDP will shrink by 6.8 percent this year -- its worst performance since the 1980s oil glut.

The austerity drive would boost state coffers by 100 billion riyals ($26.6 billion), according to state media.

But the measures are unlikely to plug the kingdom's huge budget deficit.

The Saudi Jadwa Investment group forecasts the shortfall will rise to a record $112 billion this year.

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January 8,2020

Tehran, Jan 8: Iran struck back at the United States for the killing of a top Iranian general early Wednesday, firing a series of ballistic missiles at two Iraqi bases housing U.S. troops in a major escalation that brought the two longtime foes closer to war.

Iranian state TV said it was in revenge for the U.S. killing of Revolutionary Guard Gen. Qassem Soleimani, whose death last week in an American drone strike near Baghdad prompted angry calls to avenge his slaying. A U.S. official said there were no immediate reports of American casualties, though buildings were still being searched.

Soleimani's killing and the strikes by Iran came as tensions have been rising steadily across the Mideast after President Donald Trump's decision to unilaterally withdraw America from Tehran's nuclear deal with world powers. They also marked the first time in recent years that Washington and Tehran have attacked each other directly rather than through proxies in the region. It raised the chances of open conflict erupting between the two enemies, which have been at odds since Iran's 1979 Islamic Revolution.

But in a tweet shortly after the missile launches, Iran's foreign minister called a ballistic missile attack a ``proportionate measures in self-defense'' and said it was not seeking to escalate the situation but would defend itself against any aggression.

Iran initially announced only one strike, but U.S. officials confirmed both. U.S. defense officials were at the White House, likely to discuss options with Trump, who launched the strike on Soleimani while facing an upcoming impeachment trial in the Senate,

Iran's Revolutionary Guard warned the U.S. and its regional allies against retaliating over the missile attack against the Ain al-Asad air base in Iraq's western Anbar province. The Guard issued the warning via a statement carried by Iran's state-run IRNA news agency.

``We are warning all American allies, who gave their bases to its terrorist army, that any territory that is the starting point of aggressive acts against Iran will be targeted,'' The Guard said. It also threatened Israel.

After the strikes, a former Iranian nuclear negotiator posted a picture of the Islamic Republic's flag on Twitter, appearing to mimic Trump who posted an American flag following the killing of Soleimani and others Friday in a drone strike in Baghdad.

Ain al-Asad air base was first used by American forces after the 2003 U.S.-led invasion that toppled dictator Saddam Hussein, and later saw American troops stationed there amid the fight against the Islamic State group in Iraq and Syria. It houses about 1,500 U.S. and coalition forces.

Two Iraqi security officials said at least one of the missiles appeared to have struck a plane at the base, igniting a fire. It was not immediately clear whether it was an Iraqi or U.S. jet. There were no immediate reports of casualties from the attacks, according to the officials, who spoke on condition of anonymity as they had no permission to brief journalists.

About 70 Norwegian troops also were on the air base but no injuries were reported, Brynjar Stordal, a spokesperson for the Norwegian Armed Forces told The Associated Press.

Trump visited the sprawling Ain al-Asad air base, about 100 miles or 60 kilometers west of Baghdad, in December 2018, making his first presidential visit to troops in the region. He did not meet with any Iraqi officials at the time, and his visit inflamed sensitivities about the continued presence of U.S. forces in Iraq. Vice President Mike Pence also has visited the base.

Iranian state TV said the Guard's aerospace division that controls Iran's missile program launched the attack, which it said was part of an operation dubbed ``Martyr Soleimani.'' Iran said it would release more information later.

The U.S. also acknowledged another missile attack on a base in Irbil in Iraq's semiautonomous Kurdish region.

``As we evaluate the situation and our response, we will take all necessary measures to protect and defend U.S. personnel, partners and allies in the region,'' said Jonathan Hoffman, an assistant to the U.S. defense secretary.

Wednesday's revenge attack happened a mere few hours after crowds in Iran mourned Soleimani at his funeral. It also came the U.S. continued to reinforce its own positions in the region and warned of an unspecified threat to shipping from Iran in the region's waterways, crucial routes for global energy supplies. U.S. embassies and consulates from Asia to Africa and Europe issued security alerts for Americans. The FAA also warned of a "potential for miscalculation or mis-identification" for civilian aircraft in the Persian Gulf amid in an emergency flight restriction.

A stampede broke out Tuesday at Soleimani's funeral, and at least 56 people were killed and more than 200 were injured as thousands thronged the procession, Iranian news reports said. Shortly after Iran's revenge missile launches early Wednesday, Soleimani's shroud-wrapped remains were lowered into the ground as mourners wailed at the grave site.

Tuesday's deadly stampede took place in Soleimani's hometown of Kerman as his coffin was being borne through the city in southeastern Iran, said Pirhossein Koulivand, head of Iran's emergency medical services.

There was no information about what set off the crush in the packed streets, and online videos showed only its aftermath: people lying apparently lifeless, their faces covered by clothing, emergency crews performing CPR on the fallen, and onlookers wailing and crying out to God.

``Unfortunately as a result of the stampede, some of our compatriots have been injured and some have been killed during the funeral processions," Koulivand said, and state TV quoted him as saying that 56 had died and 213 had been injured.

Soleimani's burial was delayed, with no new time given, because of concerns about the huge crowd at the cemetery, the semi-official ISNA news agency said.

A procession in Tehran on Monday drew over 1 million people in the Iranian capital, crowding both main avenues and side streets in Tehran. Such mass crowds can prove dangerous. A smaller stampede at the 1989 funeral for Ayatollah Ruhollah Khomeini killed at least eight people and injured hundreds.

Hossein Salami, Soleimani's successor as leader of the Revolutionary Guard, addressed a crowd of supporters gathered at the coffin in a central square in Kernan. He vowed to avenge Soleimani, who was killed in a U.S. drone strike Friday near Baghdad's airport.

``We tell our enemies that we will retaliate but if they take another action we will set ablaze the places that they like and are passionate about," Salami said.

``Death to Israel!'' the crowd shouted in response, referring to one of Iran's longtime regional foes.

Salami praised Soleimani's work, describing him as essential to backing Palestinian groups, Yemen's Houthi rebels and Shiite militias in Iraq and Syria. As a martyr, Soleimani represented an even greater threat to Iran's enemies, Salami said.

Soleimani will ultimately be laid to rest between the graves of Enayatollah Talebizadeh and Mohammad Hossein Yousef Elahi, two former Guard comrades killed in Iran's 1980s war with Iraq. They died in Operation Dawn 8, in which Soleimani also took part. It was a 1986 amphibious assault that cut Iraq off from the Persian Gulf and led to the end of the war that killed 1 million.

The funeral processions in major cities over three days have been an unprecedented honor for Soleimani, seen by Iranians as a national hero for his work leading the Guard's expeditionary Quds Force.

The U.S. blames him for killing U.S. troops in Iraq and accused him of plotting new attacks just before he was killed. Soleimani also led forces supporting Syrian President Bashar Assad in that country's civil war, and he also served as the point man for Iranian proxies in countries like Iraq, Lebanon and Yemen. Russian President Vladimir Putin met with Assad in Syria on Tuesday amid the tensions between Washington and Tehran.

Soleimani's slaying already has led Tehran to abandon the remaining limits of its 2015 nuclear deal with world powers as his successor and others vow to take revenge.

In Iraq, pro-Iranian factions in parliament have pushed to oust American troops from Iraqi soil following Soleimani's killing. Germany and Canada announced plans to move some of their soldiers in Iraq to neighboring countries.

The FAA warning barred U.S. pilots and carriers from flying over areas of Iraqi, Iranian and some Persian Gulf airspace. The region is a major East-West travel hub and home to Emirates airline and Dubai International Airport, the world's busiest for international travel. It earlier issued warnings after Iran shot down a U.S. military surveillance drone last year that saw airlines plan new routes to avoid the Strait of Hormuz.

The U.S. Maritime Administration warned ships across the Mideast, citing the rising threats. ``The Iranian response to this action, if any, is unknown, but there remains the possibility of Iranian action against U.S. maritime interests in the region,'' it said.

Oil tankers were targeted in mine attacks last year that the U.S. blamed on Iran. Tehran denied responsibility, although it did seize oil tankers around the crucial Strait of Hormuz, the narrow mouth of the Persian Gulf through which 20% of the world's crude oil travels.

The U.S. Navy's Bahrain-based 5th Fleet said it would work with shippers in the region to minimize any possible threat.

The 5th Fleet ``has and will continue to provide advice to merchant shipping as appropriate regarding recommended security precautions in light of the heightened tensions and threats in the region,'' 5th Fleet spokesman Cmdr. Joshua Frey told The Associated Press.

Iran's parliament, meanwhile, has passed an urgent bill declaring the U.S. military's command at the Pentagon and those acting on its behalf in Soleimani's killing as ``terrorists," subject to Iranian sanctions. The measure appears to be in response to a decision by Trump in April to declare the Revolutionary Guard a ``terrorist organization.''

The U.S. Defense Department used that terror designation to support the strike that killed Soleimani.

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