Viral victory: How Saudi Arabia won the war against MERS

Dromedaries are believed to be the animal source of infection in humans. (AFP)
Updated 06 September 2018

Viral victory: How Saudi Arabia won the war against MERS

  • Middle East respiratory syndrome (MERS) was discovered in 2012. The height of the outbreak was in 2015, and this year the number of cases has fallen to a record low
  • MERS can cause severe acute respiratory disease, gastrointestinal problems, kidney shutdown, respiratory failure and death.

DUBAI: It has been six years this month since the first outbreak of Middle East respiratory syndrome (MERS) was reported in Saudi Arabia, but world health experts now say the deadly virus is no longer a serious public health threat in the Kingdom.
While new infections are still being sporadically recorded, the disease, also referred to as MERS coronavirus (MERS-CoV), has fallen to record lows in 2018, according to the World Health Organization (WHO), as experts hail stringent measures put in place in Saudi Arabia — the most severely affected country — to isolate incidences of the disease. 

Dr. Amgad Elkholy, WHO epidemiologist in the Eastern Mediterranean Regional Office, told Arab News that from the discovery of MERS in 2012 up to the end of August 2018, a total of 2,246 cases of the disease were reported, including 796 related deaths — a mortality rate of about 40 percent. Most of these cases (83 percent) were reported from Saudi Arabia. 

“The number of cases in Saudi Arabia in 2018 so far falls below the average of the past few years: 108 cases from beginning of January to end of August in 2018, compared with an average of 282 cases for the same months in the past five years,” Elkholy explained.

He said that the risk of contracting MERS, which can cause acute respiratory disease, gastrointestinal problems, kidney failure and death, is now very low.

“WHO monitors the epidemiological situation of MERS-CoV, works with the affected member states to follow up on contacts, and conducts risk assessments. 

“Currently, the overall public health risk from MERS-CoV is low, and this is unlikely to change, despite the expectation that some new cases will continue to occur in Saudi Arabia and, sporadically, other countries in the region.”

Dr. Ulrich Wernery, scientific director of Dubai’s Central Veterinary Research Laboratory, which plays an important role in efforts to combat the virus, said public awareness programs and stringent precautions in health-care settings, which is how most of the known human-to-human transmissions occurred, meant that the disease is no longer “a serious threat to public safety.”

The height of the MERS-CoV epidemic was in April 2015 when 395 cases were recorded, most in Saudi Arabia (342 cases). 

However, Wernery cautioned that MERS has “not disappeared.” While he said there is no longer any concern about the virus in the Kingdom, “MERS will exist for years to come.

“If you look back to 2015 during the height of the outbreak, there was panic,” he said. “There were new cases every day, every week and there was a 40 percent fatality rate — which is big.”

Now, thanks to measures put in place, cases are few and far between. “There are still a few reported every month, but not like what we once saw, nowhere near,” said Wernery. “It has died down significantly, so we shouldn’t be worried. People now know more about the disease and are careful about it. 

“Most of the cases now are an original case, not one spread by human-to-human transmission. All hospitals in Saudi Arabia are knowledgeable about the virus and know the signs and symptoms. They know not to put these people in the main waiting room, for example, but to isolate them. So we don’t see the same spread that was so prolific a few years ago.  So there is no longer cause for panic. But people should still be aware of it and take all necessary precautions.”

The WHO also said the number of hospital-acquired cases of MERS has dropped significantly owing to improved infection prevention and control practices in hospitals.

Saudi Arabia’s Ministry of Health this year released its fifth annual report on MERS as a guideline for health-care professionals. Each year, a large group of national and international experts in epidemiology, infectious diseases, veterinary medicine and public health are hosted by the Saudi Ministry of Health to review current knowledge and update the guidelines. 

The latest report lists strict measures for health-care workers to follow if they treat a patient with potential signs of the virus, and consequent reporting of any confirmed cases.

According to WHO, the 50–59 age group continues to be at most  risk of acquiring infection of primary (or original) cases. The 30–39 age group is most at risk for secondary cases (human-to-human transmission). The number of deaths is higher in the age group 50–59 years for primary cases and 70–79 years for secondary cases.

MERS continues to exist because of the source of the disease, explained Wernery. Although some cases of MERS have been attributed to human-to-human infections in health-care settings, scientific evidence indicates that dromedaries, or one-humped camels of the kind familiar in the Gulf, are a major reservoir host for the virus and an animal source of the infection in humans. 

Wernery believes that camels that are the main source of MERS. “But we are in the Middle East, where camels are prevalent, so you can’t just eliminate the source. We have to live with it. It will be around for years to come, but there are two possibilities: Find a vaccine for the camels and/or find a vaccine for humans.”

Wernery’s laboratory is working to find a vaccine for camels.  International researchers are also working to find vaccines for humans, with candidates now awaiting clinical trials. 

However, WHO and other health groups remain optimistic. “Since 2015, the increase in the number of asymptomatic contacts identified in health-care settings is due to a policy change by the Saudi Ministry of Health, in which all high-risk contacts are tested for MERS-CoV regardless of the development of symptoms,” it said.

“I think we can expect to see further positive news about the reduced prevalence of this virus, and we hope that one day we can see zero reported cases in humans,” Wernery said.

On track for 2030? Movers and shakers in KSA look ahead

Kingdom tower in Riyadh, Saudi Arabia. (Shutterstock)
Updated 52 min 22 sec ago

On track for 2030? Movers and shakers in KSA look ahead

  • “The comprehensiveness of Vision 2030 and the wider horizons it addresses positively transform the Saudi citizen’s life to become more integrative and enjoy new prosperity," says Dr. Saad Saleh Al-Rwaita.
  • Cybersecurity has a crucial role to play in accomplishing Vision 2030 objectives, explained Dr. Areej Alhogail.

RIYADH: Saudi Vision 2030 kicked off with the aim of boosting non-oil revenues through capitalizing on current assets, utilizing resources, and starting up new industries.

In order to reach the objectives outlined in the plan, government bodies have launched many initiatives, which have proceeded with the support of the private sector as firms have cooperated through developing their strategic plans, and overcome many challenges. 

The 88th Saudi National Day provides an opportunity not only to celebrate unification, but also to look back on the achievements of Vision 2030 and take stock of how it is paving the way to economic reforms while carving out enhanced influence for its citizens on the world stage.

Here both public and private sector leaders who contribute to the economic transition plan share their thoughts on Vision 2030. 

Homam Hashem, Chief Executive Officer at Kafalah Fund, a financing guarantee program for small- and medium-sized enterprises, commented: ”One of the main objectives of Vision 2030 is to increase the contribution of the SME private sector to 35% of GDP. Small and medium enterprises have a significant impact on raising growth rates by raising financing opportunities and providing ways of success for the advancement of the sector. The program has contributed by raising the ceiling of guarantees for regular guarantees and developing specialized programs for the sectors (tourism, working capital support, and emerging enterprises). It has also attracted new sectors such as businesswomen and promising regions by providing additional incentives and developing many incentives that contribute to support raising local lending rates for small and medium enterprises up to 20% by 2030. The focus was on supporting the sectors that are compatible with the Kingdom's vision 2030 and diversifying the means of support.” 

Dr. Fahad Al-Shathri, Deputy Governor of Supervision at the Saudi Arabian Monetary Authority (SAMA), said: “In view of the demographic challenges, Saudi Arabia cannot solely rely on the same economic model as during the past five decades, namely oil. Twelve years from now, I would expect the economy to be more dynamic and to have multiple sectors driving growth and job creation, including tourism and logistics. Entrepreneurship will be the central focus for young people in future, inspired by the great accomplishments of their peers. These will be the new drivers of the economy that Vision 2030 is aiming at, and we hope that everyone will strive to contribute to its success.”

As education will play a crucial role in the development of human capital in the Kingdom, we asked Alfaisal University president Dr. Mohammed Al-Hayaza for his take. The former Shoura Council member said: “The Ministry of Education has taken unprecedented measures to ensure that our institutes of higher education are both the best in the region and top-ranked internationally. Vision 2030 has developed job specifications for each field of education, and by utilizing these specifications Alfaisal University is closing the gap between the learning outcomes of higher education and that of the demands of the job market through continued targeted alignment.”

Dr. Saad Saleh Al-Rwaita, Vice-Rector for administrative and financial affairs at Prince Sultan University in Riyadh, commented: “The comprehensiveness of Vision 2030 and the wider horizons it addresses positively transform the Saudi citizen’s life to become more integrative and enjoy new prosperity. 

The Vision will safeguard the Kingdom against dependence on circumstantial changes of the natural resources market and being influenced by external factors that are beyond our control, while empowering the Kingdom to create change and exert influence that surpass the local reality to direct the international compass and take the initiative, particularly in the economic field, in order to guarantee a bright future for the future generations.”

Looking to the real estate sector, Ehab Al Dabbagh, CEO of real estate development firm Ijmal, said the industry was likely to see big changes in future: “Firstly, the demand for housing products would be met. Technology and industrial progression will play a major role in building a variety of eco-friendly housing products. Houses could be ordered through an online application and fabricated in weeks.”

Another vital contributor in Vision 2030 is the food industry. Engineer Abdul-Mohsen Al-Yahya, who founded the chain of fast food restaurants Kudo, and currently an investor in supply and support at the food sector, said: “From my own experience in food services for more than 30 years in Saudi Arabia, I believe that in future the food service sector will continue to grow with more investments, products diversity and quality will increase, while continuing to become an extension of economic growth in Saudi Arabia and a key industry generating employment opportunities.”

Cybersecurity has a crucial role to play in accomplishing Vision 2030 objectives, explained Dr. Areej Alhogail, assistant professor in the Department of Information Systems at Imam Muhammad bin Saud Islamic University in Riyadh, who sits on the Saudi group of information security, said: “The Kingdom has taken pioneering steps, such as establishing the National Cybersecurity Authority, the Saudi Federation for Cybersecurity, and allocating scholarships in the field of information security. (These initiatives) will enable the Kingdom to be at the forefront of countries in the field of cybersecurity by 2030, and will protect the local economy, perhaps attracting foreign investments in various fields of information to be the ideal environment of trained local professionals and advanced laboratories and legislation protection.”