The COVID-19 novel coronavirus appears to be spreading rapidly in the Middle East. Saudi Arabia, Jordan, Tunisia, and Morocco reported on Monday that the virus had arrived in their countries, while Egypt, Iraq, Kuwait, Lebanon, and Qatar confirmed additional cases. Iran, which has emerged as a focal point in the global spread of the virus, raised its number of confirmed cases to 1,501 and the (disputed) death toll to 66. The United Arab Emirates began evacuating its citizens from Iran on Monday and will quarantine all returnees.
Owing to its geographical location and centrality to Eurasian trade networks, the Middle East has historically been a conduit for the spread of pandemics. While Iran has registered the greatest number of cases in the region by far, the first country in the Middle East to register cases of the coronavirus was the UAE, on January 29, in four members of a Chinese family who had arrived from Wuhan, where the epidemic originated. It comes as no surprise that a global pandemic would arrive in the UAE early, given that Dubai and Abu Dhabi are both global financial centers and major hubs for international travel.
The Middle East is also uniquely at risk of a disease like COVID-19 spreading rapidly because of routine mass migrations of people from one country to another, whether for religious, economic, or safety reasons. Iraq closed its border with Iran in late February, as did Turkey, Afghanistan, Armenia, and Pakistan, while Syria closed at least one border crossing with Iraq last week. Still, the virus has already had plenty of time to spread via these routes. The aforementioned borders, traversing miles of uninhabited desert, are also difficult to seal completely. It is likely too late for border closures and evacuations to halt or even slow the spread of COVID-19 in the Middle East.
Muslims travel by the millions each year to the holy cities of Mecca and Medina for the hajj and umrah pilgrimages, while Shia Muslims in particular make pilgrimages to holy shrines in Iraq and Iran. Saudi Arabia has suspended visas for foreigners planning to visit the country to make umrah, the lesser pilgrimage — a major blow to the large number of travel agencies in Muslim countries that specialize in arranging pilgrimages. The impact on the hajj, which takes place in late July this year, is not yet certain. Qom, a major pilgrim destination, is one of the epicenters of the outbreak in Iran, so thousands of pilgrims from other countries with Shia Muslim populations may have been exposed to the virus there before the outbreak was detected and announced.
The Middle East is also home to millions of expatriate workers who travel frequently between their home countries and the countries where they work. These extensive economic links create additional opportunities for a pandemic to spread, but also exacerbate the economic impact of border closures and travel restrictions.
A pandemic is unwelcome news anywhere in the world, but it is particularly alarming in a region already affected by multiple civil wars and refugee crises, where many countries lack robust health care systems, and where public health reporting is often unreliable. No cases have been confirmed thus far in Syria or Yemen, the least stable and most dangerous countries in the region. As these war-torn countries are hardly popular travel destinations, COVID-19 may be late in arriving there, but the World Health Organization is rightly concerned that when it does, the impact will be particularly severe on large, vulnerable populations of displaced people.
In northwestern Syria, fighting between government and rebel forces has driven as many as 948,000 people from their homes since early December. Many of these internally displaced people are living in acutely precarious circumstances, with inadequate shelter (if any), limited supplies of food and medicine, and increasingly sparse health facilities. While the coronavirus is only severe in a relatively small percentage of cases, the already poor health of this population and their lack of access to health care puts them at greater risk of becoming seriously ill or dying from the virus.
These failed states also have a high risk of massive outbreaks. Disease can spread rapidly in the confines of a displaced people’s camp, while refugees on the move are difficult to keep track of, making the spread impossible to contain or monitor. In total, there are over 6 million internally displaced people in Syria and 4 million in Yemen, plus millions more refugees from these war zones in other countries throughout the region. The governments of these countries are not well equipped to handle a crisis like this. International health and refugee organizations are well aware of the risk and will do everything they can to prevent disaster, but it may not be enough.
The public health risk of COVID-19 in the Middle East is worrying enough, but the attendant geopolitical and security risks are also cause for concern. Iran’s government has faced significant internal and external criticism for failing to detect or report its coronavirus outbreak in a timely manner. That the government reported deaths on the same day as its first infections suggests that they either knew about the outbreak earlier and chose to cover it up — or were too busy preparing for national elections to notice the arrival of the virus.
If a deadly outbreak across the Middle East is blamed on duplicity or incompetence in Tehran, Iran’s already shaky international reputation will suffer additional damage. It’s also not unthinkable that the virus could destabilize the Iranian government entirely. One of the Iranians who died of coronavirus on Monday, Mohammad Mirmohammadi, was an advisor to Supreme Leader Ayatollah Ali Khamenei. Mirmohammadi is one of several Iranian officials to have contracted the virus, including Vice-President Masoumeh Ebtekar and Deputy Health Minister Iraj Harirchi, and the third to die. It’s plausible Khamenei himself may have been exposed. Even those who would cheer the collapse of the Islamic Republic must acknowledge that now would be a very bad time for a crisis of that magnitude.
The other potential fallout from a Middle Eastern coronavirus outbreak will land in Europe. The recent intensification of the Syrian conflict has sent more Syrian refugees pouring over the border to Turkey. The intended destination for many of these Syrians (along with economic migrants from Afghanistan, Iran, Pakistan, and other Muslim countries) is the European Union, which they hope to enter via Greece. On February 28, the Turkish government announced that it would stop trying to control its land and sea borders with Europe, setting these migrants loose in an attempt to pressure Europe to support Ankara’s military intervention in the Syrian war. Greece’s conservative government, of course, is having none of this, and has redoubled its own border patrol efforts to keep the migrants out, declaring that it will turn away anyone who attempts to enter the country illegally.
The collapse of Turkey’s arrangement with Europe to police its borders and keep migrants out is just one of several reasons why unorganized migration from the Middle East into Europe is on the rise again. The potential presence of the coronavirus among this migrant population will only exacerbate the political impact of this latest increase. Over the past five years, the migrant crisis has been perhaps the most significant contributing factor in the rise of the new right-wing nationalist movement throughout Europe. Depicting immigrants as disease vectors is the oldest xenophobic trope in the book, but if it turns out that migrants are in fact bringing COVID-19 with them into Europe, that will only strengthen the right’s argument for tighter borders both within the E.U. and on its periphery.