Oman Confronts H1N1

C O N F I D E N T I A L MUSCAT 000933 SIPDIS E.O. 12958: DECL: 2019/09/30 TAGS: PGOV AMED AEMR TBIO KFLU MU SUBJECT: Oman Confronts H1N1 REF: 09 MUSCAT 855 CLASSIFIED BY: Richard J. Schmierer, AMB, Department of State, Embassy Muscat; REASON: 1.4(B),(D) ¶1. (SBU) SUMMARY. Although Oman's H1N1 infection rate continues to rise, the Sultanate is responding proactively, and the infection rate is tracking with global trends. Some measures, such as the significant delay of the school year (in effect closing the school for an additional month),closely follow WHO guidance on school closures and class suspensions. Other responses include public service announcements via text message, radio, and periodicals; heightened hygiene at barbershops and beauty parlors; and general recommendations to avoid unnecessary public contact. Beyond these measures, however, there are infrastructure concerns regarding Oman's inability to test individuals exhibiting symptoms. ¶2. (C) SUMMARY CONTINUED. The Sultanate has also grown exceptionally cautious. Signs of trepidation include the cancellation of the annual month-long Muscat Festival and an advisory from the palace to cabinet members that eliminated almost all high-level observations of the Eid Al Fitr. In the past, efforts to combat the spread of H1N1 were guided by the National Committee for Follow-Up and Management of H1N1; a new higher-level Supreme H1N1 Committee indicates that the heightened alert comes directly from the Sultan. END SUMMARY. ¶3. (C) INFECTIONS SPIKE, DEATHS ON THE RISE. The state Oman News Agency (ONA) reported on September 26 that the H1N1 death toll to date is 21. On September 29, the Undersecretary for HEALTH Affairs, Ahmad bin Muhammad Al Sa'idi, reported a total of 1,821 cases since June. Cases continue to be concentrated more heavily in the southern city of Salalah and surrounding areas. Oman appears to be accurately disclosing the numbers of those infected and dying of H1N1 and has allowed for relatively thorough media coverage. ¶4. (SBU) START OF THE 2009-2010 SCHOOL YEAR. On September 15, the Ministry of Education announced that schools will reopen in phases starting October 3. Schools were originally set to start on August ¶29. Private schools that demonstrate preparedness are at liberty to chose their own start dates. The American International School of Muscat (TAISM) and the American British Academy reopened on schedule and have remained open. As of September 27, no student has been diagnosed with H1N1 at TAISM. To curb the spread of H1N1 once schools reopen, the Ministry of Education and the Ministry of Health plan to circulate a guide to government and private schools that provides advice on how to contain the virus. ¶5. (C) MUSCAT FESTIVAL CANCELLED. The Muscat Municipality cancelled the Muscat Festival, a popular month-long annual event scheduled for late January. The ostensible purpose for the cancellation was to prevent the spread H1N1 amongst the several hundred thousand attendees, some of whom travel from abroad to attend the festival. While H1N1 concerns undoubtedly played a large role in the cancellation, Sultan bin Hamdoun Al-Harthy, chairman of Muscat Municipality and head of the Muscat Festival Organizing Committee, may have had additional reasons for calling off the event. Al-Harthy is relatively new to his position and the only Festival he organized before, the 2009 Festival, was widely considered to be poorly organized. ¶6. (SBU) WARNINGS ABOUND. Multiple government bodies have advised citizens to refrain from shaking hands, hugging, and kissing. The advisories also address the danger of physical contact in mosque settings. The Ministry of HEALTH text-messaged subscribers to state-controlled Omantel, advising subscribers to avoid hugging, kissing, and hand-shaking. Arabic and English radio stations in Oman are carrying public service announcements. Muscat Municipality is requiring all workers at barber shops and beauty salons to wear protective masks and gloves. In a public statement Oman's Grand Mufti stressed to Muslims that the "teachings of Islam urge people to take precautionary measures and avoid harming others." Finally, the Majlis Ash'shura, the elected body charged with recommending laws to the Sultan, warned citizens to avoid social gatherings, recommending that Omanis "achieve their social goals through modern means." The Majlis's warning was probably not followed during the Eid celebrations, which emphasize family and social gatherings. ¶7. (SBU) VACCINE DELIVERY. Oman, like most of the world, awaits distribution of the vaccine with bated breath. On September 6, state-owned English-language daily, "Oman Observer," reported that Novartis pledged delivery of 100,000 doses of its H1N1 vaccine to the Sultanate. The Ministry of HEALTH will dispense vaccines to both private and public clinics for administration to patients free of charge. Cooperation between the Ministry of HEALTH and private medical care providers is indicative of the Ministry's coordinated approach. Both Arabic and English media have been routinely covering expected release dates for the H1N1 vaccine. ¶8. (SBU) INFRASTRUCTURE CONCERNS. Oman is ill-equipped to test all individuals exhibiting symptoms. Oman has only ONE testing facility, the Public HEALTH Laboratory in Muscat. Prior to the rapid increase of H1N1 cases, Oman tested international travelers arriving at its airports. Although Oman stopped testing symptomatic individuals at airports several months ago, testing was widely available to those exhibiting mild symptoms until mid-August. As fear of infection grew with the increase in confirmed cases, Oman's lone testing facility was overwhelmed by demand. The Ministry of Health has now limited testing to severely ill patients who are already admitted to a hospital. The Ministry of HEALTH directed health care professionals to provide otherwise healthy patients exhibiting symptoms with Tamiflu and advise rest. (NOTE: Lack of infrastructure to confirm the presence of H1N1 has lead to the over-distribution of Tamiflu. Such over-distribution may lead to drug resistant viral strains. The inability to confirm cases in the general public also prevents the early diagnosis of the virus and subsequent home-quarantine of the patient. END NOTE). ¶9. (SBU) PRIVATE SECTOR TAKES ACTION. The English-language daily "Times of Oman" reported on September 16, that the executive panel of the Safety and Occupational HEALTH Committee met to establish an "Emergency Plan of Action" for the private sector. The panel plans on training employers and employees on how to curb the spread of H1N1 in the workplace. It does not appear that the panel addressed issues regarding possible absenteeism or curbs on expatriate travel, which could have dramatic negative impacts on productively in the private sector. ¶10. (C) THE SULTAN'S DISCREET GUIDANCE. Oman's response appears to be increasingly guided by Sultan Qaboos. The Majlis Ash'shura praised the Sultan's "constant keenness to ensure that all resources are made available for maintaining public HEALTH through concrete government action." On September 5, the Sultan formed the Supreme H1N1 Committee (The Supreme Committee),which contains the Minister of the Royal Office, the Minister of Interior, the Minister of the National Economy, the Deputy Chairman of the Financial Affairs and Energy Resources Council, the Minister of Health, the Minister of Awqaf and Religious Affairs, and the Minister of Information. The Supreme Committee has met two times to date. The Supreme Committee is in addition to the National Committee for Follow-Up and Management of H1N1, previously the government body charged with addressing H1N1. It is unclear how the two committees will work together. The Supreme Committee's formation clearly indicates the personal interest of the Sultan. According to well-placed sources within the court the Sultan is contemplating cancelling his annual "Meet the People" tour. The "Meet the People" tour is a form of traveling government wherein the Sultan selects an area of the country to visit allowing the people to petition His Majesty with personal grievances. The same sources stated that the Sultan advised cabinet members to avoid public greetings. Accordingly, most ministers celebrated Eid privately. ¶11. (C) COMMENT. The Sultanate promptly addressed H1N1 and has remained refreshingly transparent regarding its efforts. The accurate and thorough reporting on the issue is a marked change from the Oman's typical response of downplaying any "bad news" in the media. The Sultan is increasingly taking part in guiding government policy, as seen in his creation of the Supreme H1N1 Committee. Whether the Sultan's personal involvement at this point will aid the effort to stem the spread of H1N1, or cause confusion as to which committee is spearheading the government's response, remains to be seen. END COMMENT. Schmierer