Behind the scenes of Qatar’s response to the pandemic

The first case of community transmission of COVID-19 in Qatar was identified on March 6, 2020. But even before the discovery of this case, a science-based approach was already in action, where scientific analyses were being conducted to prepare the country for what was coming.

At one point, Qatar had one of the world’s highest per-capita COVID-19 infection rates; however, its death rates have also been one of the lowest. And according to a Qatar Foundation (QF) healthcare expert, the key to Qatar’s resilience in the face of an extraordinary year was its ability to think and look ahead.

“One of the first analyses was focused on forecasting healthcare needs in the country, and looking for a potential impact of social and physical expensing restrictions,” explains Dr. Laith Abu-Raddad, Professor of Population Health Sciences at Qatar Foundation partner university Weill Cornell Medicine – Qatar, and Director of the World Health Organization Collaborating Center for Disease Epidemiology Analytics.

“By forecasting health care, I mean acute care, Intensive Care Unit (ICU) beds, hospital admissions. The forecasts were quite close to what evolved eventually. So the country was able to prepare well for what was coming, and at no time was the health system overwhelmed or even near its threshold.”

Qatar based its estimates on science-based epidemiological approaches and mathematical models in order to respond to the pandemic – including forecasting the impact of social and physical distancing restrictions.

From the very beginning of the pandemic, Qatar had chosen a path of epidemic suppression, to flatten the curve as much as possible, according to Dr. Abu-Raddad. Ultimately, Qatar was able to reduce the epidemic peaks for both, acute admissions and ICU hospital admissions, by more than 75 percent.

“The mathematical model is still being used to monitor, track and forecast the progression of the epidemic,” he said. “One of the most important uses of modeling these days is to monitor the effective reproduction number of the virus or what we call Rt – which is a key measure of how fast the virus is growing.

“This will tell us whether there is a second wave coming, and so far, we do not see any imminent signs of a second wave for Qatar, because Rt continues to be, on average, below one. One of the most consequential applications of mathematical modeling has been the timing and manner of easing of restrictions.”

From the early stages of the pandemic, options were being weighed as to how the government was going to ease restrictions. With use of the modeling, it was very evident that if restrictions were eased too prematurely, the pandemic would be amplified, or a second wave would come in very quickly. Both of these, of course, were not acceptable to policymakers.

“The country’s leadership wanted to ease restrictions in such a way that we can achieve two things,” Dr. Abu-Raddad said. “The first one was to avoid a second wave as much as possible, because of the health consequences and the damage to the country's economic and social activity. And the second was to try to avoid an intermittent application of restrictions, because these will also harm stability.”

With these two conditions in mind, mathematical modeling was used to predict the easing of restrictions so that these goals could be achieved. And, according to Dr. Abu-Raddad: “It was predicted that the earliest day we could ease restrictions was on June 15 – which was exactly what happened.

This would allow us to have stability and functionality. And also, we would not need an intermittent application of restrictions. I considered this quite a triumph, because the decision to ease restrictions and the exact day was done based purely on science.”

This strategy proved to be successful. Restrictions were gradually eased for nearly six months. “What we see is an epidemic decline. Currently, it's slowly declining, but it’s still an epidemic,” said Dr. Abu-Raddad, who also says this kind of scientific approach supports the functionality and stability of a country’s economy and society.

Today, many of the restrictions have been lifted, and residents in Qatar are living with some form of normalcy. In the coming days, Qatar is expected to receive the first batch of the COVID-19 vaccine – the country was one of the first to sign agreements with Pfizer and Moderna.

Besides the mathematical modeling methodologies that were part of the national response, Qatar also invested in major epidemiologic studies to understand the infection’s epidemiology and to further support the country’s response.

A centralized database system for everything COVID-19-related was used by researchers. They were able to assess the whole population in terms of infection and reinfection. “We looked at the risk of reinfection in the full cohort of those who have a PCR confirmed infection, and through this study, were able to confirm several reinfections,” said Dr. Abu-Raddad.

“In fact, in the first study, four reinfections were confirmed using viral genome sequencing. The key value of the study was, however, in assessing the risk of reinfection, which turned out to be very low –out of every 10,000 PCR confirmed infections, there were only two reinfections.”

Dr. Abu-Raddad was speaking at the Precision Medicine and Functional Genomics 2020 virtual summit organized by Sidra Medicine – a Qatar Foundation member – where he stressed the value that scientific methods brought to the country’s resilience in dealing with the pandemic. He said: “Thanks to this approach, which was science based, that we were able to prepare well for what was actually coming, and consequently this facilitated stability for the economy and society as well.”

By taking the scientific route in responding to the pandemic, Qatar has once again displayed its commitment to invest in research, development and innovation (RDI) – not just for now, but for many years to come, helping to make the Arab world a global leader of RDI once again.

RDI will be the primary driver of Qatar’s development for the next decade and beyond. And Qatar Foundation’s RDI environment is set to be at the heart of making this happen.