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How will the second wave of the dreadful COVID-19 be with the increasing number of the infected cases and mortality in Iraq?
¿Cómo será la segunda ola de la terrible COVID-19 con el número creciente de casos infectados y mortalidad en Irak?
A.A. Dawooda,
Corresponding author
aad@uomosul.edu.iq

Corresponding author.
, Z.A. Dawoodb
a Department of Anatomy, College of Medicine, University of Mosul, AlJameaa 34, St. 1, Build 1, R.3, Mosul, Iraq
b Department of Poultry, College of Veterinary Medicine, University of Mosul, Alsedeeq 5, St. 12, Build 1, Mosul, Iraq
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It has been assured that people with diabetes&#44; renal and heart failure&#44; chronic lung disease&#44; and immunocompromised persons are considered to be at a high risk of viral infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">From the beginning of the outbreak&#44; most of the world business dealings&#44; flights&#44; education&#44; social activities&#44; and entire works have been stopped&#46; In addition to that&#44; cities have become lockdown&#44; streets that were populated with people are empty and restricted to their home quarantine&#44; and self-isolation&#46; Protection against imported diseases takes place under the local and state jurisdiction&#46; The government municipalities enacted several sear regulations the arriving foreigners&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The safety of people is taken into consideration earnestly in the quarantine&#44; so without proper strategies being available and transaction with people can be a challenge during the prospect pandemic&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a> But&#44; with quarantine&#44; improving the abilities and fitted alertness of ultimate importance are required for the aim of public safety&#46; The elevation of the patient&#39;s number in most countries is due to the problem of executing quarantine has always proved extremely difficult&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">6&#44;7</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">The history of quarantine</span><p id="par0025" class="elsevierStylePara elsevierViewall">Quarantine means separation of people who are not yet symptomatic signs but may expose to a contagious person or believed to be at risk of developing an infection&#46; Quarantine is an old tactic that has been deliberated for the first time since the 14th century in Italy to protect seaboard cities from plague epidemics&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">8&#44;9</span></a> The origin of the word &#40;quarantine&#41; derived from the Italian words <span class="elsevierStyleItalic">Quaranta Giorni</span> which means forty days&#46; The actual concern of quarantine has become from the scare of transmission after a patient&#39;s recovery which may create earnest challenges for state and society&#46; Thus&#44; the WHO concentrated on quarantine as a gauge for public health in which the healthy individuals have to separate from others who have symptoms started and early detected cases&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">10</span></a> Measures have been put in place alongside the implementation of quarantine instructions by the second edition of the Public Health Guidelines for the community to face the pandemic&#46; Through the outbreaks period&#44; the elevation of the isolation rate contributes to the prevention of epidemics&#46; Experimental results in some cities showed that the suggested strategies had a great impact on the control of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">11</span></a> In addition to that&#44; the improvement of the isolation rate in the latent infection period is key to the surveillance dispersal of the disease&#46; Quarantines can be volitional or voluntary&#46; In common&#44; the long-time quarantine equals the length of the incubation period of a disease that a person may expose&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">The first wave of COVID-19 in Iraq</span><p id="par0030" class="elsevierStylePara elsevierViewall">Since the first emerging of COVID-19 was discovered on the 24th of February&#44; in Iraq by an Iranian student who was visiting the Najaf city&#46; The Ministry of Health announced the registration of new cases almost daily&#46; At the first wave of imported cases&#44; most cities and villages followed the health instruction&#46; All public or private congregations&#44; non-fundamental services&#44; gyms&#44; and recreation facilities have ceased&#46; Schools&#44; universities&#44; and cinemas were sealed&#46; Iraq still goes about their daily activities without the use of a mask&#44; unless they were unwell&#46; The government has dramatically reversed their commendations on the use of masks because they may confer additional protection&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Iraq is among the few countries with high rates of death related to the virus&#44; which reached 2&#46;6&#37;&#44; and it is twice the rate compared with other countries&#46; The impact of preventing roving at the beginning of the outbreak had a limit circulation of the virus but without the serious obligation to the healthy instructions for struggling the prevalence of the epidemic led to an increase in the number of cases&#46; The quarantine has been a main factor for curbing the virus in the early stages&#44; but on the contrary&#44; no leverage was observed recently&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Few points are highlighted here&#46; Among them&#44; the main snag for entering a quarantine was the loss of income of most jobs during the period of the outbreak&#46; Furthermore&#44; there was a reduction in collaboration between people&#44; most of them rejected entry to quarantine places&#44; and some of them returned illegally&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">13</span></a> As it is difficult to predict pandemics&#44; COVID-19 has brought economic&#44; financial&#44; health&#44; and social issues to people in Iraq&#46; Thus&#44; people have to accept and understand that public health is the priority above all&#46; Some people in quarantine felt like they were in prison while others felt this is a kind of retribution&#44; but as they are safely discharged&#44; their spirits are promoted&#44; being is much better and they wish to follow the quarantine practices and protocols&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Statistical analysis of infected and death cases</span><p id="par0045" class="elsevierStylePara elsevierViewall">At the first wave time&#44; the Ministry of Health was managing the altitude of the flatten curve of the novel coronavirus&#44; but later it has seen a rapid upward trending because citizens failed to comply with sear instructions and health safety&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; Between the 24th of February to 21st of September&#44; the number of cases was elevated in a linear curve to reach 322&#44;658 cases&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; After approximately seven months from the first infected case&#44; the number of mortality is recorded 8625 cases&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; Based on the statistical analysis&#44; the current data is spotted with significant value <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#46; The mean&#44; standard error&#44; and standard deviation were extracted from the SPSS software version 25&#44; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The growing of cases amongst citizens living in the dormitories could be due to the limited space&#44; their culture of communal and involvement in parties&#44; and banquets led to an increase in infection cases&#46; Given the above factors and conditions&#44; it is difficult to properly hand out the contribution of wearing masks versus social distancing&#44; tough tracing of human contact&#44; and other control measures&#46; On the other hand&#44; there has been a noticeable increase in the number of people recovering since the beginning of the epidemic&#44; as their number reached approximately 273&#44;266 cases on the 21st of September&#44; with a rate of 80&#37; of the total cases&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">The World Health Organization &#40;WHO&#41; has warned that Iraq will face a second wave of coronavirus next Autumn&#46; This caution is concerning to the lack of commitment of citizens to thorough bans&#44; proceed to the holding of special events&#44; lack of application rules of social divergence&#44; and increasing activity in the markets&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">14</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The cooperation between WHO and affected countries coordinates the global health response to COVID-19&#44; including the provision of updated information on the situation&#44; assessment of potential risks&#44; improving guidance&#44; training for health authorities&#44; technical health agencies on provisional surveillance recommendations&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a> laboratory testing of cases&#44; the prohibition of infections&#44; control&#44; and clinical management&#46; Observation should be continued to promote between contiguous countries according to WHO guidelines&#44; along with prohibition and facilitate cooperation in healthcare facilities&#46; Properly worn face masks probably help fence dispersal of the virus&#46; Other environmental and ambient factors including temperature&#44; wind velocity&#44; and wetness may also inspire how the respiratory droplets transmit&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">A previous study found that unless travel constraints are combined with control and prohibition of infection measures&#44; the initial prevalence of COVID-19 will not be delayed&#46; The researchers conducted that the travel restrictions are most beneficial in both the early and late stages of the outbreak&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">17</span></a> Governments&#44; healthy institutions&#44; and society have to make precise decisions to putout guidelines and coordinate to overcome challenges&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The easing of the house ban does not mean a return to banquets and gatherings&#44; as the virus is still at its peak&#44; and the infections have not been obstructed&#46; At the beginning of the spreading disease&#44; people were resented by home quarantine&#44; so the government decided to implement partial quarantine&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">20</span></a> In the following weeks&#44; the number of infections and mortality began to rise unprecedented&#46; Based on the available numbers and statistical analyzes on the virus&#44; the region&#44; including our country&#44; maybe on the verge of a real disaster&#46; It is well known that preventive measures lead to significant benefits during a pandemic crisis&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">21</span></a> The public needs to act responsibly&#44; physical distancing measures&#44; and pay heed to this advice&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">22&#44;23</span></a> The adage that &#8220;prevention is better than cure&#8221; is especially relevant today&#44; due to the given escalating medical and socioeconomic costs are associated with this pandemic&#46; It is important to note that the high number of recovering people compared to the number of cases is a good indicator despite all the negative obstacles mentioned previously&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Human resource management in a crisis is difficult and full of challenges&#44; particularly in pandemics such as COVID-19&#46; The thoroughness of SARS-CoV-2 is affected by a few factors including the health infrastructure&#44; health staff&#44; availability and accessibility of the facilities&#44; lifestyle of the people who were quarantined&#44; and also the social culture&#46; In the current study&#44; we need more social consciousness and one global state-society approach for tackling the contagious disease&#46; This approach sustains the preparedness to follow the procession of pandemics throughout the world&#46; To see the country free from COVID-19&#44; the responsibility has to focus on the meet of the public health requirements at a proper time&#46; This work encourages the study estimation managements and human psychology through times of a pandemic that provides a better realization and reduces the prevalence of infectious diseases&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Funding</span><p id="par0075" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors have declared no conflict of interest&#46;</p></span></span>"
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          "titulo" => "Keywords"
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          "titulo" => "Resumen"
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          "titulo" => "Palabras clave"
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        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
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        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "The history of quarantine"
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        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "The first wave of COVID-19 in Iraq"
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        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Statistical analysis of infected and death cases"
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        8 => array:2 [
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          "titulo" => "Discussion"
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        11 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conflict of interest"
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        12 => array:2 [
          "identificador" => "xack538556"
          "titulo" => "Acknowledgment"
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        13 => array:1 [
          "titulo" => "References"
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      ]
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-09-10"
    "fechaAceptado" => "2020-09-30"
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          "clase" => "keyword"
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          "palabras" => array:5 [
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            1 => "Coronavirus"
            2 => "Quarantine"
            3 => "Pandemic"
            4 => "Infection"
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          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1388520"
          "palabras" => array:5 [
            0 => "Terrible"
            1 => "Coronavirus"
            2 => "Cuarentena"
            3 => "Pandemia"
            4 => "Infecci&#243;n"
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    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Since the first period of the virus&#39;s emergence in Iraq&#44; the government and health-related authorities have rushed to impose home quarantine and suspend work in all facilities of the country besides prescribed the sear measures for doubtful cases&#46; From that time&#44; the detected cases elevated with the number of mortality&#46; Our study aims to take an overview of the disease during the past seven months&#44; and a general review of the effects of quarantine measures that have resulted in an altitude graphic curve for both injuries and deaths&#46; Data were analyzed using statistical software with significant values&#46; The number of cases and mortality was elevated in a linear curve&#46; The quarantine has been a factor for containing the virus in the early stages&#44; but on the contrary&#44; no impact was observed recently&#46; The World Health Organization has warned that Iraq will face a second wave of coronavirus next fall&#44; due to the lack of commitment of citizens to the comprehensive implementation of the ban and shortcomings rules of social spacing&#44; proceed to hold special events&#44; and increased activity in the markets&#46; To see the country free from COVID-19&#44; the responsible necessity to focus on the indigence to meet the public health requirements at a proper time&#46;</p></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Desde la primera aparici&#243;n del virus en Irak&#44; el gobierno y las autoridades sanitarias se apresuraron a imponer cuarentena domiciliaria y suspender el trabajo en todas las instancias del pa&#237;s&#44; adem&#225;s de prescribir medidas de b&#250;squeda para casos dudosos&#46; Desde ese momento&#44; los casos detectados se elevaron&#44; al igual que el n&#250;mero de muertes&#46; El objetivo de nuestro estudio es establecer una visi&#243;n de la enfermedad durante los &#250;ltimos siete meses&#44; as&#237; como una revisi&#243;n general de los efectos de las medidas sobre cuarentena&#44; que han derivado en una curva gr&#225;fica de incremento de lesiones y muertes&#46; Se analizaron los datos utilizando <span class="elsevierStyleItalic">software</span> estad&#237;stico con valores significativos&#46; El n&#250;mero de casos y muertes se elev&#243; en una curva lineal&#46; La cuarentena ha sido un factor de contenci&#243;n del virus en las primeras etapas&#44; pero&#44; por el contrario&#44; no se ha observado impacto alguno recientemente&#46; La Organizaci&#243;n Mundial de la Salud ha advertido que Irak se enfrentar&#225; a una segunda ola de coronavirus el pr&#243;ximo oto&#241;o&#44; debido a la falta de compromiso de los ciudadanos con la implementaci&#243;n amplia de la prohibici&#243;n y la carencia de normas sobre distanciamiento social&#44; celebraci&#243;n de eventos especiales e incremento de actividad en los mercados&#46; Para ver al pa&#237;s libre de COVID-19&#44; existe la necesidad responsable de centrarse en la indigencia para satisfacer los requisitos sobre salud p&#250;blica en el momento adecuado&#46;</p></span>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Total coronavirus cases by date&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Total coronavirus deaths by date&#46;</p>"
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos