The Coronavirus Outbreak in China and Its Implications for the Healthcare Insurance in Oman

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The Coronavirus Outbreak in China and Its Implications for the Healthcare Insurance in Oman Published on February 12, 2020

Status is online Ali Mansouri Writer, Researcher, Consultant

“The coronavirus disease has been spreading like a Demon" Xi Jinping, Chinese President Page 1 of 8


The Coronavirus Outbreak in China has been causing a great deal of panic, fear, and anxiety not only in China but all over the world. It has led to hundreds, if not thousands, of deaths and has put millions of people in lockdown. Many airlines have suspended their flights to China and many countries have advised their citizens to avoid visiting China. The disease has been spreading very rapidly in and outside China. As the Chinese President Xi Jinping has put it, “The disease has been spreading like a Demon”—a demon is a type of jinni! This is why they now call this new coronavirus in China as the “devil’s bug”. The coronavirus outbreak started in Wuhan, the city of 11 million and the capital of Hubei province, one of the important provinces in China. The flu-like virus is believed to have jumped to humans at a live wild animal market in Wuhan. There is now neither vaccine nor treatment for the new coronavirus disease which has been spreading in other Chinese provinces and in many countries at an alarming and frightening rate. Almost 60 million people in China are in lockdown; the streets are virtually empty in many provinces. This is a public health catastrophe which is having a devastating impact on China and on the world. “Scientists are scrambling to find out exactly where it came from. Now, a new study provides more clues to the virus' origins, and points to bats as the most likely hosts. In the study, published today (Jan. 29) in the journal The Lancet, the researchers analyzed 10 genome sequences of the novel coronavirus, dubbed 2019-nCoV, obtained from nine patients in China who were sick with the virus. They found that all 10 of the genome sequences were extremely similar — they shared more than 99.98% of the same genetic sequence, the authors said. This suggests the virus made its "jump" to humans very recently, because if that jump had happened long ago, the virus sequences would have differed more, given the fast rate at which viruses tend to mutate and evolve. Based on these results, the authors said the 2019nCoV likely originated in bats. However, no bats were sold at the Huanan seafood market, which suggests that another yet-to-be-identified animal acted as a stepping stone of sorts to transmit the virus to humans. "It seems likely that another animal host is acting as an intermediate host between bats and humans," said study co-lead author Guizhen Wu, of the Chinese Center for Disease Control and Prevention. (Rachael Rettner, Live Science, 29 Jan 2019) The World Health Organization (WHO) has declared the coronavirus outbreak a global health emergency. The World Health Organisation (WHO) warned the 'whole world needs to be on alert' over the new coronavirus outbreak as it declared it an international public health emergency. Speaking at a press conference in Geneva, Switzerland, Director-General of the WHO, Tedros Adhanom, said: "Over the past few weeks, we have witnessed the emergence of a previously unknown pathogen, which has escalated into an unprecedented outbreak, and which has been met by an unprecedented response. "As I have said repeatedly since my return from Beijing, the Chinese government is to be congratulated for the extraordinary measures it has taken to contain the outbreak, despite the severe social and economic impact those measures are having on the Chinese people. Page 2 of 8


"We would have seen many more cases outside China by now - and probably deaths - if it were not for the government's efforts, and the progress they have made to protect their own people and the people of the world." General Dr. Tedros Adhanom Ghebreyesus of the WHO said: "The main reason for this declaration is not because of what is happening in China, but because of what is happening in other countries. "Our greatest concern is the potential for the virus to spread to countries with weaker health systems, and which are ill-prepared to deal with it." The number of cases in an outbreak of a new strain of coronavirus in China is likely to have been grossly underestimated, according to a new study, which warns that human-to-human transmission of the mysterious virus may be possible. Authorities in China city have confirmed thousands of cases of the 2019 new coronavirus, which is in the same family as the deadly severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). They have also admitted some “shortcomings and deficiencies” in the fight against the new rapidly spreading disease. While world markets have reacted nervously to news of the Wuhan coronavirus outbreak and many are predicting consequences for Chinese global trade and investment, the Chinese economy is the most directly affected. Some industries are already showing signs of a major slow-down. The Chinese New year period represents a peak in domestic travel as tradition demands that families gather across generations. For the 2020 celebration, 3 billion trips were expected, yet the government has now restricted movement and many scared citizens have abandoned their travel plans. The film industry, estimated to be the second-largest movie market in the world, is also being hit hard by the timing of the outbreak as it has coincided with the long Chinese New Year holiday — lasting anywhere from 10 days to two weeks — as people have time to visit the movie theaters. The domestic economy will most likely be affected. It is too early to have figures now, but suffice to say that the Chinese New Year is a massive shopping season, with special offers, outside eating, and the offering of gifts. While a lot of shopping takes place online, deliveries have been halted or slowed-down given the risks of the coronavirus. “Wuhan serves as a critical industrial, research and education base, and integrated transport hub for the nation. Wuhan’s GDP growth was 7.8 percent in 2019, 1.7 percentage points higher than the national average, local government data showed”. Indeed, Wuhan hosts many top Chinese 500 company offices and plants. “The economic impact of the virus is still impossible to determine, but one state media outlet and some economists have said that China's growth rate could drop two percentage points this quarter because of the outbreak, which has brought large parts of the country to a standstill. A decline on that scale could mean $62 billion in lost growth.

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China can ill afford that kind of hit. A disease of this magnitude wasn't even on China's radar. Before the outbreak, the government was more worried that social unrest could be its "black swan" problem — an improbable but chaotic event official feared could be spurred by rising unemployment. Now Beijing is scrambling to stop the virus from cratering its economy. So far, policymakers have taken some steps to help the businesses that are most affected by the rapid spread of the disease. Central and local governments have allocated $12.6 billion so far to spend on medical treatment and equipment. Major banks have cut interest rates for small businesses and individuals in the worst-hit areas. And the Bank of China said it would allow people in Wuhan and the rest of Hubei province to delay their loan payments for several months if they lose their source of income because of the disruption.” (Laura He, CNN Business, January 31, 2020). It has also been said that China will pump more than $170 billion to the financial markets to boosts its economy. China has a very good healthcare infrastructure and is well-prepared to fight this coronavirus and similar ones. China has opened its first coronavirus hospital after around 500 workers and volunteers spent just 48 hours converting an empty building into a modern hospital. The medical building had been set to open in May, but following the deadly outbreak, it was all hands on deck to get it completed. Two more hospitals are expected to open in Wuhan ground zero as a response for the outbreak - within days. China is to evacuate citizens abroad over racial abuse linked to the coronavirus outbreak as many people in other countries are overreacting to the outbreak and blame the innocent, ordinary Chinese people for it! The coronavirus outbreak offers bitter lessons and stark warnings to all the countries of the world. An effective healthcare system for all citizens and residents has become an essential element for a decent, human life if they are really serious about the well-being of their people and if they want to behave as a conscientious nation in the modern world. After working and living in Oman for almost 15 years, I realized that the Oman healthcare system is defective as expatriate workers are not offered effective healthcare insurance in the private sector. So I wrote an article and offered some suggestions to improve the present situation. There is no attack on the system but there are suggestions as any reader can see from the article itself. The article was titled, “Oman Health at Risk: Oman Labour Law and Medical Insurance Companies’, and was published on October 12, 2015 on LinkedIn and other international websites. For convenience and because of its importance, I would like to quote the article below: “Productivity and health are closely connected. This is one of the axioms in economics and in life. People cannot work if they are sick; productivity is greatly reduced if they do not feel healthy. The Healthcare System in Oman differentiates between Omanis and expatriates and Page 4 of 8


between those who work for the government institutions and those who work in the private sector. Omani nationals, as is the case in many countries in the world, receive their health care in government hospitals and other medical facilities that are, in general, very well equipped and well-staffed. Expatriate workers who work for the government also receive their health care in government medical facilities but need to pay in some cases. However, they are a lot better off than those who work in the private sector. Expatriates and their families working in this sector are supposed to receive the same, or almost the same, level of health care and we find the Oman Labour Law instrumental in ensuring that expatriates should get good health care. Article (33) deals with this point: Article (33): “The employer shall provide medical facilities for his workers in the establishment, and if the number of his workers in one place or one town exceeds one hundred the employer shall employ a qualified nurse to carry out the first aid. The employer shall also designate a doctor to visit the workers and treat them in a place that is equipped for this purpose and shall give the workers the necessary medicines for their treatment which shall be free of charge. If the number of workers exceeds five hundred, the employer shall provide his workers in addition to the aforementioned with all other facilities of treatment which requires the assistance of specialist doctors or surgery operations or the like, as well as the necessary medicines, all of which shall be free of charge with the exception of the costs of dental, ophthalmic and maternity treatment. If the worker is treated in a government or private hospital, the employer shall incur the cost of treatment, medicine and in-patient care at the hospital in accordance with the regulations and financial rules applicable in such hospitals without prejudice to the provisions of the Social Insurance Law.” Frankly, I love to read this article of the Oman Labour Law not only because it is directly relevant to my health and the health of my teachers and students, and we are the largest and most important organization in the University, but because I find in it "a touch of humanity" which we greatly miss in reality. Some people are, regrettably, too greedy to apply such an article effectively; they cheat! Yes, they cheat on an unbelievable scale!! Let us go back to this article and see what it offers. It says very lucidly that the “employer should provide medical facilities for his workers in the establishment". So in a college or a university, expatriate teachers are supposed to get medical care inside the college or the university as the Law says but they do not! They are supposed to get "medicines" for their illnesses and diseases in the area where they work but they do not! Medicines are not available in small towns and nobody would care to bring them to a university in the middle of nowhere. They are supposed to be covered with medical care for all illnesses or diseases but they are not! So what is happening here? Cheating and fraud! How do they do that?! The private colleges and universities in Oman enter into "special contracts" with medical insurance companies to provide health care for their expatriate teachers and employees. The cheaper these contracts, the better for the VC! The medical insurance companies then put their own policies that do not only lack the human touch of the Law but they are above the Law! I just don’t know how these policies have been approved by the Oman Ministry of Health and the relevant authorities. They exclude from the medical coverage a large number of illnesses and diseases, and even the consultation and the medical tests for these diseases. The companies formulate these policies in very lengthy explanations and forms and in a very complicated and circular language. The more you read these policies, the less you understand them! You get confused and you give up. But the Law is very clear and does not say these 'awkward' things, so from Page 5 of 8


where do they get them? I really don't know, but I have never seen such a level of deception with so important an issue like human health. These companies also add their own terms and conditions on reimbursement if the expatriate worker or teacher is treated in a government or a private hospital. They find hundreds of ways to avoid reimbursement. "You have submitted your claim late and you will not be paid."!! But, according to the Law, there is no "time limitation" on the claim, as these companies dictate to us. Let us look again at what the Law says, “If the worker is treated in a government or private hospital, the employer shall incur the cost of treatment, medicine and in-patient care at the hospital in accordance with the regulations and financial rules applicable in such hospitals...” You try to explain your position to the HR officer who is in charge of the medical cards, she answers you, "This is the policy of the insurance company, go and argue with them."! Is this the job of the teacher?! He had signed a work contract with the university not with the insurance company and, as per the Law, the university is responsible for the health care of its teachers and employees. The teacher does not need to argue with a company he does not know. When your medical card expires, nobody cares to replace it. You go to the HR Department, they would promise to give it to you “tomorrow” but “tomorrow” means for them a month or two as it happened last year and it happens every year. The last thing the HR would care about is our health!! It means nothing to them! The situation is miserable and dangerous; it has very grave consequences for the health of everyone living in Oman. First, illnesses and diseases do not differentiate between Omanis and non-Omanis, between those who work for the government and those who work for the private sector. We are on the same ship and if it sinks, God forbid, we will all sink with it. Second, most of the expatriate workers and teachers cannot afford the cost of the medical treatment of many diseases that are not covered by the medical insurance policies. Take hepatitis, for example, which is not covered. Type C of this disease infects and gradually destroys the liver; it is very serious and highly contagious. But its treatment in Oman is really costly. If we take the ordinary common treatment with injections (the standard therapy is a combination of interferon and ribavirin), we find that each injection costs, as far as I know, about RO 290 (almost 300) (last year's figures). The patient needs one injection every week for a year or more. This means he needs to spend RO 1200 per month for the injections only. What about the doctor's fees and the cost of the consultation, lab tests, etc.? Well, this is the expatriate worker's problem! He has got to find a solution. But he lives in a society and can infect other people in different ways and here is the danger. We do need to think about that. At best, some expatriate teachers “postpone” their treatment until they go to their countries on their annual leave because they cannot afford the treatment here. At worst, they do not do anything. They have to wait for their fate! Is this an exaggeration? Of course, not. The examples I have talked about are from real life and real experience. If you investigate, you may find out more, bearing in mind that the families and children of the Foundation Program teachers in one of the universities, and I really don’t know how they call it a university, are not covered by any medical insurance at all. They don't mean anything to this university. I think this is the only university in the world, which does not care about the families and children of its teachers and employees. There are certainly many loopholes and shortcomings in the healthcare system in Oman as related to the expatriate workers and need to be quickly addressed. We do miss the touch of the humanity of the Law. Oman is in need of the expatriate workers and the expatriate workers are in need of good healthcare to be healthy and productive. So we cannot leave the health of the nation to greedy VCs and greedy medical insurance companies that think of accumulating huge profits at the expense of our health. We hope for the best but we should be Page 6 of 8


prepared for the worst. We urgently need those in charge of the health system in Oman to listen and take action at this critical time when all sorts of infectious diseases are around in the region and in the world. We are talking here about the health of Oman; not about coffee shops!!” Abood Al-Sawafi and Hamed Al-Hajri did not like this article. They regarded it as an attack on the Oman Health system! Again, they have revealed themselves as stupid and ignorant people. They do not understand anything in English nor do they care about the health of their employees and their own people. As the reader can clearly see, this article praises the Government Healthcare system; it says “Omani nationals, as is the case in many countries in the world, receive their health care in government hospitals and other medical facilities that are, in general, very well equipped and well-staffed.” Any expatriate working in Oman would tell you about the different health care the Omani nationals get from that offered to the expatriate workers in the private sector. This is one of the bitter realities facing expatriates in Oman and it is a very serious problem which needs to be addressed by the health authorities in Oman in order to keep the country healthy. I have said this very clearly: “illnesses and diseases do not differentiate between Omanis and non-Omanis, between those who work for the government and those who work for the private sector. We are on the same ship and if it sinks, God forbid, we will all sink with it.” The article is a very serious attempt to tackle a serious issue anywhere in the world, that is, the health care system and how it can be made more effective for everybody for the safety and well-being of the whole country. The writer should have been rewarded, as many lawyers in the court told me, not put on trial. The other important point is the fact that the article does not mention Abood Al-Sawafi or Hamed Al-Hajri or A’Sharqiyah University by name so what has the article got to do with them? Are they the representatives of the Ministry of Health in Oman? The Ministry of Health knows about the article and has read it and I have sent them a copy. They are educated people and they understand English and, later on, they sent me more than one survey about the healthcare provided by the private sector in Oman. So where is the problem in order for Abood Al-Sawafi and Hamed Al-Hajri to take the article to court and claim “it is s cybercrime”?! Is this a sign of intelligence and education or a sign of utter stupidity, ignorance, wickedness, and lack of leadership? After working and living in Oman for almost 15 years, you cannot really regard yourself as “a stranger” or a “a foreigner”. It is very normal to regard yourself as one of the people of the country and you take care to help the country avoid any serious problem, especially when it comes to the health and well-being of the people. This is how we should look at any article or suggestion offered by any expatriate worker or a university professor to improve the health situation in the country. It is utter nonsense to regard such an article as a “cybercrime” and take the University Professor to court. The article has nothing to do with any cybercrime. There is not a single definition of a cybercrime that applies to it! A cybercrime is usually defined as “a crime in which a computer is the object of the crime (hacking, phishing, spamming) or is used as a tool to commit an offense (child pornography, hate crimes).” (Wikipedia). Techopedia explains that a “Cybercrime encompasses a wide range of activities, but these can generally be broken into two categories: 

Crimes that target computer networks or devices. These types of crimes include viruses and denial-of-service (DoS) attacks. Page 7 of 8


Crimes that use computer networks to advance other criminal activities. These types of crimes include cyberstalking, phishing and fraud or identity theft.”

So the definition and the explanation of a cybercrime does not apply to the article in question. No one in their senses would tell you or believe that a cybercrime includes writing a general article on LinkedIn or other websites on general or specific topics. But this is what Abood AlSawafi, the former VC of A’Sharqiyah University and Hamad Al-Hajri, his Assistant VC, have wickedly twisted the meaning of the term. Saif Al-Saltti, the Deputy Public Prosecutor in Ibra, Oman, told me that the article is being treated as a cybercrime as per Article 16 of the Oman Penal Code. I went to the Oman Penal Code (available online) and found out this law is intended to protect privacy. It has nothing to do with cybercrimes in the normal sense. It is similar to what we usually call “Libel” laws. It never mentions writing articles on the Internet. The article, as we have explained, does not qualify for the legal definition of a cybercrime or a libel case in any way whatsoever, as it is void of any explicit mention of names of individuals, families or entities, which is an essential legal requirement for an article to be included in a “cybercrime” or a “libel” case, even by Oman Penal Code. Let us go back now to the main theme of this article: The Coronavirus Outbreak and Healthcare Insurance in Oman. As we have already mentioned in the article, the healthcare insurance offered for expatriate workers in Oman is seriously defective and does not meet the challenges of modern life. This insurance is far less satisfactory when compared with the healthcare services offered to the Omani nationals in scope and in quality. It is also less satisfactory compared with the health insurance being offered to expatriate workers in other GCC countries. There are, therefore, very high risks for public health in the A’Sharqiyah region, for Oman, and for the world. Unfortunately, there are many points of similarity between the city of Wuhan in China and the town of Ibra where A’Sharqiyah University is located. It is widely reported that the coronavirus in China has started in a dirty market for domestic and wild animals including dogs, snakes, bats, and monkeys. We find the same sort of wild-animal market in Ibra where all sorts of wild animals are sold and illegally slaughtered for their meat, especially dogs and donkeys. Just go to Ibra and ask expatriate construction workers about this unhealthy practice. Then comes the fact that Ibra itself is a very dirty town full of flies, insects, scorpions, snakes, bats, and wild dogs. This makes it an ideal place for strange illnesses and diseases like the Congo Fever and MERS (Middle East Respiratory Syndrome) which broke out in the Middle East in 2012 and in 2016. In fact, Abood Al-Sawafi’s son, who was aged 6 or 7, died of MERS in 2016! This is also a strain of the coronavirus and is transmitted from camels to humans bearing in mind that Hamed AlHajri has spent most of his life as a camels’ breeder and he regards camels as sacred animals. There are many people in the A’Sharqiyah region like Hamed Al-Hajri and Abood Al-Sawafi who wash their faces with the camels’ urine and drink it for divine blessings. What a disaster! The Ministry of Health in Oman is well-advised to investigate the situation at A’Sharqiyah University and A’Sharqiyah region before it is too late.

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