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With the appearance of first cases of Coronavirus disease (COVID-19), strict control measures were implemented in the Kurdistan Region of Iraq to combat the infection. These measures included the closure of schools and universities, the closure of borders and airports, cancellation of public and religious gatherings, and mandatory quarantine for persons returning from traveling abroad. Such measures have played a major role in the control of COVID-19 spread. However, due to social and economic pressures, the government relaxed the lockdown. After relaxing the measures, a sharp increase in the number of patients was noticed. Besides, there was a significant increase in the number of symptomatic patients and the case fatality rate was doubled. In addition, the outbreak and outbreak response led to the loss of trust and a breakdown in relations between the society and local authority. To minimize the consequences for population health, local authority should have a plan that balances between health imperatives and socioeconomic imperatives. Finally, to be successful in controlling the infection, the government must rebuild public trust in the handling of COVID-19 outbreak and compensate people for lost earnings.

Social distancing is important to decrease the interactions between people in the society. As a set of measures, social distancing is taken to reduce infections transmitted by droplets. To achieve its aim, social distancing should include the cancellation of funerals and weddings, the closure of schools and universities, and the cancellation of mass gatherings (1). In a study conducted in China during the epidemic outbreak of coronavirus disease 2019 (COVID-19), the death rate was about 10% in the epicenter of the epidemic whereas the death rate was 1% in other areas. It was concluded that the high death rate was due to the breakdown of the healthcare system owing to the large number of patients. It was then recommended that social distancing may help in preventing the breakdown of healthcare system (2). In another study in China, it was concluded that social distancing can reduce the number of infections by 98% and the number of deaths by 99% (3). The first case of COVID-19 in Kurdistan region was diagnosed in beginning of March 2020, and from that time 324 confirmed cases have been recorded onwards. The region is divided into four cities: Duhok (15 COVID-19 cases), Erbil (168 cases), Sulaimani (120 cases), and Halabja (21 cases). The age range of COVID-19 patients was from 10 months to 70 years old. Amongst the 324 patients, 52% were female, 80% were asymptomatic and diagnosed while in the quarantine, and 0.9% passed away (4). The regional government in Kurdistan, northern Iraq imposed strict measures to stop the spread of the infection. These measures included the closure of educational institutions, workplaces, roads, and the cancellation of public gatherings including Friday prayers, church gatherings, funerals, and weddings. Besides, measures included mandatory quarantine of uninfected subjects with a history of travel We would like to thank all the doctors and medical staff working in COVID-19 hospital for their continuous support during the study. As a part of COVID-19 national program, all the COVID-19 data are

Background and aims The coronavirus disease-2019 (COVID-19) pandemic impacted healthcare services for kidney disease patients. Lockdown and social distancing were mandated in Kurdistan, Iraq to combat the transmission of the infection. The report analyzed the impact of the COVID-19 pandemic on kidney disease patient care in Duhok City, Kurdistan Region of Iraq. Methods This study took place in the Duhok Kidney Disease and Transplant Center and compared data from February–April 2019 and 2020. Results The average number of patients visiting the consultation unit per week was reduced from 68.67 ± 13.6, to 33.42 ± 29.36 (P = 0.001) during the pandemic. In the dialysis unit, weekly hemodialysis sessions were reduced from 341.5 to 306.42 sessions (P = 0.002). The number of patients visiting the kidney transplant consultation unit was significantly reduced (135.7 ± 37.7 versus 102.5 ± 26.3; P = 0.005). The number of kidney transplant operations per week was reduced from 1.167 to 0.5 (P = 0.025). Conclusions The COVID-19 pandemic interrupted healthcare services and may continue to impart long-term negative consequences for kidney disease patients.

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