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Is visiting Qom spread CoVID-19 epidemic in the Middle East?


Abstract and Figures

The CoVID-19 epidemic started in Wuhan, China and spread to 217 other countries around the world through direct contact with patients, goods transfer, animal transport, and touching unclean surfaces. In the Middle East, the first confirmed case in both Iran and UAE originated from China. A series of infections since those confirmed cases started in the Middle East originated from Qom, Iran, and other Shi'ite holy places. Thereafter, CoVID-19 has been transmitted to other countries in the Middle East. This report aims to trace all of the confirmed cases in the Middle East until March 6, 2020 and their further spread. This report proves that further transmission of CoVID-19 to the Middle East was because of human mobility , besides engaging in different Jewish and Shi'ite religious rites. This report suggests avoiding several religious rites, closing the borders of infected countries, and supporting the infected countries to prevent further transmission .
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Abstract. The CoVID-19 epidemic started
in Wuhan, China and spread to 217 other coun-
tries around the world through direct contact
with patients, goods transfer, animal transport,
and touching unclean surfaces. In the Middle
East, the rst conrmed case in both Iran and
UAE originated from China. A series of infec-
tions since those conrmed cases started in
the Middle East originated from Qom, Iran, and
other Shi’ite holy places. Thereafter, CoVID-19
has been transmitted to other countries in the
Middle East. This report aims to trace all of the
conrmed cases in the Middle East until March
6, 2020 and their further spread. This report
proves that further transmission of CoVID-19
to the Middle East was because of human mo-
bility, besides engaging in different Jewish
and Shi’ite religious rites. This report suggests
avoiding several religious rites, closing the
borders of infected countries, and supporting
the infected countries to prevent further trans-
Key Words:
Epidemiology, Coronavirus, Infection.
The Middle East is a term given to describe
the transactional region located in southwest Asia
and northeast Africa. İt includes the Arabian
Peninsula (i.e., Saudi Arabia, United Arab Emir-
ates (UAE), Kuwait, Bahrain, Qatar, Oman, and
Yemen), the Levant region (i.e., Jordan, Palestine,
Lebanon, Syria, Asian part of Turkey, Cyprus,
the West Bank, Occupied Palestine “Israel,” and
Gaza), and other countries (i.e., Egypt, Iraq, and
Ir an)1,2. Religious demographics in the Middle
East vary from one country to another. Islam
is the predominant religion in the Middle East,
followed by Christianity, and then several other
smaller groups (i.e., Judaism, Bahá’í, Druze, and
Muslims can be categorized into several de-
nominations based on their belief. Sunni is the
main denomination representing around 85% of
all Muslims globally. Their faith is based on fol-
lowing the Prophet Mohammad and Hadith. The
Shi’ite is the second denomination representing
around 15% of Muslims globally. Shi’ites believe
that “Ali ibn Abi Taleb,” Prophet’s Mohammad
son-in-law, is the rightful heir succeeding him,
followed by his descendants “Imams,” to other
minor denominations4. Each denomination has
different cultural rituals. However, the Haj is an
annual pilgrimage to Mecca, which is the holiest
city for all of the Islamic denominations, and it is
performed in the Islamic month “Dhul Hijjah.
Haj is a mandatory religious duty for all of the
denominations at least once during their lifetime.
Unlike Haj, Umrah involves visiting Mecca and
“Kaaba (the Sacred House of God)” any time of
the year5.
Sunnis believe that Kaaba, Sacred Mosque
in Mecca, Prophet’s Mosque in Medina, and
Al-Aqsa Mosque in Jerusalem are the only holy
places in the world6. Unlike Sunnis, Shi’ites
consider all of the sites associated with Prophet
Mohammad and his descendants “Shia Imams
in their beliefs” as holy (i.e., Najaf and Karba-
la in Iraq, Imam Reza Shrine, and Jamkaran
Mosque in Qom, Iran)7. Mecca is considered as
the holy place that gathers the largest number of
humans (6.6 million for Umrah and 4 million for
Haj in 2019)8.
However, Najaf and Qom are considered as
the most important scientic “Hawza” head-
quarters for Shia. Both belong to the same
doctrine “Twelfth Ja’fari” and they have the
same teaching method and beliefs9. There is
intensive competition between them to lead
the Shi’ites around the world. Both Najaf and
Qom are signicant destinations of Shi’ites pil-
grimages10. Twenty million Shi’ites visit Qom
European Review for Medical and Pharmacological Sciences 2020; 24: 5813-5818
Department of Computer Engineering, Faculty of Engineering and Architecture, Istanbul Gelisim
University, Istanbul, Turkey
Corresponding Author: Nadia AL-Rousan, MD; e-mail:
Is visiting Qom spread CoVID-19 epidemic in
the Middle East?
N. Al-Rousan, H. Al-Najjar
every year and are either from Iran or other
Shi’a around the world, particularly the Middle
East and Gulf countries. During their visit,
Shi’ites have different cult rituals (i.e., kissing
and touching Shi’ite shrines)11 ,12 . Recently, the
World Health Organization (WHO) declared a
state of emergency because of the novel corona-
virus CoVID-19 pandemic13 -16. The Coronavirus
disease started in Wuhan, China and infected
around 848329 cases globally until the end of
March, 2020. The number of infected cases
in the Middle East is 96990. In addition, there
are 44605 cases in Iran, with 2898 death cases,
which is considered to be one of the highest
number of deaths outside China. This report
aimed to trace the causative factors for the
spreading of CoVID-19 in the Middle East and
to study whether the disease was exported to
the Middle East by transportation or by visiting
holy sites and shrines.
Materials and Methods
To investigate the causative factor of spread-
ing coronavirus disease in the Middle East, this
study collected open source data from several
global sources. The data consist of several attri-
butes, namely, Id, country, gender, age, symp-
toms, conrmation date, conrmation place,
visited Wuhan or not, travel history, and the
link of source. Another dataset presents the
global distribution of the reported conrmed
cases, deaths, and recovered data starting from
January 22, 2020 until March 30, 2020 was
considered. These data were published by Johns
Hopkins University17.
Hierarchical clustering principle was used to
trace the history of the infections in the Middle
East. The goal is to cluster the infected cases
based on the countries and travelling history, and
to connect between the infected cases in a spe-
cic region and the place from which they came
from or visited during the incubation period. The
dataset contains information about 13458 cases
globally between January 15, 2020 and March 30,
2020. The data on Middle Eastern countries were
only considered from January 22, 2020 to March
15, 2020. Middle East data contain information
about the rst infected cases in various coun-
tries (i.e., UAE, Iran, Kuwait, Oman, Lebanon,
Bahrain, Qatar, Palestine, Occupied Palestine,
Iraq, Saudi Arabia, Jordan, Egypt, Turkey, and
Cypr u s).
The dataset is clustered based on the infected
countries and the conrmation date of conrmed
cases, as well as whether these cases were im-
ported from other countries or infected locally.
Analyzing the available data showed that the rst
coronavirus case in the Middle East was trans-
ported from Wuhan to UAE on January 25, 2020.
Three other cases from the same family were
conrmed in UAE and all of them lived in Wuhan
before their conrmation of CoVID-19 infection
on January 29, 2020. On February 1, 2020, anoth-
er case in UAE was conrmed and determined
to originate from Wuhan. On February 7, both
a Chinese and a Filipino case were conrmed in
UAE, whereas two other cases (one Chinese and
one Filipino) were positively conrmed in UAE
on February 8. On February 10, an Indian nation-
al who had been in contact with one of the other
known cases was conrmed. Another Chinese
case was conrmed by February 16.
Iran is the second infected country in the
Middle East following UAE. Two Iranian cases
that visited Wuhan were conrmed in Qom by
February 19. Other three Iranian cases were
conrmed on February 20. Two of these cases
were conrmed in Qom, whereas the third one
was conrmed in Arak. On February 21, four,
seven, and two cases were conrmed in Tehran,
Qom, and Rasht, respectively. On the same date,
Lebanon registered the rst CoVID-19 case. In
addition, this same case visited Qom on Febru-
ary 20. On February 22, an Iranian couple who
traveled to Iran during their incubation period
was conrmed in UAE. Ten other cases were
conrmed in Iran without any information about
their conrmation cities.
In Kuwait, ve cases were conrmed on Feb-
ruary 24. It was reported that one of these cases
visited Tehran, one case visited Qom, and the rest
of these cases visited Mashhad in Iran, which
is also considered as a holy place for Shi’ites.
Similar to Kuwait, Oman, Iraq, and Bahrain reg-
istered their rst cases on February 24. Two cases
were registered in Oman, one in Iraq, and one in
Bahrain. The common thing among these cases
was that all of them visited Iran. The case that
was conrmed in Iraq involved an Iranian who
visited Najaf and travelled back to Iran although
of coronavirus conrmation. The case involving
a Bahraini national visited Iran on the same day
when coronavirus infection was conrmed.
On February 25, Kuwait, Oman, Iraq, and
Is visiting Qom spread CoVID-19 epidemic in the Middle East?
Bahrain registered four, two, four, and nine new
cases, respectively. All of these cases visited
Iran, and it was reported that eight Bahrainis
cases visited Iran via Sharjah, UAE, and one via
Dubai, UAE. On February 26, 17, 1, and 10 new
cases were conrmed in Kuwait, Lebanon, and
Bahrain, respectively. It was reported that all of
these cases visited Iran, whereas the Lebanese
case specically visited Qom. Another Lebanese
case who visited Iran on February 24 was con-
rmed on February 27. On the same date, a new
case was conrmed in Baghdad, Iraq, two cases
were conrmed in Oman, and six cases were
conrmed in UAE. The cases conrmed in both
Iraq and Oman had visited Iran, whereas the six
cases in UAE were infected locally without any
information whether these cases were moved
from a nearby country (e.g., Iran). Qatar reported
its rst case on February 29, and this case visited
Iran prior and was quarantined once he or she
arrived at Doha Airport, with several suspected
cases returning back to Iran18. Qatar conrmed
401 cases by March 15, whereas on that same day,
Iraq, Oman, Bahrain, Kuwait. UAE, and Lebanon
conrmed 124, 19, 214, 112, 98, and 110 cases,
respectively. By the end of March, Qatar, Iraq,
Oman, Bahrain, Kuwait, UAE, and Lebanon con-
rmed 781, 694, 192, 567, 289, 664, and 463 cases
Saudi Arabia reported 103 cases by March
15, whereas the rst case in Qatif was con-
rmed on March 219. The second conrmed
case was a companion of the rst case and was
conrmed on March 4. Both cases visited Iran
via Bahrain without disclosing their visit for
political reasons. On March 5, three new cases
were conrmed in Saudi Arabia. Two of them
visited Iran via Kuwait, whereas the other case
travelled to Iraq and Iran through Bahrain, ac-
companying the rst and the second cases who
were conrmed on March 2 and 420. In Jordan,
one case who had own home from Italy was
conrmed by March 3. By March 15, new
ve cases involving French tourists who visited
Jordan were among the 4,499 cases who were
conrmed in France. Similar to Jordan, Turkey
conrmed its rst coronavirus cases on March
11, which involved a Turkish individual who re-
cently returned from Europe. Turkey announced
about six cases by March 15. Cyprus conrmed
its rst case by March 10, namely, an elderly
Germany tourist21. Egypt earlier announced its
rst case involving a German tourist who visited
Luxor on February 14. On March 15, Egypt had
110 conrmed cases. By the end of March, Sau-
di Arabia, Jordan, Turkey, Cyprus, and Egypt
conrmed 1563, 274, 13531, 262, and 710 cases
The rst conrmed case of CoVID-19 in Oc-
cupied Palestine was reported on February 21,
which involved an Israeli who had own home
from the Diamond Princess Cruise that stopped
by Wuhan and Japan. The rst case was tested
and conrmed in Ben Gurion Airport and was
privately quarantined. On February 23, a new
case was positively conrmed among the Dia-
mond Princess Cruise passengers. Occupied Pal-
estine separately reported two new cases among
the quarantined passengers on February 27 and
28. Occupied Palestine instituted an isolation
rule to anyone who had visited China, Japan,
or South Korea. Furthermore, non-citizens were
barred from entry into the country. However,
this decision was not helpful in avoiding further
spreading of the coronavirus in “Israel” because
of the Jewish pilgrimage to Israel22. Six pilgrims
were positively tested and conrmed by the be-
ginning of March; therefore, 1,400 Italian and
200 Israeli visitors were quarantined. By March
15, 193 cases were conrmed in “Israel.” It was
reported that most of these cases may have been
infected during the Jewish pilgrimages and other
religious rituals. In addition, 35 cases were re-
ported in the West Bank by March 15 and they
were infected from Israel, whereas no conrmed
cases in isolated Gaza and Yemen have been re-
ported. By March 31, Occupied Palestine, West
Bank, and Syria reported 5358, 117, and 10 cases
The dendrogram in Figure 1 shows the possible
route of infected cases in the Middle East until
March 5, 2020 based on country, conrmation
data, and source of infection.
This study investigated whether the CoVID-19
pandemic was imported to Middle Eastern
countries via Qom and other holy places in the
Middle East or if it was exported outside China
via Wuhan. Based on the reported historical
data on the mobility of diagnosed cases, the
rst cases in both UAE and Iran had visited
Wuhan before or at the time the CoVID-19 ep-
idemic was initially announced. Several cases
were infected via exposure to those cases that
originated from Wuhan. However, the Middle
N. Al-Rousan, H. Al-Najjar
East reported 122 cases until the end of Febru-
ary, and 86% of these cases visited Iran during
their incubation period or after being suspected
of or diagnosed to be infected with CoVID-19.
Furthermore, 77% of these cases visited Qom,
Mashhad, or Najaf, whereas 68.5% had visited
Qom. Several cases visited Qom for spiritual
treatment and recovery from coronavirus infec-
Figure 1. Tracing infected cases based on date, location, and visits to religious places.
Is visiting Qom spread CoVID-19 epidemic in the Middle East?
tion. This is because Shi’ites believe that visiting
shrines and performing religious rites help in
healing coronavirus infections and prevent fur-
ther transmission23. Moreover, it was reported
that the representative of the Iranian Guide in
Qom “Mohammad Saeed,” who is considered
as one of the most important Shi’ites’ spiritual
leaders, urged Shi’ites and Iranians to continue
visiting the shrines, especially Qom as a treat-
ment place24. Scientically, visiting such places
in emergency cases and epidemics is a very
dangerous and controversial issue. This is due
to overcrowding and irrational religious rites
that are performed by some Shi’ites (i.e., kissing
and licking shrines)25. Several cases reported
that Shi’ites who were kissing the shrine in Qom
believe that these behaviors will kill coronavirus
and other diseases as well, despite new govern-
ment regulations and possible imprisonment25.
However, such behaviors are not accepted
among Sunnis who visit Kaaba to pray. Further-
more, although Mecca is the most crowded reli-
gious place in the world, the rst ve CoVID-19
cases in Saudi Arabia visited Iran without dis-
closing about their trip for political reasons. A
dispute between Sunnis and Shi’ites have thus
emerged in relation to this issue. For Sunnis,
licking or kissing in Kaaba is forbidden, despite
being considered as their holiest place.
Jewish pilgrims may have spread CoVID-19
to Israel via religious rituals as well. Jewish pil-
grims who visited Italy or came from Italy had
infected several individuals in Palestine. Thus,
we infer that visiting Qom and other Shi’ite
sites, Jewish pilgrimages, and open tourism
are the three major factors that have facilitated
the spread of CoVID-19 in the Middle East,
whereas visiting Qom and other shrines in Iran
is the main transmission route for CoVID-19 in
the Gulf countries. Approximately 79.5% of the
reported cases in the Gulf countries had visited
Qom. In addition, it was reported that Saudi
Arabia had suspended Umrah from outside the
country in late February26. However, nationals
of Gulf countries are able to travel across the
Gulf borders until the date of writing this re-
port. This study thus suggests closure of borders
between Gulf countries, Lebanon, and Iran.
This may also prevent further human mobility
or exposure to people who travelled to Gulf
countries. In addition, it is necessary for WHO
and other countries to consider Iran and Iraq as
centers of the epidemic to control further spread
of the coronavirus disease.
This research traced all of the conrmed cases
between January 29, 2020 (the day when the rst
CoVID-19 case in the Middle East was con-
rmed) and March 5, 2020 in the Middle East
and identied the site with the highest increase in
CoVID-19 infections in the Middle East based on
collected data from international centers, news-
papers, social media, and other sources. Our
main ndings are as follows:
All of the CoVID-19 cases were related to hu-
man mobility.
Several cases travelled to other countries, al-
though they were only suspected of engaging
in religious rites.
Tourism is one of the main causes of CoVID-19
spread in various countries.
Approximately 68.5% of the conrmed
CoVID-19 cases in the Middle East had visited
Qom, whereas the rest of the conrmed cases
visited other Shi’ite holy places, participated
in Jewish pilgrimages, travelled as tourists, or
ew in from Wuhan.
Stop US sanctions on Iran to allow them to im-
port medical supplies and equipment. Besides,
support both Iraq and Iran that have the highest
number of death cases in Middle East because
of their poor-quality healthcare systems.
Conflict of Interest
The Authors declare that they have no conict of interests.
The authors thank LetPub for allowing the quick scientic
editing services of this article without a fee.
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... A total of 18 studies (Agley, 2020;Ali & Alharbi, 2020;Al-Rousan & Al-Najjar, 2020;Alzoubi et al., 2020;Atique & Itumalla, 2020;Capponi, 2020;Choi et al., 2020;Chukwuorji & Iorfa, 2020;Freeman et al., 2020;Hill et al., 2020;Jaja et al., 2020;Kang, 2020;Kim et al., 2020;Lan et al., 2020;Lorea, 2020;Mat et al., 2020;Shah et al., 2020;Wildman et al., 2020) have addressed religion as a cause for transmission, of which religious gatherings and practices contributed to the outbreak and spread of COVID-19. COVID-19 was predominantly spread through religious gatherings without adhering to the physical distancing recommendation. ...
... Religious institutions or communities were identified as spaces where misinformation about the infection proliferated which further cultivated mistrust towards science and health care directives among religious adherents of these communities (Appendix 3). Specifically, studies mainly discussed how religious gatherings spread COVID-19 and the negative association between religiosity and trust in science and public health guidelines (Agley, 2020;Ali & Alharbi, 2020;Al-Rousan & Al-Najjar, 2020;Alzoubi et al., 2020;Atique & Itumalla, 2020;Capponi, 2020;Choi et al., 2020;Chukwuorji & Iorfa, 2020;Freeman et al., 2020;Hill et al., 2020;Jaja et al., 2020;Kang, 2020;Kim et al., 2020;Lan et al., 2020;Lorea, 2020;Mat et al., 2020;Shah et al., 2020;Wildman et al., 2020). ...
... Twenty-six studies reported on the mitigating role of religion during the early stage of COVID-19 Al-Rousan & Al-Najjar, 2020;Ali & Alharbi, 2020;Atique & Itumalla, 2020;Crubézy & Telmon, 2020;Ebrahim & Memish, 2020a, 2020bEscher, 2020;Frei-Landau, 2020;Gautret et al., 2020;Ha, 2020;Hong & Handal, 2020;Iqbal et al., 2020;Kim et al., 2020;McCloskey, et al., 2020aMcCloskey, et al., , 2020bMemish et al., 2020;Muurlink & Taylor-Robinson, 2020;Quadri, 2020;Tarimo & Wu, 2020;Waitzberg et al., 2020;Weinberger-Litman et al., 2020;Wildman et al., 2020;Wong et al., 2020;Yezli & Khan, 2020a, 2020b (Appendix 3). ...
Full-text available
The objective of this systematic review was to summarize the roles that religious communities played during the early stage of COVID-19 pandemic. Seven databases were searched and a total of 58 articles in English published between February 2020 and July 2020 were included in evidence synthesis. The findings of the literature showed diverse influences of religion as a double-edged sword in the context of COVID-19 pandemic. Religious communities have played detrimental and/or beneficial roles as a response to COVID-19 pandemic. A collaborative approach among religious communities, health science, and government is critical to combat COVID-19 crisis and future pandemics/epidemics.
... 40 At the beginning of the pandemic, Qom city, Iran, hosted a religious event conducted as a pilgrimage, and infection was spread to the Middle East before travel suspension was instituted. 41 Another bioinformatics study analysing the MENA region has shown Dubai, UAE, to be a travel hub for SARS-CoV-2, with numerous infections introduced from both Iran and Europe. 42 In Africa, there were more than 211 separate presentations of the virus, of which 43% were from Europe. ...
Full-text available
Objective To describe the chronological genomic evolution of SARS-CoV-2 and its impact on public health in the Middle East and North Africa (MENA) region. Methods This study analysed all available SARS-CoV-2 genomic sequences, metadata and rates of COVID-19 infection from the MENA region retrieved from the Global Initiative on Sharing All Influenza Data database from January 2020 to August 2021. Inferential and ‎descriptive statistics were conducted to describe the epidemiology of SARS-CoV-2. Results Genomic surveillance of SARS-CoV-2 in the MENA region indicated that the variants in January 2020 predominately belonged to the G, GR, GH or O clades and that the most common variant of concern was Alpha. By August 2021, however, the GK clade dominated (57.4% of all sequenced genomes), followed by the G clade (18.7%) and the GR clade (11.6%). In August, the most commonly sequenced variants of concern were Delta in the Middle East region (91%); Alpha (44.3%) followed by Delta (29.7%) and Beta (25.3%) in the North Africa region; and Alpha (88.9%), followed by Delta (10%) in the fragile and conflict-affected regions of MENA. The mean proportion of the variants of concern among the total sequenced samples differed significantly by country (F=1.93, P=0.0112) but not by major MENA region (F=0.14, P=0.27) or by vaccination coverage (F=1.84, P=0.176). Conclusion This analysis of the genomic surveillance of SARS-CoV-2 provides an essential description the virus evolution and its impact on public health safety in the MENA region. As of August 2021, the Delta variant showed a genomic advantage in the MENA region. The MENA region includes several fragile and conflict-affected countries with extremely low levels of vaccination coverage and little genomic surveillance, which may soon exacerbate the existing health crisis within those countries and globally.
... A lot of research has been conducted on COVID-19 from a purely medical perspective; however, little research has been done on the interplay between it and religion. The interplay between religion and the pandemic started to draw attention at the beginning of 2020 first at Iran [3], South Korea [4], Southeastern Asian countries such as Malaysia [5], and after that in Africa [6]. Many gatherings and assemblies (e.g., congregations, funerals, marriages, births, baptisms, etc.) were held in religious sites and resulted in putting large numbers of people very close to each other making them "as a potential focal point for dispersal of novel pathogens" ( [7] p. 219) mainly those which are airborne. ...
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Background Coping with the pandemic caused by the SARS-COV- 2 has been a global challenge. To this end, several measures have been adopted to control the transmission of the disease and to ensure public safety. One factor that has greatly affected the community’s behaviors, attitudes, and practices in Palestine has been religious beliefs. Aim This study aims to investigate the role of religion as a factor in adherence to the COVID-19 medical directives in Palestine. Methods A descriptive cross-sectional study was performed from August to October 2021. In this study, 1,353 participants were asked to complete a questionnaire that consisted of 20 items that measured the impact of religious beliefs and the role played by religious scholars in the promotion and application of medically-approved health directives and the rectification of COVID-19 related information. The data were analyzed by using SPSS version 22 software. Results More than 50% of the participants agreed that religion has a positive impact on community adherence to the health instructions in the majority of studied items. The responses were significantly variable based on the age and place of residence in most of the questions ( p -value < 0.05). However, gender and to a lesser extent, the level of education affected the responses to many research aspects less significantly. Conclusions Religion could be an effective tool in dealing with challenging health issues such as COVID-19. Intervention programs can be developed based on the community’s religious beliefs, attitudes, and practices, to dispel myths regarding the disease and to encourage community commitment and adherence to health directives.
... MGEs imply the gathering of people in restricted spaces, either indoor or outdoor, over a prolonged period of time, where food and/or drink are generally consumed, usually in close proximity to others, and involving the movement of populations [14,[21][22][23]. The conditions of MGEs have been associated with the spread of SARS-CoV-2, but few MGE studies [24,25] have published quantification and adjustment for potential risk factors. ...
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Objective: Mass gathering events (MGEs) are associated with the transmission of COVID-19. Between 6 and 10 March 2020, several MGEs related to the Falles festival took place in Borriana, a municipality in the province of Castellon (Spain). The aim of this study was to estimate the incidence of COVID-19 and its association with these MGEs, and to quantify the potential risk factors of its occurrence. Methods: During May and June 2020, a population-based retrospective cohort study was carried out by the Public Health Center of Castelló and the Hospital de la Plana in Vila-real. Participants were obtained from a representative sample of 1663 people with potential exposure at six MGEs. A questionnaire survey was carried out to obtain information about attendance at MGEs and COVID-19 disease. In addition, a serologic survey of antibodies against SARS-Cov-2 was implemented. Inverse probability weighted regression was used in the statistical analysis. Results: A total of 1338 subjects participated in the questionnaire survey (80.5%), 997 of whom undertook the serologic survey. Five hundred and seventy cases were observed with an attack rate (AR) of 42.6%; average age was 36 years, 62.3% were female, 536 cases were confirmed by laboratory tests, and 514 cases were found with SARS-CoV-2 total antibodies. Considering MGE exposure, AR was 39.2% (496/1264). A dose-response relationship was found between MGE attendance and the disease, (adjusted relative risk [aRR] = 4.11 95% confidence interval [CI]3.25-5.19). Two MGEs with a dinner and dance in the same building had higher risks. Associated risk factors with the incidence were older age, obesity, and upper and middle class versus lower class; current smoking was protective. Conclusions: The study suggests the significance of MGEs in the COVID-19 transmission that could explain the subsequent outbreak in Borriana.
... However, it is useful to see that the variant analysis shows what we suspect at the genome level. A related study also came to this conclusion by using contact tracing from cases related to religious events in the city of Qom, Iran [16]. ...
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Background Coronavirus (COVID-19) was introduced into society in late 2019 and has now reached over 88 million cases and 1.9 million deaths. The Middle East has a death toll of ~80,000 and over 35000 of these are in Iran, which has over 1.2 million confirmed cases. We expect that Iranian cases caused outbreaks in the neighbouring countries and that variant mapping and phylogenetic analysis can be used to prove this. We also aim to analyse the variants of severe acute respiratory syndrome coronavirus-2 (SARS -CoV-2) to characterise the common genome variants and provide useful data in the global effort to prevent further spread of COVID-19. Methods The approach uses bioinformatics approaches including multiple sequence alignment, variant calling and annotation and phylogenetic analysis to identify the genomic variants found in the region. The approach uses 122 samples from the 13 countries of the Middle East sourced from the Global Initiative on Sharing All Influenza Data (GISAID). Findings We identified 2200 distinct genome variants including 129 downstream gene variants, 298 frame shift variants, 789 missense variants, 1 start lost, 13 start gained, 1 stop lost, 249 synonymous variants and 720 upstream gene variants. The most common, high impact variants were 10818delTinsG, 2772delCinsC, 14159delCinsC and 2789delAinsA. These high impact variant ultimately results in 36 number of mutations on spike glycoprotein. Variant alignment and phylogenetic tree generation indicates that samples from Iran likely introduced COVID-19 to the rest of the Middle East. Interpretation The phylogenetic and variant analysis provides unique insight into mutation types in genomes. Initial introduction of COVID-19 was most likely due to Iranian transmission. Some countries show evidence of novel mutations and unique strains. Increased time in small populations is likely to contribute to more unique genomes. This study provides more in depth analysis of the variants affecting in the region than any other study.
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COVID-19 pandemic has affected everyone's life around the globe in many different ways. The pandemic seems to have changed the way individuals and businesses work due to the restrictions imposed on travel by different countries. Accordingly, Halal tourism (like many other business sectors) suffered great losses because of the epidemic. Since the start of the COVID-19 crisis, two viewpoints seem to have emerged concerning the crisis among individuals and travelers around the world. Most individuals perceived COVID-19 as a worldwide pandemic and dealt with it according to this view. However, some others considered COVID-19 an international conspiracy led by major powers to control the globe economically and politically. The paper aims to offer a theoretical exploration of these two viewpoints with a view to provide some insights into Halal travellers' behaviour during COVID-19 in Muslim-majority countries. The paper offers an attempt to address different impacts of COVID-19 on Muslim travellers and also on Halal tourism activities. Scholars are encouraged to investigate this phenomenon with empirical data to gain insights into how to minimize the negative impact of COVID19 on the Halal industry.
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This paper concerns a problem, the global pandemic COVID-19, which has influenced religious practices with respect to health protection across the Muslim world. Rapid transmission of the virus between people has become a serious challenge and a threat to the health protection of many countries. The increase in the incidence of COVID-19 in the Muslim community took place during and after the pilgrimages to Iran's Qom and as a result of the Jamaat Tabligh movement meetings. However, restrictions on religious practices have become a platform for political discussions, especially among Muslim clergy. This paper is an analysis of the religious and political situation in Muslim countries, showing the use of Islam to achieve specific goals by the authorities, even at the price of the health and life of citizens.
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Since the start of the COVID-19 Crisis, two viewpoints emerged concerning the Crisis among Muslim travellers. Most customers perceived COVID-19 as a worldwide pandemic and dealt with it according to this view. However, some customers considered COVID-19 an international conspiracy led by major powers to control the globe economically and politically. The paper aims to offer a comprehensive theoretical investigation of these two viewpoints in an attempt to understand Muslim travellers' behaviour during the COVID-19 Crisis. The paper offers a genuine attempt to address the different impacts of COVID-19 on Muslim travellers and Halal tourism activities. Keywords: COVID-19, Halal Tourism, Muslim Travellers, Islamic Destinations, Halal Tourism Future Directions.
The COVID-19 pandemic is causing a variety of socioeconomic changes around the world. There is a widespread outbreak of coronavirus in Bangladesh. Due to this terrible situation, various changes are taking place in the context of the people of Bangladesh. In this commentary, the social changes caused by corona virus economically and socially such as food habits, communication system, communication rituals, online education activities, online shopping, unemployment, economical threat, and changes of marriage pattern have been highlighted. This commentary also reveals the challenging issues of Bangladesh due to COVID-19. This commentary reveals the context of how political and social organizations have stood by the helpless people in dealing with coronavirus. Attempts have been made to find out the social impact and challenges of COVID-19 for the Rohingya refugees who came to Bangladesh from Myanmar. Above all, the main goal of this commentary is to highlight the huge changes that have taken place in the socioeconomic condition of Bangladesh due to the COVID-19 pandemic.
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Background: The SARS CoV-2 (COVID-19) pandemic has triggered a severe economic contraction and public health concerns in
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The World Health Organization (WHO) has issued a warning that, although the 2019 novel coronavirus (COVID-19) from Wuhan City (China), is not pandemic, it should be contained to prevent the global spread. The COVID-19 virus was known earlier as 2019-nCoV. As of 12 February 2020, WHO reported 45,171 cases and 1115 deaths related to COVID-19. COVID-19 is similar to Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) virus in its pathogenicity, clinical spectrum, and epidemiology. Comparison of the genome sequences of COVID-19, SARS-CoV, and Middle East Respiratory Syndrome coronavirus (MERS-CoV) showed that COVID-19 has a better sequence identity with SARS-CoV compared to MERS CoV. However, the amino acid sequence of COVID-19 differs from other coronaviruses specifically in the regions of 1ab polyprotein and surface glycoprotein or S-protein. Although several animals have been speculated to be a reservoir for COVID-19, no animal reservoir has been already confirmed. COVID-19 causes COVID-19 disease that has similar symptoms as SARS-CoV. Studies suggest that the human receptor for COVID-19 may be angiotensin-converting enzyme 2 (ACE2) receptor similar to that of SARS-CoV. The nucleocapsid (N) protein of COVID-19 has nearly 90% amino acid sequence identity with SARS-CoV. The N protein antibodies of SARS-CoV may cross react with COVID-19 but may not provide cross-immunity. In a similar fashion to SARS-CoV, the N protein of COVID-19 may play an important role in suppressing the RNA interference (RNAi) to overcome the host defense. This mini-review aims at investigating the most recent trend of COVID-19.
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This study aimed to assess the uptake of recommended vaccines and to identify the factors associated with the vaccines' uptake among Malaysian Hajj and Umrah pilgrims. A cross-sectional survey among Malaysian Hajj and Umrah pilgrims in 2018. The uptake of the recommended vaccines was surveyed through an anonymous self-administered questionnaire to pilgrims attending a pre-departure Hajj/Umrah orientation course. Descriptive statistics were used for elaborating the demographic characteristics and vaccines uptake of the respondents. Multiple logistic regression was used for predicting the factors associated with the vaccines' uptake. A total of 1,274 pilgrims participated in the study with a mean age (standard deviation) of 42.42 (15.6). A total of 833 (65.4%) participants were females and 232 of the participants (18.2%) had at least more than one chronic disease. The uptake of influenza and pneumococcal vaccines were 28.6% (364/1,274) and 25.4% (324/1,274), respectively. Among the 527 pilgrims who were "at increased risk" of infections, 168 (31.9%) and 184 (34.9%) received influenza and pneumococcal vaccines, respectively. Gender, marital status and occupation were the common predictors associated with vaccines uptake. The vaccination uptake among Malaysian Hajj and Umrah pilgrims is low and declining from previous years. Educating the pilgrims toward vaccine uptake is essential and exploring the barriers for vaccination.
The revival of madrasas in the 1980s coincided with the rise of political Islam and soon became associated with the "clash of civilizations" between Islam and the West. This volume examines the rapid expansion of madrasas across Asia and the Middle East and analyses their role in society within their local, national and global context.Based on anthropological investigations in Afghanistan, Bangladesh, China, Iran, and Pakistan, the chapters take a new approach to the issue, examining the recent phenomenon of women in madrasas; Hui Muslims in China; relations between the Iran’s Shia seminary after the 1979-Islamic revolution and Shia in Pakistan and Afghanistan; and South Asian madrasas. Emphasis is placed on the increased presence of women in these institutions, and the reciprocal interactions between secular and religious schools in those countries. Taking into account social, political and demographic changes within the region, the authors show how madrasas have been successful in responding to the educational demand of the people and how they have been modernized their style to cope with a changing environment.A timely contribution to a subject with great international appeal, this book will be of great interest to students and scholars of international politics, political Islam, Middle East and Asian studies and anthropology.
Presidents George H. W. Bush and George W. Bush both led the United States through watershed events in foreign relations: the end of the Cold War and the terrorist attacks of September 11, 2001. Many high-level cabinet members and advisers played important foreign policy roles in both administrations, most notably Dick Cheney, Colin Powell, and Condoleeza Rice. Both presidents perceived Saddam Hussein as a significant threat and took action against Iraq. But was the George W. Bush administration really just "Act II" of George H. W. Bush's administration? In The Gulf, Michael F. Cairo reveals how, despite many similarities, father and son pursued very different international strategies. He explores how the personality, beliefs, and leadership style of each man influenced contemporary U.S. foreign policy. Contrasting the presidents' management of American wars in Iraq, approach to the Israeli-Palestinian peace process, and relationships with their Israeli counterparts, Cairo offers valuable insights into two leaders who left indelible marks on U.S. international relations. The result is a fresh analysis of the singular role the executive office plays in shaping foreign policy. Copyright © 2012 by The University Press of Kentucky All rights reserved.
The study of tourism in the Muslim world can be about religious topics such as hajj and pilgrimage, but it actually means and involves much more. Because religious life and secular life in Islam are closely intertwined, study of its tourism is also partly about its worldview and culture as well as a means of reflecting on Western concepts of travel and hedonistic tourism. This review article introduces selected aspects of Islam to non-Muslims and reviews the tourism literature to identify themes and areas for further research. In addition to scholarly goals, an understanding of the patterns and requirements of the growing numbers of Muslim travellers is of practical importance for the tourism industry. Significantly, the Muslim world provides opportunities for studying differences in policy and development decisions that can offer new insights and inform tourism by providing alternative perspectives.
Intercultural sensitivity is one of the most important factors that significantly influence effective communication. This paper aims to investigate intercultural sensitivity among the followers of two Muslim sects, the Shia and Sunni in Iran. To this end, we have applied Bennett's Intercultural Sensitivity theory as a conceptual framework. This theory states that the development of communication among people decreases their intercultural sensitivity levels. In this paper, religious affiliation has been assumed as an index of development of communication among the inhabitants of three cities in Iran. We measured the levels of intercultural sensitivity in two groups separately and have concluded that development of communication has decreased their intercultural sensitivity. We also found that, according to the six stages of intercultural sensitivity model, the orientation of these groups towards each other is “Minimization”(Bennett, 1998, p. 27), meaning that they tend to highlight their similarities and to ignore their differences.
The Middle East Unveiled. Hachette UK
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A study on current culinary culture and religious identity in the Gulf Region: Focused on the ashura practice among the Shia Muslims of Bahrain and Kuwait
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