In Oman, the first cluster of COVID-19 cases was reported in Muttrah District, Muscat Province on 15 March 2020. Mutrah, with a population of 269,507 (76% expatriates), has a major seaport and a crowded traditional market. Both of these represent opportunities for COVID-19 importation and spread. Objective: We describe the epidemiologic and clinical features and interventions for the first COVID-19 cases confirmed in Muttrah between 15th March-15th July 2020.
Methodology
We identified cases from health centers and outreach teams. Demographic, clinical, and epidemiological data were collected by using specific form and entered into the e-notification system "Tarasud". Diagnosis was confirmed through RT-PCR on nasopharyngeal or oropharyngeal swabs processed in the regional laboratory.
Results
We identified 8,400 cases and 51 fatalities (case fatality rate= 0.61%) from 15 March to 15 July 2020. The mean age was 37 (±12.3) years; 85.6% were males. The most common symptoms were fever (48%), cough (34%), and sore throat (24%). A total of 17,202 tests were performed with 48.8% positivity rate. 77.5% of cases were non-Omani workers in the local market and seaport. These patients had low socioeconomic levels and often lived-in crowded housing. The majority of the patients were Indians (35%) and Bengalis (33%). Community education, lockdowns, mass testing, and isolation of confirmed cases were applied to control the outbreak.
Conclusion
Most of the early cases occurred among male migrants who worked at the old market or the seaport. They lived and worked in crowded conditions, with contact with travellers, which may have contributed to the spread of COVID-19 in Oman. Initially, they had lower accessibility to health care and awareness messaging due to financial and lingual problems. The large-scale implemented interventions have slowed the disease spread but could have been optimized by tailoring to the highest risk groups.