SYRIA IN CONTEXT - CORONAVIRUS UPDATE #7
Dear friends and colleagues,
In recent weeks, Syria in Context has been making our COVID-19 coverage available for free to a wider audience. Last week, we also made it available in Arabic, tailored to a Syrian audience. Given the lack of independent and reliable coverage of the unfolding crisis, we think this is an urgent necessity and have received valuable feedback.
You can find previous updates in English on our website.
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Thank you,
Emma, Tobias and Asser
Syria in Context will continue to cover the impact and response to COVID-19 in Syria throughout the coming weeks. You can find previous updates on our website.
We are a wholly subscriber-funded publication. If you have found this update useful, we encourage you to consider joining our growing community by subscribing.
SPOTLIGHT: COVID-19 UPDATE
As of early Tuesday, Syria had 43 reported and confirmed COVID-19 cases, with 19 recoveries and 3 deaths. All cases are located in government-controlled areas of the country, though one confirmed case originates in a government-controlled pocket in the northeast.
Government-controlled areas: The Ministry of Health currently reports 43 confirmed COVID-19 cases - with 19 recoveries and 3 deaths. According to the MoH’s new detailed reporting, all but one case, which is from Daraa, originates in Damascus or rural Damascus (this, in turn, disregards the confirmed case in the northeast, raising further questions about the reliability of data. According to the same announcement, the 43 cases are evenly distributed by gender while three cases are aged 0-9; two are 10-19; three are 20-29; nine are 30-39; three are 40-49; eleven are 50-59; ten are 60-69; two are aged between 70-79.
Meanwhile, reports of suspected but unconfirmed COVID-19 cases continued to emerge across the country, with STJ’s researchers reporting on a number of suspected cases in Douma in rural Damascus being taken to quarantine centres. In one case, police are said to have evacuated a building and quarantined the entire family of a suspected resident.
Presently, the Damascus lab is the only operational lab, while additional sites are being set up in Aleppo, Latakia, and Homs. All satellite sites have already received testing kits and only Latakia is waiting on PCR machines. According to the WHO, training for 24 laboratory technicians is ongoing, with 12 technicians graduated thus far. As of April 22, around 1,500 tests had been conducted by the main national lab in Damascus, including 24 samples from Al-Hasakah, 22 from Deir Ezzour and two from Raqqa. According to the Ministry of Health, more than half of these tests (850) were conducted on residents of the town of Mneen in rural Damascus, which had been under lockdown to contain suspected community spread after a resident had died of the virus in March. This week, presumably after the test results from the residents of Mneen came back negative, the quarantine on the town was lifted.
Meanwhile, broader movement restrictions remain in place across the country. A curfew is in place from 19:00 until 06:00 Sunday to Thursday, and 19:30 until 06:00 on Friday and Saturday, with the start time each evening adjusted due to the month of Ramadan. After two days of exemptions last week, travel between governorates and areas was once again restricted, with the next easing announced for April 30 to May. The closure of schools and universities was extended until after Eid. All students will simply progress to the next year of schooling after automatically passing, except for those sitting brevet and baccalaureate exams, which will be rescheduled for later in the year under social distancing measures.
Limited store openings were allowed as of last week, with specific days designated for certain types of stores and product sales. According to a statement from today, popular markets and commercial and industrial shops and services can open daily from eight in the morning until 5pm in the evening as long as they adhere to health safety conditions. Dentists can similarly work every day until 5pm. Restaurants and catering services have received a Ramadan extension to 7:30pm as reports of food shortages spread across the country. In As-Sweida, photos showed empty shelves as well as overcrowding at bread and food distribution centers where people can purchase rationed amounts of bread and other basics using government-issued Smart Cards,
The Ministry of Interior announced that 140 people have been arrested and 426 shops closed for violations of the curfew or restrictions on store openings. Local researchers report of people being detained for curfew violations paying bribes to be released, being beaten while in custody and witnessing unfair treatment by security forces enforcing the curfews.
On Sunday, the Council of Ministers announced that all ministries would begin increasing their work again, beginning with 40% capacity this week. A particular focus would be on reopening essential government services to citizens. Civil registry services have reopened for documentation such as marriage or birth registry, divorces, filing rent contracts, and other matters. Governorates will provide services in a reduced number of facilities, with reduced hours.
Northwest: 230 tests have been carried out in Syria’s northwest, all of which have returned negative. As of March 24, one lab has been in operation in Idlib city with a capacity to undertake 5,300 tests. Samples from Afrin, Azaz and Jarabalus areas are sent to Turkey to be processed. Efforts are underway to add additional lab capacity in the area but it remains unclear when those will become available. Some testing of respiratory illness and flu-like-illness patients has begun, in an effort to proactively screen a larger number of potential cases in Idlib as a mitigation measure. As self-isolation remains difficult in northwest Syria due to high population density, particularly in areas of large-scale displacement, community-based isolation centres are being planned in order to quarantine people with mild suspected COVID-19 symptoms. Work on these quarantine centres has begun and will have the capacity for 1,400 people in 28 places across the area eventually.
As of April 22, the Idlib laboratory only had PPE to last two weeks. Procurement of more was said to have proved difficult due to global shortages. However, 10,000 gloves, 1,400 disposable gowns, 900 face shields, 500 N95 masks, 200 protective goggles, and 10,000 surgical masks have reached northwest Syria and are being distributed, according to the WHO. This is unlikely to last for long given the population of Idlib. The COVID-19 taskforce for the northwest has also been facing procurement difficulties as it works to add 90 ventilators to the local ICU capacity of 203 ventilators. As of last week, none of the existing machines were available despite 21 having been repurposed for COVID-19 use. In addition to three existing isolation facilities in the northwest, Idlib, Salqin and Daret Azza will also designate separate areas within their ICUs for future positive cases. Another hospital has been identified in northern Aleppo that could be used as a referral hospital. Taskforce activities are being carried out primarily by local NGOs who are each working to provide assistance through training of healthcare workers, distribution of WASH assistance, information to communities and other small scale interventions. Capacity in Idlib was decimated in recent months and years due to the conflict.
Restrictions are in place on border crossings, with even emergency healthcare transfers from the northwest to Turkey under restrictions. Any exemptions must be approved by Turkish officials in charge of the border crossings. The Syrian Interim Government says they are facing pressure to allow movement between areas in the northwest from traders who staged protests. In other preventative measures, education is being delivered by distance learning where possible, while changes have been made to the operations of the justice department. While social distancing measures are supposed to be in place in the northwest to contain any potential COVID-19 outbreak, in particular around public gatherings, the SNHR established that payers were held in Saed Bin Abu Waqqas Mosque in Idlib city on April 24 with a large turnout of locals praying in close proximity to each other. The difficulty in enforcing social dispatching and preventing large gatherings could spell disaster if COVID-19 cases reach Idlib, particularly in light of the growing number of cases in Turkey and traditional reasons for social occasions during Ramadan.
Northeast: There have been few updates on the situation in the northeast after the controversy caused by the lapse in notification surrounding a COVID-19 fatality from the area. In late March, a man from Al-Hasakah had become ill and was tested for the virus before passing away on April 2. His positive test result was completed the same day though the WHO failed to inform authorities until April 5, with local administration in the northeast not notified for eleven days. The family of the deceased gentlemen were tested for COVID-19 and at least one member was said to be ill. It is not yet clear what the test results were or whether any further infection has been identified. Last week, the WHO told Syria in Context that they were looking to improve notification systems.
As of April 22, 24 samples from Al-Hasakah, 22 from Deir Ezzor and two from Raqqa had been sent to Damascus for processing as no lab had been set up in the northeast. Meanwhile, PCR machines acquired by the local administration were in the process of being set up in order to provide some initial independent testing capacity in the region.
On 20 April, NGOs in the northeast opened the first stage of a 120-bed hospital for COVID-19 patients in a repurposed factory building outside Al-Hasakah. They are also setting up isolation wards in the National Hospital in Raqqa, as well as a quarantine centre in Hawari Bu Median school in Raqqa. Isolation centres are being set up in camps and informal areas around the northeast (the AA-NES says they have identified over one dozen potential quarantine centres). A delivery of 20 tonnes of medical supplies to the northeast has finally been distributed, with the WHO stating that 95% has been delivered to Al-Hasakah, Tabqa, and Raqqa hospitals as well as to Deir Ezzour and Al-Hol IDP camp.
The curfews in place in northeast Syria have been extended until at least May 1, with the possibility of further extension if the virus outbreaks elsewhere are not brought under control. Under the current restrictions, some sectors are able to work, including industry, agriculture, and service sectors. Construction can continue as long as PPE is worn. Food stores including grocery shops, butchers, and bakeries, are all able to be open. Large gatherings, including Iftars during Ramadan, are all prohibited with fines for curfew violations ranging from 5,000-45,000 SYP. People quarantined on arrival at the airport in the northeast have begun to be released after presenting no Coronavirus symptoms.
Humanitarian access to the north-east has been an ongoing problem for a variety of reasons. Last week, MSF called on the KRG to allow aid workers and supplies to travel through the KRG to the north-east of Syria. In the last weeks, the pontoons at the Fishkabour border crossing have been repaired, meaning humanitarian supplies up to half a tonne in size are able to use the crossing if permissions are given.
Neighbouring countries: Turkey remains the worst-hit of Syria’s neighbours with at least 112,261 reported cases of which 2,900 have died and 33,791 have recovered. On Tuesday, it was reported that a 19-year-old Syrian refugee in Adana was shot dead by Turkish police while breaking curfew. The boy was said to have been out during restricted times to work to support his family when he was approached by police. Frightened, he attempted to flee and was shot dead. Turkish authorities have detained the officer and charged him with the killing.
Lebanon has 717 reported COVID-19 cases of which 24 have died and 145 have recovered. Last week a Syrian woman living in a refugee camp in Baalbek was confirmed to have COVID-19. On April 23, it was announced that there were four new cases in the same camp in Baalbek, all of whom were close to the initial case. 150 additional random checks were conducted in the area and were all reported negative. Last week, the Lebanese government released a phased plan for easing lockdown measures, but this week has seen protestors take to the streets as the currency devalues. The Syrian embassy in Beirut
Iraq has 1847 confirmed cases, of which 88 have died and 1,286 have recovered. The KRG eased movement restrictions on April 24, but have seen a new increase in cases since then with today seeing reports of 10 people testing positive for COVID-19 in Erbil‘s Soran district, and an elderly man passing away from the virus in Erbil city.
Jordan has contained its outbreak of COVID-19 through strict measures and has managed to keep to just 449 cases, seven deaths, and 342 reported recoveries.
Key Reads:
Elizabeth Tsurkov and Qusai Jukhadar explain the gravity of a COVID-19 outbreak in Syria, a country where the healthcare system has been extremely compromised by years of conflict: ‘Ravaged by war, Syria’s health care system is utterly unprepared for a pandemic’, (EN, Middle East Institute, April 23, 2020)
Syrian security forces have been using the country’s partial curfew measures as a new source of bribes and method to threaten and oppress the people, according to a report by STJ: ‘Syrian Executive and Security Forces Take Advantage of COVID-19 Curfew to Oppress Civilians’ (EN, Syrians for Truth and Justice, April 20, 2020)
The Syrian regime’s policies and the lack of international recognition of the de facto autonomous administration in northeast Syria could lead to a health disaster in the area, writes Joanne Stocker: ‘Politics hampers humanitarian response in Rojava’, (EN, Rudaw, April 22, 2020)
Selma Akay Erturk examines, in two blog pieces, the effect of COVID-19 on Syrian refugees in Turkey, and how state and non-state actors are responding to support this vulnerable community: ‘The effects of COVID-19 on Syrian refugees in Turkey’ and ‘National and Local Responses to Support Syrian Refugees in Turkey in the Times of COVID-19’, (EN, Southern Responses to Displacement, April 24, 2020)
Syria in Context will continue to cover the impact and response to COVID-19 in Syria throughout the coming weeks. You can find previous updates on our website.
We are a wholly subscriber-funded publication. If you have found this update useful, we encourage you to consider joining our growing community:
SYRIA IN CONTEXT is a subscription newsletter edited by Emma Beals and Tobias Schneider and written with Asser Khattab. You can follow us on twitter @SyriaInContext or email us at SyriaInContext@gmail.com .
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