The Spread of Covid-19 in Gaza Strip, Judea and Samaria (Updated to November 9, 2020)

Overview

• The situation in the Gaza Strip:
  • This past week the sharp rise in the number of active Covid-19 cases in the Gaza Strip continued with 1,738 new cases (approximately 250 new cases per day). As of November 9, 2020, the number stood at 3,014, up from 2,549 last week.
  • Sources in the public health system in the Gaza Strip said the number of serious and critical cases had risen, and they are concerned that the designated hospitals will be unable to admit new patients (according to estimates, about 5% of active cases require hospitalization in ICUs). A spokesman for the ministry of health complained of a lack of medical equipment and test kits.
  • Sources in the ministry of health linked the rise in the spread of infection to public unwillingness to follow health guidelines and implement preventive measures, and warned of an impending general lockdown if the situation continues to deteriorate. A specialist in respiratory diseases said he expected the situation to worsen during the winter as ordinary seasonal flu compounds another wave of Covid-19.
• The situation in Judea and Samaria:
  • This past week the number of active Covid-19 cases in Judea and Samaria rose again, with 2,358 new cases. As of November 8, 2020, there were 4,281 active cases, down from 4,315 a week ago. The number of deaths stands at 477, up from 455 a week ago. Weddings remain one of the main venues for spreading the virus.
  • The Nablus district continues as the district with the largest number of active cases in Judea and Samaria. However, the authorities have not yet imposed a general lockdown and instead close localized coronavirus epicenters.
  • In light of the rise in the extent of infection, Mahmoud Abbas extended the state of emergency in the Palestinian Authority (PA) territories for an additional 30 days. PA Prime Minister Muhammad Shtayyeh ordered the security services to strictly enforce the preventive measures and the sanctions imposed on law-breakers.
  • The PA is also preparing to deal with the rise in the number of cases expected during the winter by preparing and equipping hospitals and medical centers throughout Judea and Samaria (ministry of health in Ramallah Facebook page, November 3, 2020).
  • In the east Jerusalem neighborhoods the number of active cases rose this past week. According to the PA, there were 423 active cases in east Jerusalem, up from 300 a week ago. According to the Jerusalem municipality, as of November 9, the number of verified active cases stood at 344.

The Gaza Strip

Extent of the Covid-19 infection

In the Gaza Strip the number of new active cases continues spiking. Between November 3 and 9, 2020, 1,738 new cases were detected (about 250 a day). As of November 9, 2020, the number of active cases was 3,014. So far, there have been 39 coronavirus deaths, up from 34 a week ago.

The increase of active cases inside the Gaza Strip over the past week

The biweekly rate of the increase of Covid-19 cases in the Gaza Strip

Notes

• The current number of active cases in the Gaza Strip as of November 9, 2020, was 3,014. On August 24, 2020, before the first cases were detected inside the local population, the number was 36.
• Until Covid-19 was detected inside the Gaza Strip, an average of seven new cases were detected every two weeks. Since the disease spread to the local population, there has been an average of 1,329 new cases every two weeks.

Red areas

• As of November 8, 2020, according to the ministry of health in Gaza the red areas are the northern Gaza Strip, most of the Gaza City district, the Jabalia and Nuseirat refugee camps, the center of the city of Khan Yunis and the eastern area of the Rafah district.

The Covid-19 patients’ condition and combatting infection

• Dr. Ashraf al-Qidra, spokesman for the ministry of health in the Gaza Strip, noted a significant increase in the number of new active cases, mostly in the central Gaza Strip and the Rafah district. Regarding Covid-19 infection in Gaza in general, he stressed the following (Dunia al-Watan, November 7, 2020):
  • About 97% of the cases are mild, although there has been a significant increase in the number of seriously and critically ill patients. Twenty seriously ill patients are hospitalized in the European Gaza Hospital in Khan Yunis, nine of them on ventilators. Three or four ICU patients are young and had no preexisting conditions.
  • More than 70% of the new patients came into contact with verified active cases, and they are why the rate of infection has risen.
• Ashraf al-Qidra said the accelerated increase in the daily number of infections exerts direct pressure on the public health system and on the occupancy of beds in hospitals and quarantine centers. He said the capabilities of the two hospitals designated for Covid-19 patients are limited and at the current rate of infection they are liable to reach full capacity (Ma’an, November 3, 2020; Palestine Online, November 5, 2020).
• Other senior figures in the public health system in Gaza said the following:
  • Dr. Iyad Abu Kirsh, director of emergency medical services in the ministry of health in Gaza, said the number of serious and critical cases has risen significantly in recent weeks. He said there are 20 such cases, nine of them on ventilators, indicating a dangerous development in the epidemic, and that the situation could worsen (al-Ra’i news agency, November 5, 2020).
  • Dr. Muhammad al-Sheikh Ali, head of the team for combatting the Covid-19 epidemic in the European Gaza Hospital, said a significant number of cases needed medical treatment, but not in an ICU ward. Therefore the hospital opened an intermediate care unit with 25 beds for ICU patients whose condition improved (Facebook page of the European Gaza Hospital, November 9, 2020).

Warnings about the disregard of preventive measures

• Spokesmen for the ministry of health in Gaza say the increase in the number of active cases is due to the public’s deliberately disregarding health guidelines and preventive measures. The spokesmen warn that continuing such behavior will worsen the situation. Dr. Rami al-Abadla, head of the department of infectious diseases in the ministry of health in Gaza, said they had offered recommendations to the committee for combatting Covid-19, and the ministry of the interior in Gaza will take legal action against anyone who comes into contact with an active case or willfully disregards preventive measures (Dunia al-Watan, November 6, 2020).
• Dr. Rami al-Abadla, head of the department of infectious diseases in the ministry of health in Gaza, said the increase in the spread of coronavirus infection was due to the disregard of preventive measures. He added that large gatherings, contact with asymptomatic active cases and with people who had come into contact with active cases contribute to the spread of infection. In his estimation, about 5% of all active cases need hospitalization in ICUs. He said sites have been prepared for admitting moderately, seriously and critically ill patients, adding that they are preparing the Turkish Hospital for admitting patients in the future [in addition to the two hospitals currently dedicated to the care of Covid-19 patients] (Dunia al-Watan, November 6, 2020).
• Iyad al-Buzum, spokesman for the ministry of the interior in Gaza, said people came into contact with one another in wedding halls more than in other locations, and therefore the decision had been made to close them. He added that strict measures would be taken against local residents who hold weddings in their homes, because they aid the spread of the virus (Shehab, November 8, 2020). He said the ministry of the interior reported that five of the gatherings dispersed by the police had been weddings (ministry of the interior in Gaza website, November 8, 2020).

   
Right: A wedding in Khan Yunis. No masks, no social distancing (Facebook page of the Masar Studio in Khan Yunis, November 4, 2020). Left: A wedding in Rafah. No masks, no social distancing (Facebook page of the al-Emir Studio in Rafah, November 8, 2020).

• Saeb al-Sarafandi, a specialist in respiratory diseases in the Nasser Medical Center in Khan Yunis, expects the situation in the Gaza Strip to worsen when ordinary seasonal flu compounds another wave of Covid-19. He said the cold dry air of winter damages the respiratory system. He called on the public to be vaccinated against the flu to limit its spread, which in turn will help medical teams combat Covid-19 (Safa, November 7, 2020)..

New preventive measures

• Dr. Ashraf al-Qidra, spokesman for the ministry of health in the Gaza Strip, reported that with the help of an epidemiological investigatory committee, the ministry of health and government agencies had divided the Gaza Strip into 55 geographical areas. He said the government could increase the strictness of preventive measures in areas where Covid-19 was prevalent and ease restrictions in less dangerous areas. He added that insofar as was possible, they were trying to prevent the need for a general lockdown, and instead were using limited lockdowns in accordance with recommendations from the epidemiological committee. However, he warned that if the rate of infection continues to rise all scenarios are possible, even the need for a general lockdown (Palestine Online, November 5, 2020).
• On November 5, 2020, the ministry of the interior announced that in light of the rise in the number of active cases, the following measures will be implemented:
  • Increasingly strict measures will be imposed on quarantined homes. No one will be allowed to leave for any reason. Legal action, including imprisonment, will be taken against anyone who violates the quarantine.
  • Gatherings inside homes are banned, as is the erection of mourning tents and the holding of mass-attended weddings. Violators will be punished immediately.
  • The curfew will begin at 20:00, there will be no movement in the streets and all businesses and stores will be closed.
  • The mosques and schools will be closed in red areas. Only twelfth grade students are exempt from the order.
  • Local residents riding in cars have to implement preventive measures and wear masks. The vehicles of violators will be impounded and passengers will be detained (ministry of the interior in Gaza website, November 5, 2020).
• Iyad al-Buzum, spokesman for the ministry of the interior in Gaza, said the ministry had abstained from imposing a total lockdown and preventing entrance into and exit from red areas out of a desire to meet the public’s needs and in light of the terrible situation of Gaza Strip residents. However, he said, steps will be taken against anyone who violates the restrictions. He said the restrictions will remain in place until the curve in the red areas flattens (Safa, November 7, 2020).

Returning to routine daily life

• Alongside the new restrictions, measures are also being take to return to routine daily life: the ministry of labor announced the beginning of teaching at the government and private vocational training centers throughout the Gaza Strip (al-Ra’i news agency, November 3, 2020). The ministry for social development announced the opening of accredited daycare centers, on the condition that they fully implement preventive measures (al-Ra’i news agency, November 4, 2020). The department of public relations in the ministry of education in Gaza announced the third phase of returning first through sixth grade students to school, with the exception of the red areas (Ma’an, November 8, 2020).

Help for the Gaza Strip

• The W.H.O. delivered 140 test kits to the public health authorities in Gaza, enough to administer more than 13,000 tests (Facebook page of the W.H.O. office in the territories, November 7, 2020).
• Dr. Ashraf al-Qidra complained that while there were many offers to help the public health system in Gaza combat Covid-19, in reality, so far only a small part of what was promised has arrived. He said the ministry of health’s plan included purchasing medical appliances, ventilators, ICU beds, laboratory equipment and machines, and PPE at an estimated total cost of $59 million (Palestine Online, November 5, 2020). He also said the limited reserves of materials for laboratory testing prevented the administration of more tests (Ma’an, November 3, 2020).

Judea and Samaria

Extent of Covid-19 infection in Judea and Samaria: Overview

This past week the number of active cases in Judea and Samaria rose again with the detection of 2,358 new cases. As of November 8, 2020, the number of active cases in Judea and Samaria stood at 4,281, down from 4,415 on November 1, 2020. Forty Palestinians are in ICUs, ten of them on ventilators. This past week 22 Palestinians died. Since the outbreak of coronavirus in Judea and Samaria 49,688 cases have been detected and 477 Palestinians have died. The number of tests administered in Judea and Samaria daily is 2,670, with a 15.36% positive rate.

Covid-19 infection in Judea and Samaria since October 18, 2020

The biweekly rate of the increase of Covid-19 cases in Judea and Samaria

Notes

• The current number of active cases in Judea and Samaria as of November 8, 2020, was 4,281. Around June 14, 2020, at the beginning of the second wave, there were 48 active cases.

During the first wave, an average of 52 new cases were detected every two weeks. In the second wave, the average rose to 5,147 new cases every two weeks.

Geographic Distribution of COVID-19 Epicenters

Overview

The Nablus district still has the largest number of cases, with 1,453 new cases this past week, up from 1,153 a week ago. Infection in the Hebron district continues declining, with 429 active cases, down from 697 a week ago. The distribution of active cases in Judea and Samaria (4,415), by district, as of November 8, 2020, was the following: Nablus, 1,453; Bethlehem, 940; Hebron, 429; Ramallah, 359; the villages around Jerusalem, 96; Qalqilya, 190; Jericho, 139; Tulkarm, 239; Jenin, 298, Salfit, 79; and Tubas, 59.

The distribution of active cases in the various districts

Hebron district

The decline in the number of active cases in the Hebron district continues, after months of having the highest number. As of November 8, 2020, the number of active cases stood at 429, down from 697 on November 2, 2020. The Hebron district currently has the third largest number of cases in the PA territories.

Number of active cases in the Hebron district

Nablus district

This past week the sharp increase in the number of active cases in the Nablus district continued. As of November 8, 2020, were there 1,453 active cases, up from 1,153 a week ago. The Nablus district currently has the largest number of active cases in Judea and Samaria. Despite the difficult situation, a general lockdown has not been imposed and only localized measures are being implemented.

• Given the rise in the extent of infection, the emergency committee for combatting Covid-19 expressed concern that if the number of active cases increases the ability to treat them will be limited. The committee warned of the danger of an increase in coronavirus infection and called on all Palestinians to take preventive measures, practice social distancing, wear a mask and wash their hands (Facebook page of the Nablus district governor, November 2, 2020).
• Anan al-Atira, the deputy government of the Nablus district, said the rise in the number of active cases was the result of gatherings held to celebrate Muhammad’s birthday. She said they would be forced to take stricter steps, and a full lockdown could be on the agenda (Dunia al-Watan, November 2, 2020). On another occasion she claimed the situation in the district was under control and the decision to impose a lockdown had been made by the PA. She said a lockdown would be recommended only if the situation became very bad and the lives of the residents were in danger (al-Madinah YouTube channel, November 5, 2020).

Jenin district

There was a rise in the number of active cases in the Jenin district. As of November 8, 2020, there were 298 active cases, up from 270 last week.

•  On November 6, 2020, the police dispersed three weddings in villages in the Jenin district (PA police website November 7, 2020). Given the rise in the number of cases, Akram al-Rajoub, the district governor, locked down the village of al-Jalameh, including the public institutions and facilities, the schools and the mosques. He said weddings and other events would be strictly banned and reception venues would be closed (Facebook page of the Jenin district governor, November 2, 2020).

 
Right: A wedding in the village of Yamun (Facebook page of alyamun.alhabeba, November 7, 2020). Left: A wedding in the village of Sanur (Facebook page of the Firas al-Awna Studio in the Jenin district, November 6, 2020).

Qalqilya district

As of November 8, 2020, the number of verified Covid-19 cases in the Qalqilya district was 190, up from 177 a week ago.

• On November 7, 2020, the PA police and security services dispersed three weddings and closed a mourning tent in the Qalqilya district (PA police website, November 7, 2020).

The East Jerusalem Neighborhoods

The number of active cases in the east Jerusalem neighborhoods rose this past week. According to the PA, as of November 8, 2020, there were 261 new cases and the number of active cases stood at 423, up from 300 a week ago. According to the Jerusalem municipality, on November 8, 2020, the number of verified active cases was 344, up from 240 a week ago. According to the Jerusalem municipality, so far 88 residents of east Jerusalem have died. According to the municipality, this past week the positive tested rate of infection was high, 8.9% up from 5.1% a week ago.

The number of active Covid-19 cases in east Jerusalem, according to the PA

The total number of Covid-19 cases in east Jerusalem, according to the PA

The distribution of Covid-19 infection in east Jerusalem
(According to the Jerusalem municipality, November 2, 2020)

The PA Combats Covid-19

• In light of the rise in infection and in order to prevent the continued spread of Covid-19, on November 3, 2020, Mahmoud Abbas extended the state of emergency throughout Judea and Samaria for an additional 30 days, beginning the same day (Wafa, November 3, 2020). Alongside support for Mahmoud Abbas, Facebook users posted surprise, wondering what good a state of emergency would do without a lockdown (Mahmoud Abbas’ Facebook page, November 3, 2020).
• PA Prime Minister Muhammad Shtayyeh met with the heads of the Palestinian security services, the emergency committee to combat Covid-19 and the district governors to examine preparations for the possible outbreak of another wave of Covid-19 during the winter and the preparedness of the Palestinian public health system for all possible scenarios (Muhammad Shtayyeh’s Facebook page, November 5, 2020). He instructed the security services to reinforce preventive measures and the sanctions imposed on Palestinians who broke the law. As to prayers in the mosques, he told the security services to make sure worshippers wore masks and followed public health guidelines. Prayers could be held for no longer than 15 minutes (Wafa, November 5, 2020).

• Dr. Naji Nizal, head of hospitals in the ministry of health in Ramallah, said the ministry was prepared for winter and the rise expected in the number of patients. He said a number of hospitals and medical centers had been upgraded; the new hospital in Dura had been fully equipped, the number of beds had been increased to 120 and it had 20 ventilators; the center for drug rehabilitation in Bethlehem had been given four ventilators and the number of beds had been increased to 37; and the hospital in Azoun in the Qalqilya district had been equipped with an additional 20 beds and six ventilators (Facebook page of the ministry of health in Ramallah, November 3, 2020).

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