The number of COVID-19 cases continue to spike upward throughout Judea and Samaria, compared with the low number in the Gaza Strip (Updated to July 13, 2020)

Overview

The numbers of active coronavirus cases continue to spike upwards in Judea and Samaria, part of the second wave of COVID-19. According to reports from the Palestinian Authority (PA) ministry of health, the number of active cases now stands at 5,121, up from 3,758 last week (updated to the evening of July 12, 2020). Of the active cases, 4,140 are in the Hebron district (3,150 a week ago), 81% of the total number of active cases in Judea and Samaria. There are 16 ICU patients, seven on ventilators. According to the ministry of health, 41 people have died, most of them in the Hebron district (as of July 13, 2020). Since the outbreak of the disease 6,153 Palestinians have been diagnosed with the virus. There has also been a significant increase of infection in the east Jerusalem neighborhoods, where the number of active cases is currently 632 (according to PA reports).

The rise in the number of COVID-19 patients in Judea and Samaria

The Spread of COVID-19 in Judea and Samaria

• The salient information about the outbreak of COVID-19 in Judea and Samaria is the following:
  • This past week as well the number of active cases continued to spike upward. The Hebron district has the greatest number (about 81% of the total). According to the minister of health, between 20% and 30% are elderly. Medical sources in the PA have expressed concern over a loss of control over the spread of the disease.
  • There is a serious shortage of medical equipment, especially ventilators and test kits. A spokesman for the Palestinian ministry of health reported that about 70% of the beds in ICUs are in use. In addition, about 70% of the ventilators are in use and there are currently fewer than 100 ventilators for COVID-19 patients.
  • The sharp rise in the number of active cases in east Jerusalem continues, and this past week the number almost tripled. According to PA reports there are 632 active COVID-19 cases in east Jerusalem, up from 268 last week. A significant rise was also noted in the villages surrounding Jerusalem.
  • The number of deaths has risen along with the number of infections. Since the outbreak of COVID-19 41 people have died in Judea, Samaria, east Jerusalem and the Gaza Strip, 20 of them during the past week. Most of the deaths have been in the Hebron district, the main epicenter of the infection.
  • The PA has taken additional preventive measures, including banning movement between the districts and locking down the epicenters. Despite the efforts of the security apparatuses to strictly enforce the lockdown, Palestinians continue violating the guidelines.
  • Particularly serious this past week was the outbreak of COVID-19 in the Jalazone refugee camp (Ramallah-al-Bireh district), whose residents have been particularly critical of the government. Refugee camp activists accused the government of abandoning them and called on all the local authorities to provide isolation centers for infected people because the crowding of the houses makes the refugee camp unsuitable for quarantine.
  • Compared with the PA’s problems, the Hamas administration has been very successful in dealing with the outbreak of the disease. The number of active cases continues to decline, and there are currently only eight active cases. The ministry of health in Gaza offered to send teams of medical specialists to the West Bank to help the PA deal with the coronavirus, but so far the offers have been rejected.
  • The deputy governor of the Hebron district claimed people continue gathering and attending festivities in locations under Israeli control in the southern Mt. Hebron area. He said the PA security apparatuses cannot enter the area to enforce the PA ministry of health’s guidelines, which may lead to the spread of the coronavirus to all the PA territories.
  • The worsening of infection led the PA to enact measures to limit contacts with Israel. The PA called on Israel to close all the crossings between the PA territories and Judea and Samaria; it called on Israeli Arabs not to go to PA territories (despite the fact that their entrance is an important source of income for the PA); and Palestinians were banned from going to work in Israel.

Distribution of COVID-19 fatalities in Judea, Samaria, east Jerusalem and the Gaza Strip

Geographical Distribution of COVID-19 Epicenters

Overview

The following is the geographic distribution of the 5,121 active COVID-19 cases by district: Hebron, 4,140; Bethlehem, 335; Nablus, 160; Ramallah-al-Bireh, 190; the villages around Jerusalem, 211; Tulkarm, 36; Jericho, 24; Qalqilya, nine; Jenin, seven; Salfit, five; and Tubas, three. This past week there was a significant rise in the number of active cases in the Jericho district and the villages around Jerusalem.

• The district governors continue their local policy of closing the district borders and taking preventive measures in addition to the government lockdown. They ordered the pinpointed lockdowns of several villages where COVID-19 patients were detected. In some districts local residents, organizations and institutions signed a “national honor agreement” which included promising not to hold weddings or erect large mourning tents. The agreement also called on all Palestinians to obey the guidelines issued by the ministry of health, and for Palestinians working in Israel to be tested every time they arrived at the crossings (Ma’an, July 8, 2020).

Distribution of active COVID-19 cases in the PA districts^[1]

The Hebron district

• The number of active COVID-19 cases in the Hebron district currently stands at 4,140, up from 3,150 a week ago (as of the evening of July 12, 2020). Thus Hebron has about 81% of all the active cases in Judea and Samaria. According to the minister of health, about 20%-30% of all the patients in the district are elderly. Medical aid was sent to the Hebron district, including a number of ventilators.

Rate of the spread of COVID-19 in the Hebron district

• Dr. Usama al-Najar, director of medical services in the Palestinian ministry of health and a member of the ministry’s emergency committee, spoke in an interview about the situation in the Hebron district. He said they were suffering from a severe shortage of test kits, with only between 1,000 and 1,500 remaining. He said he was concerned over a loss of control over the situation, saying the medical teams were working 24 hours around the clock. Regarding the delay and mistakes in publishing test results, he said that next week an Internet site would be launched where test results could be seen (Ma’an, July 13, 2020).
• On July 8, 2020, control teams in the Hebron district closed about 50 stores and businesses which had violated the lockdown order (Facebook page and Samer al-Sharawi, July 8, 2020). On July 9, 2020, control teams visited 137 stores and businesses, nine of which were closed for not complying with the guidelines (Facebook page of the Hebron district governor, July 10, 2020)

   
Right: The lockdown in Hebron (Wafa, July 9, 2020). Left: The Palestinian security apparatuses close a store that violated the lockdown order (Facebook page and Samer al-Sharawi, July 8, 2020).

• In light of the situation the ministry of health sent equipment from its warehouses in Ramallah to medical centers in the Hebron district. The equipment included four ventilators, CT scanners and hospital beds. Medical teams were also sent as reinforcement (Facebook page of the Palestinian ministry of health, July 10, 2020).

   
Delivering aid from the Palestinian ministry of health in Ramallah for the medical centers in Hebron (Facebook page of the Palestinian ministry of health, July 10, 2020)

Khaled Dudin, deputy Hebron district governor, claimed festivities and gatherings continued to be held in areas under Israeli control. He said the PA security apparatuses could not enter the areas, which was liable to lead to a greater spread of the virus (Dunia al-Watan, July 7, 2020). Families in southern Hebron under Israeli control, families in al-Falluja and the Fatah branch in the district published an open letter calling on all the residents of the southern region of the Hebron district to commit themselves to obeying the guidelines of the ministry of health and not to gather, erect mourning tents or hold ceremonies or festivities (Wafa, July 7, 2020).

The Bethlehem district

• In the Bethlehem district there are 335 active cases, up from 249 a week ago. Four of the new cases were employees of the district health administration, and thirty were quarantined, but reportedly the health administration continues providing services (Wafa, July 10, 2020).

The Nablus district

• In the Nablus district there are 160 active cases. At a meeting of the “crisis cell” of the district’s emergency committee, an updated map of epidemiological developments was revealed. According to the data, 85% of the active cases attended weddings or other festivities, or paid condolence calls at mourning tents (Facebook page of the Nablus district governor, July 6, 2020).
• Anan al-Atira, deputy district governor, reported that a working plan had been prepared for a significant rise in the number or cases, like what happened in the Hebron district. According to the plan, examination centers would be set up in the emergency medicine departments in every hospital in addition to their quarantine centers. Backup teams were prepared to reinforce the regular medical personnel (al-Najah website, July 6, 2020).
• The Palestinian security apparatuses, the ministry of the national economy and the department of health continue enforcing the lockdown (website of the PA police, July 9, 2020). Police and the security apparatuses closed 40 businesses, among them two cafés, which violated the guidelines. They also confiscated 40 vehicles whose drivers violated the state of emergency orders forbidding driving (website of the PA police, July 8, 2020)

   
The Palestinian security apparatuses patrol the markets in Nablus
(website of the PA police, July 9, 2020).

The Ramallah-al-Bireh district

• In the Ramallah-al-Bireh district there are 190 active cases, up from 49 a week ago. One of the epicenters is the Jalazone refugee camp. Layla Ghanem, governor of the Ramallah-al-Bireh district, announced the establishment of a facility for Palestinians who have tested positive because of the speed of the spread of the virus throughout the camp and because the crowding of the houses makes it impossible to quarantine people at home (Wafa, July 12, 2020).
• The residents of the Jalazone refugee camp used the social media to ask for other locations for quarantine because the houses in the camp are close to one another and conditions are unsuitable for quarantine. Refugee camp activists accused the PA government of abandoning them. Others condemned the government’s delay or refusal to provide them with hotels for quarantine, claiming it did not have the funds or medical personnel for such an arrangement. Others said they opposed turning the schools into quarantine camps (Dunia al-Watan, July 10, 2020).

The Qalqilya district

• In the Qalqilya district there are ten active cases, up from six a week ago. The office of Rafi’ Rawajba, governor of the Qalqilya district, reported that a resident of the town of Ras Atiya, in the southern part of the district, tested positive for COVID-19 after having attended a wedding in Israel. As a result the governor decided to lock down the town (Facebook page of the governor of the Qalqilya district, July 10, 2020), The UNRWA hospital in Qalqilya was closed after three patients tested positive (Sawa, July 12, 2020).
• The police and the Palestinian security apparatuses oversaw the implementation of precautionary measures. The police confiscated the cars of private individuals who exploited the state of emergency and charged people for rides. The police also closed stores and detained people who violated the emergency orders (website of the PA police, July 10, 2020). On July 9, 2020, the police dispersed the guests at a wedding in one of the villages. The groom and his father were detained for violating the ban on gatherings (website of the PA police, July 9, 2020).

The Jenin district

• In the Jenin district there are seven active cases, up from six last week. After a resident of the Jenin refugee camp tested positive for COVID-19, Ikram Rajoub, the district governor, locked down the camp for 48 hours to allow for contact tracing. The lockdown was lifted after 48 hours (Facebook page of Ikram Rajoub, July 10, 2020).
• The Palestinian police closed stores and businesses whose owners violated emergency orders and reported residents and drivers who did not wear masks and gloves. Among the businesses closed were a textile workshop, a sports venue and five taxi stands, and eight vehicles used for public transportation had their licenses revoked (website of the PA police).

East Jerusalem

• This past week there was spike in the number of active cases in east Jerusalem. According to PA reports, the number of active cases in east Jerusalem is 632, up from 268 a week ago. According to statistics from the PA ministry of health, since the beginning of the coronavirus outbreak there have been 812 COVID-19 cases.

Active cases in the east Jerusalem neighborhoods (since early May 2020)

Total number of COVID-19 cases in east Jerusalem (since early May 2020)

The PA Increases Preventive Measures

• The continuing spiking upward of active COVID-19 cases has led to the Palestinian government’s continuing the lockdown and adding preventive measures. Ibrahim Melhem, spokesman for the PA government, held a press conference where he announced more intensive preventive measures, including the following:
  • For the next two weeks there will be no movement between the districts. The situation will be reevaluated daily.
  • The districts of Hebron, Bethlehem, Nablus and Ramallah (where the number of active cases is higher) will be locked down for an additional four days. In other districts the villages, neighborhoods and refugee camps where active cases have been detected will be locked down.
  • There will be a curfew from 20:00 at night until 06:00 the following morning in every district for two weeks. Over the next two weekends there will be a total lockdown from Thursday until Sunday.
  • There will be a total ban on weddings, erecting mourning tents and gatherings in general.
  • Israeli Arabs are called on not to enter the West Bank. Palestinians are also banned from going to work in Israel.
• PA Prime Minister Muhammad Shtayyeh appealed to the United Nations Truce Supervision Organization to supervise the entrance and exit of Palestinians through the crossings between Israel and the PA. He said the fact that the Palestinian security apparatuses did not have control over the crossings was the main reason for the rise in infection. He also called on Israel to close the crossings (al-Quds, July 6, 2020).
• Muhammad Shtayyeh called a meeting of the heads of the Palestinian security apparatuses to demand they increase their presence in the Palestinian cities and villages to prevent the spread of the virus (Wafa, July 7, 2020).

Public Violation of Lockdown Order

• Despite the spike in the number of COVID-19 cases, the Palestinian public continues not following the guidelines. Usama al-Najar, director of medical services in the PA ministry of health and member of the ministry’s emergency committee, said some COVID-19 patients violate the quarantine leave their homes, thereby contributing to the spread of the disease. He said there was no choice but to use stronger measures against them (Facebook page of Samer al-Sharawi, July 9, 2020). As deterrence the government set high fines for people who violated ministry of health guidelines. The fines will be between one hundred and five hundred shekels (between about $29 and $145). Violators will have to pay the fines within 30 days and anyone who does not pay will have to appear before a court (Ma’an, July 7, 2020).
• Nevertheless, violations continued. For example:
  • On July 11, 2020, the medical emergency committee in the village of Taffuh, one of the villages in the Hebron district with many coronavirus cases, reported that because of violations of the guidelines and precautionary measures issued by the ministry of health, the teams in the medical centers were suspending their activity for the next 48 hours and the committee had relieved itself of all responsibility. The committee assigned responsibility for any deterioration of the situation to the Palestinian security apparatuses. Patients would be sent to medical centers in Halhul and Dura for care (Facebook page of the medical emergency committee in the village of Taffuh, July 11, 2020).
  • A number of sectors in the PA expressed their objection to the lockdown because of the economic problems it created. For example, the union of public transportation workers in the West Bank announced its members would not be subject to the stay-at-home decision. The union called on all the drivers to go back to work on July 12, 2020, maintaining the protocols of the ministry of health. The union said that if the government did not exempt drivers from paying their debts to the government for 2020, it would announce an escalation (Sawa, July 9, 2020).
  • On July 11, 2020, the PA ministry of education announced the results of the 2020 matriculations exams. In preparation, Ibrahim Ramadan, governor of the Nablus district, asked people not to publicly celebrate the results. He asked them to limit their expressions of joy to the family circle and to follow the orders banning gunfire into the air and setting off fireworks (Facebook page of Ibrahim Ramadan, July 10, 2020). Despite the calls, cities including Hebron, Nablus and Ramallah held parades in violation of the lockdown and the guideline to wear masks (QudsN Facebook page, al-Risalah Twitter account, July 11, 2020).

Influence of the COVID-19 Crisis on the PA’s Financial Situation

• Nasri Abu Jish, PA minister of labor, signed an agreement with a legal consulting firm to monitor the legal rights of the Palestinians who work in Israel and were harmed by measures taken by Israel during the COVID-19 crisis. The measures included preventing work opportunities, unfair salary conditions and revoking work permits. He said personal and class legal actions would be instituted to achieve equality between the rights of Palestinian and Israeli workers in the Israeli work market (Wafa, July 9, 2020).
• PA Prime Minister Muhammad Shtayyeh participated in a virtual international summit meeting of the International Labor Organization to discuss the coronavirus. The meeting was an Organization activity held with the participation of heads of state, ministers and businessmen from the member countries. Its objective was to formulate ways to deal with the economic and social influences of the coronavirus and to help workers return to work once the crisis ends (Wafa, July 8, 2020).
• The EU transferred the sum of €22 million for humanitarian aid for the Palestinians in Judea, Samaria and the Gaza Strip to help them overcome the influence of the spread of the coronavirus (EU website, July 8, 2020).

Palestinians Return to the PA

• Despite the increase in COVID-19 infection in Judea and Samaria, Palestinians continue returning to the PA territories from abroad. Ahmed al-Dayak, advisor to the Palestinian foreign minister, said the discourse with Egypt regarding the arrival of Palestinians continues:
  • The foreign ministry announced that a group of 257 Palestinians had returned from Dubai and Saudi Arabia. Upon arriving in the PA from the Jordanian airport they were taken to the Nuway’imah camp near Jericho for testing (Dunia al-Watan, July 9, 2020).
  • Two hundred and fifty-five Palestinians arrived from Turkey, Indonesia, Sweden, Lebanon, Malaysia, Malta, Holland, South Korea and Azerbaijan. They flew from Turkey to Jordan and entered the PA territory via the Allenby Bridge and from there were taken to the Nuway’imah camp where they were tested for COVID-19 by teams from the Palestinian ministry of health. They were all sent to home quarantine to await the test results (Wafa, July 10, 2020).
  • According to foreign ministry, Palestinians interested in returning from European and other countries can book a seat on the Jordanian Airlines flight leaving from Frankfurt on July 13, 2020. According to the announcement, the flight has 270 seats (Wafa, July 11, 2020).

The Gaza Strip

The extent of infection

The ministry of health in Gaza announced the recovery of three additional COVID-19 patients, reducing the number of active cases to eight, all quarantined in the hospital at the Rafah Crossing (Safa, July 10, 2020). The total number of COVID-19 infections in the Gaza Strip is 72, of whom 63 have recovered. Twenty-one of those who recovered have been transferred to quarantine centers to complete the period of isolation and 42 have been released to their homes. There was one death (Dunia al-Watan, July 12, 2020).

• The ministry of health in Gaza reported that as on July 12, 2020, 13,130 tests had been administered, of which 13,058 were negative (Dunia al-Watan, July 12, 2020). There are still 323 people in six quarantine centers in the Gaza Strip (Dunia al-Watan, July 11, 2020). The ministry of health continues disinfecting the quarantine centers in preparation for the receipt of new patients (website of the ministry of health in Gaza, July 7, 2020).

Opening the markets

• In light of the significant improvement in the coronavirus situation in the Gaza Strip, the Hamas administration decided to open the main markets in Gaza, beginning on July 11, 2020, in accordance with precautionary health measures. It is the responsibility of the local municipality, the police and teams from the ministry of the interior to monitor the implementation of the health guidelines by merchants and local residents (Filastin al-Yawm, July 10, 2020). According to an article about the opening of the markets, there was no great following of precautionary measures (Twitter account of the al-Mamlaka channel, July 12, 2020).

    
Report on reopening the markets: no masks, little social distancing
(Twitter account of the al-Mamlaka TV channel, July 12, 2020).

Concerns the situation will worsen

• Despite the promising situation, medical team activity continues in the Gaza Strip in preparation for it to worsen. The W.H.O. reported that members of the French Médecins du monde (MdM), in collaboration with the W.H.O., instructed 14 representatives of the ministry of health in Gaza to improve their knowledge about the operation of emergency centers for patients with respiratory difficulties. Forty personnel from the ministry of health participated in simulations at an emergency center for respiratory patients at the Shuhadaa al-Aqsa Hospital to improve their preparedness for treating cases suspected as COVID-19 in the safest and most beneficial way possible (W.H.O. website, July 9, 2020).

Proposal to send aid to Judea and Samaria

• Dr. Yusuf al-Rish, deputy minister of health in Gaza, said his ministry had decided to send multi-disciplinary medical teams to the West Bank to support their colleagues in coping with the coronavirus pandemic (Quds Press, July 7, 2020). Ashraf al-Qidra, spokesman for the ministry of health, said the ministry was in contact with the ministry in Ramallah to arrange the exit of medical teams from Gaza and their entrance into the West Bank. He said the team included specialists in epidemiology, infection prevention, anesthesia and intensive care. He added the team had received training for dealing with every COVID-19 scenario, and was prepared to work wherever necessary and do whatever necessary for the ministry of health in the West Bank (Safa, July 7, 2020).
• In response to the Gaza Strip initiative Kamal al-Shakhra, spokesman for the PA ministry of health, said he was not rejecting the initiative, but the situation was currently under control. He said the PA ministry of health had asked for the names of the doctors from Gaza, and should the situation require their arrival in the West Bank, the PA would work to receive them without hesitation (QudsN, July 10, 2020).

^[1] On July 12, 2020, the Palestinian minister of health again issued data about the distribution of patients according to district, after she had not done so for a number of days. ↑

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