The Spread of Covid-19 in Gaza Strip, Judea and Samaria (Updated to November 2, 2020)

Overview

• The situation in the Gaza Strip:
  • This past week the sharp rise number of active Covid-19 cases in the Gaza Strip continued with 1,408 new cases. As of November 3, 2020, the number stood at 2,647, up from 2,080 on October 27, 2020.
  • Despite the spike in infection, the Hamas administration has so far not imposed a full lockdown, and its spokesmen claim the situation is under control. Public health officials in Gaza have noted the violations of preventive measures, stating that a continued rise in the number of infections could lead to the implementation of “drastic measures” [i.e., a full lockdown].
  • Despite the rise in infection, junior high schools have partially reopened, with the exception of schools in red areas. The Rafah Crossing was opened for two days to allow Palestinians to enter the Gaza Strip.
  • Senior figures in the public health system reported hospitals at near capacity and a lack of medical and laboratory equipment. In the meantime, alternatives are being examined in case the hospitals become overloaded and are unable to admit new patients (such as transferring them to schools or other facilities for treatment).
• The situation in Judea and Samaria:
  • This past week the number of active Covid-19 cases in Judea and Samaria rose, with 2,330 new cases. As of November 1, 2020, there were 4,415 active cases, up from 4,389 a week ago. The number of deaths stands at 455, up from 417 a week ago. Despite the rise in infection, so far the Palestinian Authority (PA) has not imposed a full lockdown, instead implementing localized measures.
  • The Nablus district has the largest number of active cases in Judea and Samaria, followed by Bethlehem. The number of active cases in the Hebron district continues declining. In the east Jerusalem neighborhoods the trend towards a decline continues. According to a PA report, on November 1 there were 300 active cases in east Jerusalem, down from 458 a week ago. According to the Jerusalem municipality, there were 240 active cases, down from 271 a week ago.
  • The number of tests administered the PA is relatively low and the rate of positive results is high (more than 15%). Therefore, in Israel it is estimated that the number of active Covid-19 cases in Judea and Samaria is higher than what has been reported. The number of deaths is also thought to be higher in Judea and Samaria than the official count because people die of coronavirus without being hospitalized and their deaths go unreported.
  • According to reports, tens of thousands of Israeli Arabs go to the PA territories every week for purposes of entertainment, restaurant meals and shopping in violation of social distancing and mask-wearing orders. In addition Israeli Arabs continue holding weddings in Judea and Samaria. Such actions are liable to result in the mutual infection of the Israeli Arab and Palestinian populations.

The Gaza Strip

Extent of the Covid-19 infection

In the Gaza Strip the number of new active cases continues spiking. Between October 27 and November 2, 2020, 1,408 new cases were detected (about 200 a day). As of November 3, 2020, the number of active cases was 2,647. So far, there have been 34 coronavirus deaths.

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

• According to a statement from the ministry of health in Gaza, a sharp rise in coronavirus infection was recorded in Jabalia, the Nuseirat refugee camp, the al-Amal neighborhood in Khan Yunis and in eastern Rafah (Facebook page of the ministry of health in Gaza, October 29, 2020). A spike was also recorded in the Rafah district: on October 31 and November 1, 2020, more than 20 new active cases were detected, while previously the numbers of new cases had been single-digit. According to the map issued by the ministry of health, red districts include the northern Gaza Strip, most of the Gaza City district, the al-Bureij and Nuseirat refugee camps, and the central area of the city of Khan Yunis.

• More senior Palestinian Islamic Jihad (PIJ) and Hamas figures have been infected, among them senior PIJ figure Khader Habib, and Musa Abu Marzouq, a member of the Hamas political bureau (Musa Abu Marzouq’s Twitter account, October 27, 2020).

Hospitals in the Gaza Strip approach full capacity

Yusuf al-Akkad, director of the European Gaza Hospital in Khan Yunis, the main epidemiological hospital in the Gaza Strip, said the hospital is close to full capacity. Most of the patients are asymptomatic and some of the patients have mild symptoms. He said the capacity of the hospital itself and the nearby school is 500 patients, and so far 350 beds are already occupied. About 100 beds have been reserved for serious cases and cannot be allotted. He said that if the hospital reaches full capacity they will have to move the asymptomatic patients to schools or other facilities to free beds for symptomatic patients. He warned that as cold weather approaches they expect the number of active cases to continue climbing (Safa, November 1, 2020).

• Other senior public health figures in the Gaza Strip said the following:
  • Dr. Muhammad Abu Salmiya, director of the Shifaa Medical Center, said the situation is under control although it is becoming more and more dangerous. He said if the number of active cases increases so will the number of deaths. He warned the public that if they continue disregarding public health guidelines they can expect a “hard winter” (al-Ra’i news agency, October 27, 2020).
  • Dr. Iyad Abu Kirsh, director of emergency medical services in the ministry of health in Gaza, said that in preparation for combatting coronavirus as winter begins they had prepared an ICU in the European Gaza Hospital in Khan Yunis. There will be room for 100 beds with ventilators, monitoring equipment, medical equipment and drugs. In addition, 52 ICU doctors have undergone intensive training in dealing with seriously and critically ill patients (website of the ministry of health in Gaza, November 2, 2020).
  • Amid Mushtaha, head of the laboratory department in the ministry of health in Gaza, said the laboratories lacked reagents and equipment. He said they had increased the number of Covid-19 tests administrated daily, and if they had more test kits they could analyze more than 3,000 samples a day. He called on international agencies to support the Gaza Strip and provide the necessary laboratory reagents and equipment (Shehab, October 31, 2020).

Threat of another lockdown in the Gaza Strip

• Hamas administration spokesmen say that so far the situation is under control, but warn that a rise in the spread of infection is liable to call for drastic measures. According to Salama Maarouf, chairman of the government media information bureau, a rise in the number of active cases was expected because of lifting restrictions and renewing activity in the various sectors. He said the outbreak of Covid-19 is still under control, but everyone has to employ preventive measures. He said a large number of active cases may lead to a separation of the districts and a general lockdown, among other possible options. However, he said, as long as the situation is under control no lockdown will be imposed (al-Ra’i news agency, November 1, 2020).
• Spokesmen for the ministry of health say the sharp rise in active cases is caused by the public’s disregard of preventive measures and public health guidelines. They threaten a possible reimposition of a general lockdown (Facebook page of the ministry of health in Gaza, October 29, 2020).
  • Dr. Ashraf al-Qidra, spokesman for the ministry of health in the Gaza Strip, said the spike in the coronavirus curve was the result of non-compliance with self-isolation orders, especially by Gazans who came in contact with active cases, adding that it made up for more than 75% of new infections (al-Ra’i news agency, October 29, 2020). On another occasion he said that if the rate of infection continues to rise because of lack of compliance with public health guidelines, a general lockdown may be imposed (Shehab, October 31, 2020).
  • Dr. Rami al-Abadla, head of the department of infectious diseases in the ministry of health in Gaza, regards social and family ties as behind the spread of coronavirus in Gaza. He said no more than 10% of Gazans make it a point to wear masks (website of the ministry of the interior in Gaza , November 1, 2020).
  • Randa Abu Rabi’, spokesperson for the W.H.O., said the situation in the Gaza Strip was still under control but that could change at any moment. She said the rise in the number of active cases, despite the preventive measures taken, made it clear that local residents were not following the ministry of health’s guidelines. She said she hoped the number of cases requiring hospitalization would not exceed what hospitals could provide. She added that there was concern that the public health system would not be able to contain the number of cases and might collapse. The collapse of the public health system would be, she said, “a catastrophe greater than war, the [so-called Israeli] siege and the hunger suffered by the Gazans” (qudsnet.com. October 31, 2020).

Opening the Rafah Crossing

• The ministry of the interior in Gaza announced the opening of the Gaza Strip in both directions between November 2 and 5, 2020 (website of the ministry of the interior, November 1, 2020). The ministry of health announced that from now on returning Gazans would have to bring certification of a PCR examination administered 48 hours before their return. They would then be permitted to return immediately to their homes and comply with public health guidelines. Gazans who return without having been examined with a PCR test will be tested at the Rafah Crossing, and will then have to return to their homes and remain there until the test results have been obtained (Facebook page of the ministry of health in Gaza, October 29, 2020).
• Dr. Ashraf al-Qidra, spokesman for the ministry of health in the Gaza Strip, said the new rule had been instituted because the last group of returning residents had not influenced the curve of Covid-19 infection, and the rate of infection among them was 0.7% (Shehab Twitter account, October 31, 2020).

Schools continue reopening

• On November 2, 2020, students in UNRWA junior high schools returned to in-person lessons, with the exception of the schools in red areas. According to Farid Abu Athra, chief of UNRWA’s education program in Gaza, students have been divided into two groups. Each group will alternate between studying at school for three days a week and from home three days a week (Palestine Online, November 1, 2020).

   
Students in UNRWA junior high schools return to school (Facebook page of photojournalist Usama al-Kahlut, November 2, 2020).

Aid for the Gaza Strip

• The W.H.O. sent the Gaza Strip 50,000 swabs and 1,000 fast-result test kits (Facebook page of the W.H.O. in the territories, October 28, 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 with the detection of 2,330 new cases. As of November 1, 2020, the number of active cases in Judea and Samaria stood at 4,415, up from 4,389 on October 26, 2020. Thirty-five Palestinians are in ICUs, nine of them on ventilators. This past week 38 Palestinians died, bringing the total number of deaths to 455. Since the outbreak of coronavirus in Judea and Samaria, 47,330 cases have been detected.

Covid-19 infection in Judea and Samaria since October 10, 2020

Geographic Distribution of COVID-19 Epicenters

Overview

The Nablus district has the largest number of cases, followed by the Bethlehem district. This past week the number of Covid-19 cases in the Hebron district continued declining. The distribution of active cases in Judea and Samaria (4,415), by district, as of November 2, 2020, was as follows: Nablus, 1,153; Bethlehem, 764; Hebron, 697; Ramallah, 402; the villages around Jerusalem, 222; Qalqilya, 177; Jericho, 191; Tulkarm, 331; Jenin, 270, Salfit, 157; and Tubas, 51.

The distribution of active cases in the various districts

Hebron district

The number of active cases in the Hebron district continues to decline after months of having the largest number. As of November 2, 2020, the number of active cases stood at 697, down from 749 on October 25, 2020. The Hebron district currently has the third largest number of cases.

Number of active cases in the Hebron district

Nablus district

This past week there was a spike in the number of active cases in the Nablus district. As of November 1, 2020, were there 1,153 active cases, up from 862 a week ago. The Nablus district currently has the largest number of active cases in Judea and Samaria. Despite the rise in the extent of infection, a general lockdown has not been imposed and only localized measures are being implemented.

• Given the rise in the number of active cases, the emergency committee for combatting Covid-19 held a meeting to discuss limiting the spread of the disease, especially in view of the approach of winter. The following measures were decided on: appointing a monitoring committee, reactivating the regional and neighborhood emergency committees, allotting two centers for testing and classification in the eastern part of the city, increasing assessment and the strict implementation of health protocols, especially in public areas. The committee also decided to support Red Crescent hospitals in the district to enable them to admit Covid-19 patients (Facebook page of the Nablus district governor, October 28, 2020).
• The emergency committee expressed concern over the number of new cases detected in recent days, stating that if the number continues rising, they will consider raising the district’s level of emergency. The call was again issued to local residents to follow public health guidelines and employ preventive measures, including wearing masks at work, and avoiding gatherings and indoor or crowded areas.
• The emergency committee ordered the closing of a number of institutions after active cases were detected, among them the internal revenue office and two schools in Beit Furik and the city of Nablus (Facebook page of the Nablus district governor, October 26, 2020). Mahmoud al-Habash, the head cadi, ordered the closing of the Sharia appeals court in Nablus after its cadi was infected with Covid-19 (Wafa, October 28, 2020).

Jenin district

As of November 1, 2020, the curve in the Jenin district has flattened. There were 270 active cases in the Jenin district, up from 268 last week.

• Akram al-Rajoub, district governor, and Dr. Wissam Bakr, director of the government hospital in Jenin, opened an emergency ward for suspected active Covid-19 cases. Until it was opened, such cases were admitted in a tent erected on hospital grounds (Wafa, October 27, 2020).
• Akram al-Rajoub, district governor, announced a three-day lockdown of the village of Silat al-Harithiya after a rise in the number of Covid-19 cases (Facebook page of the Jenin district governor, October 28, 2020). The Palestinian police in Jenin broke up three wedding parties, held despite the ban (website of the Palestinian police, October 29 and 31, 2020).

      
Right: A wedding in the village of Yamun, in the Jenin district (Facebook page of alyamun.alhabeba, October 31, 2020). Left: The event held for the signing of the marriage broker’s agreement in Yamun (Facebook page of alyamun.alhabeba, October 301, 2020).

The villages around Jerusalem

As of November 1, 2020, there were 222 active cases in the villages around Jerusalem, up from 215 a week ago.

• During Palestinian police patrols in the towns and villages northeast of Jerusalem, six wedding parties were broken up and the owners of six wedding halls were taken for questioning by the Palestinian police (Palestinian police website, October 31, 2020). In ITIC assessment, some of the weddings were held by residents of east Jerusalem neighborhoods, who prefer the PA territories because public health guidelines are more laxly enforced than on the Israeli side, where enforcement is stricter.

The East Jerusalem Neighborhoods

The number of active cases in east Jerusalem neighborhoods continues declining. According to the PA, as of November 1, 2020, there were 138 new cases and the number of active cases stood at 300, down from 458 on October 26, 2020. According to the Jerusalem municipality, on November 2, 2020, the number of active cases was 240, down from 271 on October 25, 2020. According to the Jerusalem municipality, so far 85 residents of east Jerusalem have died. According to the municipality, the positive tested rate of infection is 5.1%.

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

• At the beginning of the weekly government meeting, PA Prime Minister Muhammad Shtayyeh announced the launching of a new free app called Amankom (“Your safety”), administered by the ministry of health. It provides information about Covid-19, including contact tracing. Muhammad Shtayyeh called on the Palestinian public to download and use it (Facebook page of the ministry of health in Ramallah, October 26, 2020).

• Samer al-Assad, responsible for preventive medicine in the ministry of health in Ramallah, said the ministry administered 4,000 Covid-19 tests every day (Palinfo Twitter account, October 29, 2020).

Israeli Arabs Visit the PA Territories

According to reports, every week tens of thousands of Israeli Arabs visit the PA territories for entertainment. They usually visit the large cities, where they go to restaurants, shopping centers and stores without PA security service enforcement. Israeli Arabs also continue holding weddings in the PA territories.

• Such visits can lead to mutual infection and reinfection between Israeli Arabs and Palestinians in Judea and Samaria. Ayman Sayif, who holds the Covid-19 portfolio in Israeli Arab society^[1], said the matter had been raised at deliberations held by the ministry of health. He added that they were considering various options. One solution could be to declare some of the [Palestinian] cities red, and anyone who returned from the PA territories would have to self-isolate. He said they had to make decisions, because if the matter is not dealt the spread of Covid-19 in Israeli Arab society will increase (Ynet, November 1, 2020).

Returning Palestinians from Abroad

• The PA foreign ministry announced that in cooperation with the Jordanian consulate in Ramallah and the PA representative in Amman, the operation to return stranded students will continue. Nine students left the PA to return to Ireland and nine to return to France. Sixteen students will return to the PA (Dunia al-Watan, October 30, 2020). The foreign ministry said two flights had left for Istanbul for residents who had been unable to join previous flights (Wafa, October 30, 2020).

• Aid for the PA

• The German government donated fifty ventilators to the PA. Mai al-Kayla, PA minister of health, said 15 would be transferred to hospitals in the Gaza Strip (Facebook page of the ministry of health in Ramallah, October 27, 2020).

   
Ventilators donated by Germany
(Facebook page of the ministry of health in Ramallah, October 27, 2020).

^[1] For Dr. Ronni Gamzu, the Coronavirus Project Coordinator. ↑

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