The fight against COVID-19 in the Gaza Strip (updated to April 26, 2020)

Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)

Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)

Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)

Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)

Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)

Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)

Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)

Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)

Crowds in an open market in the northern Gaza Strip (Filastin al-Aan’s Twitter account, April 25, 2020)

Crowds in an open market in the northern Gaza Strip (Filastin al-Aan’s Twitter account, April 25, 2020)

Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, handing the test kits to the staff of the central lab in Gaza (Facebook page of the WHO’s representative office in the territories, April 24, 2020)

Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, handing the test kits to the staff of the central lab in Gaza (Facebook page of the WHO’s representative office in the territories, April 24, 2020)

Main developments
  • Following are the main developments in the Gaza Strip:
    • According to reports from the Hamas Health Ministry in the Gaza Strip, the number of confirmed COVID-19 cases over the past week rose from 13 to 17. Two sick Palestinians were identified at the Rafah Crossing and sent to isolation. Ten patients have recovered and seven are still in isolation. Up to now, Hamas’s handling of the spread of the virus is (still) under control.
    • Hamas is concerned about the spread of the virus into the Gaza Strip. The healthcare system in the Gaza Strip estimates that in such a case, the number of patients will reach 16,000-20,000. The goal of the preventative measures currently being taken is not to reach such a scenario.
    • The Hamas administration is preparing for the month of Ramadan. As part of these preparations, all mosques have been closed, mass feasts for breaking the fast have been banned and safety measures have been taken at malls and shopping centers. In practice, however, there have been crowds at shopping centers and the beach, despite the instructions. Over the past few days, senior Hamas officials sense a decline in the population’s compliance with the preventive measures (staying at home, wearing masks, refraining from gatherings) and are time and again warning the residents that more stringent preventive measures may be taken.
    • According to reports, the healthcare system in the Gaza Strip is now capable of performing around 500 COVID-19 tests per day. The World Health Organization (WHO) believes that in the near future, the healthcare system will be able to perform 3,000 tests per day. On the other hand, there is a shortage of ventilators, medical devices, and lab materials.
    • Hamas operatives and senior Hamas officials continue to blame Israel for the grave medical and humanitarian situation in the Gaza Strip[1]. These accusations are accompanied by threats against Israel. The Hamas Forum quoted a senior Hamas official as saying that “if the problems in the Gaza Strip are not resolved, wait for a hot summer and an explosion that will lead to instability in the region” (Hamas Forum, April 26, 2020).
Morbidity

According to reports from the Health Ministry in the Gaza Strip, the number of confirmed cases over the past week rose from 13 to 17. The Ministry spokesman announced at a press conference that two more Palestinians who had returned to the Gaza Strip had tested positive and been sent to quarantine centers (Facebook page of the Gaza Health Ministry, April 21, 2020). Ten patients have recovered, and seven patients in stable condition are still at the Rafah Crossing isolation hospital (Al-Ra’i News Agency, April 25, 2020). The first two COVID-19 patients, sheikhs who had returned from Pakistan, left the isolation center at the Rafah Crossing after making a complete recovery (Al-Ra’i News Agency, April 25, 2020).

 The first two COVID-19 patients in the Gaza Strip, sheikhs who had returned from Pakistan, leaving the isolation center at the Rafah Crossing (Filastin al-Aan’s Twitter account, April 21, 2020)     The first two COVID-19 patients in the Gaza Strip, sheikhs who had returned from Pakistan, leaving the isolation center at the Rafah Crossing (Filastin al-Aan’s Twitter account, April 21, 2020)
The first two COVID-19 patients in the Gaza Strip, sheikhs who had returned from Pakistan, leaving the isolation center at the Rafah Crossing (Filastin al-Aan’s Twitter account, April 21, 2020)
  • By April 23, a total of 4,368 COVID-19 tests had been performed (WHO website, April 23, 2020). All the confirmed cases were people who arrived at the Rafah Crossing from Egypt and were identified without entering the Gaza Strip. In the Gaza Strip itself, according to reports by the Hamas Health Ministry, no COVID-19 patients have been identified. In the Gaza Strip, there are currently 1,971 people in 28 quarantine centers (Al-Ra’i News Agency, April 25, 2020). Hence, according to the available information and based on Hamas’s reports, the handling of the spread of COVID-19 in the Gaza Strip is (still) under control, although there is concern over the spread of the COVID-19 within the Gaza Strip.
  • Speaking at a meeting with media figures, Gaza Deputy Health Minister Dr. Yusuf Abu al-Rish said that the Ministry expects COVID-19 to penetrate into the Gaza Strip despite all the steps being taken. Dr. Al-Rish added that the worst case scenario that they anticipate and are preparing for is 8-10 COVID-19 patients per 1,000 residents, i.e., between 16,000 and 20,000 patients in the Gaza Strip throughout the pandemic. He added that they are not on the way to this scenario, and must not reach it under any circumstances. Dr. Al-Rish added that their plan is that as a result of the steps that they are taking, the number of patients would not reach more than 2,000 at the same time (Dunya al-Watan, April 22, 2020; PALSAWA, April 22, 2020).
  • In view of this, the Hamas administration spokesmen continue to warn residents of complacency and failure to comply with the instructions. Interior Ministry Spokesman Iyad al-Buzum called on residents to act responsibly. He went on to say: If we feel that the residents are taking preventive measures seriously, we will respond by easing the steps that we have taken; but if we feel that they are disregarding them and not taking them seriously, we will introduce more stringent measures (PalToday Channel website, April 19, 2020) According to the Hamas administration’s Information Bureau Chairman Salameh Ma’aruf, over the past few days there has been a decline in residents’ compliance with personal preventive measures, i.e., staying home and wearing masks (Al-Ra’i News Agency, April 20, 2020).
Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)     Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)
Failure to comply with the preventive measures: crowds of Palestinians at the beach in the Gaza Strip (Al-Quds, April 18, 2020)
The sign on the left reads: Stay Home, Stay Safe (Al-Ra’i News Agency, April 22, 2020)     Outdoor signs throughout the Gaza Strip calling on residents to comply with the instructions. The sign on the right reads: Stay Healthy, Wear Your Mask.
Outdoor signs throughout the Gaza Strip calling on residents to comply with the instructions. The sign on the right reads: Stay Healthy, Wear Your Mask. The sign on the left reads: Stay Home, Stay Safe (Al-Ra’i News Agency, April 22, 2020)
Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)       Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)
Guidance by the police and the civil defense unit. Masks as well as information leaflets were also distributed (Twitter account of the Gaza Interior Ministry, April 23, 2020)
Medical capabilities: overview
  • According to Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, 500 tests per day can now be performed in the Gaza Strip. This week and next week, the WHO will provide additional test kits enabling healthcare personnel to carry out 2,000 tests per day. According to Dr. Sabah, the WHO is not concerned about testing rate, and guarantees that kits will always be available in the Gaza Strip.
  • Dr. Sabah added that the Gaza Strip is currently in need of medical equipment and lab materials. According to him, the only laboratory in the Gaza Strip has two PCR devices (a device used to identify the unique genetic structure of COVID-19) and the WHO is now purchasing a third device. However, there is a need for 10 PCR devices (Al-Jazeera.net, April 24, 2020).
  • The daily report by the Gaza Health Ministry has designated the European Hospital as a hospital for COVID-19 patients, assisted by three schools adjacent to it (Gaza Health Ministry website, April 19, 2020). According to Gaza Deputy Health Minister Dr. Yusuf Abu al-Rish, they are working day and night to prepare the hospital to treat 2,000 patients. He added that the hospital’s capacity is 240 beds, and they are working to increase its capacity to 2,000 beds, along with the nearby schools where patients whose condition is more stable will be treated.
  • According to Dr. Al-Rish, based on international statistics, out of every 2,000 patients, 1,600 will be slightly and moderately affected by the virus, and they will be treated at the schools located in the vicinity of the hospital. A total of 400 patients will be treated at the hospital, 100 of whom will need intensive care and ventilators. He stressed that this is a series of complicated steps, necessitating a complete change in the hospital infrastructure (PALSAWA, April 22, 2020).
  • According to Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, the hospital is being commissioned with the aid of the WHO, but is still far from ready to receive patients. This is due to lack of medical equipment and the need for staff training. According to him, the capacity of the hospital together with the three adjacent schools will be 1,750 patients, if necessary, but there are problems with the supply of equipment due to the global shortage. For example, the hospital needs a testing lab, and the number of ventilators must be increased from 17 to 100. This is at a time when the governmental, non-governmental and private medical sector in the Gaza Strip have only 87 ventilators, two-thirds of which are being used by ordinary patients (aljazeera.net, April 24, 2020). In another interview, Sabah said that the WHO had managed to purchase 30 ventilators out of the 100 that the hospital needs, and that they would soon arrive in the Gaza Strip (Palestine Online, April 24, 2020).
  • Hamas operatives and the Hamas administration continue the smear campaign against Israel, blaming it for the grave condition of the Gaza healthcare system. The Gaza Help Ministry spokesman continued to call for the lifting of the “[Israeli] siege” on the Gaza Strip, saying that Israel is responsible for the deterioration of the medical and humanitarian situation in the Gaza Strip while the COVID-19 pandemic is spreading throughout the region (Al-Ra’i News Agency, April 20, 2020).
Preparations for the month of Ramadan
  • The focal point of the Hamas administration’s plan for the month of Ramadan is to prevent residents from gathering in public places. This includes preventing prayers, preventing mass feasts for breaking the fast and taking safety measures at malls and shopping centers. The competent authorities will monitor compliance with these instructions (Al-Ra’i News Agency, April 23, 2020).
  • On April 20, after a meeting between the Council of Religious Scholars and Muftis in the Gaza Strip, and the Hamas Administration’s Emergency Committee, the Deputy Minister of Religious Endowments in the Gaza Strip announced a decision to continue keeping the mosques closed during Ramadan as well. He called on residents to hold prayers in their homes rather than at mosques (Al-Ra’i News Agency, April 20, 2020).
  • Interior Ministry Spokesman Iyad al-Buzum announced that during Ramadan, the Interior Ministry would be particularly stringent about closing beaches, function halls and restaurants. He warned against the failure to comply with the decision to close the mosques, saying that the Ministry would not permit residents to conduct public prayers elsewhere. According to him, the police will monitor places where there may be gatherings such as open markets, restaurants and bakeries, in order to reduce gatherings. Open markets will also be monitored in order to prevent price gouging (Gaza Interior Ministry website, April 22, 2020).
Police patrolling in open markets and directing traffic (Twitter account of the Gaza Interior Ministry, April 24, 2020)      Police patrolling in open markets and directing traffic (Twitter account of the Gaza Interior Ministry, April 24, 2020)
Police patrolling in open markets and directing traffic (Twitter account of the Gaza Interior Ministry, April 24, 2020)

Police blocking the entrance to a mosque (Twitter account of journalist Hassan Aslih, April 24, 2020)
Police blocking the entrance to a mosque
(Twitter account of journalist Hassan Aslih, April 24, 2020)

  • Government Administration Bureau Chairman Salameh Ma’aruf said that since the beginning of Ramadan, civilians had demonstrated a great commitment to the implementation of preventive measures against COVID-19. He added that there is a real danger of a COVID-19 outbreak in the Gaza Strip and therefore strict compliance with the measures being taken is essential. According to him, the present complacency in society must end, and the public must behave responsibly and refrain from gathering in open markets and shopping malls. He threatened that the Prosecutor General’s Office would monitor every display of complacency in the Gaza Strip and would take strict steps against those who failed to obey the instructions (Al-Ra’i News Agency, April 25, 2020; Dunya al-Watan, April 25, 2020).
Crowds in the open market in Nuseirat (Filastin al-Aan, April 24, 2020)       Crowds in the open market in Nuseirat (Filastin al-Aan, April 24, 2020)
Crowds in the open market in Nuseirat
(Filastin al-Aan, April 24, 2020)

Crowds in an open market in the northern Gaza Strip (Filastin al-Aan’s Twitter account, April 25, 2020)
Crowds in an open market in the northern Gaza Strip
(Filastin al-Aan’s Twitter account, April 25, 2020)

Additional measures taken by the Hamas administration in the fight against COVID-19
  • Following are additional measures taken by the Hamas administration in the fight against COVID-19:
    • The Economy Ministry and other government ministries are working to supply basic food products for a period of over three months. This is being accomplished by increasing the stock of food products. To this end, taxes on 13 basic commodities have been lifted (Safa Agency, quoting Gaza Strip Governmental Monitoring Committee Chairman Muhammad Awad, April 22, 2020).
    • The Education Ministry issued a statement detailing the procedures for the end of the current school year for grades 1-11 in view of the COVID-19 crisis: 80% of the grade will be given based on the student’s achievements in the first semester. 20% of the grade will be based on their achievements in the first month of the second semester, up to March 5. All students will be promoted, apart from those who received a failing grade (Al-Ra’i News Agency, April 23, 2020). Ziyad al-Thabet, Deputy Minister of Education in the Gaza Strip, said that all the details had been agreed upon with the Ministry in Ramallah. He added that the program for holding the matriculation exams on schedule (May 30) had been completed, with all the precautionary and hygiene measures being taken (Al-Ra’i News Agency, April 21, 2020).
    • The Health Ministry has launched an initiative whereby students studying medical science who do not work for the Health Ministry, and medical, dental and pharmacology students in their last year of study, will take training courses that will prepare them to work at healthcare institutions. This is in order to reinforce the healthcare services at the various institutions (Facebook page of the Gaza Health Ministry, April 19, 2020).
Aid for the war on COVID-19 in the Gaza Strip
Israel
  • According to Israeli media reports, Israel’s Minister of Defense Naftali Bennett ordered the IDF laboratory for the interpretation of COVID-19 tests to stop performing tests on suspected COVID-19 patients from the Gaza Strip after two days in which 100 tests were performed. IDF Spokesperson said in response: “The IDF has performed tests on residents of the Gaza Strip, due to a localized inability to complete the testing process. At present, these tests are not being performed at the IDF lab” (website of Israeli daily Maariv, April 22, 2020).
  • Gaza Deputy Health Minister Dr. Yusuf Abu al-Rish responded by saying: We do not send samples for COVID-19 testing of Gaza residents to the labs of the [Israeli] “occupation” because its procedures are unreliable and our teams perform them at the relevant departments in the Gaza Strip. The announcement of the “occupation” regarding inaccuracies in tests causes us not to trust them, and we do not jeopardize our patients in this regard (sanad news, April 22, 2020).
PA Health Ministry’s support to the Gaza Strip
  • According to Gaza Health Ministry Spokesman Dr. Ashraf al-Qidra, the Health Ministry in Ramallah sent the Gaza Strip 1.25 million dollars’ worth of drugs, disposable medical supplies and lab equipment. According to him, 2.25 million dollars’ worth of medical supplies and drugs have arrived since the beginning of the year. This constitutes only 5% of the Gaza Health Ministry’s annual need for drugs, disposable medical supplies and lab equipment. According to him, the needs of the healthcare system in the Gaza Strip are estimated at $47 million a year (Facebook page of the Gaza Health Ministry, April 21, 2020).

The drugs and medical equipment sent from Ramallah at the Kerem Shalom Crossing. According to reports, 18 pallets of drugs and medical supplies from the Health Ministry warehouses in the PA have entered the Gaza Strip. This was the first shipment to arrive from Ramallah since the beginning of the COVID-19 crisis (Twitter account of journalist Hassan Aslih, April 13, 2020)
The drugs and medical equipment sent from Ramallah at the Kerem Shalom Crossing. According to reports, 18 pallets of drugs and medical supplies from the Health Ministry warehouses in the PA have entered the Gaza Strip. This was the first shipment to arrive from Ramallah since the beginning of the COVID-19 crisis (Twitter account of journalist Hassan Aslih, April 13, 2020)

The International Red Cross
  • On April 23, the International Red Cross sent vital intensive care equipment to the Gaza Strip, including ventilators, monitors, defibrillators, suction devices and pumps (key equipment needed to treat severe cases of COVID-19). The Red Cross is also working to improve the infrastructure at the European Hospital in Gaza, which has been designated as the central COVID-19 hospital. It is setting up a contamination control facility at the hospital and is renovating its water treatment plant. It also plans to donate protective equipment in order to ensure all hospital personnel are protected. In addition, the organization donated masks and medical safety goggles to the Palestinian Red Crescent Society in the Gaza Strip and Judea and Samaria (International Red Cross website, April 23, 2020).
Aid sent to the Gaza Health Ministry by the International Red Cross (Gaza Health Ministry website, April 23, 2020)     Aid sent to the Gaza Health Ministry by the International Red Cross (Gaza Health Ministry website, April 23, 2020)
Aid sent to the Gaza Health Ministry by the International Red Cross (Gaza Health Ministry website, April 23, 2020)
The World Health Organization (WHO)
  • The WHO sent COVID-19 test kits for 480 people in the Gaza Strip. They were purchased by a UN agency, The occupied Palestinian Territory Humanitarian Fund (oPt HF). The WHO also sent the Gaza Strip 2,500 liters of hand sanitizer and 1,000 bottles of disinfectants (Facebook page of the WHO’s representative office in the territories, April 24, 2020).

Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, handing the test kits to the staff of the central lab in Gaza (Facebook page of the WHO’s representative office in the territories, April 24, 2020)
Dr. Abd al-Nasser Sabah, director of the WHO office in the Gaza Strip, handing the test kits to the staff of the central lab in Gaza (Facebook page of the WHO’s representative office in the territories, April 24, 2020)

Shipment of hand sanitizer (Facebook page of the WHO’s representative office in the territories, April 20, 2020)      Shipment of hand sanitizer (Facebook page of the WHO’s representative office in the territories, April 20, 2020)
Shipment of hand sanitizer
(Facebook page of the WHO’s representative office in the territories, April 20, 2020)
The United Arab Emirates (UAE)
  • Aid in the sum of $100,000 donated by the UAE was distributed in the Gaza Strip. The aid consisted of “hygiene packages” intended for the quarantine centers in the Gaza Strip. The “hygiene packages” contain disinfectants, personal hygiene equipment; refrigerators and electric urns (Al-Ain, April 21, 2020; Al-Ra’i, April 20, 2020).
The aid donated by the UAE (Al-Ain, April 21, 2020)      The aid donated by the UAE (Al-Ain, April 21, 2020)
The aid donated by the UAE (Al-Ain, April 21, 2020)
Jordan
  • On April 19, 2020, the Jordan Hashemite Charity Organization dispatched an aid convoy to the Gaza Strip, consisting of two trucks carrying 20 tons of gluten-free flour and five incubators. The aid will be delivered to the Jordanian Army field hospital in the Gaza Strip and distributed to people eligible for it (Al-Ghad, April 19, 2020). The trucks entered the Gaza Strip via the Beit Hanoun (Erez) Crossing on April 21, 2020 (Gaza Interior Ministry website, April 21, 2020).
Turkey
  • On April 24, 2020, Hamas Chairman Ismail Haniya called Turkish President Erdoğan to wish him a happy Ramadan. Erdoğan told Haniya that Turkish medical aid would arrive in Gaza and the West Bank this week (Hamas website, April 24, 2020).

[1] See the ITIC’s Information Bulletin from April 23, 2020: “What is the true reason for the shortcomings of the medical system in the Gaza Strip?”