The Palestinian Authority and Hamas Fight COVID-19: the First Month Overview and Initial Insights

Delivery of 1,500 COVID-19 test kits to the PA (Israeli Coordinator of Government Activities in the Territories' Facebook page in Arabic, March 29, 2020).

Delivery of 1,500 COVID-19 test kits to the PA (Israeli Coordinator of Government Activities in the Territories' Facebook page in Arabic, March 29, 2020).

Yahya al-Sinwar visits COVID-19 hospital being built in Rafah (Filastin al-A'an Twitter account, March 23, 2020).

Yahya al-Sinwar visits COVID-19 hospital being built in Rafah (Filastin al-A'an Twitter account, March 23, 2020).

Hamas military wing operatives disinfect public facilities in the Gaza Strip (Filastin al-A'an, March 24, 2020).

Hamas military wing operatives disinfect public facilities in the Gaza Strip (Filastin al-A'an, March 24, 2020).

Hamas military wing operatives disinfect public facilities in the Gaza Strip (Filastin al-A'an, March 24, 2020).

Hamas military wing operatives disinfect public facilities in the Gaza Strip (Filastin al-A'an, March 24, 2020).

Construction of 1,000 quarantine units in Rafah and the northern Gaza Strip (Msdrnewsnetwork Facebook page, March 21, 2020).

Construction of 1,000 quarantine units in Rafah and the northern Gaza Strip (Msdrnewsnetwork Facebook page, March 21, 2020).

Overview

The objective of this study is to present an overview and initial insights regarding the preventive measures taken by the Palestinian Authority (PA) and Hamas to check the spread of COVID-19 during the first month of its outbreak. It examines the spread of contagion, the behavior of the PA and Hamas, and the potential threats for Israel if the disease spreads unchecked. This overview and insights are based on methodical observations carried out by ITIC researchers once the first cases of COVID-19 were discovered in Judea, Samaria and in the Gaza Strip.

  • While the ITIC’s information is incomplete and despite the question marks hovering over the reliability of the data issued by the PA and Hamas, it is possible to make the following observations (as of April 5, 2020): the number of COVID-19 cases in the PA territories has reached 214 and the disease is spreading rapidly. In the Gaza Strip, on the other hand, there are 12 cases (five of which have recovered). So far it seems that the situation in the PA and Gaza Strip is under control. That may change as the number of cases increases, along with the difficulty in controlling the spread of the disease and treating patients who are seriously and critically ill.

Spread of COVID-19 Cases in the PA Territories since the First Patients Were Diagnosed (Updated to April 5, 2020)

  • Along with the efforts made by the PA and Hamas to prevent the spread of COVID-19 they have increasingly blamed Israel for its spread.[1] Hamas claims Israel is responsible for the serious condition of the Gaza Strip’s medical infrastructure (ignoring the priority it has given for years to its military buildup at the expense of the civilian population). The PA claims Israel is spreading the virus in the PA territory through Palestinians who worked in Israel and are returning to Judea and Samaria. The PA and Hamas also accuse Israel of neglecting the care of Palestinian prisoners in danger of contagion (according to the Israeli prison services, no Palestinian security prisoners have contracted COVID-19). The PA’s accusations have increased to the point of accusing Israel of waging “biological warfare” against the Palestinians. Blaming Israel is liable to intensify as the number of COVID-19 cases and their accompanying economic difficulties increase, and as public criticism of how the PA and Hamas handle the crisis increases.
  • In ITIC assessment, the current situation presents two main threats for Israel:
    • Threats of contagion: An uncontrolled spread of COVID-19 is liable to penetrate into Israel. That is especially relevant for Judea and Samaria, where a large interface with Israeli population centers exists, while passage to and from the Gaza Strip is limited and can be blocked. The most serious threat is in the greater Jerusalem area, which is a COVID-19 hotspot for both Israel (1,132 COVID-19 cases in Jerusalem so far, according to the Israeli ministry of health, April 3, 2020); and for the PA territories (Bethlehem, the towns and villages north and south of Jerusalem and the Ramallah area. In those areas there are more than 119 COVID-19 cases, representing more than 90% of all the Palestinians in Judea and Samaria who have been infected, as of April 2, 2020). In addition there is a risk of an uncontrolled spread of the virus among the approximately 350,000 Palestinians living in east Jerusalem.[2]
    • Threats of terrorism: During the first month of the COVID-19 crisis Judea, Samaria and the Gaza Strip were relatively quiet (with the exception of one rocket fired into Israeli territory and the “routine” throwing of stones and Molotov cocktails at Israeli vehicles on the roads in Judea and Samaria). However, in ITIC assessment the rate of the virus’ spread and the worsening of an economic crisis are liable to lead to public protests against Hamas and/or the PA. The combination of internal criticism, economic hardships and a broad spread of the virus are liable to increase the threat of terrorism against Israel from the Gaza Strip and the PA (although so far the Palestinian public has given the PA and Hamas credit regarding the way they have dealt with the crisis). Explicit threats have already been heard from the Gaza Strip, mainly a statement from Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, who said that “if our corona patients can’t breathe, we will prevent six million Israelis from breathing.”
  • In ITIC assessment statements from Yahya al-Sinwar and other senior Hamas figures may reflect an intention to exert violent pressure on Israel, should the crisis become more serious. Their objective will be to force Israel to increase the amount of medical and humanitarian assistance it delivers to the Gaza Strip. For example, there may be rocket fire and/or mass riots and violence near the border fence in Gaza. The PA, for its part, may turn public anger towards Israel by encouraging popular terrorism, which is an official PA/Fatah strategy.

A Hamas-forum user: "If the number [of COVID-19 cases] increase we [will] ask the Izz al-Din Qassam Brigades to enlist its operatives and strike the entity [i.e., Israel] with all its force. We don't want to die of corona" (Hamas forum, March 26, 2020).
A Hamas-forum user: “If the number [of COVID-19 cases] increase we [will] ask the Izz al-Din Qassam Brigades to enlist its operatives and strike the entity [i.e., Israel] with all its force. We don’t want to die of corona” (Hamas forum, March 26, 2020).

  • This study has three appendices:
    • Appendix A: Data of Palestinian contagion and its significance
    • Appendix B: The nature of the fight against COVID-19 conducted by the PA and Hamas
    • Appendix C: Blame and threats against Israel
Appendix A
Data of Palestinian contagion and its significance

Judea and Samaria – Basic data

Incidence of contagion

  • The first seven cases of COVID-19 in the PA territories were diagnosed a month ago in Bayt Jala, near Bethlehem. The seven were hotel employees who were infected by a group of pilgrims from Greece, some of whom were diagnosed as ill with the virus. The outbreak of the disease in the PA territories came at a time when the there was an increase of its spread in Israel and Israeli preventive measures were made more stringent.

The number of Palestinians diagnosed with COVID-19 has risen within a month to 214 (as of April 5,2020). The PA reported that 18 patients have recovered and were sent home; one woman has died.

  • The reliability of the data is uncertain, and the real number of COVID-19 patients in the PA territories may be far higher, especially since no methodical testing has been conducted.[3] In addition, the ITIC has no data about the number of seriously and critically ill patients, an important statistic for assessing the PA’s ability to provide a proper response for such patients if the incidence of infection increases. According to the PA, in Judea and Samaria there are 175 ventilators, 255 ICU beds for adults and 16 for children. Those numbers, coupled with the lack of doctors, medical personnel and medical equipment, will make it very difficult to provide proper treatment should there be a broad spread of the disease
Delivery of 1,500 COVID-19 test kits to the PA (Israeli Coordinator of Government Activities in the Territories' Facebook page in Arabic, March 29, 2020).   Delivery of 1,500 COVID-19 test kits to the PA (Israeli Coordinator of Government Activities in the Territories' Facebook page in Arabic, March 29, 2020).
Delivery of 1,500 COVID-19 test kits to the PA (Israeli Coordinator of Government Activities in the Territories’ Facebook page in Arabic, March 29, 2020).
Rate of the increase in the spread of COVID-19
  • The disease has spread rapidly during the past month (see graph). Within a short time (in ITIC assessment, within ten days) the number of cases is liable to grow to several hundreds. That may lead to an increase in the number of seriously and critically ill patients. That will make it more difficult for the PA to provide proper treatment, especially for the seriously and critically ill.

Spread of COVID-19 Cases in the PA Territories since the First Patients Were Diagnosed (Updated to April 5, 2020)

Geographical distribution

The ITIC has incomplete information about the geographical distribution of the disease. However, so far more than 90% of the cases have been diagnosed in the areas of Bethlehem, Ramallah and the towns and villages north and south of Jerusalem. There are other Judean and Samarian towns and villages where an isolated number of cases have been diagnosed.

  • In ITIC assessment, the geographic distribution in the PA territories and in Israel may indicate mutual infection between Jerusalem (which has the largest number of COVID-19 cases in Israel) and the cities, towns and villages north and south of Jerusalem (from Ramallah in the north to Bethlehem in the south). That may be the consequence of workers from east Jerusalem and the PA territories who are employed in Jerusalem, and the movement of residents between Jerusalem and the PA territories for reasons other than work.
The Gaza Strip

Incidence of contagion

The first two COVID-19 patients diagnosed in the Gaza Strip were Palestinians who returned from Pakistan on March 19, 2020. They were sent to the quarantine center established at the Rafah Crossing, but they infected seven security operatives who came into contact with them. To those two were added three COVID-19 patients who arrived from Egypt. Thus the number of COVID-19 cases transferred to various quarantine facilities is reported as 12. According to a spokesman for the ministry of health in the Gaza Strip, five have recovered and the condition of the others is reported as “stable and encouraging.” According to reports from the ministry of health in Gaza, all the cases diagnosed were found at the Rafah Crossing and so far no other case has been reported in the Gaza Strip proper (cases within the community). In addition, there are 1,897 Palestinians in 27 isolation centers and their health is reported as good (as of April 5, 2020).

  • The Gaza Strip has a high potential for the rapid spread of COVID-19. That is because of its crowding, poverty and shaky medical infrastructure. In addition, it is under the control of Hamas, a terrorist organization whose first priority is its military buildup for a campaign against Israel, not the needs of its civilian population.
  • Nevertheless, so far the number of reported COVID-19 cases has been very low. There can be two explanations for that:
    • The relative isolation of the Gaza Strip from the outside world: There is no tourism and only a very small number of foreigners enter Gaza. Entrance and exit are through two crossings (the Israeli Erez Crossing and the Egyptian Rafah Crossing) which are easy to close and control. At an early stage Hamas and Israel banned the entrance of workers from the Gaza Strip into Israel, as opposed to PA policy.
    • Uncertain data: Hamas has a long tradition of hiding problematic information, casting into doubt the reliability of the numbers provided by the Hamas administration. Moreover, in light of the lack of methodical testing, it is possible that there are additional COVID-19 patients inside the Gaza Strip about whom the Hamas administration has no information. Thus the number of cases may be far higher than the number announced publicly by Hamas spokesman and the Hamas administration.
  • In any event, even if the numbers are higher, in ITIC assessment the incidence of contagion in Gaza is still under control. However, it would seem that even Hamas is aware of the potential for the extensive rapid spread of the virus in Gaza. Therefore senior figures in the Hamas administration repeatedly warn of the possibility of a medical and humanitarian crisis. Officials in the WHO and UNRWA have even warned of a “disaster of gigantic proportions” should COVID-19 spread throughout the Gaza Strip.
  • Should COVID-19 spread throughout the Gaza Strip, leading to a large number of serious and critical patients, the ability of the ministry of health in Gaza to treat them will be limited. The WHO reported that there are 64 ventilators in Gaza and an additional 50-100 ventilators are needed (Yahya al-Sinwar, in his most recent speech, said the Gaza Strip needed 100 ventilators). There is also a lack of doctors, medical teams and test kits.
Appendix B
The nature of the fight against COVID-19 conducted by the PA and Hamas Judea and Samaria
  • In Judea and Samaria, Prime Minister Muhammad Shtayyeh took it upon himself to lead the fight against COVID-19. Mahmoud Abbas, on the other hand, kept a low media profile until recently. Only after a month, on April 3, 2020, did he give a speech dealing with the fight against COVID-19. He said he was extending the state of emergency declared on March 5, 2020 by an additional 30 days. The extension is meant to enable the Palestinian security forces and health services to continue the fight and enforce various orders issued by the PA. To that end Muhammad Shtayyeh is supported by the Palestinian security forces, the Fatah movement, which appointed local “emergency committees” in the cities, villages and refugee camps, and the government ministries, especially the ministries of the interior and of health.
Al-shabiba (Fatah's youth movement) operatives distribute flyers in E'izariya about the proper way to wash hands (Facebook page of Fatah's Jerusalem branch, March 22, 2020).    Fatah emergency committee operatives in the town of E'izariya disinfect taxis.
Right: Fatah emergency committee operatives in the town of E’izariya disinfect taxis. Left: Al-shabiba (Fatah’s youth movement) operatives distribute flyers in E’izariya about the proper way to wash hands (Facebook page of Fatah’s Jerusalem branch, March 22, 2020).
  • During the first stage of the COVID-19 infection the PA made do with imposing a quarantine on Bethlehem and with pinpoint measures to contain the disease and prevent it from spreading. However, after about two and a half weeks, on March 22, 2020, Prime Minister Muhammad Shtayyeh announced a quarantine would be enforced on all the districts, and residents would be forbidden to leave their houses (with certain exceptions). Anyone who violates the quarantine will be punished. In ITIC assessment, so far the quarantine has not been fully enforced. Additional intensive activities of the security forces (sometimes also volunteers and Fatah activists) will be necessary to convince the Palestinians to stay at home and not congregate.

While in Judea and Samaria the PA administration is waging the fight against COVID-19, in the Gaza Strip it is being waged by Hamas, which is a terrorist organization. The PA government has no significant influence on the decisions made by Hamas and how it wages the fight. That means that Hamas’ strategy, which gives priority to its military buildup and the fight against Israel, determines how the fight against COVID-19 is waged and what resources are allotted to it.

  • The most prominent figure leading the fight is Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, who is exploiting the COVID-19 crisis to promote his own public image. Another important figure is Tawfiq Abu Na’im, head of the internal security forces in the Gaza Strip, whose operatives are on the front line of the fight against COVID-19 (as noted by Yahya al-Sinwar in his most recent speech). To fight the virus Hamas is employing its security forces and administration ministries, the most important of which is the ministry of health. Hamas also works in cooperation with municipality heads, religious figures, UNRWA, UN agencies and the international aid organizations operating in the Gaza Strip. Hamas is also employing operatives of its military wing to carry out tasks such as constructing quarantine units and disinfecting public facilities.
  • So far Hamas has been very active in issuing instructions to contain the epidemic and prevent it from spreading throughout the Gaza Strip. At the same time, it is making preparations for a possible scenario of the spread of the disease within the Gaza Strip and a significant rise in the number of cases. The preparations include: a compulsory two-week quarantine for anyone entering the Gaza Strip; assistance for those in isolation; erecting dozens of quarantine centers; upgrading hospitals and medical facilities; banning gatherings; disinfecting public facilities; closing restaurants, coffee shops, and reception halls; banning prayers in mosques; help for needy families and preparing a stock of vital goods..
  • In the meantime, Hamas is formulating an emergency plan which has not yet been implemented. Hamas is constructing 1000 quarantine units in the northern and southern Gaza Strip, and has erected field hospitals and quarantine facilities. However, Hamas has not yet imposed a complete lockdown on the Gaza Strip, unlike the PA, apparently because of the relatively small number of patients and the assessment that it is successfully preventing the spread of the disease.
Appendix C
Blame and threats against Israel

The PA

While there have been examples of cooperation between Israel and the PA in the fight against the spread of COVID-19, from the very beginning senior PA figures have blamed Israel and the Israeli communities in Judea and Samaria for the spread of the disease. Some have even accused Israel of [allegedly] waging “biological warfare” against the PA, deliberately returning Palestinian workers with COVID-19 to the PA to spread the virus and prevent the PA from fighting it (Usama Qawasmeh, Fatah spokesman in Judea and Samaria, for example, accused Israel and the settlers of spreading COVID-19 in the PA and infecting Palestinian facilities).

  • The Palestinian spokesmen’s anti-Israeli campaign focuses on three issues:
    • The Palestinians employed in Israel: Initially the PA allowed workers to stay in Israel for a month to two months because their salaries are an important source of income. Later, when the virus spread in Israel and the PA territories, the PA forbade Palestinians to work in Israel and called on them to return to the PA. As part of its smear campaign against Israel, Palestinian spokesmen claimed the workplaces in Israel were “incubators for the coronavirus” (while in reality the source of the first case of COVID-19 in the PA territories was a group of pilgrims from Greece. Later carriers of the virus were located at the Allenby Crossing as coming from Turkey, Britain, Pakistan and other countries).
Palestinian workers try to enter Israel after a lockdown was imposed on the PA territories (Palestine Online Twitter account, March 23, 2020).    Palestinian workers try to enter Israel after a lockdown was imposed on the PA territories (Palestine Online Twitter account, March 23, 2020).
Palestinian workers try to enter Israel after a lockdown was imposed on the PA territories (Palestine Online Twitter account, March 23, 2020).
  • The Israeli communities in Judea and Samaria: As opposed to the permission given to Palestinians to work in Israel, the PA forbade them to continue working in the Israeli communities in Judea and Samaria (before the outbreak of COVID-19 there were about 73,000 Palestinians workers in the communities). The (false) reason given was that the communities were a source of COVID-19 contagion. The PA threatened to use strict measures against anyone who violated the decision (the ITIC has no information about Palestinians who continued working in the Israeli communities).
  • Palestinian terrorists imprisoned in Israeli jails: The PA assigned Israel full responsibility for their welfare and claimed Israel neglects their health. The PA warned of the danger for “a genuine disaster” if the virus spreads among them. PA (and Hamas) spokesmen demanded Israel release the prisoners or at least the sick and the young. The PA also appealed to the Red Cross and the WHO regarding the issue of the prisoners.

Hamas

  • A few days after the first two COVID-19 cases were diagnosed Hamas began blaming Israel for the poor condition of the health system in the Gaza Strip. During the first month of the crisis Hamas repeatedly blamed Israel for the lack of medical equipment and drugs, and for what it called the “methodical destruction of the health system and humanitarian services in Gaza.” It was all, Hamas claimed, because of the Israeli “siege” and the actions of the “Zionist occupier.”
  • As the COVID-19 crisis continues, accusations turned into an explicit threat of the use of force against Israel. One prominent declaration was in a speech given by Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, who is leading Hamas’ fight against COVID-19. In a speech given on April 2, 2020, he responded to a statement made by Naphtali Bennett, the Israeli minister of defense the previous day, interpreted by the Palestinians as conditioning humanitarian assistance to the Gaza Strip on the return of the missing Israelis. He said:

If our corona patients can’t breathe, we will prevent six millions Israelis from breathing. If our people have no food, [Naphtali] Bennet will see how we educate him. When our people need ventilators and medical equipment we will take what we need from him as ‘protection,’ and he knows we can do it.”

[1] For further information, see the March 26, 2020 bulletin, "The Palestinian Authority and Hamas Blame Israel for the Spread of Coronavirus (Updated to March 26, 2020)."
[2] The numbers of Palestinians in east Jerusalem who have been diagnosed as carrying the virus (according to the Jerusalem municipality) are: the Old City, 4; Bayt Safafa, 4; Bayt Hanina, 2; Shuafat, 1, A-Tor, 1; Issawiya, 2; Sur Bahr, 1; the village of Aqab, 1. In ITIC assessment the statistics are incomplete and the number of cases is probably higher.

[3] Initially there was a lack of test kits in the PA territories. Later it was reported that Palestinian general intelligence along with the Palestinian ministry of health and the ministry for civilian affairs had acquired 30,000 kits from abroad, of which 10,000 had been delivered to the Palestinian ministry of health (Fatah's Facebook page, March 29, 2020). Israel also delivered 1,500 kits (Facebook page of the Israeli Coordinator of Government Activities in the Territories, March 29, 2020).