The Spread of Covid-19 in Judea and Samaria (Updated to December 21, 2020)

Overview

• In light of the significant rise in the number of Covid-19 cases, over the weekend severe restrictions were placed on Judea, Samaria and the Gaza Strip, although (so far) a general lockdown has not yet been imposed. Despite the restrictions, the number of active cases and percentage of positive test results continue climbing.
• The situation in the Gaza Strip:
  • The number of active Covid-19 cases in Gaza is still very high. Between December 15 and 21, 2020, 5,372 new cases were detected. There have been 271 deaths, up from 202 on December 14. On December 21 there were 336 hospitalized patients, 226 in serious condition.
  • The rise in infection poses many difficulties for the public health system in the Gaza Strip, including a shortage of hospital beds, especially a shortage of ICU beds. There is also a shortage of medical equipment, oxygen and skilled manpower. Spokesmen for the ministry of health in Gaza report that they are facing a new wave of Covid-19 infections with an ongoing rise in number of cases, and they warn of an imminent peak and loss of control.
  • According to the ministry of the interior in the Gaza Strip, all the recently-instituted preventive measures will remain in place. The universities, schools, kindergartens and mosques will remain closed; gatherings are banned; the nightly weekend curfews and partial lockdown will continue. However, the Hamas administration is considering a general lockdown in a scenario of the loss of control over the spread of the virus.
  • According to a senior source in the health system in Gaza, vaccines will not be available before the spring, with the hope of the arrival of four million doses that will be purchased in March 2021.
• The situation in Judea and Samaria:
  • This past week the rate of infection declined slightly, but the number of active cases is still high. On December 21 the number stood at 13,529, down from 14,328 a week ago. Of the daily tests administered, 23.3% were positive, down from 25.7% a week ago. The Nablus district remains the district with the highest number of cases in Judea and Samaria, followed by the Ramallah-al-Bireh district.
  • According to the Palestinian Authority (PA), in the east Jerusalem neighborhoods the number of active cases rose to 1,515 from 1,390 a week ago.
  • PA Prime Minister Muhammad Shtayyeh held a press conference where he proclaimed new restrictions and guidelines for the two weeks between December 17, 2020, and January 2, 2021: as part of the instructions, Israeli Arabs will be forbidden to enter the PA territories and Palestinian workers will be forbidden to pass between the PA and Israel. All Palestinians working in Israel will be required to remain at their places of employment and undergo medical tests.
  • In the meantime, the PA is making preparations to take delivery of the vaccines which are supposed to arrive in a number of months. Hospitals in the PA complain of the high rate of occupancy of beds, especially ICU beds. Palestinians continue congregating, especially at weddings, which continue to be held in the villages around Jerusalem and act as a vector for Covid-19 infection for east Jerusalem Arabs.

The Gaza Strip

Extent of the Covid-19 infection

This past week the number of new active cases in the Gaza Strip rising. Between December 15 and 21, 2020, 5,372 new cases were detected, bringing the number of active cases to 9,700 (up from 8,717 a week ago); there have been 271 coronavirus-related deaths, up from 202 a week ago. Of the 336 hospitalized patients, 226 are in serious or critical condition. Fathi Abu Warda, deputy minister of health in Gaza, said all the districts in the Gaza Strip are currently designated red (Dunia al-Watan, December 15, 2020).

• Spokesmen for the ministry of health said the Gaza Strip is facing a new wave of Covid-19 and the numbers are still rising; they warn of an imminent loss of control over the spread of the virus. The ministry of health in Gaza said that in the coming weeks they expect the virus to peak. In addition, the growth of the number of active cases endangers society and efforts have to be concentrated to flatten the curve (ministry of health in Gaza Facebook page, December 17, 2020).
• Dr. Muhammad Abdallah Abd al-Mun’im, a specialist in respiratory diseases in the al-Shifaa Hospital, said the recent spike in infection was caused by unusually high crowding in the markets, stores and bakeries. Under the shadow of the lockdown, he said, shoppers had not taken the necessary preventive measures.
• Dr. Yusuf al-Akkad, director of the European Hospital, said the Gaza Strip had entered a new wave of infection, more serious than the previous ones (Dunia al-Watan, December 16, 2020). He said the number of coronavirus patients in the Gaza Strip had reached a new high, adding that a general lockdown was on the table and being discussed by the “[Covid-19] crisis cell” (website of the al-Shabab radio station, December 17, 2020).
• Dr. Yusuf Abu al-Rish, deputy minister of health in Gaza, said the coming two weeks would be the most dangerous period. He stressed that the situation demanded an increase in effort and preparations, however, all the hospitals were functioning and providing medical services around the clock (al-Ra’i news agency, December 17, 2020).
• Majdi Dheir, head of the department of preventive medicine in the ministry of health in Gaza, said the ministry was still capable of coping with developments in the epidemiological situation, despite the growth in the rate of infection. He said that if they lose control of the number of patients on ventilators they may impose a general lockdown (Telegram channel of the committee for combatting Covid-19 in the Gaza district, December 19, 2020; al-Ra’i news agency, December 19, 2020).

Positive daily test results for the past week

The change in active cases in the Gaza Strip over the past month

Difficulties facing the Gaza Strip’s health system

• Senior health system figure Dr. Majdi Dheir said Covid-19 had peaked in the Gaza Strip and the coming three weeks will be the epidemic’s most critical stage, and that he is concerned the rate of infection will spike out of control. He said between 8,000 and 10,000 Gazans currently had to have Covid-19 tests and that the laboratory in the Gaza Strip could process only 3,000 tests a day. He said 1,000 active cases had been detected in a single day, but the number did not reflect the real situation because about 40% of the cases were asymptomatic. Regarding vaccines, he said they would not arrive before the spring, and he hoped to purchase four million doses in March 2021 (Telegram channel of the committee for combatting Covid-19 in the Gaza district, December 19, 2020).
• Other senior figures in the public health system in Gaza said the following:
  • Dr. Muhammad Abu Salamia, director of the Shifaa Medical Center and responsible for the emergency committee to combat Covid-19 in the Gaza Strip, said he was concerned that if the number of active cases increases, there is a danger that the medical staffs will have to choose whom to treat. He said the period between December 15, 2020 and the end of January 2021 will be the most difficult because of the combination of coronavirus, the cold weather and spread of seasonal flu (al-Ra’i news agency, December 17, 2020).
  • Dr. Yusuf al-Akkad, director of the European Hospital, reported there were 260 patients in serious or critical condition in the hospital, and of its 300 beds, only 40 were vacant (Paltoday, December 19, 2020, Sabaq24, December 19, 2020). He said if the virus continues to spread the crisis in the Gaza Strip will be extreme because the coronavirus-designated hospitals (the European Hospital and the Turkish Hospital) will be completely full (Dunia al-Watan, December 15, 2020).
  • Dr. al-Akkad said that their greatest challenge is to provide oxygen because the mobile oxygen stations can barely meet the hospital’s demands. He said the hospital can treat two hundred patients in serious and critical condition, but there might not be enough oxygen for a higher number (Amad, December 16, 2020). Dr. Muhammad Abu Salamia said the main problem is the mobile oxygen stations. He appealed to the W.H.O. to provide the ministry of health with mobile oxygen stations as soon as possible (Felesteen, December 16, 2020; Safa, December 15, 2020).
  • Dr. al-Akkad also noted the lack of manpower sufficient to deal with the growing number of Covid-19 patients (al-Shabab Radio website, December 17, 2018). Dr. Fathi Abu Warda, advisor to the PA minister of health, said that 3.5% of the medical teams had contracted Covid-19 (Dunia al-Watan, December 15, 2020).
  • Dr. Muhammad Abu Salamia said the Gaza Strip had a stock of swabs for Covid-19 testing sufficient for one week. He called for more swabs to be delivered to the Gaza Strip (Safa, December 15, 2018).

Hamas administration preventive measures

• The ministry of the interior in Gaza announced that in light of the recommendations from the ministry of health and preparations being made for the coming weeks when the spread of Covid-19 is expected to peak, it had been decided that all preventive measures recently put in place would continue. Among them are the universities, schools, kindergartens and mosques; the ban on all kinds of gatherings, including weddings and mourning tents; and the continuation of the nightly curfew and full lockdowns on weekends. The measures will remain in force based on ongoing evaluation of the epidemiological situation (website of the ministry of the interior in Gaza, December 17, 2020).
• At the end of the week a full lockdown was again imposed on the Gaza Strip. More than 10,000 policemen and operatives of Hamas’ security forces participated in enforcing it. Hamas administration spokesmen pleaded with local residents not to congregate before the enforcement of the lockdown and not to go shopping at the last minute (website of the ministry of the interior in Gaza, December 17, 2020).

   
Operatives of the Hamas security forces direct the movement of shoppers to prevent crowding (Twitter account of the ministry of the interior in Gaza, December 17, 2020).

• Iyad al-Buzum, spokesman for the ministry of the interior in Gaza, said long-term general lockdowns are an option on the agenda (website of the ministry of the interior in Gaza, December 18, 2020). Dr. Ashraf al-Qidra, spokesman for the ministry of health in Gaza, said it was still too early to talk about the influence and results of the weekend lockdowns because they would only be felt in 14 days. He said local residents in all sectors also had to implement all the preventive measures during the rest of the week. He stressed that all possibilities were under discussion, including a long-term general lockdown. He added that an effort was being made not to disrupt daily life for civilians and commerce (Dunia al-Watan, December 19, 2020). Dr. Fathi Abu Warda said that if a partial lockdown does not cause a significant flattening of the curve, the ministry of health will be forced to impose a general lockdown for at least two weeks (Dunia al-Watan, December 15, 2020).

Foreign aid for Gaza

• Salameh Maarouf, head of the government media bureau in Gaza, said it was unfortunate that the government in Ramallah was not responding to the crisis in the Gaza Strip. He said they were witnessing a significant decrease in the regular supply of medical aid and the value of the medical equipment that reached the Gaza Strip during the past year was not more than $2.5 million. He added that the support the Gaza Strip receives to combat the Covid-19 epidemic arrives from donors (Palestine Online, December 17, 2020).
• The W.H.O. delivered ten ventilators to the Gaza Strip and 72 CPAP masks (Facebook page of the W.H.O. representative in the territories, December 15, 2020).
• The UAE sent a third plane with 14.4 tons of medical equipment for the Gaza Strip, including approximately 100 ventilators and 200,000 PCR tests (UAE News Agency, December 16, 2020). Majdi Dheir, head of the preventive medicine department in the ministry of health in Gaza, claimed the UAE aid included swabs not used for Covid-19 testing, and no appliance for laboratory testing arrived (Telegram channel of the emergency committee to combat Covid-19 in the Gaza Strip, December 19, 2020).

     
Right: Aid for the Gaza Strip from loaded onto a UAE plane (UAE News Agency, December 16, 2020). Left: The aid enters the Gaza Strip through the Rafah Crossing (Twitter account of journalist Hassan Aslih, December 17, 2018).

Judea and Samaria

Extent of Covid-19 infection in Judea and Samaria

This past week the number of active cases in Judea and Samaria declined somewhat; 7,471 new cases detected, down from 8.434 a week ago. As of December 21 2020, the number stood at 13,529, down from 14,328 a week ago. There are 136 patients in ICUs, 37 on ventilators. During the past week 100 people died, up from 99 a week ago, bringing the total number of deaths to 898. In Judea and Samaria 4,378 tests were administered, with a positive infection rate of 23.3% (down from 25.7% on December 14). The PA reported 999 new cases in east Jerusalem. On December 21 there were 1,515 active cases in east Jerusalem, up from 1,390 a week ago. According to the Jerusalem municipality, the number of active cases was 1,383, up from 1,168 a week ago.

Covid-19 infection in Judea and Samaria (according to the PA)

The spread of Covid-19 infection (according to the PA)

Geographic distribution of COVID-19 epicenters

Overview

The Nablus district still has the largest number of Covid-19 cases, with 3,834 new cases detected during the past week, down from 4,245 a week ago. The distribution of active cases by district, as of December 21, 2020, was the following: Nablus, 3,834; Ramallah, 1,824; Jenin, 1,753; Hebron, 1,710; Bethlehem, 1,153; Tulkarm, 904; the villages around Jerusalem, 754; Qalqilya, 585; Salfit, 443; Tubas, 335; and Jericho, 234.

The distribution of active cases in the various districts

Nablus district

The Nablus district still has the largest number of Covid-19 in Judea and Samaria although the number declined somewhat. As of December 21 there were 3,834 active cases, down from 4,245 a week ago.

Number of active cases in the Nablus district

Hebron district

In the Hebron district there was a decrease in coronavirus infection. As of December 21 the number of active cases stood at 1,710, down from 2,008 a week ago. The Hebron district currently has the fourth largest number of cases in the PA territories.

Number of active cases in the Hebron district

Bethlehem district

The gradual trend in the Bethlehem district towards the decline in the number of active cases continues. As of December 21 there were 1,1536 active cases, down from 1,178 a week ago.

Jenin district

The rise in the number of active cases in the Jenin district continues. As of December 21 there were 1,753 active cases, up from 1,641 a week ago.

• In light of the rise in coronavirus infection, Akram al-Rajoub, the governor of the Jenin district, met with the ministry of health in Ramallah. He stressed that the epidemiological curve for his district continues steadily rising, and that situation demands a reevaluation of measures to limit the spread of the virus. He said the Khalil Suleiman Government Hospital could no longer admit patients because of the shortage of ICU beds. He asked the minister of health to designate a new district hospital for Covid-19 patients (Facebook page of the Jenin district governor, December 16, 2020).
• Wissam Sabihat, head of the department of health in Jenin, said the epidemiological curve was steadily rising. He said the percentage of positive test results had reached 27%, the total number of cases was more than 7,000, there were 1,700 active cases and 87 people had died. He said the number of cases requiring hospitalization had grown significantly, and 100% Covid-19 beds and 95% of the ICU beds in the government hospital in Jenin were occupied (Wafa, December 16, 2018).
• Despite the critical health situation, crowded events continue in the Jenin district. The district police closed dozens of stores and handed out hundreds of citations to people who did not take the preventive measures ordered by the ministry of health. The police also broke up wedding parties in Jenin (website of the PA police, December 2020).

The Qalqilya district

As of December 21 the number of active cases in the Qalqilya district continued declining, standing at 585, down from 655 a week ago.

• The Palestinian police closed dozens of stores and detained civilians violating the lockdown (website of the PA police, December 19, 2020). Rafi’ Rawajba, governor of the Qalqilya district, noted the almost total compliance with the weekend lockdown. He said that during the lockdown the curve had flattened (Wafa, December 13, 2020).

   
Right: Weddings in Qalqilya continue (Facebook page of the Muhammad Aram Studio in Qalqilya, December 19, 2020). Left: A wedding in the village of Baqa al-Hatab, east of Qalqilya (Facebook page of baqa.al-hatab, December 15, 2020).

The Ramallah district

In the Ramallah district the number of active cases continues rising, and the district now has the second largest number of cases in Judea and Samaria. As of December 21 the number of active cases stood at 1,824, up from 1,778 a week ago.

• Mu’tassem M’heisen, head of the department of health in the Ramallah-al-Bireh district, said the epidemiological graph for the Ramallah-al-Bireh district was steadily rising, and the percentage of positive test results had reached 20% (Wafa, December 15, 2020). He said the numbers were rising because residents did not take preventive measures. He added that if the numbers continue rising they will recommend enforcing stricter measures, including a lockdown of the entire district. He said the hospitals are finding it increasingly difficult to continue admitting patients, adding that the Hugo Chavez Hospital and the Palestine Medical Center have almost no empty beds (Wafa, December 13, 2020).

   
Weddings in Dir Amar (Facebook page of the Risal Studio, December 19, 2020).

The villages around Jerusalem

As of December 21 the number of active Covid-19 cases in the villages around Jerusalem was 754, up from 695 a week ago. Weddings and other mass events continue to be held, some of them, in ITIC assessment, by residents of east Jerusalem.

The East Jerusalem Neighborhoods

According to the PA, as December 21 999 new active cases were detected, down from 1,390 a week ago. The number of active cases was 1,515. According to the Jerusalem municipality, on December 21 the number of active cases was 1,383, up from 1,168 a week ago.

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

The extent of Covid-19 infection in east Jerusalem, according to the Jerusalem municipality, December 21, 2020

New restrictions and preparations for receiving vaccines

• At the weekly government meeting the PA passed a plan for supplying a Covid-19 vaccine compatible with W.H.O, standards. According to PA Prime Minister Muhammad Shtayyeh, vaccination will be voluntary and they will act in accordance with W.H.O. criteria, giving priority to hospital medical staffs and the elderly. He said a program would be devised by the PA in coordination with the W.H.O. (Wafa, December 14, 2020).
• Mai al-Kayla, PA minister of health, met with the director of the W.H.O. in the PA. They discussed the vaccines expected to be sent to the PA. The PA will follow the W.H.O. criteria for vaccination, beginning with medical staff, [chronically] ill patients and the elderly (Facebook page of the ministry of health in Ramallah, December 15, 2020).
• PA Prime Minister Muhammad Shtayyeh declared a number of restrictions and new guidelines for the coming two weeks (December 17, 2020, to January 2, 2021):
  • All educational institutions will be closed.
  • A total ban will be imposed on movement between the districts, including Jerusalem.
  • Palestinians will be banned from entering Israeli territory. Palestinians working in Israel will be required to remain there and undergo medical tests.
  • A protocol will be devised for prayers in the mosques and churches.
  • All gyms, hairdressers, restaurants and places of entertainment will be closed.
  • Work will be limited in official offices and institutions. Public and private institutions will operate according to emergency protocols. Production sectors will work at 50% of manpower capacity.
  • Weddings, mourning tents and all other forms of gatherings will be banned.
• Muhammad Shtayyeh described the efforts being made by the PA to diversify the sources of Covid-19 vaccines by contacting countries, the W.H.O. and the companies manufacturing the vaccines, including companies in Russia and China. He said the vaccines would arrive in a number of months.

 
Right: Muhammad Shtayyeh reports on the measures being taken by the PA in its efforts to combat the coronavirus (Facebook page of Muhammad Shtayyeh, December 17, 2018). Left: Cartoon by Muhammad Sabaaneh mocking PA Prime Minister Muhammad Shtayyeh’s decision for distance learning. The Arabic reads, “Online studies…first lesson, take a single computer and divide by three” (Twitter account of Muhammad Sabaaneh, December 19, 2020).

Foreign aid for the PA

• The PA continues receiving medical aid from various sources:
  • The German government provides food for needy families in Gaza Strip, Judea and Samaria, products worth €4 million for 2020, €5 million for 2021 (Sawa, December 17, 2020).
  • The Palestinian minister of health signed an agreement with Norway for a health aid package worth $7.6 million. It includes $6.3 million to combat Covid-19 and $1.3 million for the National Public Health Institute (Facebook page of the ministry of health in Ramallah, December 17, 2020).
  • The ministry of health received medical equipment and PPE from the Korean Agency for International Cooperation. It was the third time the PA received aid from the Korean agency. The equipment includes masks, gloves and ventilators, and it is intended for two hospitals, determined by the ministry of health (Sawa, December 20, 2020).

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