Gaza struggles to contain COVID-19, as hospitals ‘days away’ from running out of beds

Health officials in Gaza say they are days away from running out of hospital beds, sounding the alarm as coronavirus cases continued to radically spike over the last week, sending younger patients to critical care wards for the first time. 

Less than three months ago there were under 100 total confirmed cases in Gaza. Today there are over 10,000 active cases, and the positivity rate is over 30%, making Gaza home to the second highest positivity rate in the world, outpaced by only Bolivia. 

With Gaza’s scant resources, only 3,000 tests are run each day, and tests are only available to Palestinians who are already quarantined either in an isolation facility for returning travelers, or for symptomatic patients in treating hospitals. 

“Any day now, we will no longer be able to receive critical cases,” head of the European Hospital, Dr. Yousef al-Aqqad, said. He runs the only dedicated facility for critical cases in Gaza. In total around 2,000 COVID-19 patients are being treated between his hospital and one more, or in isolation facilities including schools and hotels. 

His hospital has a total 150 ICU beds, but only 100 of them are fully equipped, “we can’t use them all due to the lack of the instruments for the ventilators, like monitors that determine the oxygen level.” 

According to al-Aqqad, weeks ago there were only seven people in the ICU and his hospital was equipped with a total of 20 functional ICU beds. As of Monday, 90% of his ICU beds are full. 

“Before autumn, it was older people with chronic diseases who needed ICU care and oxygen ventilators, but now the patients are mostly young without per-existing conditions.”

According to the Health Cluster, an international consortium of 70 organizations and UN agencies working with local health officials, prior to the pandemic Gaza had 152,426 patients with chronic conditions out of a population of 2 million. By comparison, in the West Bank the same agency found 41,780 have chronic conditions for a population that has 700,000 more than Gaza. 

Since mid-March, more than 100,000 Palestinians have tested positive for the coronavirus, of whom 23,023 live in Gaza. The virus has taken the lives of 873 Palestinians, including 122 in Gaza. With temperatures dropping due to the winter, the fatalities are expected to escalate, and the plans to control the virus are growing more dismal. 

Palestinian doctors take part in a medical campaign that simulates treating Palestinians patients with COVID-19, in the European Hospital in southern Gaza on April 6, 2020. (Photo: Ashraf Amra/APA Images)
Palestinian doctors take part in a medical campaign that simulates treating Palestinians patients with COVID-19, in the European Hospital in southern Gaza on April 6, 2020. (Photo: Ashraf Amra/APA Images)

In late August the first cases of community spread were discovered in a refugee camp in Gaza, only after a Palestinian woman traveling in Jerusalem tested positive and health officials immediately swabbed her close relations. Attempts of contact tracing fell apart just two weeks later when Gaza’s ministry of health announced it only had around half of the laboratory supplies to process the needed COVID-19 tests. Since then Gaza has been bereft of basic medications, places to treat patients, and even the lab equipment needed to process coronavirus tests. 

Currently in Gaza there is a 31% shortage of medical supplies, a 56% shortage of laboratory supplies including those needed to process COVID-19 swabs, and only 45% of the necessary medications are in stock, according to Ashraf al-Qedrah, Gaza’s ministry of health spokesperson. 

Over recent months a surge of healthcare workers were trained to respond to the pandemic, but al-Qedrah said treating facilities are still plagued by shortages.

 “The ministry of health has a quality trained staff and healthcare workers to deal with the pandemic,” he commented. “The WHO resupplies the ministry with testing kits, but there is a huge shortage in beds and medical supplies that the ministry cannot cover.”

“Gaza has been supplied with about 1,600 testing kits until now, which can test around 160,000 samples.” said Dr. Abdelnasser Suboh, head of WHO emergency committee in Gaza.

Palestinians wait to in line outside a post office in Gaza for cash grants on December 3, 2020. The Qatari government began disbursing $100 to poor families on Thursday. (Photo: Ashraf Amra/APA Images)

Microbiologist and member of Gaza’s pandemic task force, Dr. Abdelraof Manaama believes that the mounting infections come by way of two reasons: first, people have not rigorously adopted social distancing and preventative measures, and second, colder temperatures in advance of winter.

“Low temperatures keep viruses live longer,” he said, noting the live coronavirus can survive on some non-porous surfaces 10 times longer in colder months. A recent Australian peer-reviewed study published in the Virology Journal found SARS-CoV-2, the virus that causes COVID-19, can live on stainless steel surfaces for up to 28 days in 68 degrees Fahrenheit, yet, only 48 hours in 100 degrees Fahrenheit. 

“The ultraviolet rays of the sun become less effective as clouds obscure them,” Manaama said. “It is also because of the cold, people stay in enclosed places, shut windows. Even in large environments like schools, universities, and markets, if ventilation is blocked, this is beneficial for the virus’ survival and reproduction.”

“The best plan to control the spread of COVID-19 during this critical stage is by a complete shutdown” and only removing restrictions once the rate of infection slows,” Manaama said.

Health officials did announce a second round of closures beginning on November 24 and lasting two weeks. Fifty-six of Gaza’s most congested neighborhoods were marked as “red zones,” where residents were ordered to shelter in place, and 125 schools were shut down. In areas with lower rates of infection, an evening curfew will be in place for all businesses with the exclusion of pharmacies, restaurants and bakeries. Indoor gatherings are limited to 15 people.

“Until now,” the European Hospital’s director Yousef al-Aqqad said, “the hospital is keeping pace with patients who need intensive care, but numbers are escalating fast.” 

 “The hospital has not yet run out of options, but we have nothing we can do if critical cases exceed the number of beds we have,” he said.

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