Coronavirus disease 2019 (COVID-19) Situation Report 45
occupied Palestinian territory, issued 24 September 2020

Information for period: 5 March – 24 September 2020

Highlights
  • Shortages of COVID-19 test kits and supplies are being reported in West Bank and Gaza Strip
  • WHO continued to coordinate and deliver vital medical equipment and supplies, including lab kits and extraction supplies, to support the response in the occupied Palestinian Territory (oPt)
  • COVID-19 cases across the oPt so far this month rose by 37%, and by 86% in the Gaza Strip
In response to the critical shortage of COVID-19 laboratory testing supplies in the Gaza Strip, today WHO urgently procured and delivered COVID-19 testing kits and necessary reagents to support testing of 8,000 people, thanks to UK Aid, see image to the left.

In addition on September 21, WHO delivered 20,000 swabs and laboratory extraction supplies to conduct 6,000 tests in the Gaza Strip. Thanks for the Government of Germany and oPt Humanitarian Fund.​

WHO preparedness, readiness and response

WHO is continuing to work with partners to support Ministry of Health’s (MoH) efforts to respond to the COVID-19 outbreak.

 Coordination, planning and monitoring ​
  • The Palestinian Authority received confirmation that Palestine will be eligible for GAVI support for procurement of COVID-19 vaccines – once available – through the global COVAX Facility, a collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines
  • A joint meeting of the Ministry of Health (MoH), UNICEF and WHO took place on 22 September to discuss the details of Palestine’s participation in the COVAX facility, following this the MoH participated in a global virtual brief on the progress and next steps required to introduce the new COVID-19 vaccine when it becomes available
  • On 24 September, the MoH and the Consul-General of Italy with technical support from WHO co-chaired a meeting of the Health Sector partners, which focused on maintaining the essential health services, including immunisation, in times of COVID-19, amongst other important health sector developments
  • In the Gaza Strip, the Gaza-Egypt Rafah crossing is scheduled to open for three days starting from Sunday, 27 September 2020, allowing exit of 1,500 people to Egypt, and entry of approximately 2,000 Palestinians to Gaza
  • Health authorities reported that six testing centers, across the five governorates, were assigned for sample collection for PCR testing of people leaving to Egypt, according to set schedules, in order to avoid crowdedness and minimize transmission
  • As per the updated protocols in the Gaza Strip, all returnees are to be directed to quarantine facilities upon arrival, where they would be tested on day 7 of quarantine. Those who test negative will be discharged, while the ones testing positive will be referred to isolation facilities
  • The Israeli Government’s three-week lockdown continues until October 11 to address the spike in COVID-19 cases
Surveillance  
This month WHO and UNICEF are delivering large quantities of essential medical equipment to the Ministry of Health in Ramallah to support the COVID-19 response, including: 
  • 6 portable ECGs (to check a heart’s rhythm and electrical activity)  
  • 20 Patient monitors (monitors, measures, records and displays patient information such as blood pressure, heart rate and temperature) 
  • 150 oxygen flowmeters (see picture, used to regulate the flow of oxygen) 
  • 30 intravenous poles (to hold bags of intravenous fluids) 

Thanks to the Government of Kuwait for supporting this delivery 

  • The WHO risk assessment remains very high as the number of people testing positive for SARS-CoV-2 continues to increase
  • The total number of cases in oPt increased to 47,830 including 45,217 cases in the West Bank and 2,613 in the Gaza Strip; in the West Bank 42 patients are in serious condition requiring intensive care unit (ICU) treatment, with 11 requiring mechanical ventilation; a total of 526 health workers are among confirmed cases in the West Bank
  • So far this month (to September 24), the total number of COVID-19 cases has risen by 37% or 17,892, an average of 745 cases per day. In the Gaza Strip, cases have risen by 86% or 2,257, an average of 94 cases per day for the same period. Most cases are linked to community transmission
  • The highest daily total for confirmed cases for oPt was recorded on 15 September with 1,118
  • In the West Bank, most cases recorded are from Hebron (16,626) and East Jerusalem (10,239)
  • In the Gaza Strip, the cumulative total of confirmed cases is 2,613, including 1,746 active cases, 17 deaths and 850 recovered; seven patients are in a serious condition requiring ICU treatment, including four connected to mechanical ventilators, and three in critical condition. A total of 96 health workers are also among the confirmed cases
  • To-date, the Ministry of Health reported a total of 35,341 cases have recovered: 34,491 in the West Bank and 850 in Gaza. Three hundred and twenty two have died, with an overall case fatality rate (CFR) of 0.67%
  • More than half (52.7%) of all confirmed cases are female (19,831 cases) and more than two-third (70%) of all cases (26,594 cases) are below the age of 50 years.
Laboratory diagnostics  ​
  • A total of 385,169 laboratory samples have been tested for COVID-19 according to the MoH
  • In both the Gaza Strip and West Bank, there are reports of limited lab supplies for testing for COVID-19
  • On 22 September, the PA Minister of Health announced experiencing severe shortages in COVID-19 test kits and swabs as 100,000 tests were damaged before they arrived in Palestine due to improper storage conditions. This is further constraining testing capacity
  • Similarly, on 22 Sept health authorities in Gaza reported acute shortages in critical laboratory supplies required for COVID-19 testing. On 24 September, health authorities announced that the COVID-19 testing capacity at the Gaza Central Laboratory decreased by 50% due to depletion of extraction kits
  • In the Gaza Strip, in response to the critical shortage of COVID-19 laboratory testing supplies, on September 24 WHO mobilized and delivered COVID-19 testing kits and necessary reagents to support testing of 8,000 people, thanks to UK Aid. In addition, on September 21, WHO delivered 20,000 swabs and laboratory extraction supplies to conduct 6,000 tests to in the Gaza Strip. These new supplies will allow testing to continue and scale-up efforts to contain the spread of the virus. Thanks for the generous support of the Government of Germany and oPt Humanitarian Fund.
Infection Prevention and Control (IPC), Isolation and Case Management, Operations Support and Logistics 

WHO has coordinated and supported the entry of 10 ventilators (pictured left), 25 hospital beds and mattresses (pictured right) and surgery tables to the Ministry of Health in Ramallah to support the COVID-19 response. These items, and more on the way, were generously donated by the King Salman Humanitarian Aid & Relief Centre. WHO also supported coordination of medicines donated by the Government India, also due to be delivered this week.

  • 34,191 Palestinians are in quarantine (home or facility-based) to prevent further spread of the disease
  • In the West Bank, this week, WHO and the Palestinian National Institute of Public Health with support of Juzoor and Augusta Victoria Hospital conducted a training on critical case management for 15 doctors and nurses. Additional trainings are underway for MoH staff and health workers from private health facilities
  • In the Gaza Strip, 76 people are in one of three quarantine facilities which include health facilities and hotels
  • On 17 September, the WHO conducted an assessment at the COVID-19 designated hospital, the European Gaza Hospital, to evaluate the Intensive Care Unit (ICU) capacity. WHO in coordination with its Regional Office, is planning to organise a series of training sessions for staff of ICU on critical care management
  • On 22 September, WHO supported the training of 28 health workers that will be supporting preventive medicine teams in trackingsuspected cases and contacts under home-quarantine
  • Additionally, WHO continues to coordinate and support the delivery of vital medical equipment for the COVID-19 response across Gaza and the West Bank (see images for detail).
East Jerusalem ​
  • As of 23 September, there is a total of 35 COVID-19 patients in hospitals in East Jerusalem including: 7 patients in Al Makassed Hospital, 25 in St. Joseph Hospital, 3 patients in Augusta Victoria Hospital.
  • The East Jerusalem Hospital Network has a capacity for 50 beds for 50 COVID-19 patients and 64 % of the beds are occupied in the two designated COVID-19 hospitals (Al-Makassed and St. Joseph); 90% of these are in St. Joseph.
  • There are 12 staff in St. Joseph infected with COVID-19 in addition to 3 in Al-Makassed.
Sustaining Essential Health Services: WHO Trauma Programme ​

WHO delivered 55 special stretchers for transporting patients and a specialised surgical orthopaedic operations table to the Limb Reconstruction Unit (LRU) at Nasser Medical Complex, and on September 23 to local health authorities and emergency departments in the Gaza Strip.  

  • WHO is supporting specialised capacity building in the Gaza Strip by providing ‘Virtual Class Through Glass’ – weekly distance training sessions online in two levels of care:
    • A six-week long refresher training course in first aid for Palestine Red Crescent Society ambulance personnel and paramedics using apps and personalised online platforms. The training will increase the knowledge, skills and capabilities of paramedics
    • Weekly live online sessions are being hosted for Limb Reconstruction Unit (LRU) physicians and orthopaedic surgical residents with limb reconstruction experts from abroad, focusing on the optimal management of patients
  • WHO delivered a specialised surgical orthopaedic operations table to the Limb Reconstruction Unit (LRU) at Nasser Medical Complex, and 55 special stretchers for transporting patients to local health authorities and emergency departments in the Gaza Strip (pictured)
  • Additionally, WHO delivered 5,490 Personal Protective Equipment kits and 10,000 single use uniforms, and five triage kits for Gaza’s five main hospitals. Triage kits are essential to help first responders to manage an emergency situation and to effectively deliver life-saving interventions.
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