Coronavirus Disease 2019 (COVID-19) Situation Report 52

November 2020
Information for period: 5 March – 12 November 2020

Highlights

• On 11 November, 300 new COVID-19 cases reported in the Gaza Strip, the highest number in a 24-hour period since the beginning of the outbreak
• Health Authorities in the Gaza Strip are reporting continued chronic shortages of laboratory supplies for COVID-19 testing
• The Ministry of Health and partners made further preparations for the introduction of the COVID-19 vaccine when it becomes available

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

Key Performance Indicators

 Coordination, planning and monitoring ​​

• The Prime Minister’s Office for the Palestinian Authority has established a National Coordination Committee for introduction of COVID-19 vaccine with participation of key line ministries, national experts and international partners to ensure that the health system and the eligible population is ready when the vaccine becomes available
• The occupied Palestinian territory (oPt) is eligible to receive financial support for immunisation of an estimated 20% of its population for protecting the most vulnerable in the population, such as health workers, elderly people aged over 65 years and those with pre-existing health conditions
• The Committee will discuss and develop an action plan for the oPt based on the findings of the COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT), which MoH and international partners completed to provide a roadmap for the introduction of the COVID-19 vaccine and a structured framework to self-monitor readiness and progress against key milestones
• A joint Health Cluster meeting for Gaza and West Bank was held on November 11, attended by 50 partners. Partners highlighted priority needs for Gaza’s COVID-19 response (outlined below). In addition, the MoH highlighted the need to intensify efforts to protect healthcare workers as the number of infected workers continues to rise, creating further constraints for  the health system. Partners were provided with an update on the Humanitarian Response Plan process. The Cluster highlighted the need for greater local NGO participation in the submission of projects, and training of all partners on mainstreaming gender, age and protection against sexual exploitation and abuse.

GAZA IN-FOCUS

The WHO head of office, also acting as the UN Humanitarian Coordinator, Dr Gerald Rockenschaub, visited the Gaza Strip from 9-10 November to meet with local authorities to discuss the progress and challenges of the COVID-19 response and made the following observations:

• Health authorities are reporting an increasing number of mild and moderate cases (see COVID-19 capacity analysis below)
• There is concern of potential increase in the number of severe cases as more cases are being reported among older people over 60, particularly female
• Health officials continue to report laboratory supplies and kits at low stock levels. While this remains a concern, testing in Gaza has not been delayed, with more than 2,500 tests a day being conducted. Authorities estimate 120,000 tests ( for an estimated US $2.8 million) are needed until the end of 2020 and WHO is working to mobilize resources to procure the required quantities from global suppliers. Further resources are needed to cover existing funding gaps
• Health authorities report a shortage of oxygen supply for COVID-19 patients at the dedicated COVID-19 hospital, the European Gaza Hospital
• WHO is recommending and advocating stricter adherence to public health measures to better control the further spread of the disease.

Analysis of COVID-19 case management capacity in Gaza: 
Local health authorities report a capacity to admit and treat 3,234 COVID-19 cases, as of November 12:

• 60 ICU beds with ventilators are available in European Gaza Hospital (EGH) for critical cases. EGH ICU is at 21% occupancy rate, with 13 of 60 beds currently utilised. Another 11 ventilators are being installed
• 590 beds are dedicated for mild and moderate cases (at 87% occupancy rate, 512 of 590 beds currently utilised at three sites), including: 240 beds in EGH – 187 beds currently utilised, 170 beds in Turkish Hospital – fully utilised, 180 beds for mild or asymptomatic cases in Ihsan Agha school adjacent to EGH. Currently, 155 beds utilised
• 2,554 beds are available for isolation of asymptomatic cases in 20 isolation centres

Surveillance  

• The WHO risk assessment remains very high
• An epidemiological analysis of trends in the last week (04 – 10 November) highlight:
• oPt reported almost the same number of newly confirmed cases was reported as in the previous week (28 Oct to 3 Nov). However, the number of new cases reported in the Gaza Strip continues to increase: from 1,619 last week to 1,719 this week. On 11 November, 300 new confirmed cases were reported in Gaza – the highest number over a 24-hour period
• Gaza accounts for almost 40% of all active cases in the oPt, followed by the West Bank governorates of Nablus (17.8%), Bethlehem (11.8%), Jerusalem (6.8%), Hebron (5.6%) and Ramallah (4.3%)
• The number of deaths has decreased from 44 to 33, with an overall Case Fatality Rate (CFR) of 0.85% since the beginning of the outbreak. The CFR is the proportion of deaths among identified confirmed cases
• The number of new cases among health workers did not change significantly.

Laboratory diagnostics  ​

• A total of 580,341 laboratory samples have been tested for COVID-19 according to MoH.

Infection Prevention and Control (IPC), Isolation and Case Management, Operations Support and Logistics 

• 11,74 Palestinians are in quarantine (home or facility-based) to prevent further spread of the disease
• Capacity building activities continue, targeting health workers in the Gaza Strip. The seventh group of 17 maternal and child health workers have completed infection prevention training, conducted by the Palestinian National Institute of Public Health and WHO.

East Jerusalem

• The Palestinian Authority’s (PA) financial crisis continues to impactthe financial sustainability of the East Jerusalem Hospitals. A total of US $68 million debts and payment delays to the EJHN are jeopardizing operations of the EJ hospitals
• The debt affects the operational capacity of East Jerusalem hospitals at a time when the COVID-19 pandemic caused a decline in their revenues (a 30% reduction since July 2020) due to the reduction of referrals and reduced utilization of health services.

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