Coronavirus disease 2019 (COVID-19) Situation Report 54

Issued 3 December 2020

Highlights

  • The oPt continues to witness a significant surge of SARS-CoV-2 cases in the community, especially in the West Bank. The cumulative total of COVID-19 cases in oPt surpassed 100,000
  • The risk that the health system may reach its capacity limits and get overwhelmed remains high
  • Decisive public health measures and strict adherence to hygiene protocols and physical distancing are still needed to regain control and reduce the spread of the disease
  • Essential medical supplies and equipment, including lab testing kits and ventilators, are arriving in Gaza and West Bank to expand treatment capacities, including for intensive care units
  • The Palestinian Authority, in partnership with WHO and UNICEF, continues preparatory efforts for the introduction of the COVID-19 vaccine in 2021

With thanks to the generosity of the Government of Kuwait, WHO delivered 21 ventilators to the Ministry of Health in a ceremony in Ramallah on Nov 30. The ventilators are essential to provide extra capacity to support critically-ill COVID-19 patients in the West Bank and Gaza.​ ​

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.

Surveillance  

  • The WHO risk assessment remains very high
  • The oPt continues to witness a concerning increase in COVID-19 cases, with significant community transmission of SARS-CoV-2 over the reporting period, in the West Bank and in the Gaza Strip. The West Bank is for the first time reporting more than 1,000 cases a day
  • A 27% increase in confirmed cases (by 12,912) and a 17% increase in deaths (by 97) was reported between 27November-3 December, compared to the previous week (20-26 November). The overall Case Fatality Rate (CFR) remains at 0.8 %. The CFR is the proportion of deaths among identified confirmed cases
  • Gaza accounts for 42% of all active cases, followed by the West Bank governorates of Nablus (14%), Bethlehem (7%), Hebron (6%), Jenin (6%), Ramallah (5%), Tulkarm (4%) and East Jerusalem (4%)
  • On 3 December, 1,689 new confirmed cases were reported in the West Bank, the highest number over a 24-hour period since the start of the pandemic
  • An increase in the number of infected health workers is also raising concerns about adherence to infection prevention and control protocols in hospitals
  • Authorities are discussing additional closures and movement restrictions to mitigate a further increase in case numbers
  • WHO strongly recommends communities to implement effective prevention protocols to help curb the current increasing transmission trends, to save lives and to ease the pressure on the health system.

WHO recommends the public adhere to stricter protective health measures. Essential protective measures include:

  • wearing a mask
  • following good respiratory hygiene
  • regularly washing hands
  • physical distancing of at least 1 metre including avoiding crowds and gatherings
  • staying  home and self-isolating if people develop Corona related symptoms.  ​

Laboratory diagnostics  ​

  • The number of tests conducted in the oPt has increased by 18% in the reporting period (27—3 December), with 55,867 more tests conducted compared to the previous week
  • With the increased community transmission and due to resource limitations in the Gaza Strip, local health authorities on December 1 revised the criteria for COVID-19 RT-PCR testing, to target high risk groups, including:
    • Symptomatic contacts and suspected cases above 50 years
    • Symptomatic contacts and suspected cases of high-risk groups
    • Symptomatic MoH and Ministry of Information employees
    • Patients admitted for more than 48 hours in departments for intensive care, internal medicine, children, oncology, thoracic and respiratory treatment
  • Symptomatic suspected cases of healthy young individuals, including children, are diagnosed clinically as COVID-19 cases and are requested to self-isolate for 14 days
  • While the continued supply of lab testing kits and supplies remains a challenge in Gaza, testing has been sustained. On Dec 1, Gaza Central Laboratory reported critical shortages in COVID-19 detection and extraction kits, with supplies expected to run out by 3 December.

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

WHO delivered 15 ventilators to the local health authorities in the Gaza Strip on 29 November to help prepare extra capacity for critically-ill COVID-19 patients as the numbers of newly confirmed cases continue to surge. 

This essential medical equipment was provided with the funding from the Government of Kuwait.

  • In the Gaza Strip, the overall occupancy rate of dedicated COVID-19 hospital beds is 69%, with 343 of 500 beds occupied. Currently, of the 70 Intensive Care Unit beds, 43 or 61% are occupied, including 5 patients on ventilators
  • The provision of oxygen for treatment of COVID-19 patients at the European Gaza Hospital continues to be a challenge; the Health Cluster continues to work with partners to resolve supply issues in early 2021
  • Under the leadership of the MoH, Palestinian National Institute of Public Health continued conducting Basic Life Support training in November for 85 MoH and private clinic doctors, nurses, and emergency medical teams. The Basic Assessment and Support in Intensive Care course, conducted in partnership with Juzoor for Health and Social Development and Augusta Victoria Hospital, also continued this month for 20 doctors and nurses.

​”The training was extremely useful and badly needed with the increase of COVID-19 cases. We have been exposed to new topics in infection prevention and control in both primary health care and hospitals, we need to have such training periodically to be updated with evidence-based precautions and interventions. We have trained 30 health care providers at the province and they found the training very useful,” commented a participant from Qalqilya. On November 25, the MoH and Palestinian National Institute of Public Health, hosted an Infection Prevention and Control training-of-trainers program for participants from the Nablus, Tulkarm, Qalqilya, and Jenin governorates. Participants will train health workers in their governorates, and will train 150-200 health workers by mid December 2020.​

COVID-19 vaccination: ​

  • The National Immunisation Technical Advisory Group, led by the Minister of Health, met on December 2 to review the status of COVID-19 vaccine preparatory efforts. WHO and UNICEF are working with partners to support the MoH in developing preparedness plans and required documentation.

Access to essential health services 

  • As of 23 November, the Palestinian Ministry of Health resumed the coordination patient and companion permit applications in the Gaza Strip through its Health Liaison Office. On the same day, WHO stopped accepting new permit applications through the temporary coordination mechanism set up on 6 September to support patients and companions requiring exit from the Gaza Strip.
  • From 6 September to 23 November 2020, 1,359 patient permit applications and 1,604 patient companion applications were submitted through the mechanism. By 23 November 2020, responses had been received for 1,075 permit applications for patient and 1,316 applications for companions. For patient applications, 767 (71%) were approved, 15 (1%) denied, and 293 (27%) delayed. For companion applications, 571 (43%) were approved, 75 (6%) were denied and 670 (51%) were delayed.