Libya

Libya: COVID-19 - Situation Report No. 2, As of 21 April 2020

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HIGHLIGHTS

  • As of 20 April 2020, there are 51 confirmed cases of COVID-19 reported in Libya, including one death.

  • Continuing attacks on hospitals and critical water infrastructure affect people’s access to medical services and safe drinking water. Electricity outages have also been reported across parts of the West.

  • Intensified fighting along the western coast resulted in the suspension of services at four hospitals in Sabratha and Surman that were conducting around 18,000 medical consultations per week.

  • To date, 11,497 calls have been received, 7,192 of which have been answered by the Common Feedback Mechanism’s information hotline.

  • Immediate needs include support to rapid response teams, personal protective equipment, lab diagnostic kits and supplies, establishment and support to isolation sites, training, and education/awareness.

SITUATION OVERVIEW

As of 20 April 2020, the Libyan National Centre for Disease Control (NCDC) reported 51 confirmed cases, including one COVID-related death, in Libya. Around 11 people have recovered and 39 are under follow-up. A total of 808 tests have been performed. Most new confirmed cases are people who have come into contact with others who have previously tested positive, confirming local transmission. However, few of the confirmed COVID-19 patients have been hospitalized and there are no clear criteria for hospitalizing patients.

In Tripoli, the Prime Minister of the Government of National Accord (GNA) has announced that the country will be placed under a 24hr curfew for 10 days, starting on 17 April 2020. Only small neighbourhood grocery shops and bakeries will remain open and people have been asked to walk instead of using public transport or private cars. In the East, in areas controlled by the Libyan National Army (LNA), the daily curfew has been relaxed to 7 p.m. to 7 a.m.
The Director of the NCDC has announced that, with the exception of birth doses of Bacillus Calmette–Guérin (BCG), hepatitis and polio, all routine childhood vaccinations will be suspended for one month so as to limit the risk of transmitting COVID-19. Given the increased risk of a measles outbreaks, which typically occurs every two years in Libya, WHO has urged the NCDC to resume measles vaccinations as soon as possible.

During the week, the Humanitarian Coordinator and WHO discussed the situation in the South with representatives from Ghat, Sabha, Qatroun and Ubari. The South has severe shortages of supplies, equipment and qualified health workers to respond to COVID-19. A plan of action was agreed (based on a recent WHO assessment), including training, supply requirements and the facilities in each municipality to be designated as isolation centres.

The Health Sector, with support from REACH, will be rolling out a Rapid Health Facility Assessment (RaHFA) aimed to identify and map health facilities and isolation spaces and assess facilities’ capacity to respond to a COVID-19 outbreak.

COVID-19 preparedness will be assessed according to: facilities’ reported availability of resources (medicines, medical supplies, COVID tests, staff employed); infrastructure capacity (number of patients serviced per day, space for and number of in-patient beds, existence of intensive care units, etc.); existence of COVID-specific protocols (referrals to other health facilities, staff trainings, community awareness campaigns, sanitation/decontamination protocols, etc.); and the health facilities’ access to regional/national/global guidelines and information.

Procurement and distribution personal protective equipment (PPE), essential testing equipment and other medical supplies continues. WHO has donated four GeneXpert machines to Sebha, Tripoli, Yefren and Tobruk and is reviewing options for procurement of additional machines. On 18 April, the Ministry of Health and WHO received a flight carrying 3 metric tonnes of PPE and medical supplies donated to the African Union by two international foundations.

Heavy fighting continues impacting both on civilians and civilian infrastructure. On three occasions from 6 to 10 April, the Al Khadra Hospital in Tripoli, which was assigned to receive suspected or confirmed COVID-19 cases, was struck by shelling. Furthermore, intensified fighting along the western coast over the past week has resulted in the suspension of services at four hospitals in Sabratha and Surman, which were conducting, on average, 18,000 medical consultations per week. Since the start of the year until 31 March, the UN Support Mission in Libya has documented at least 131 civilian casualties (64 deaths and 67 injuries), representing an overall increase in civilian casualties of 45 per cent compared to the previous three months.

The first data from an ongoing survey on possible discrimination related to COVID-19 has highlighted several protection concerns: migrants with an irregular status are more vulnerable with increased police and military prompting them not to leave their homes for fear of being identified and deported; communities in Tripoli are aware of COVID-19 but are less aware of what to do and where to go if someone contracts the disease; East and West African community leaders reported a fear of increasing discrimination and barriers to accessing healthcare; and a main concern facing all population groups in Tripoli is disruption to livelihoods, especially for those relying on the informal economy.

Additionally, UN Women conducted a flash survey with 290 women across Libya to capture the pandemic’s specific impact on women. The survey found that current COVID-19 prevention measures have negatively affected women’s livelihoods, especially for self-employed women. Around 52 per cent of surveyed women indicated that their work had been affected, and 26 per cent believed that their source of livelihood would be affected if curfews were extended. Respondents reported fears of increased violence due to pressures from curfews and 70 per cent reported needing support from male family members to access medical services. Many respondents reported being involved in more domestic work including in educating children and more housework arising from continuous sterilization.

The survey also highlighted difficulties in meeting needs of people with disabilities, with 49 per cent of respondents having a person with a disability in the family and reporting barriers in obtaining necessary healthcare. Health services for women were also expected to be more difficult, with 71 per cent of the sample expressing concerns regarding their access to healthcare, particularly for pregnant and post-partum women, due to lack of capacity in health facilities. The survey highlights the need to include women in decision-making and for responding organizations incorporating a gender perspective when developing and implementing activities to combat COVID-19, including women frontline responders, women leaders and women networks. Activities need to respond to the varied needs of different groups and ensure that all groups, particularly women, have equal access to social protection policies, outreach and other services.

While access remains challenging, there are ongoing efforts, including at the highest levels, to ensure unrestricted humanitarian access. This includes working with municipal and national authorities for authorizations for humanitarian personnel and supplies to be able to deliver humanitarian assistance. In the last two weeks, OCHA has successfully negotiated authorizations to move during curfew hours and between municipalities that will allow humanitarian organizations to deliver assistance to more than 40,000 people. This also includes critical personal protective equipment for health care staff from Tripoli to the East and South.

UN Office for the Coordination of Humanitarian Affairs
To learn more about OCHA's activities, please visit https://www.unocha.org/.