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Syrian Arab Republic: COVID-19 Humanitarian Update No. 17 As of 1 September 2020

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Situation Report
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This report is produced by OCHA Syria in Damascus in collaboration with WHO Syria and Damascus-based humanitarian partners, and does not reflect cross-border operations.

HIGHLIGHTS

• Number of people confirmed by the Ministry of Health (MoH) to have COVID-19: 2,830 (116 fatalities, 646 recovered).
• Areas of concern: Densely populated areas, notably Damascus/Rural Damascus, Aleppo and Homs, and those living in camps and informal settlements in NES, collective shelters throughout the country, as well as other areas including Deir-Ez-Zor, and where hostilities may be ongoing making sample collection more challenging.
• Populations of concern: All are susceptible. However, the elderly; people with underlying health conditions; vulnerable IDPs and refugees; and healthcare workers with inadequate personal protective equipment (PPE) are at greater risk.
• Of the cases announced to date by the MoH, 90 are reported to be healthcare workers, largely in Damascus.
• As of 24 August, the MoH has reported approximately 26,572 tests have been performed in laboratories in Damascus, Aleppo, Homs and Lattakia governorates.
• Socio-economic impacts of COVID-19, notably in food security and livelihoods, are likely to exacerbate existing substantial humanitarian needs across the country.

SITUATION OVERVIEW

The global situation remains highly fluid. However, at the time of writing, 25,327,098 laboratory-confirmed cases of COVID- 19, including 848,255 deaths (CFR=3.4 per cent) had been reported globally. The United States has the most confirmed cases (5,936,572) and the most deaths to date (182,162). In the Eastern Mediterranean Region, more than 1,924,511 COVID-19 cases have been reported, including 51,019 deaths, around 42 per cent of which occurred in Iran.
In Syria, 2,830 laboratory-confirmed cases have been reported by the MoH to date: ten in Deir-ez-Zor; 26 in Al-Hasakeh; 64 in Dar’a; 73 in Quneitra; 87 in Tartous; 106 in As-Sweida; 114 in Hama; 211 in Homs; 290 in Rural Damascus; 359 in Lattakia; 466 in Aleppo; and 1,024 in Damascus. In total, 1,153 new cases have been announced since the last report. The MoH has also announced 116 fatalities – an increase of 52 since the last report – and 646 recoveries. Of the cases, 105 cases were announced as imported and 203 as a secondary case (exposure/contact with a known case).

Of note, according to the MoH, 90 healthcare workers have tested positive for COVID-19; an increase of 21 since the last report. This includes 51 in Damascus, 14 in Rural Damascus, six in Aleppo, five in Quneitra, four in Lattakia, three in Tartous, two each in Hama and As-Sweida, and one each in Homs, Hama and Al-Hasakeh. This highlights the particular risks faced by healthcare workers and underscores – given Syria’s fragile healthcare system with already insufficient numbers of qualified healthcare personnel – the potential for its overstretched healthcare capacity to be further compromised. Of concern, humanitarian actors continue to receive reports that healthcare workers in some areas do not have sufficient PPE. The WHO continues to lead efforts to support increased distribution of PPE where needed to ensure the protection of healthcare workers already operating under very challenging circumstances.

In particular throughout July and August, humanitarian actors have received ongoing and increased numbers of unverified reports concerning additional possible cases, and information indicating that in some areas, existing healthcare facilities have been unable to absorb all suspected cases and/or healthcare facilities are suspending surgeries or adapting wards to accommodate increased numbers of COVID-19 patients. Unverified reports received include a rise in obituaries, death notices and burials. Increased reporting across a range of media outlets on COVID-19 has also continued in Syria, notably on Facebook, where health care professionals, posting in a personal capacity, have indicated that the actual COVID-19 caseload in Damascus alone is far higher than official records.

While the UN is not in a position to verify this information or directly link it to cases of COVID-19; it is clear that during the past two months the epidemiological situation across Syria has rapidly evolved. In July, 532 cases were confirmed, compared to 157 cases in June and 79 cases in May. At the time of writing, authorities have confirmed 2,008 cases in August and 65 in September. Given the limited testing across Syria, it is therefore likely that in particular asymptomatic and mild cases are going undetected and the actual number of cases may far exceed official figures. Of note, among official cases confirmed by the MoH the source of approximately 89 per cent of cases to date remains unknown. These factors indicate that community transmission across Syria is now widespread.
As official numbers have increased, contact tracing has also emerged as a particular challenge, including in more remote governorates and camps. In addition, for reasons including community stigma and individual reluctance to go to hospitals, it is likely significant numbers of people with symptoms are not seeking treatment or obtaining private services offering home care. In addition to making actual numbers of cases difficult to ascertain, this may increase the risk of late referral of severe/complicated cases for treatment, negatively impacting the long-term health prospects and survival of patients.

Since the last report, authorities in Northeast Syria (NES) have announced a further 323 cases bringing the total in NES to 557 (460 in Al-Hasakeh, 62 in Aleppo, 32 in Ar-Raqqa, and 21 in Deir-ez-Zor). Of these, 34 fatalities have been reported, with 88 recoveries. Healthcare workers have also been affected, with 92 reported cases.

As of 24 August, the MoH report around 26,572 tests have been conducted by the Central Public Health Laboratory (CPHL) in Damascus and the public health laboratories in Aleppo, Lattakia and Homs. The UN continues to advocate for the enhancement of laboratory and case investigation capacity across Syria, including in NES, and the timely communication of all information relevant to the safeguarding of public health.

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