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Syrian Arab Republic: COVID-19 Humanitarian Update No. 18 As of 17 September 2020

Format
Situation Report
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Originally published

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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: 3,654 (163 fatalities, 889 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 by the MoH, 126 are reported to be healthcare workers, largely in Damascus.
  • As of 12 September, the MoH has reported approximately 34,033 tests have been performed in laboratories in Damascus, Aleppo, Homs and Lattakia governorates. A new laboratory in Rural Damascus has also come online.
  • Socio-economic impacts 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, 29,444,198 laboratory-confirmed cases of COVID- 19, including 931,231 deaths (CFR=3.2 per cent) had been reported globally. The United States has the most confirmed cases (6,496,246) and the most deaths to date (193,119). In the Eastern Mediterranean Region, more than 2,148,615 COVID-19 cases have been reported, including 56,084 deaths, around 42 per cent of which occurred in Iran. In Syria, 3,654 laboratory-confirmed cases have been reported by the MoH to date: three in Ar-Raqqa; 13 in Deir-ez-Zor; 26 in Al-Hasakeh; 76 in Dar’a; 76 in Quneitra; 103 in Tartous; 128 in As-Sweida; 133 in Hama; 255 in Homs; 318 in Rural Damascus; 401 in Lattakia; 819 in Aleppo; and 1,303 in Damascus. In total, 889 new cases have been announced since the last report. The MoH has also announced 163 fatalities, representing an increase of 54 since 1 September, or one-third of all reported deaths. In addition, 889 recoveries were announced. Highlighting the particular risks faced by healthcare workers, according to the MoH, 126 healthcare workers have tested positive for COVID-19; an increase of 36 since the last report. This includes 53 in Damascus; 28 in Lattakia; 14 in Rural Damascus; seven in Aleppo; six in Quneitra; six in Tartous; three each in Hama, Dar’a and Al-Hasakeh; two in As-Sweida; and one in Homs. Of particular concern, 11 healthcare workers are reported to have died, most recently on 3 September. The steady increase in affected healthcare workers reported since July 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. 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. Even while the official numbers remain relatively low, it is clear that in past weeks the epidemiological situation in Syria has rapidly evolved and all factors – including that some 91 per cent of announced cases to date have not been linked to exposure/contact with a known case – point to community transmission now being widespread. Since July, official numbers have risen sharply and outpaced the rate of expansion in reported numbers of tests performed. In the past four weeks alone, confirmed cases reported by the MoH have increased by around 110 per cent. As earlier reported, humanitarian actors have received ongoing and increased numbers of unverified reports concerning additional possible cases. In addition, other information received has indicated that in past weeks in some areas, existing healthcare facilities have been unable to absorb all suspected cases and/or are suspending surgeries or adapting wards to accommodate increased COVID-19 patients, however subsequent reports suggest this may have alleviated. While the UN is not in a position to verify or directly link such reports to COVID-19, other unverified reports received include difficulty obtaining a COVID-19 test; and rises in obituaries, death notices and burials. Nevertheless, given the limited testing across Syria, it is therefore likely that the actual number of cases may far exceed official figures. In particular, it is likely significant numbers of asymptomatic and mild cases are going undetected. 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 further likely significant numbers of people with symptoms are not seeking treatment or are 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. As of 12 September, authorities in Northeast Syria (NES) have reported 841 cases (679 in Al-Hasakeh, 81 in Aleppo, 54 in Ar-Raqqa, and 27 in Deir-ez-Zor), including 34 fatalities and 88 recoveries. Healthcare workers have also been affected, with 92 reported cases. As is the case elsewhere, limited testing may mean significantly higher numbers exist. As of 12 September, the MoH reported around 34,033 tests have been conducted by the Central Public Health Laboratory (CPHL) in Damascus and the public health laboratories in Aleppo, Lattakia and Homs. Within the reporting period, another laboratory in Rural Damascus has come online. 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 relevant public health information.

UN Office for the Coordination of Humanitarian Affairs
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