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Syrian Arab Republic: COVID-19 Humanitarian Update No. 19 As of 29 September 2020

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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: 4,102 (194 fatalities, 1,074 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 19 September, the MoH has reported approximately 37,000 tests have been performed in laboratories in Damascus, Aleppo, Homs, Lattakia and Rural Damascus governorates.

  • 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, 33,249,563 laboratory-confirmed cases of COVID19, including 1,000,040 deaths (CFR=3.1 per cent) had been reported globally. The United States has the most confirmed cases (7,044,327) and the most deaths to date (203,620). In the Eastern Mediterranean Region, more than 2,369,048 COVID-19 cases have been reported, including 61,007 deaths, around 42 per cent of which occurred in Iran.

In Syria, 4,102 laboratory-confirmed cases have been reported by the MoH to date: 7 in Ar-Raqqa; 13 in Deir-Ez-Zor; 35 in Al-Hasakeh; 79 in Quneitra; 94 in Dar’a; 121 in Tartous; 142 in Hama; 145 in As-Sweida; 333 in Homs; 360 in Rural Damascus; 423 in Lattakia; 964 in Aleppo; and 1,386 in Damascus. In total, 526 new cases have been announced since the last report. The MoH has also announced 192 fatalities, representing an increase of 85 since 1 September, or 44 per cent of all reported deaths. In addition, 1,074 recoveries were announced.

Highlighting the particular risks faced by healthcare workers, according to the MoH, 143 healthcare workers have tested positive for COVID-19. This includes 59 in Damascus; 30 in Lattakia; 14 in Rural Damascus; nine in Aleppo; seven in Hama; six each in Quneitra, Tartous and Dar’a; three in 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 current official numbers remain relatively low, it is clear the epidemiological situation in Syria has rapidly evolved and all factors – including that more than 92 per cent of announced cases to date have not been linked to exposure/contact with a known case – point to widespread community transmission. Since July, official numbers have risen sharply; including a peak of more than 1,600 confirmed cases (around half the current total) in August.

As earlier reported, humanitarian actors have received ongoing numbers of unverified reports concerning additional possible cases, in addition to other information which has indicated in some areas, existing healthcare facilities, particularly in July and August, were unable to absorb all suspected cases and/or are suspending surgeries or adapting wards to accommodate increased COVID-19 patients. 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.

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 is also 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 tests or 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 28 September, authorities in Northeast Syria (NES) have reported 1,557 cases (1,174 in Al-Hasakeh, 164 in Aleppo, 183 in Ar-Raqqa, and 36 in Deir-ez-Zor), including 62 fatalities and 47 recoveries. Healthcare workers have also been affected, with 92 reported cases. As is the case elsewhere, limited testing likely means significantly higher numbers exist.

As of 19 September, the MoH reported around 37,000 tests have been conducted by the Central Public Health Laboratory (CPHL) in Damascus and the public health laboratories in Aleppo, Lattakia, Rural Damascus 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 relevant public health information.

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