COVID Situation in Syria Deteriorating – As Crisis In India Continues To Worsen Health Systems 30/04/2021 • Madeleine Hoecklin Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) A doctor providing essential health services to children in a refugee camp in northwest Syria during the COVID-19 pandemic. Even as foreign aid from multiple countries arrives in India in response to its COVID-19 surge, a new epicenter of the SARS-CoV2 virus is emerging in Syria. The situation in Syria is “deteriorating extremely rapidly,” according to UN agencies and aid relief organizations. Although the official number of confirmed cases and deaths in Syria is extremely low as compared to its neighbouring countries, the spread of the virus in Syria is “rapid and accelerating,” warned UN officials in a briefing to the Security Council on Wednesday. That’s in comparison to data showing recent declines in new cases in countries nearby such as Turkey, Lebanon, as well as Jordan and the Israeli-occupied West Bank and Gaza – where vaccine campaigns of various degrees are now underway – albeit at a much slower pace than Israel. Credible data collection is a serious challenge in the conflict-ravaged country, which, combined with low testing rates, makes knowledge about the scale of the pandemic uncertain. But the available data suggests that cases are surging nationwide. The number of new cases recorded by the Ministry of Health in March was double the number from February and reports indicate that hospitals in Damascus are at capacity, according to UN officials. After 10 years of war, Syria’s health system is weak and lacks the infrastructure to trace and diagnose cases and contain the spread of the virus. Approximately 90% of the population live in poverty. In northeast Syria, controlled by Kurdish-led forces, over 5,300 new COVID-19 cases have been confirmed in April alone, accounting for more than half of the total recorded in 2020. Some 47% of tests are coming back positive in the past week. In addition, two refugee camps in northern Syria, Al-Hol and Roj, have recorded cases recently, but neither have the resources to treat COVID-19 patients. The only COVID-19 lab in northeast Syria is at risk of suspending testing services in less than seven days because of a shortage of testing kits. “Testing capacity in the northeast has never been sufficient, and now it may be lost altogether,” said Misty Buswell, Policy and Advocacy Director for the International Rescue Committee in the Middle East and North Africa, in a press release. “Currently, 83% of patients who receive invasive ventilation in the region are not surviving and we fear that things will only get worse. Treatment facilities are being forced to close due to a lack of funding, oxygen is beginning to run out, and COVID cases are reaching the highest levels seen to date,” said Buswell. Seven UN and NGO-funded treatment facilities have been forced to close due to a lack of funding. In March, the UK cut aid to Syria by a third in a move that aid agencies criticized as causing lives to be lost in the future. Some 24 million people in Syria rely on aid to survive, a figure that has increased during the pandemic. The International Rescue Committee has issued an urgent call for the UN Security Council to reauthorize the Al Yarubiyah border crossing on the Syrian-Iraqi border so UN agencies can deliver relief and support the region’s COVID-19 response. Cross border aid deliveries into northwest Syria are currently only authorized through a single crossing, Bab al-Hawa, on the Syrian-Turkish border. China and Russia vetoed resolutions to re-open the two other border crossings, Al Yarubiyah and Bab al-Salam, on the Syrian-Turkish border. “The vaccine doses that reached north-west Syria were delivered, like all UN humanitarian assistance there, through the Bab al-Hawa border crossing. It is really not clear how future such deliveries could reach north-west Syria unless you confirm the reauthorization of UN cross-border access,” said Mark Lowcock, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, in a briefing to the Security Council. COVAX Vaccines Arrived in Syria Syria received its first batch of AstraZeneca vaccines from COVAX on 22 April. Syria received its first bulk of vaccines from the COVAX facility last week, with 203,000 doses of the AstraZeneca vaccine arriving in Damascus and 53,800 doses delivered to the northwest of the country. The distribution and administration of the jabs will begin in early May. “This is a milestone in our collective fight against the pandemic,” said Akjemal Magtymova, WHO Representative in Syria, in a press release. “Delivery of the COVID-19 vaccines by COVAX and partners brings us closer to vaccine equity and gives hope for the people in Syria, whose lives have been shattered by a decade of conflict and the devastating impact of the pandemic.” The COVAX delivery was followed by the arrival of 150,000 doses of the Sinopharm vaccine, donated by China. COVAX plans to allocate a total of 912,000 doses to Syria in the coming months, with an additional 336,000 doses intended for northwest Syria. In addition, a donation of 150,000 doses of China’s Sinopharm vaccine arrived in Damascus on 24 April. Healthcare workers and vulnerable populations will be prioritized in the vaccination campaign. Currently, it is not known when doses will reach the northeast of Syria, where supplies of oxygen are limited and testing resources are running out. “Although they will not be a silver bullet, they cannot get there soon enough,” said Buswell. COVID Crisis Continues to Worsen in India As India hit a new record high of daily COVID-19 cases on Thursday and hospitals and crematoriums are increasingly overwhelmed, emergency medical supplies arrived in Delhi from the United States on Friday. Amid a deadly second wave and soaring infections, India reported 386,555 new cases on Thursday – another global record – and 3,498 deaths within 24 hours. The country has surpassed 18.7 million cases recorded since the beginning of the pandemic, six million of which took place in April. The catastrophic rise in cases has devastated the country’s health system, with hospital beds and oxygen in dangerously low supply. Crematoriums have had to build makeshift funeral pyres to cope with the rising death toll. “If we get more bodies then we will cremate on the road. There is no more space here,” Jitender Singh Shanty, a crematorium coordinator in Delhi, told the Guardian. “We had to request authorities to allow us to extend the facility to the parking lot.” Several crematoriums in Delhi are performing over 100 funerals per day and say that the official death toll doesn’t reflect the overwhelming increase in demand for their service. Currently families are forced to wait up to 20 hours for a funeral pyre, while the crematoriums are attempting to rapidly expand to increase capacity to complete several hundred cremations a day in the worst hit areas. Crematoriums have become overwhelmed by the surge in COVID-19 deaths, forcing them to quickly build makeshift funeral pyres to cope with the rising death toll. The second wave, which has hit major cities – Delhi, Mumbai, Lucknow, and Pune – hardest, is now spreading to smaller cities and more remote villages across the country. In Kota, a city of 1.3 million, located in Rajasthan state, 35% of the cases recorded were from April. Over the past 24 hours, Rajasthan reported 6,147 new cases and 158 deaths. Only two of the district’s 329 intensive care units were available as of Tuesday. Kabirdham district, in Chhattisgarh state, went from recording zero active cases on 1 March to recording nearly 3,000 in the past week. The district currently has a shortage of nurses and lab technicians. “We are in this situation because the government didn’t plan to augment facilities in remote areas,” a doctor in Nainital, a Himalayan city in Uttarakhand state, told BBC. “I am worried that many people in remote Himalayan areas will die and we will never hear about them. They will never show up in statistics.” Emergency Foreign Aid Arrives A US military plane carrying over 400 oxygen cylinders, nearly one million rapid COVID-19 tests, 100,000 N95 masks, and other medical equipment landed at the Indira Gandhi International Airport in Delhi on Friday. “Today we are proud to deliver our first shipment of critical oxygen equipment, therapeutics and raw materials for vaccine production,” Antony Blinken, US Secretary of State, wrote on Twitter. This is the first of several planned COVID-19 emergency relief shipments from the US. According to a State Department spokesperson, the US will deliver supplies worth over US$100 million in the coming days, including a total of 15 million N95 masks and 20,000 courses of treatment of remdesivir. AstraZeneca manufacturing supplies have also been redirected from the US to India, which will allow the country to manufacture 20 million doses. The first of several emergency COVID-19 relief shipments from the United States has arrived in India! Building on over 70 years of cooperation, the United States stands with India as we fight the COVID-19 pandemic together. #USIndiaDosti pic.twitter.com/OpHn8ZMXrJ — U.S. Embassy India (@USAndIndia) April 30, 2021 Over 40 countries have committed to send supplies to assist India’s hospitals, including nearly 550 oxygen-generating plants, over 4,000 oxygen concentrators, 10,000 oxygen cylinders, and 17 cryogenic tankers. However, experts worry that the aid will be insufficient to make a dent in India’s national COVID-19 crisis that continues to spiral out of control. Blame for Rise in Cases Largely Placed on Modi Criticism and blame is increasingly being directed at India’s Prime Minister, Narendra Modi, who continued to hold large election rallies throughout the pandemic and refused to cancel Kumbh Mela, a Hindu religious festival where pilgrims dip in the Ganges river, widely considered the largest religious gathering globally. Millions of people gathered on the banks of river Ganges to celebrate Kumbh this year, which runs from February to late April. The festival is believed to be a factor that contributed to the massive surge in COVID-19 cases, along with a lack of compliance to public health measures, low vaccination rates, and the emergence of a new contagious variant. Tens of millions gathered to celebrate the Kumbh Mela festival in India amid surging COVID-19 cases. Modi’s approval rating, while still high, is at its lowest point at 67% and a disapproval rating that rose eight points since early April to 28%. Modi has been widely criticized for the government’s lack of preparedness for the second wave and the shortages of oxygen and hospital beds that accompanied it. Only a few of the 160 new oxygen plants had been installed by April, when cases began to surge. The government claimed to have successfully contained the virus after its first wave, going so far as to stating that India was in the “end game of the COVID-19 pandemic” in early March. “That illusion came to settle in the minds of most people and clouded their judgement,” Srinath Reddy, President of the Public Health Foundation of India, told the Washington Post. Government officials focused largely on the vaccination campaign, however, the rollout was too slow and the percentage of the population vaccinated was too low to hinder the second wave. Only 9% of the population of 1.3 billion has received at least one dose of a COVID-19 vaccine. Despite the government’s plan to open up vaccinations to all adults on 1 May, several states have run out of vaccines ahead of the expansion of the inoculation drive. Vaccination centers will be closed in some cities, including Mumbai, until they receive more doses. With shortages in vaccine supplies being seen across India, hospitals and crematoriums will continue to bear the burden of the second wave. Image Credits: Sky News, International Rescue Committee, UNICEF/Khaled Akasha, Sky News. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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