麻豆APP

Issued 26 November?2020

Highlights

• The oPt is?witnessing?a concerning?dynamic of?community spread of?SARS-CoV-2,?with?increasing?numbers?of?COVID-19?cases
• While?the?health system?at this stage?can?cope with?the?increasing number of people?requiring treatment for COVID-19,?there is a?mounting?risk?that?the health system?may?reach its?capacity?limits and get?overwhelmed
• Decisive public health measures?and?strict?adherence?to?hygiene?protocols?and physical?distancing?are?needed?to?regain?control?and reduce?the?spread?of the?disease
• Oxygen supply?generators have been?identified?as critical gap,?in particular in?the?dedicated treatment facility for COVID-19 patients in?Gaza,?and the health cluster is working on mobilizing respective equipment through international suppliers
• WHO?and partners?have?co-ordinated?the delivery of?35?ventilators, to arrive over the coming days?in Gaza?to augment treatment capacities?accordingly.

Thanks to the generous support of the Government of Kuwait,?WHO?delivered five ventilators?to?local health authorities in the Gaza Strip to support the management of critical patients with COVID-19.??
A further 30 ventilators are due to arrive in Gaza this week, 15 procure with funding from Kuwait, 15 are a donation from the Government of Germany. ?

WHO preparedness, readiness and response

WHO is continuing to work with partners to support Ministry of Health’s (MoH) efforts to respond to the COVID-19 outbreak.

?Coordination,?planning?and monitoring???

WHO conducted a monitoring visit to?the European Gaza Hospital (EGH), the dedicated facility in the Gaza Strip to manage critical, severe and moderate COVID-19 cases.?The WHO team observed the COVID-19 patients’ pathway and visited the Emergency Unit, Intensive Care Unit, Maternal and Child Unit as well as the wards where moderate and severe cases are hospitalized.?

• In the West Bank,?a?weekend and?night-time?closure and movement restrictions?will be imposed from?27 November 2020?to?mitigate?a?further?increase in?case?numbers
• The?Rafah?Border Crossing, between?the?Gaza?Strip?and Egypt, has been open for?three?days (24-26 November).?During the first two days, 595 Palestinians entered Gaza, and 1,849 people exited to Egypt. All returnees were requested to present a COVID-19 PCR certificate?or tested?upon entry.

Surveillance??

• The WHO risk assessment?remains?very high
• The oPt is?witnessing?a concerning increase in COVID-19 cases, with?significant?community transmission of SARS-CoV-2?over?the?reporting?period,?in the West Bank and?in the?Gaza?Strip
• A?66% increase in confirmed cases?(by 10,1716)?and?a?57% increase in deaths?(by?83)?was reported?between?20-26 November,?compared to the previous week?(13-19 November).?The overall Case Fatality Rate (CFR)?remains?at?0.8 % since the beginning of the outbreak. The CFR is the proportion of deaths among?identified?confirmed cases
• Gaza accounts for 42% of all active cases in oPt, followed by the West Bank governorates of Nablus (15%), Bethlehem (8%), Hebron (6%), Ramallah and Jenin (5%) Jerusalem (3%)
• On?21?November,?891?new confirmed cases were reported in Gaza,?the highest number over a 24-hour period
• WHO?is strongly?recommending and advocating stricter adherence to public health?measures.?At this stage it is critical?that communities?implement effective?prevention?protocols?to help?curb the?current?increasing transmission?trends,?to?save lives and?to?ease the pressure on?the health?system. Essential?protective measures?include?wearing a mask;?following good respiratory hygiene;?regularly?washing?hands;?social?distancing of at least 1 metre including avoiding crowds and gatherings;?staying??home and self-isolating?if?people develop Corona?related symptoms.
• Meanwhile?health system?strengthening efforts?with a focus on?enhanced?surveillance,?further?contact tracing?capacity, and?improved?case?management?are needed.

Laboratory diagnostics???

WHO delivered 200 testing kits to local health authorities in the Gaza Strip on November 17 and 19 to conduct more than 19,000 COVID-19 tests. The delivery arrived at a critical time, with laboratory supplies and tests in demand due to the higher numbers of COVID-19 cases detected in Gaza. In addition, 70,000 swabs were delivered to help maintain Gaza’s testing capacity and support the detection of new COVID-19 cases.?

• The?number?of?tests conducted?has increased significantly?in the reporting period (20—26 November), with 47,408 more tests conducted compared the previous week
• In Gaza, while the?continued?supply of?lab testing kits and?consumables?remains?a?challenge, testing has?been sustained.?WHO delivered 200 testing kits on 17 and 19 November, to conduct?almost 2,500?tests per?day.?Additionally,?on November 25,?WHO delivered 70,000 swabs to help maintain Gaza’s testing capacity and support the detection of new COVID-19 cases.

Infection Prevention and Control (IPC), Isolation and Case Management, Operations Support and Logistics?

“I found the training useful, especially during the spread of COVID-19 because it refreshed our knowledge and skills in infection prevention and control” – Eman, Midwife, Primary Healthcare Center, Khan Younis.??A comment from one of the 137 health workers being trained in the Gaza Strip on Infection Protection and Control during the COVID-19 pandemic. The latest course, conducted on November 17-18 by PNIPH and WHO, included role playing demonstrations, discussions, and practical sessions.?

• In the?Gaza Strip,?the overall occupancy rate?of dedicated?COVID-19?beds in health?facilities?is?61% (307 beds). Local health authorities expanded the?capacity to manage critical and severe cases at European Gaza Hospital?(EGH)?by 30%?to 150 beds,?including 70 intensive care units (equipped?with ventilators) and 80 high-dependency beds.?The Gaza health authorities?have?identified?the provision?of oxygen?for treatment of COVID-19 patients?through the?central supply?system in?the?EGH?as critical?bottleneck. The?Health Cluster has been working?with?partners?to?mobilize?essential?oxygen generation?equipment?through international suppliers,?but complex international?logistics?will?likely?allow?delivery only?by?early?2021.
• Local authorities introduced ‘home isolation’ for mild COVID-19 cases on November 14, while?patients who?require?medical care will remain isolated at the two designated treatment facilities:
  • moderate, severe, and critical cases to be hospitalized at?EGH
  • mild cases?with co-morbidities?to be hospitalized at the Turkish?Hospital
• WHO delivered 25 adjustable beds to support the screening of people for COVID-19 in?respiratory?triage?centres?outside Gaza’s five main hospitals on November?9.?With more medical equipment for case?management?due?to arrive?in?Gaza?to?further?scale-up?hospital?capacity,?WHO is recommending?health authorities consider?increasing?human resources?capacity, particularly?for?ICU nurses
• WHO has supported the provision of fuel to Palestine Red Crescent Society (PRCS) ambulances, through?UNRWA, in response to an increased demand for its?services.?Since COVID-19 community transmission was detected in Gaza in August,?PRCS?has increased their services by more than 300%. The fuel will cover the needs of ambulances in Gaza and Rafah governorates for?approximately two?weeks.

East Jerusalem

• Since November 20, 44 cases and 10 deaths were reported in East Jerusalem (EJ)
• 31 COVID-19 patients are?currently?hospitalized in EJ?hospitals, 16?are?at St. Joseph?Hospital, 11 at?Makassed?hospital and 4 at Augusta Victoria Hospital.?Since March 2020, St. Joseph hospital treated 368 COVID-19 patients.

COVID-19 vaccination:??

• The?Prime Minister’s Office?organised two meetings of the?National Immunisation Technical Advisory Group (NITAG)?for introduction of the COVID-19 vaccine. The Minister of Health, Dr Mai Al-Kaila,?chaired the meetings which were attended by the?MoH, other line ministries, WHO, UNRWA?and?UNICEF.?The meetings reviewed the status of implementation of the mandatory tasks ahead, including the completion of the GAVI AMC-92 application, cold chain assessment, WHO-UNICEF Vaccine Introduction Readiness Assessment Tool (VIRAT) and the World Bank’s VRAF tool.

Sustaining Essential Health Services?

WHO thanked the Norwegian Government for its generous funding of 8.5 million Norwegian Krone (USD $958,000) to support the strengthening of the Gaza’s Strip’s public health laboratory to respond to the public health threats caused by infectious disease outbreaks on November?25.?Pictured is WHO’s Head of Office Dr Gerald Rockenschaub and the Norwegian Representative to Palestine,?Ms?Torunn Viste, signing an agreement which will support a scale up Gaza’s laboratory?capacity?and capability, by enhancing infrastructure and increasing skill and knowledge among the laboratory’s workforce.??

• The delivery of essential health services continues to be?impacted?by the pandemic. Local?health authorities in Gaza announced closure of all public outpatient clinics and temporary suspension of elective surgeries for two weeks on November 24, while?maintaining?urgent and life-saving surgeries only
• As of 23 November,?the?Palestinian Authority’s?Ministry of Health Liaison Office?resumed patient and companion?permits?coordination?to support Palestinian patients and companions required by Israel to apply for?permits?to access essential health services outside the Gaza Strip,?following the Palestinian Authority’s decision to resume coordination with Israeli authorities. WHO had?initiated?a?temporary coordination mechanism to support patients and companions?requiring?exit from Gaza on 6?September?when coordination was?suspended.

More local information