Spike in the Number of COVID-19 Infections in the Palestinian Authority Territories: Overview and Analysis (Updated to June 22, 2020)

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Empty streets in Hebron after preventive measures are implemented (Palinfo Twitter account, June 21, 2020).

Empty streets in Hebron after preventive measures are implemented (Palinfo Twitter account, June 21, 2020).

Empty streets in Hebron after preventive measures are implemented (Palinfo Twitter account, June 21, 2020).

Empty streets in Hebron after preventive measures are implemented (Palinfo Twitter account, June 21, 2020).

Palestinian medical teams conduct tests in the town of Dura (south of Hebron) (Wafa, June 18, 2020).

Palestinian medical teams conduct tests in the town of Dura (south of Hebron) (Wafa, June 18, 2020).

Palestinian medical teams conduct tests in the town of Dura (south of Hebron) (Wafa, June 18, 2020).

Palestinian medical teams conduct tests in the town of Dura (south of Hebron) (Wafa, June 18, 2020).

Empty streets in Nablus (Palinfo Twitter account, June 21, 2020).

Empty streets in Nablus (Palinfo Twitter account, June 21, 2020).

Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).

Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).

Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).

Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).

The first group of Palestinians returning from Canada to the PA through the Allenby Crossing in Jericho enters a quarantine facility in Jericho (Wafa, June 19, 2020).

The first group of Palestinians returning from Canada to the PA through the Allenby Crossing in Jericho enters a quarantine facility in Jericho (Wafa, June 19, 2020).

The first group of Palestinians returning from Egypt through the Allenby Crossing undergoes testing at the national security forces' al-Nuwaimeh training camp (Wafa, June 21, 2020).

The first group of Palestinians returning from Egypt through the Allenby Crossing undergoes testing at the national security forces’ al-Nuwaimeh training camp (Wafa, June 21, 2020).

The first group of Palestinians returning from Egypt through the Allenby Crossing undergoes testing at the national security forces' al-Nuwaimeh training camp (Wafa, June 21, 2020).

The first group of Palestinians returning from Egypt through the Allenby Crossing undergoes testing at the national security forces’ al-Nuwaimeh training camp (Wafa, June 21, 2020).

The first group of Palestinians returning from Canada to the PA through the Allenby Crossing in Jericho enters a quarantine facility in Jericho (Wafa, June 19, 2020).

The first group of Palestinians returning from Canada to the PA through the Allenby Crossing in Jericho enters a quarantine facility in Jericho (Wafa, June 19, 2020).

 Overview
  • The following were the main developments in the spread of COVID-19 in Judea and Samaria during the past week:
    • The number of reported active cases of COVID-19 in Judea and Samaria spiked and now stands at 458 (compared with 48 active cases last week). Most of the active cases (399) are in the Hebron district (compared with 26 last week). In the Nablus district, which had been coronavirus-free, 31 active cases were detected, including several doctors. According to the Palestinian minister of health, the scope of infection indicates a second wave of COVID-19, more dangerous than the previous one. In addition, the number of reported active cases in the east Jerusalem neighborhoods is currently 38 (compared with 27 last week).
    • The total overall number of COVID-19 infections since the outbreak of the pandemic in Judea and Samaria stands at 843 (compared with 420 last week). Most patients are stable, with the exception of one man from Hebron in an ICU. For the first time since the beginning of the pandemic, medical personnel have tested positive.
    • In the wake of the spike in the number of infections over the past few days the PA decided to enforce preventive measures more strictly. That included a five-day general lockdown in the Hebron district. In view of the rise in infections the PA is trying to limit physical interaction between Palestinians and Israel. PA Prime Minister Muhammad Shtayyeh called on Palestinians working in Israel to remain at their places of employment for two weeks. He also called on Israeli Arabs not to visit the PA territories for two weeks.
    • The spike in infections is focused in the Hebron district, which has been the epicenter of the spread of the disease for most of the time. The district has most of the second wave’s active cases (about 87%). That is because of a combination of the considerable physical interaction with Israelis (the entrance of Palestinian workers, including illegal workers, into Israeli territory[1]) and the social structure of the tribes and clans (which makes it difficult to implement effective measures to isolate and quarantine COVID-19 patients and practice social distancing).
  • The following are the three main conclusions to be drawn from recent developments:
    • There is a correlation between the rise in infection in the PA territories and the rise of infection in Israel: in ITIC assessment, the correlation is a function of the significant contact between Palestinians and Israelis (the transit of workers; the illegal entrance of Palestinians into Israeli territory; the entrance of Israeli Arabs into Judea and Samaria; the movement of local residents, especially in the greater Jerusalem area; and the delivery of merchandise). The mutual prevention of infection has become more difficult because of the decline in the level of the PA’s coordination with Israel, following its fight against Israel’s intention to impose Israeli law on territories in Judea and Samaria.
    • The number of active cases in Judea and Samaria has spiked while the number in the Gaza Strip remains small: as opposed to the spike in cases in the PA territories in Judea and Samaria, Hamas has (so far) managed to prevent an uncontrolled spread of the coronavirus inside Gaza despite its enormous potential for infection. In ITIC assessment, that is because the Gaza Strip can be isolated relatively easily and because Hamas has implemented more effective measures, preventing Gazans from entering Israel and closely controlling the entrance of Palestinians from Egypt through the Rafah Crossing. On the other hand, it is difficult for the PA to isolate Judea and Samaria or to prevent Palestinians from coming into physical contact with Israelis. In addition, the PA’s preventive measures are apparently less effective and local residents seem to have less faith in them and be less willing to obey the PA’s guidelines.
    • The interaction of health and politics: A (probably considerable) part of political and public attention in the PA territories has turned towards the fight against the coronavirus and its attendant economic difficulties. That can make it difficult for the PA to convince the Palestinian public to enlist in the campaign against Israel’s intention to impose its law, and to participate in popular events on the ground. In addition, the decline in the level of coordination with Israel in the fight against COVID-19, which was high at the beginning of the outbreak, has made it more difficult for the PA to deal with the spike in infections.
Extent of the Infection in Judea and Samaria
Overview

This past week there was a spike in the number of active COVID-19 cases in Judea and Samaria. As of June 22, 2020, there were 458 reported active cases, (compared with 48 active cases a week ago). Most of the new infections were found in the Hebron district, where there are 399 cases (compared with 26 last week). Since the beginning of the pandemic 843 cases have been reported, 420 this past week. According to reports the condition of most patients is stable, with the exception of one man in Hebron in an ICU (Facebook page of the Palestinian ministry of health, updated to June 22, 2020).

  • According to Mai al-Kayla, PA minister of health, the PA is experiencing a second wave of coronavirus. She said the symptoms of the second wave are the same as the first. She associated the rise in the number of active cases with the conduct of the local residents who, she said, do not follow the guidelines. Regarding lockdowns she said each case would be decided according to its own merits and that anyone who could be self-isolated would be sent home, since it was difficult to find places for quarantines (Palestinian TV, June 19, 2020). She said there were 1,500 tests that had to be analyzed, and that on June 19, 2020, 4,300 Palestinians had been tested. She said the number of test kits was sufficient, but that testing should only be done if necessary (Palestinian TV, June 19, 2020).
Number of active cases of COVID-19 in Judea and Samaria

Number of active cases of COVID-19 in Judea and Samaria

Overall number of COVID-19 cases since the outbreak of the coronavirus in the PA territories

Overall number of COVID-19 cases since the outbreak of the coronavirus in the PA territories

Geographical Distribution of Active COVID-19 Cases

Of the 458 active COVID-19 cases, 399 are in the Hebron district, 31 in the Nablus district (which last week was coronavirus-free), eight in the Ramallah district (which was also coronavirus-free last week), nine in the Bethlehem district, four in the Jenin district, three in the Qalqilya district, two in the Tulkarm district and two in the Jericho district. In addition there are 38 active cases in the east Jerusalem neighborhoods.

Hebron district
  • There was a spike in cases in the Hebron district, with 399 active cases (compared with 26 a week ago). Since March 2020 550 active cases have been detected in the Hebron district. Mai al-Kayla, PA minister of health, said they were trying to concentrate the patients and not place them in a large number of hospitals (Palestinian TV, June 19, 2020).
Number of reported active COVID-19 cases in the Hebron district

Number of reported active COVID-19 cases in the Hebron district

  • In light of the spike, Jibrin al-Bakri, governor of the Hebron district, following instructions from the PA prime minister, imposed a five-day full lockdown on the district (until the evening of June 23, 2020) (Facebook page of the governor of the Hebron district, June 18, 2020). That means a stay-at-home order for the entire district and closing all businesses and workshops, with the exception of food stores, pharmacies and offices linked to the fight against the coronavirus (Wafa, June 21, 2020).
  • Midhat Hamdoune, a member of the COVID-19 security committee in the Hebron district, said there were several causes for the spread of the virus in the Hebron district [during Ramadan] even before Eid al-Fitr. He added that many people went outside to hold prayers or went visiting and came in contact with carriers (Palinfo Twitter account, June 20 2020).
Nablus district
  • In the Nablus district, which until this past week was coronavirus-free, 31 active cases were reported. According to the PA minister of health, among them were a doctor working in a private hospital, a doctor working in the al-Rahma Medical Center (operated by a charitable society) and a dentist in private practice. She said the turn of events was very worrisome but that the source of infection for each case was known (Palestinian TV, June 19, 2020).
  • The ministry of health decided to close the Nablus Special Hospital to ordinary patients. It will be turned into a quarantine center for its medical personnel, since one staff member had tested positive (Facebook page of the Palestinian ministry of health, June 18, 2020). The al-Najah National University Hospital announced it was closing its ambulatory facilities and postponing elective surgery (Facebook page of al-Najah University, June 20, 2020).
  •  In light of the spread of the coronavirus the Palestinian prime minister ordered Nablus to be locked down. Ibrahim Ramadan, Nablus district governor, announced the full lockdown of the city for 48 hours, with the exception of bakeries, pharmacies and supermarkets, which would operate normally. Students can take their matriculation examinations if they observe guidelines and preventive measures. Weddings are banned, as is the erection of mourning tents, until further notice. All the government officers in Nablus will be closed (Facebook page of the governor of the Nablus district, June 20, 2020).
Empty streets in Nablus (Palinfo Twitter account, June 21, 2020).   The Palestinian police in Nablus implement the lockdown on the city (Wafa, June 21, 2020).
Right: The Palestinian police in Nablus implement the lockdown on the city
(Wafa, June 21, 2020). Left: Empty streets in Nablus (Palinfo Twitter account, June 21, 2020).
Bethlehem district
  • In the Bethlehem district, where the first COVID-19 case was detected, nine new cases were detected after the district had, until recently, been declared coronavirus-free. Kamel Hamid, the governor of the Bethlehem district, said residents should obey guidelines and take preventive measures (Facebook page of the governor of the Bethlehem district, June 21, 2020). He also said the ministry of health had ordered the closing of the Jordan Bank branch in Bethlehem after an employee tested positive (Palinfo Twitter account, June 21, 2020). He toured the district and visited government offices, supermarkets and public facilities for a first-hand look at the implementation of preventive measures (PNN website, June 16, 2020).
Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).    Kamel Hamid, the governor of the Bethlehem district, visits sites in his district (PNN website, June 16, 2020).
Kamel Hamid, the governor of the Bethlehem district, visits sites in his district
(PNN website, June 16, 2020).
Tulkarm district
  • In Tulkarm district, which had been coronavirus-free, two cases were detected. On June 20, 2020, Issam Abu Baker, governor of the Tulkarm district, announced a ban on weddings, graduation ceremonies, receptions and mourning tents, until further notice (Facebook page of the Fatah movement in Tulkarm, June 20, 2020).
Qalqilya district
  • In the Qalqilya district the number of active cases fell to three from 16 last week.
Ramallah and al-Bireh district
  • In the Ramallah district eight cases were detected after the district had been coronavirus-free. Layla Ghanem, governor of the Ramallah and al-Bireh district, decided to lock down a village after two residents tested positive (Wafa, June 19, 2020).
The east Jerusalem neighborhoods
  • The number of active cases in east Jerusalem rose to 38 from 27 last week. Since the outbreak of the virus 195 cases have been detected in the east Jerusalem neighborhoods.
Number of active COVID-19 cases in the east Jerusalem neighborhoods

Number of active COVID-19 cases in the east Jerusalem neighborhoods

Overall number of COVID-19 cases since the outbreak of the pandemic

Overall number of COVID-19 cases since the outbreak of the pandemic

Stricter Enforcement of Preventive Measures Following the Rising Number of Infections
Government announcement about stricter enforcement of preventive measures

Given the significant rise in the number of active COVID-19 cases, PA Prime Minister Muhammad Shtayyeh and the Palestinian minister of health held a press conference in Ramallah. Shtayyeh announced a five-day lockdown of the Hebron district (including stopping movement within the district and the closing of all businesses with the exception of food stores and pharmacies). The lockdown is intended to allow medical teams to gain control over the outbreak of the virus. Shtayyeh also announced a 48-hour lockdown of Nablus to allow medical teams to map active COVID-19 cases. In all districts weddings are banned, as are graduation parties, condolence calls and other types of gatherings (Wafa, June 20 2020).

The Facebook page of the ministry of health with a reposting of the guidelines and explanations for the Palestinian public (Facebook page of the Palestinian ministry of health, June 16, 2020).
The Facebook page of the ministry of health with a reposting of the guidelines and explanations for the Palestinian public (Facebook page of the Palestinian ministry of health, June 16, 2020).
  • In the meantime Muhammad Shtayyeh announced additional measures:
    • The establishment of a unit led by the police force, medical teams and the ministry of the economy, which will oversee the implementation of the guidelines and preventive measures in all the districts. He also made it clear that any site in violation of the guidelines would be closed.
    • Quarantine centers which had closed would reopen.
    • The movement of government officials between the districts would be limited, with the exception of urgent cases.
    • A lockdown would be imposed on every city, village, refugee camp and neighborhood where the spread of the virus had endangered the general welfare.
  • Shtayyeh called on Israeli Arabs not to visit the West Bank for 14 days. He called on Palestinian workers not to go back and forth daily to their places of work in Israel. If they worked in Israel they were requested to stay there for the next 14 days. He added that work in the settlements was completely forbidden by law.

PA Prime Minister Muhammad Shtayyeh holds a press conference following the sharp rise in the number of COVID-19 infections (Wafa, June 20, 2020).
PA Prime Minister Muhammad Shtayyeh holds a press conference following the sharp rise in the number of COVID-19 infections (Wafa, June 20, 2020).

  •  On June 18, 2020, Mai al-Kayla, PA minister of health, said the PA was experiencing a second wave of COVID-19. She said it was more dangerous than the first wave because the sources of the many epicenters of the disease were unknown, and because hospital personnel were also infected (Facebook page of the Palestinian ministry of health, June 18, 2020).

Mai al-Kayla announces that a second wave of COVID-19 has begun in the PA (Facebook page of the Palestinian ministry of health, June 18, 2020).
Mai al-Kayla announces that a second wave of COVID-19 has begun in the PA (Facebook page of the Palestinian ministry of health, June 18, 2020).

  • Mai al-Kayla also announced decisions relating to hospitals and the treatment of COVID-19 patients (Wafa, June 18, 2020):
    • Treatment centers in hospitals in Nablus, Ramallah, Bethlehem and Hebron will reopen.
    • Hospital visits are forbidden. A patient can be accompanied by only one person, who can only leave the hospital if the person he is accompanying leaves.
    • All hospitals will be quarantined except for the emergency rooms. All employees in the hospital quarantine centers are required to wear masks and be fully clothed in PPE.
    • All elective surgery in the government hospital in Hebron will be postponed. All the wards will be disinfected and the out-patient clinics will be closed.
    • The Nablus Special Hospital will close and its staff and patients will be quarantined.
The Return of Palestinians Stranded Abroad
  • Despite the spike in active cases, Palestinians stranded abroad continue to return to the PA territories. Mai al-Kayla reported that 270 Palestinians had returned from Egypt. They were flown into Jordan and entered PA territory through the Allenby Crossing, where they were tested and taken to quarantine centers (Facebook page of the Palestinian ministry of health, June 21, 2020). According to the PA foreign ministry, the second group of returning Palestinians will arrive on June 22, 2020 (Wafa, June 16, 2020).
  • In the meantime it was reported that Palestinians stranded in Canada since the outbreak of the COVID-19 pandemic had returned to the PA territories through Jordan. Upon arrival they were immediately transported to the quarantine center in Jericho (Dunia al-Watan, June 19, 2020). The foreign ministry announced that Palestinians would return from Turkey on June 28 and 29, 2020. Their return will be carried out in collaboration with the Jordanians (Sama, June 20, 2020).
Foreign Aid for the PA
The Chinese delegation completes its work
  • On June 17, 2020, Mai al-Kayla, PA minister of health, held a formal ceremony to bid farewell to the delegation of Chinese doctors who arrived in the PA on June 10, 2020. Speaking for Mahmoud Abbas and Muhammad Shtayyeh, she thanked China for its help and support (Facebook page of the Palestinian ministry of health, June 17, 2020).
Mai al-Kayla bids farewell to the delegation of Chinese doctors (Facebook page of the Palestinian ministry of health, June 17, 2020).     Mai al-Kayla bids farewell to the delegation of Chinese doctors (Facebook page of the Palestinian ministry of health, June 17, 2020).
Mai al-Kayla bids farewell to the delegation of Chinese doctors
(Facebook page of the Palestinian ministry of health, June 17, 2020).
  • Mai al-Kayla signed a $700 thousand agreement with the Arab Palestinian Investment Company (APIC), according to which the company will finance the purchase of medical equipment for the ministry of health, including ventilators, drip infusions, etc. (Facebook page of the Palestinian ministry of health June 16, 2020).

The Palestinian minister of health signs an agreement with the APIC.
The Palestinian minister of health signs an agreement with the APIC.

[1] On June 21, 2020, the Border Police spokesman’s unit announced that Border Police fighters had detained seventy Palestinians from the Hebron region who were staying in Israel illegally in the Meitar Forest (close to the Israel-PA border, northeast of Beersheba). The large number illustrates the extent of the movement of illegal Palestinians from the Hebron region into Israel.



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