Northern Syria – Northern Syria is experiencing its most severe recorded wave of COVID-19 yet, with needs fast outpacing limited oxygen supplies and health facilities running out of testing kits. In the country’s northwest, the health system is already unable to cope, while in the northeast, the coronavirus is spreading at a worrying pace, said Médecins Sans Frontières (MSF).

In northwest Syria, the number of confirmed cases of COVID-19 almost doubled in September, reaching nearly 73,000, compared to the 39,000 cases recorded by the end of August.

“The peak reached in this wave so far has been as high as 1,500 cases per day, while it never exceeded 600 cases per day during previous waves,” said Francisco Otero y Villar, MSF Head of Mission for Syria.

Only 16 out of 33 COVID-19 treatment centres in the region are currently functioning. An already limited health infrastructure, as well as supply issues resulting in inadequate screening, make it impossible to both assess the real extent of the spread of the virus and offer an adequate response.

Efforts to contain the virus are hindered by poor access to healthcare and the low immunisation rate in the northwest, a region of four million people, where only three per cent of people are fully vaccinated. The low rate is owing to both people’s hesitancy to receive the vaccine and a slow vaccine rollout.

“We are directly witnessing the extent of this outbreak in the facilities we manage and support,” said Villar. “We see people in desperate need of oxygen or intensive care are stuck in queues, because no beds or ventilators are available, which is leading to a higher mortality rate compared with previous waves.”

In Afrin, 44 per cent of the patients currently admitted to a centre supported by MSF are aged between 16 and 40 years old, indicating that even people who were previously thought to be relatively safe from severe illness caused by the virus are being seriously impacted.

Our teams are trying to scale up operations based on these increasing needs. In August, we reopened two COVID-19 isolation centres in Idlib governorate, and we are now in the process of expanding their capacity. We also renewed our support to two community treatment centres in Afrin and Al-Bab, and we continue to support a treatment centre for respiratory illnesses in Afrin. More than 13 per cent of the total confirmed cases are displaced people living in camps, where we run mobile clinics to conduct COVID-19 tests and distribute prevention kits.

We have also witnessed a worrying increase in the number of people with COVID-19 in northeast Syria over the past few weeks. In the last week of September, an average of 342 people tested positive each day; the highest daily number since the pandemic began.

While numbers had started to decrease in the first week of October, the only laboratory able to perform PCR tests to diagnose COVID-19 in the region is running short on materials. They face the possibility of halting all testing in the coming weeks if numbers do not continue to decline. The supply of oxygen is also under serious strain, with the COVID-19 treatment facility in Hassakeh forced to source oxygen cylinders from Qamishli, Raqqa and Tabqa in order to meet demand.

“In response to this new COVID-19 wave, MSF is partnering with a local organisation to care for people with suspected or confirmed COVID-19 in treatment centres in Hassakeh and Raqqa city,” said Hanna Majanen, MSF emergency medical manager for Syria. “But our ability to source oxygen is stretched, and we are worried that if the number of positive cases increases again, or stays steady at such high rates, we will be unable to meet the demands for all patients.”

Even prior to the pandemic, the health system in northern Syria was already struggling and reliant on humanitarian aid to respond to medical needs. Now, healthcare facilities and humanitarian organisations alike are unable to cope with the extent of this new wave.

Today more than ever, efforts must be made to save these facilities from totally collapsing under the weight of the pandemic. Support and protection for healthcare workers, provision of testing kits and oxygen, increased bed capacity in hospitals and the expansion of vaccination coverage are urgently needed to save the lives of people, and to keep the health system functioning in northern Syria.