Libya: COVID-19 - Situation Report No. 1, As of 13 April 2020

HIGHLIGHTS

• As of 12 April 2020, there are 25 confirmed cases of COVID-19 reported in Libya, including one death.

• Several days of shelling has damaged a 400-bed hospital in Tripoli, previously identified as a potential COVID-19 facility.

• An attack on the Man-Made River project has cut off access to safe water for more than 2 million people in Greater Tripoli and the western region.

• Continuing attacks on hospitals and critical water infrastructure affect people’s access to medical services and safe drinking water, exacerbating the threat of the pandemic.

• According to a recent assessment, 48 per cent of assessed cities reported food shortages and 86 per cent of assessed cities reported food price spikes.

• Immediate needs include support to rapid response teams, personal protective equipment, lab diagnostic kits and supplies, establishment and support to isolation sites, training, and education/awareness.

SITUATION OVERVIEW

As of 12 April 2020, the Libyan National Centre for Disease Control (NCDC) reported 25 confirmed cases, including one COVID-related death, in Libya. A total of 535 tests have been performed. Of the confirmed cases, the majority are in Benghazi, Misrata and Tripoli. WHO continues to work with the Ministry of Health (MoH), the NCDC and other authorities to ensure early identification of cases and their contacts, isolation of cases and quarantine of contacts.

Immediate needs include support to rapid response teams managed by NCDC, procurement and distribution of personal protective equipment (PPE), establishment of labs and procurement of lab diagnostic kits and supplies, establishment and support to isolation sites and wards (within or outside public hospitals), provision of training, health education and awareness materials.

Conflict continues to impact civilians and civilian infrastructure, increasing the risks of COVID-19 and hampering effects to fight the threat. In recent weeks, around 745 families (3,700 individuals) have been forced to flee their homes, particularly in Abusliem Municipality, and from the neighbourhoods of Salah Eddin and Al Hadba due to the deteriorating situation. The majority of those displaced moved to safer areas within Abusliem or to adjacent Hai Al Andalus, Tajoura, Suq, Al Jumaa and Janzour. Most displaced families are reportedly staying with host families and in rented accommodation. Priority needs in displacement locations include food and non-food items, water, sanitation, hygiene, and health assistance.

On 6 April 2020, as a result of heavy shelling in Tripoli, the Al Khadra General Hospital was hit, injuring at least one health worker and damaging the fully functioning 400-bed medical facility. All patients were evacuated from the hospital with the exception of emergency cases. The hospital was one of the potential COVID-19 assigned health facilities. Since the beginning of the year, there has been at least eight recorded conflict-related incidents affecting field hospitals, health care workers, ambulances and medical supplies, killing at least four people and injuring 12 others.

On the same day, the water valves of the Man-Made River Project were shut down by an armed group in the southern region of Shwerif in Tripoli. Residents of the Greater Tripoli area and cities of the western region (particularly Tripoli,

Tahouna, Bani Walid and Gharyan), home to more than 2 million people including 600,000 children, have been without water. These water cuts have coincided with power outages affecting many parts of western Libya and are likely to further result in disruptions to water flow in highly populated areas. Water systems in Libya have already been badly damaged as a result of the ongoing conflict. If Libya is to have any chance against COVID-19, the ongoing conflict and attacks on critical civilian infrastructure must come to an immediate halt.

Strong prevention measures (border closures, restricted movement, closures of schools, restaurants, etc.) remain in place, some of which have been extended. Furthermore, only two testing laboratories (Tripoli and Benghazi) are capable of COVID-19 diagnostics and none in the South, creating significant challenges in identifying the actual number of cases in the country. Information on designated locations and hospitals assigned to care for COVID-19 patients consistently changes, largely due to refusals from communities or armed groups in those areas to have health facilities used for COVID19 treatment, as well as health workers’ refusals to care for COVID-19 patients because of insufficient protection, supplies and equipment.

The MoH has recently issued a decree transferring the management and financing of health services to municipalities. However, health services were already limited in municipalities and while they are on the front lines of combatting the pandemic, they lack funding, capacity and equipment to respond. Furthermore, many points of entry, particularly land borders, are not fully secured and lack capacity and resources for testing and quarantining. With up to 90 per cent of public health care services closed in some areas and vaccination services severely disrupted, the maintenance of essential health care services has been added as a new (ninth) pillar to the COVID-19 Health Sector Response Plan.

The ETS-managed Common Feedback Mechanism, which is supporting the NCDC by serving as a COVID-19 information channel, has so far received more than 9,500 COVID-related calls. During 5 to 11 April, calls doubled from the previous week. The majority of callers requested information while others wanted to confirm their symptoms.

REACH conducted a Rapid Market Assessment in Libya to provide a brief city-level overview of market functionality, with a focus on shortages and price spikes for basic food and hygiene items. The information was gathered between 30 March and 1 April from key informants in 21 cities across Libya. According to the assessment, 48 per cent of assessed cities reported food shortages and 86 per cent of assessed cities reported food price spikes. Shortages of basic food items, such as eggs, vegetables and wheat products, were most frequently reported. Food prices spiked in the majority of assessed cities directly after COVID-19 prevention measures were implemented, with some locations reporting temporary price increases of 500-900 per cent. In some cities in the eastern and southern regions, authorities reportedly intervened to correct price hikes.

The ongoing clashes, along with COVID-19 restriction measures, continue to hamper humanitarian access and the free movement of medical and other humanitarian personnel, as well as humanitarian assistance across the country. Many requests for movements between cities and for release of items in customs require individual authorizations to be negotiated with multiple parties. The Humanitarian Country Team continues to advocate with authorities, including at the highest levels, for immediate and unrestricted humanitarian access for humanitarian personnel and assistance, for both ongoing humanitarian programming and COVID-19 response activities. This includes the removal of all restrictions and immediate importation of health supplies both for the COVID-19 response and other humanitarian assistance.