Coronavirus in Syria: A Multi-scenario Disaster

As the coronavirus pandemic hits the whole world, experts expect the pandemic will have multiplier effect in the Syrian refugee camps. What is the situation in those camps? What are their medical preparations for combatting the virus outbreak?

The Syrian opposition with its official and non-official organization – if we don’t want to say is unable – is undoubtedly too late in taking necessary steps against a pandemic sweeping the world, and this delay is because they have another priority: Securing the families recently displaced due to the latest military operation in the Syrian north, amid the weak capabilities of the Syrian opposition’s organizations.

The Support Coordination Unit is establishing a laboratory for detecting the virus in Idlib, but it needs some time to be ready. Additionally, the interim government, in cooperation with the Turkish Ministry of Health, has taken a number of late measures, most remarkable:

  • Suspending the passage from and to Turkey, as the border crossings of Bab al-Hawa and Bab al-Salam announced prohibiting crossing from and to Turkey, as precautionary measures against the coronavirus. Besides, the holiday visits that allow Syrians in Turkey to visit the Syrian north were cancelled. Moreover, crossing from and to Assad controlled areas was suspended by closing Abu al-Zandeen crossing. Additionally a medical point was established in the crossing of al-Aoun between SDF and Syrian opposition areas near Manbij.
  • Suspending all the activities, prohibiting gatherings, and stopping all the working entities in the north, although people do not cooperate properly.
  • Participating in training courses on treating infected persons and how to cure them, as some Syrian doctors participated in training courses in Turkey and Syria about the pandemic, and launched awareness-raising campaigns on precautions and prevention of spreading the virus.
  • Seeking support to establish isolation units and calling on the World Health Organization, the International Red Cross and other institutions to intervene in northern Syria, which was responded by the WHO, announcing that it will start working in the northwest of Syria.
  • Announcing the will to establish isolation unites, as the interim government announced on March 14 that it’s willing to establish three medical isolation units, with 20 beds in each.
  • Organizing awareness: On March 22, the Civil Defense launched the Stay Home Campaign, encouraging citizens to do voluntary quarantine, and carried out sterilization campaigns in Idlib, Hama and Aleppo countryside.

As for the Salvation Government, linked to Hayyat Tahrir al-Sham, its Health Minister has participated in campaigns against the virus, and it has published some short posts on the ways of prevention.

Amid these poor procedures and poor health infrastructures in the Syrian North, in addition to the weak resistance of the people’s bodies due to food shortage for many years, the possibility of the virus outbreak in the Syrian north is very high, and if this happens, the consequences will be catastrophic.

Assad’s regime is still denying:

Havin described the situation in the opposition-held area, what about the regime-held areas?

It seems that Assad’s lack of transparency in disclosing the real number of Covid-19 infections in Syria is linked to a number of concerns, most notably:

  • Fears that revealing the real numbers will lead to instability in regime controlled areas, especially with citizens distrusting the ability and efficiency of the state’s sectors, including health sector, which is about to collapse already.
  • Fears of spreading panic in the state’s institutions, particularly the military and intelligence ones, that are most important for the Assad regime to remain and control. The psychological effect on Assad’s soldiers and their performance, if the regime resumes its battles in the Syrian north, enhances those fears.
  • The shocking effect on the collapsing economic sector, especially if Caesar Syria Civilian Protection Act will be put in force.
  • Fears of imposing international intervention to contain the outbreak, if the WHO does not allow Assad’s regime to lead the Syrian health system in case of incapability.
  • Fears of increasing international pressure on Syria to limit the entry of foreigners to Syria via Lebanon, Iraq, Iran, Russia and China, which may affect the presence and influence of these countries’ forces, militias, and advisers in Syria.

At all events, if the Assad regime will be obliged to reveal the number of infections and deaths of Covid-19, it will be exploiting this in its intelligence, military and economic policies. For instance, it will call for lifting the sanctions imposed on it, and for supporting the health system under its supervision, similar to what Iran did in its country.

The Assad regime has its excuses for denial, what about the opposition?

Actually, there is no reason for the Syrian opposition not to be transparent about the spread of the Coronavirus in the controlled areas. If there are infections recorded by the health sector there as respiratory diseases, this would be attributed to the lack of experience and ability to diagnose correctly, as well as the delay in receiving support from regional or international institutions.

Autonomous Administration … Denial is cover for incapability

The reality in the Autonomous Administration controlled areas is not much different to the reality in the opposition-held areas in terms of lack of experience and inability to diagnose infections properly. However, the Autonomous Administration wasn’t transparent in dealing with the pandemic, and this is because the PYD exploits all events for its interests, such as showing the capability of its systems – especially the health system – to contain the virus spread, attempting to cover in the incapability of its systems.

Future Expectations

There is no doubt that future expectations will be affected by finding a treatment in the near future, in addition to the nature of the virus and what will be discovered about it.

But in general, possible scenarios in Syria can be limited to the following:

  1. The virus will not spread widely in Syria, and this is unlikely to happen.

In this scenario, the virus will spread among few hundreds or thousands of people in Syria’s three areas of control. This theory based on the reality in Syria now as the three areas of control are already isolated from each other, and traffic between these areas almost does not exist. Moreover, people’s adherence to the announced precautionary measures might be higher due to their fears of a new crisis that would worsen the previous ones.

  1. The virus will be widely spread amid continual lack of transparency.

In Syria, where the capabilities to contain the virus outbreak are weak, the people’s immunity is poor due food shortages, scarcity of water, hygiene and sterilization materials, the health infrastructure in all Syria is almost collapsed, and the number of doctors and medical staff is low, the likely scenario is the virus outbreak.

If this happens, 50% to 70% of the Syrian population will be infected, especially in the high-density areas such as Latakia and Damascus and in its slums and the border areas.

On the other hand, Syria has an advantage in this regard, as it has low percentage of elderly compared to the population, and therefore it is expected that the death toll will be very low, perhaps no more than 3% of all infections in the highest levels.

Assuming that 60% of the population will be infected (the population of Syria is currently estimated at 15 million), this means at least 150,000 people will die in a relatively short time (if the death rate is 1% of the infections), and this is a large number added to the death toll of the war that did not yet stop, and accordingly, in this scenario, Syria will witness an unprecedented historical phase, and the consequences on human and social aspects, as well as economic will be very catastrophic and unlimited.

  1. The virus will outbreak amid measures taken by governing parties:

With this scenario, the virus spread in Syria will push the three governing parties to take quick precautionary measures, knowing that their health systems are too weak. They would also impose quick and strict curfew, unlike other countries, where people are not used to live with restrictions on their freedom. According to this scenario, the outbreak will be limited to some specific areas, and maybe one third of the people only will get infected, so the deaths will be around 100 to 150 thousands – if the rate is 1% – and this is the most likely to happen.

However, the number is relatively high, which means that a huge catastrophe is looming, with a coast that will be very high in terms of human lives, and which will completely paralyze social and economic life completely.

The Situation in Camps, the Greatest Misery

People living in camps adjacent to the Turkish border are worried of a Coronavirus outbreak among the IDPs, especially with the density they live in.

Some 1.5 million people live in these camps, under unsanitary conditions, with no basic services such as water, electricity and sewage systems.

Sakina Camp

It is undoubted that IDP camps in northwestern Syria are unable to combat the novel Coronavirus, as they lack medical facilities as well as infrastructure, making the virus spread an inevitable reality that might kill thousands of people. Despite the gravity of the situation, it seems that the camps’ residents have priorities other than sensing the danger of the coronavirus.

During a visit of MENA Research and Study Center to the Sakina camp on Turkey’s border, we heard the views of several residents.

Mohammed Barjes, a displaced from Idlib, says “there is more important things to think of, a house sheltering me and my family for example!”

“We, the displaced, are already quarantined; we are isolated from the world, so, how would the coronavirus arrives in our camp?” Mohammed says ironically.

“I think talking about the Coronavirus after nine years of killing, displacement, fear and terror, may not be void, as the grief of the mother who lost her son, the brother who lost his brother, and the father who hopes to know something about his detained son are the only concerns here,” he continues.

It’s obvious that the pains and tragedies that have been afflicting Syrians for more than 9 years, have rendered death an ordinary event according to Mohammed who expresses that “every day carries a new sadness and a new funeral, if not a new massacre.”

On the other hand, and despite all the tragedies, some displaced people are aware of the virus’ dangers.

Alaa Bakour, 36, displaced from north Idlib says, he’s following the daily updates on the virus, fearing an outbreak in the IDP’s camps.

“Big countries are unable to combat this epidemic with all their capabilities, so what shall we say?”, Alaa expresses his concerns. “Those, who killed our people and forced us to leave our cities, can easily spread a virus like Corona among us. Those who dig graves and burn bodies have enough hatred to do so,” he adds.

“I have read a lot about the virus and the prevention methods, I also read lots of scientific articles and I am following up all the developments,” he continues, noting that the virus will only come from an external source, and wishing all the camps to remain isolated from the external world.

Abdul Kader al-Sheikh, the camp’s director says that awareness campaigns are taking places, but they are poor, and most of the residents don’t sense the danger of the coronavirus spread in the camp.

He points out those crossing points with the regime controlled areas are open, and it’s likely that someone will cross into the camps and transfer the virus, indicating that they won’t be able to detect the infections due to lack of equipment.

It’s noteworthy that the Sakina camp is located near a high school and an elementary school, which heralds a disaster once the epidemic reaches it.

When asked about sterilization methods in the camp school and in the camp’s communal baths, Abdul Kader said: “They are very primitive sterilization means, limited to water and chlorine and sometimes water and alcohol, but the alcohol levels are almost non-existent due to its high prices.”

Al-Karama Camp

“We can’t afford buying soap, how can we combat a virus?” this was the majority’s reply when we asked them about the coronavirus.

Hussein Salama, a teacher at the camp school is following the news of the Coronavirus around the world, he tries to imagine the catastrophe if the virus will spread among Syrian refugees.

“If Corona arrived to the camps that lack the minimum conditions of health safety, a big disaster would happen, it might surpass the explosive barrels, chlorine and sarin gases that killed hundreds of thousands of Syrians during the war,” he says.

Talking to MENA Research and Study Center, Amer Sweidan, the camp’s director says: “Containing the virus spread in other cities is possible because they can impose quarantine and isolate the infected ones, they also have hospitals nearby to be transferred to in case the show symptoms; but here, where the camps lack the minimum medical needs including medical centers, and where more than 1000 families live in overcrowded tents erected on very small area, the virus will definitely spread especially that baths and toilets are shared.”

“We called on the humanitarian organizations to conduct precautionary campaigns, protecting the displaced people from the virus’ risks, but responses were too weak, limited to some posters warning of the virus, distributed by some organizations,” he adds.

“Displaced people are now in dire need for detergents, sanitizers and masks, and we shall work with maximum speed to expand the spaces between tents as precautionaty measures that would reduce the spread of the virus if it reaches the camps,” he explains.

Sweidan indicates that he, together with the directors of the camp, will be unable to stop the spread of the epidemic if it reached there as there is no means to prevent it.

Safi al-Mahmoud, a resident of the camp says: “Our fears are increasing, as the number of new infections in the world is rapidly growing.”

“Here in the camps, everything is shared, even the drinking water, we get through the shared tanks, our diet system is very poor, and we have a lack of food containing vitamins,” he expresses.

“We protected our families from missiles and barrel bombs, and we will do our best to protect them from the coronavirus; so, I decided to move my tent into a distant place, protecting my family and my sick old mother from the virus,” he says.

Othman al-Shalh, a displaced whose legs were amputated after an airstrike on his house in Khan Sheikhoun says: “I am waiting impatiently for my death in this camp, and perhaps the coronavirus is my relief, my salvation. I lost my daughter a month ago because of cold, my second child instead of being at school he goes from morning till night collecting scrap and selling it, as he is the only breadwinner of the family.”

“I do not wish to harm to anyone, but I do pray for salvation with Corona or other mean sooner. Had it not been for my fear of suicide, I would have committed it long time ago.”

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