AMMAN — The novel coronavirus (COVID-19) case-load in Syria has significantly spiked in the last month, reaching 2,118 cases and 89 deaths across the country at the time of publishing.
While the number of cases is not particularly high when compared to other neighboring countries like Iraq and Turkey—a little over 160,000 and 243,000 cases, respectively—the abysmal testing rate suggests that the actual number of cases is much higher. According to an estimate by the online publication Syria in Context, there could be as many as 85,000 COVID-19 cases in Damascus alone.
A model by researchers in the London School of Economics estimates that, if the current trajectory continues, there should be around 2,000,000 COVID-19 cases in Syria by the end of August, though if strict public measures are introduced and adhered to, that number would fall to 100,000.
The current testing rate for all of Syria, 1.3 tests per thousand people, puts Syria in last place globally among countries for which data on testing rates is available.
However, the political fragmentation of Syria means that access to testing is not equal, with northeast Syria having limited numbers of test kits. If treated as their own countries, northwest Syria and northeast Syria would have testing rates of 1.04 and .22 per thousand.
Currently there have been 54 and 253 cases of COVID-19 in the northwest and northeast, respectively.
In addition to the positive cases, over 21,653 people have been placed in medical quarantine for symptoms resembling those of COVID-19, according to the Syrian Ministry of Health. Of those placed in quarantine, 19, 906 have been released thus far.
The government’s transparency has also been questionable. Several sources in Damascus have told Syria Direct that the government has sought to suppress information about their relatives’ positive COVID-19 diagnoses.
“The problem is that there is no access to official information, the relevant ministries do not share numbers,” Mohamad Katoub, the policy and advocacy manager for the Syrian Center for Media and Freedom of Expression, told Syria Direct.
“We’ve seen a media circus, such as statements that the army is fighting the virus, which is not possible for Corona… and this was from the Minister of Health,” Katoub added.
Several human rights monitors and news outlets, such as the UK-based Syrian Observatory for Human Rights (SOHR), have reported a much higher number of active cases and deaths with symptoms similar to those of the coronavirus.
In one instance, a source close to a Syrian civilian in Reef Dimashq province who tested positive for the coronavirus on March 31 told Syria Direct that the Syrian government was reluctant to confirm the test results.
The coronavirus is being treated "as if it's a security issue," the source told Syria Direct, adding that at first, the government "denies that the patient has [the virus], and then later diagnoses it after the patient has been mingling with his social circles."
Such treatment has made tracking COVID-19 cases in Syria difficult, but numerous local sources and media outlets have told Syria Direct of cases throughout government-held territory which are not being taken into account in the official case-load.
Potential hot spots: IDP camps, prisons and foreign militias
The densely populated Internally Displaced People (IDP) camps in northwest and northeast Syria present a frightening scenario for the coronavirus to spread unabated due to the lack of medical infrastructure and supplies. Similarly, the approximately 100,000 Syrians locked away in government prisons and detention centers are particularly vulnerable to the virus.
“If the virus reaches detention centers and camps, it will [spread] quickly and there will be no way to resist it,” Katoub explained, adding that “conditions in detention centers do not even meet the minimum standards of public health.”
Still, even outside of camps in northwest Syria, “if residents in those areas decided to take measures to self-isolate, it wouldn’t be possible due to the large numbers of people there,” he said.
International human rights bodies—such as Amnesty International—have called for Damascus to release much of its prison population to prevent the spread of the virus among detainees. To that end, Bashar al-Assad issued a decree of general amnesty on March 22, which promises to free an unspecified number of detainees, but it is unclear to what extent the amnesty would apply to political prisoners, given that similar moves in the past were not actually carried out.
At the same time, testing in northwest Syria is limited, and there have only been 4,680 tests conducted thus far in the area.
Additionally, aid to the opposition-held territory has also been restricted due to constraints on organizations that also work in the government-held territory who fear having their permission to work in those areas revoked.
One such humanitarian organization told Syria Direct that Damascus denied their request to set up testing labs in IDP camps in northwest Syria, without giving a reason for the denial.
As for AA-held northeastern Syria, fifteen people have died from COVID-19 at the time of publishing. On August 19, 34 new cases were announced, bringing the total caseload to 253.
While the total number remains relatively low, the sharp spike (an approximate 500 percent increase) in COVID-19 patients at the end of July and beginning of August is worrisome. In addition, low testing rates—only 556 tests have been conducted thus far as of August 8—suggest the true number of cases could be much higher.
There are approximately 30 cases the al-Shahba region in Aleppo. The al-Shahba region is populated by 200,000 people, mostly IDPs from Afrin, and has limited access to adequate healthcare facilities. The population already suffers from malnutrition and other chronic diseases, according to a Kurdish Red Crescent (KRC) document provided to Syria Direct.
According to the same document, the one hospital which services al-Shahba is 10 kilometers away and services various other parts of Aleppo. Its staff is mostly made up of volunteer nurses with limited-to-no formal training.
This is a version of an article originally published on 05/04/2020, updated to reflect the current number of COVID-19 cases in Syria.