AMMAN — As Damascus confirmed its 121st case of the coronavirus—71 of which were caught as Syrians returned from abroad— and fourth death from the resulting disease, the government’s transparency has been questionable, as the slow rate of growth of the virus that causes COVID-19 in Syria has not followed the same exponential curve seen in most other countries.

“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." 

With little access to testing in general, especially in territories outside the Syrian government control, it is difficult to track the coronavirus spread throughout the country.

To do so, Syria Direct has aggregated reports of 318 cases of medical quarantines, as well as suspected and confirmed cases of COVID-19 throughout Syria, both via public and private sources within the country. These cases are in addition to at least 166 people who were at one point medically quarantined within the government-held territory due to symptoms similar to those of the virus as of March 30, according to a statement given to Syria Direct by the SOHR.  

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.” 

Even outside of IDP 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.

At the time of publishing, there have been no cases detected in the northwest provinces. 

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. According to Fadi Hakeem, the advocacy and communications manager at the Syrian American Medical Society (SAMS), there is only one lab in northwest Syria which has a PCR (Polymerase Chain Reaction) testing machine, the method currently approved by the World Health Organization (WHO) to diagnose the virus. 

The WHO has distributed 1,200 testing kits to Syria, 300 of which went to Idlib province, according to Hakeem. However, the kits were sent via Damascus, rather than the Turkey-Syria border crossing that is authorized by a UN Security Council resolution to be used for aid shipments to areas of Syria not under government control, as in the words of WHO spokesperson Hedinn Halldorrson, “the northwest is not a country.” 

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, the area has had three cases of COVID-19 thus far.

AA territories had its first death from COVID-19 on April 2, but the Autonomous Administration of North and East Syria (AA) was not notified by the WHO or Damascus of the death until two weeks later, impairing its ability to conduct contact tracing.

On April 29th, a husband and wife tested positive for COVID-19 in the al-Omran neighborhood of Hasakah city. Following the positive test results, the AA health ministry announced the neighborhood would be put under full quarantine.

The ability to test for the coronavirus is also limited, as there are only two PCR machines in AA-controlled territories, which were sent by Iraqi Kurdistan on April 12. Previously, the AA had to send samples to Damascus to make a diagnosis, a process that, best case scenario, takes over a week.