Conflict, division blight virus response in Libya

Conflict, division blight virus response in Libya
Members of the Libyan National Army hold a position during fighting against militants in Qanfudah, on the southern outskirts of Benghazi. (AFP/File)
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Updated 13 June 2020

Conflict, division blight virus response in Libya

Conflict, division blight virus response in Libya
  • The GNA has reported 393 coronavirus infections and five deaths nationwide, around half of them in and around Sabha

TRIPOLI: War and division are weakening Libya’s fight against the novel coronavirus, with the government struggling to deal with an outbreak deep in the desert south.
The oil-rich North African nation has been mired in chaos since a NATO-backed uprising toppled and killed longtime ruler Muammar Qaddafi in 2011.
The Government of National Accord (GNA) controls the west, including the capital Tripoli, while military strongman Khalifa Haftar controls the east and some of the far-flung oases and oilfields that dot the south.
With Libya already largely cut off from the rest of the world by conflict when it reported its first coronavirus case at the end of March, the situation appeared relatively contained.
Cases of infection were “very low” compared to neighboring countries, according to Badreddine Al-Najjar, head of Libya’s center for disease control.
“We even had weeks without new infections,” he said.
The rival administrations imposed curfews and closed borders, schools, businesses and mosques, in a bid to prevent often obsolete and worn-down health facilities from becoming overwhelmed.
But health measures “are difficult to apply due to the political and security context,” Najjar said.
The situation has changed rapidly in recent weeks, with dozens of cases appearing in the south’s largest oasis city Sabha.
The GNA has reported 393 coronavirus infections and five deaths nationwide, around half of them in and around Sabha.
But that only accounts for cases that the Tripoli-based disease control center has been able to confirm.
Najjar said local authorities in Sabha, which is under the control of pro-Haftar forces, were not equipped to deal with an outbreak, and initially refused the GNA’s help.

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The rival administrations imposed curfews and closed borders, schools, businesses and mosques, in a bid to prevent often obsolete and worn-down health facilities from becoming overwhelmed.

“It was difficult to open up isolation rooms ... and the equipment didn’t arrive until after a large number of infections among close contacts,” Najjar said.
“The residents did not cooperate and did not respect the preventive measures,” Najjar said. “They acted like nothing was wrong.”
Ibrahim Al-Zouay, head of the committee to fight the pandemic in Sabha, acknowledged that local authorities had been overwhelmed by the task.
“We were unable to isolate ‘patient zero’ because the number of cases grew,” he told AFP.
“The support and rapid intervention teams stuck to testing and monitoring the family and friends” of confirmed cases, he added.
Divisions and accusations of mismanagement have also marred a plan to repatriate more than 15,000 Libyans stuck abroad.
Libya lacks adequate infrastructure for quarantining arrivals on its soil, and the security situation prompted fears that armed individuals could release people from isolation by force.
So authorities decided to quarantine returnees before their repatriation instead, a decision critics say has led to new infections among those who came into contact with them.
“Each flight carrying returnees was like bringing back booby traps,” said Mahmoud Abdeldayem, who works in the civil registry in Tripoli.
“How come there were cases?” he asked, questioning the quarantine and testing arrangements prior to departure.
“There must be a problem in implementing the program.”
More than 8,000 people had been brought home before repatriations were suspended last week as fighting in the country intensified.
Mahmoud Khalfallah, a former Health Ministry adviser, said Libya’s political divisions had marred its handling of the pandemic.
“Health is above all a service. Involving it in political struggles is shameful and unacceptable,” he said.
“It’s Libyans who will pay the price.”


Top Lebanese hospitals fight exhausting battle against virus

Top Lebanese hospitals fight exhausting battle against virus
Updated 23 January 2021

Top Lebanese hospitals fight exhausting battle against virus

Top Lebanese hospitals fight exhausting battle against virus
  • In recent weeks, Lebanon has seen a dramatic increase in virus cases, following the holiday season

BEIRUT: Death stalks the corridors of Beirut’s Rafik Hariri University Hospital, where losing multiple patients in one day to COVID-19 has become the new normal. On Friday, the mood among the staff was even more solemn as a young woman lost the battle with the virus.
There was silence as the woman, barely in her 30s, drew her last breath. Then a brief commotion. The nurses frantically tried to resuscitate her. Finally, exhausted, they silently removed the oxygen mask and the tubes — and covered the body with a brown blanket.
The woman, whose name is being withheld for privacy reasons, is one of 57 victims who died on Friday and more than 2,150 lost to the virus so far in Lebanon, a small country with a population of nearly 6 million that since last year has grappled with the worst economic and financial crisis in its modern history.
In recent weeks, Lebanon has seen a dramatic increase in virus cases, following the holiday season when restrictions were eased and thousand of expatriates flew home for a visit.
Now, hospitals across the country are almost completely out of beds. Oxygen tanks, ventilators and most critically, medical staff, are in extremely short supply. Doctors and nurses say they are exhausted. Facing burnout, many of their colleagues left.
Many others have caught the virus, forcing them to take sick leave and leaving fewer and fewer colleagues to work overtime to carry the burden.
To every bed that frees up after a death, three or four patients are waiting in the emergency room waiting to take their place.
Mohammed Darwish, a nurse at the hospital, said he has been working six days a week to help with surging hospitalizations and barely sees his family.
“It is tiring. It is a health sector that is not good at all nowadays,” Darwish said.
More than 2,300 Lebanese health care workers have been infected since February, and around 500 of Lebanon’s 14,000 doctors have left the crisis-ridden country in recent months, according to the Order of Physicians. The virus is putting an additional burden on a public health system that was already on the brink because of the country’s currency crash and inflation, as well as the consequences of the massive Beirut port explosion last summer that killed almost 200 people, injured thousands, and devastated entire sectors of the city.
“Our sense is that the country is falling apart,” World Bank Regional Director, Saroj Kumar Jha, told reporters in a virtual news conference Friday.
At the Rafik Hariri University Hospital, the main government coronavirus facility, there are currently 40 beds in the ICU — all full. According to the World Health Organization, Beirut hospitals are at 98% capacity.
Across town, at the private American University Medical Center — one of Lebanon’s largest and most prestigious hospitals — space is being cleared to accommodate more patients.
But that’s not enough, according to Dr. Pierre Boukhalil, head of the Pulmonary and Critical Care department. His staff were clearly overwhelmed during a recent visit by The Associated Press, leaping from one patient to another amid the constant beep-beep of life-monitoring machines.
The situation “can only be described as a near disaster or a tsunami in the making,” he said, speaking to the AP in between checking on his patients. “We have been consistently increasing capacity over the past week or so, and we are not even keeping up with demands. This is not letting up.”
Boukhalil’s hospital raised the alarm last week, coming out with a statement saying its health care workers were overwhelmed and unable to find beds for “even the most critical patients.”
Since the start of the holiday season, daily infections have hovered around 5,000 in Lebanon, up from nearly 1,000 in November. The daily death toll hit record-breaking more than 60 fatalities in in the past few days.
Doctors say that with increased testing, the number of cases has also increased — a common trend. Lebanon’s vaccination program is set to begin next month.
The World Bank said Thursday it approved $34 million to help pay for vaccines for Lebanon that will inoculate over 2 million people.
Jha, the World Bank’s regional director, said Lebanon will import 1.5 million doses of Pfizer vaccines for 750,000 people that “we are financing in full.” He added that the World Bank also plans to help finance vaccines other than Pfizer in the Mediterranean nation.
Darwish, the nurse, said many COVID-19 patients admitted to Rafik Hariri and especially in the ICU, are young, with no underlying conditions or chronic diseases.
“They catch corona and they think everything is fine and then suddenly you find the patient deteriorated and it hits them suddenly and unfortunately they die,”
On Thursday night, 65-year-old Sabah Miree was admitted to the hospital with breathing problems. She was put on oxygen to help her breathe. Her two sisters had also caught the virus but their case was mild. Miree, who suffers from a heart problem, had to be hospitalized.
“This disease is not a game,” she said, describing what a struggle it is for her to keep breathing. “I would say to everyone to pay attention and not to take this lightly.”
A nationwide round-the-clock curfew imposed on Jan. 14 was extended on Thursday until Feb. 8 to help the health sector deal with the virus surge.
“I still have nightmares when I see a 30-year-old who passed away,” said Dr. Boukhalil. “The disease could have been prevented.”
“So stick with the lockdown ... it pays off,” he said.