Doctors Without Borders/Médecins Sans Frontières (MSF) warned that Palestinians in the occupied territories urgently need vaccines as Covid-19 overwhelms hospitals.

“As COVID-19 spreads further through the West Bank and Gaza, Palestinians remain unprotected. As of mid-March, fewer than two percent of Palestinians have been vaccinated against COVID-19 in the West Bank and Gaza—an alarmingly small number in light of rising case numbers,” MSF said in a press statement.

“We are very concerned about this delayed and slow vaccination roll-out,” said Ely Sok, MSF head of mission in the Palestinian Territories.

“On the one hand, in Israel, the large availability of vaccine doses is now allowing the government to pursue herd immunity, without any intention to significantly contribute to the improvement of vaccination rates in the Palestinian Territories. On the other, it has proven difficult to obtain a clear picture of the availability and delivery strategy of the vaccine doses already received from the Palestinian health authorities. Meanwhile, frontline workers and high-risk groups in Palestine are nowhere near having protection from the disease,” Sok added.

“More than 20,000 patients are currently being treated for COVID-19 in the West Bank, adding further pressure to an already fragile healthcare system and leaving medical staff struggling to provide adequate care to hospitalized patients,” the statement underlined.

MSF urged the Government of Israel and the Palestinian Authorities to “immediately and significantly increase efforts to slow the spread of COVID-19 and its new variants,” including “working to improve COVID-19 prevention—including by expediting the vaccination roll out in the Palestinian Territories of the West Bank and Gaza—and case management, as another wave of COVID-19 sweeps through the West Bank.”

“The number of positive cases is at its highest level since the beginning of the pandemic,” said Dr. Juan Pablo Nahuel Sanchez, MSF intensive care unit (ICU) doctor.

“We currently have 71 people hospitalized in Dura hospital in Hebron—the main hospital and the only COVID-designated facility in the south of the West Bank—and 27 of them are in the intensive care unit. The hospital is operating beyond capacity. There is not enough space, beds, or staff to help all of our critical patients, and people are dying,” Sanchez stressed.

Hebron has been one of the worst hit governorates in the West Bank and is seeing more and more younger people affected by the virus. One in three patients currently admitted to Dura hospital is aged between 25 and 64, whereas in the past, the majority of patients were over 64, MSF said.

According to the Palestinian Ministry of Health’s genomic analysis, approximately 75 percent of cases sampled in the West Bank are now variant B117, which originated in the UK. This variant is thought to be around 50 percent more transmissible than previous strains.

Recent studies have suggested that the variant is 40-60 percent more likely to result in severe COVID-19, necessitating supplemental oxygen and ventilator support, and an increased risk of death. With COVID-19 variants circulating in the Occupied Territories, there must be intensified sampling to understand how widely these variants have spread.

In Nablus, in the north of the West Bank, the situation is equally worrying. The Palestinian Red Crescent Society (PRCS) hospital is working beyond its capacity and needed to transform its respiratory care unit into a ward for COVID-19 patients.

“We are doing our best to save them all,” said Marius Sanciuc, an MSF ICU nurse providing training and medical support to staff at the PRCS hospital. “The biggest challenge is that hospital staff have limited experience in caring for very sick patients or patients with COVID-19.”

Simple procedures such as proning—in which a patient is turned onto their stomach to improve breathing—have been a challenge to implement. “Try to imagine turning a patient who has many IV lines and tubes leading into their abdomen and back. It is a difficult task, where you need five people, but it’s not impossible.”

In Gaza, the number of patients with COVID-19 fell in February, but in mid-March rates began to rise again. Gaza’s healthcare system is already crippled by decades of Israeli occupation and a long-running economic blockade. Another wave of COVID-19 is a grave concern to the MSF team working there.