COVID-19 response – bi-monthly situation report

30 October 2020

This report is prepared by OCHA, on behalf of and in collaboration with UN agencies and partners involved in COVID-19 response efforts in Lebanon. The report covers the period from 14-27 October 2020.

Situation

• Between 14 and 27 October, an additional 19,219 people were CUMULATIVE KEY FIGURES (as of 27 infected with the COVID-19, bringing the total number of October) reported cases since 21 February 2020 to 75,845, of whom 57 per cent are male. Overall, there have been 1,384 healthcare workers infected, mostly working in institutions dealing with the 75,845 (19,219 new) COVID-19 response. Further, a total 602 deaths were registered, 31.5 per cent of which are female. About 97 per cent of confirmed confirmed cases cases were recorded among residents. The average test (during the reporting period of 14-27 October) positivity rate during the reporting period was at 11.1 per cent. 602 (103 new) deaths • Lebanon is in phase four of the outbreak, where wider community transmission is observed. • During the reporting period, 364 additional Palestine refugees were confirmed as positive with COVID-19. A total of 1,936 37,887 (12,193 new) Palestine refugees, 995 (51 per cent) of whom are living in recovered camps, have been confirmed as positive with COVID-19, including 53 deaths, since 21 February. As of 27 October, 415 people were in home-isolation, 46 in hospitals, and six in Sibline 1,110,735 (164,550 new) isolation centre. Since the beginning of the outbreak, 1,310 PCR tests conducted* Syrian refugees and 15 refugees of other nationalities have Sources: WHO/MoPH daily report on COVID-19 tested positive for COVID-19, leading to 26 deaths, with an *Lebanon National Operations Room daily report on COVID-19 increase of 194 cases during the reporting period. So far, 33 cases have been detected in informal settlements, of whom 19 have recovered. • On 18 and 25 October, the Ministry of Interior and Municipalities issued memos amending the list of villages that go under the complete lockdown, due to the COVID-19 outbreak, with more than 60 villages are closed as of 27 October. The general curfew remained at 01.00-06.00, and wearing masks is obligatory for everyone upon any movements.

Highlights

• A total of ten community isolation sites - Abbassiyeh (30 beds), Ain w Zain (18 beds), Al Aziz (28 beds), Ayha (24 beds), Lebanese Canadian Hospital (80 beds), Quality Inn Maarad (101 beds), Tayouneh centre (58 beds), Sibline Medical centre (48 beds), Tal Hayat Mokayteh (50 beds), Wardanieh (29 beds) - were active during the last two weeks, with 119 beds occupied out of 466 available beds, as of 27 October. • In cooperation with the authorities, the UN and NGOs provided support to contain the outbreaks, including dispatching 21 nurses, subcontracting infectious disease specialists, and providing awareness sessions on COVID-19 for inmates, and delivering capacity building and training for medical staff, at Batroun Prison, Roumieh Central Prison and Zahleh Central Prison where outbreaks were previously reported and now contained. The outbreaks in Hopital Psychiatrique De la Croix, and Saydeh Elderly Home have ended. • As of 27 October, the intensive care unit (ICU) bed capacity dedicated for COVID-19 was 82.7 per cent occupied (289 beds).

Source: Lebanon National Operations Room daily report on COVID-19

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Response per pillar under Priorities 1 and 2

Pillar 2 (Risk communication/community engagement): • Produced a press release and a 32 video-message package with the Director of the Rafik Hariri University Hospital and the COVID-19 team delivering awareness messages and promoting protective measures. Partners of the RCCE External Communication taskforce are disseminating the campaign, which has been echoed by 39 media outlets, reaching an estimated audience of six million. Campaign videos, including a video of the Director of the hospital and a video of a nurse who had COVID herself, are reaching a wide audience after three videos, including above-mentioned videos, reached 1.7 million people in the early stages of the campaign, which will be implemented until early November. • Delivered 13 COVID-19 sessions for 309 participants. The sessions included: recalling core messages and planning community work in Palestine refugee camps in the north and south of Lebanon; safe return of children with disabilities to specialized schools; mental health of health workers during COVID-19 provided to Baabda Public Hospital nurses; youth and COVID-19 sessions with youth groups highlighting youth’s role in fighting the pandemic; and, open discussions on preventive measures and best practices to UN staff, parents of children in day care, and staff of Kaemakam in Koura district of . • Trained 21 NGO health care staff (nine nurses, three public health supervisors and nine community health volunteers) on numerous topics, including COVID-19 awareness, infection prevention and control (IPC) measures, screening of COVID-19 cases, protection and prevention of sexual exploitation and abuse (PSEA), to reach the target of training 51 staff. • Provided individual awareness sessions on COVID-19 and chronic conditions to 251 inmates who were screened for COVID-19 in Roumieh Central Prison. Further, a total of six group awareness sessions on COVID-19 prevention were conducted for 45 key inmates. • A hotline established by the Lebanese Order of Midwives in cooperation with an UN agency received 93 calls to provide reproductive health counselling, COVID-19 and pregnancy information. • Conducted around 4,200 outreach sessions through door-to-door visits on reproductive health, gender- based violence (GBV), COVID-19 and pregnancy, as well as peer-to-peer awareness sessions on the same topics for around 6,000 Syrian and Lebanese beneficiaries, and providing sexual reproductive health services, including one-to-one counseling sessions, to 960 beneficiaries.

Pillar 3 (Surveillance): • Recruited seven additional staff as part of the plan to upgrade the human resources capacities of the epidemiological surveillance unit (ESU) at the Ministry of Public Heath (MoPH) and the ESU COVID-19 call centre. • Printed 260,000 COVID-19 reporting forms to support contact tracing by the ESU. • Recruited 27 community health volunteers who will be responsible for the community-based surveillance activities. • Reached 860 people (out of 64,800 targets) through door-to-door screening for COVID-19, as part of community-based surveillance activity to collect data on the health status of the Syrian refugees, Lebanese and Palestinians living in informal settlements or collective shelters, using the simplified COVID- 19 case definition and forms. The sample was sent to nurse supervisors for verification, investigation, collation, analysis and response as necessary.

Pillar 4 (Points of entry) • Screened and tested 7,369 individuals, including 710 children, for COVID-19 at five border crossing points and provided them with guidance on prevention and home isolation messaging, reaching a total number of people screened since March 2020 at the border crossing points to 163,367 individuals. • Screened and tested 12,583 travelers at the Rafiq Hariri International Airport and provided them with guidance on COVID-19 prevention and home isolation. • Checked the vaccination status of 710 children and provided missing measles and polio vaccines to162 children at border crossing points.

Pillar 5 (National Lab): • Procured and delivered 26,320 reverse transcription-polymerase chain reaction (RT-PCR) tests and 20,000 ribonucleic acid extraction reactions for COVID-19 to the MoPH warehouse and Rafik Hariri University Hospital. • Procured 61,500 units of swabs and viral transport medium (VTMs) to be delivered the MoPH to facilitate specimen collection for subsequent COVID-19 RT-PCR testing.

Pillar 6 (Infection prevention and control (IPC)):

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• Distributed 25,167 boxes of medical masks, 5,741 N95 masks, 14,682 boxes of rubber gloves, 757 infrared thermometers, 7,806 disposable gowns, 2,132 goggles, 5,202 bleach, 3,446 liquid soap and 36,415 bottles of hand sanitizers to 321 dispensaries, 97 primary health care centres and 18 Qada offices, which covers the needs for three months. • Procured 6,000 box of surgical masks, 37,000 fabric medical gowns, 555 bleaches, 20,000 boxes of gloves, 7,000 bottles of hand sanitizer, 122 clinical non-contact thermometers to be delivered to the MoPH to support 82 dispensaries. • In the reporting period, distributed 417 IPC kits and 62 disinfection kits to vulnerable people who have tested positive, or share a place with infected people, bringing the total number procured so far to 5,000 IPC kits and 20,500 disinfection kits, of which 1,713 IPC kits and 1,451 disinfection kits have been distributed so far. The kits include enough materials to support five people per household for 14 days. Further, the hotline for kits distribution are being set up, where vulnerable people with COVID-19 cases can request IPC kits. • Distributed 699 bottles of alcohol, 1,398 hand sanitizer bottles, 5956 biohazard bags, 82 boxes of medical masks, 31,700 fabric masks, 79 face-shields, 286 boxes of rubber gloves, 27 infrared thermometers, 652 disposable gowns and 53 bottles of hand sanitizers for campaign-personnel protection and the prevention of COVID-19 transmission during the measles campaign. • Procured 12,000 goggles, 12,000 gowns, 1,050,000 surgical masks, and 18,000 N95 masks to build a WHO stockpile of PPEs to be distributed to hospitals and isolation centres, as needed, and to ensure the protection of healthcare workers, which covers needs for a minimum of two weeks.

Pillar 7 (Case management): • Provided stress and anger management sessions to 35 males, as part of addressing the GBV needs of women and girls. Further, a total of 18 couples, husbands and wives benefitted from a programme to increase men’s involvement in early childhood development, standardize the parenting skills with positive communication, and thereby achieve a violent-free relationship. • Reached 400 Lebanese and Syrian refugees through psycho-social support sessions in Akkar, Baalbek, Bekaa, and North governorates. • Provided nursing follow-up and IPC kits for 40 COVID-19 infected and suspected cases in coordination with the rapid response team. • Installed 12 additional ICU beds at the Tripoli governmental hospital, as part of phase two of the hospital expansion, bringing the total added bed capacity nationwide through this support initiative to 197 regular beds and 28 ICU beds ready for use in five public hospitals (Baalbek, Halba, Rafik Hariri University, Saida, Tripoli). • Strengthened COVID-19 ICU and regular beds capacity of nine governmental hospitals (Baabda, Baalbek, Bouar, Halba, Jezzine, Machghara, Nabatiye, Tripoli, Zahle) through recruitment of 99 registered nurses and 19 practical nurses on the full-time basis, as well as 60 registered nurses and five practical nurses on the part-time basis to support ICU, in addition to 58 floor nurses to support regular wards so far. • Recruited and deployed 26 new registered nurses and one nurse supervisor to active community isolation sites and specialized facilities, bringing the total number of registered nurses and supervisors currently deployed, as of 27 October, to 81 and 10, respectively. • Supported Batroun, Roumieh, and Zahle, Prisons by subcontracting two infectious disease specialists - one in Batroun and Roumieh prisons and another one in Zahle Prison- to contain the outbreaks. The specialists are conducting risk assessment visits to prisons and providing on-call COVID-19 support, as well as conducting capacity building and training for medical staff and officers from the Internal Security Forces. • Supported Tal Hayat isolation centre with running costs and maintenance, and human resource costs. • A team of ten nurses followed up on 40 COVID-19 infected or suspected cases of Syrian refugees in North and South governorates (out of a target of 900), as well as providing them with shelter and WASH activities, according to the needs identified. • Continued monitoring pregnant women who were infected with COVID-19 and providing support for hospitalized cases in 14 governmental hospitals, with 56 pregnant women infected, including one death, between 1 and 22 October. The mortality case is being investigated to clarify whether COVID-19 infection is the primary cause of the maternal death.

Pillar 8 (Operational support and logistics): • Received 155 expressions of interest from local suppliers for the consolidated procurement plan of COVID items, which is currently under the evaluation. Based on the results, the invitation to bids will be processed. • The shared platform showing all procured items and quantities related to COVID-19 per agency was shared with the public and updated regularly. • Representatives from the MoPH and Disaster Risk Management unit were invited to join bi-weekly pillar 8 meetings in order to better facilitate support to the government.

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Response per sector under Priority 4

Food Security Sector • Distributed food parcels to 6,905 people in October, as part of the support provided to the 50,000 most vulnerable Lebanese families affected by COVID-19 and the economic crisis over six months. • Continued to use a self-referral tool enabling individuals to register, which allows a UN agency and its partners to further verify their vulnerability and include them into the in-kind assistance programme, with an aim to increase its outreach and identify vulnerable population in need of food assistance. • Building on the rapid assessment of migrant workers affected by the Beirut Port explosions and finding from the multisectoral needs assessment, as well as linking to the migrant assistance portal. The needs and vulnerability assessment, which was previously conducted between May and July 2020, has been revised, refined and redesigned to take into account of the vulnerabilities exacerbated by the Beirut Port explosions. The preliminary findings of the revised needs vulnerability assessment will be finalized by the end of November and disseminated with the wider humanitarian community by the end of the year.

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