A recent report, obtained exclusively by Al Arabiya, projects a massive spread of COVID-19 in Lebanon. The forecast put in place by an international medical NGO, in early March, calculates that hundreds of thousands are at risk of infection. However, strict confinement measures imposed by the government have led to a downward revision of projections. These measures will continue curb projections, for as long as they are strictly implemented.
An internal report by the international organization Medecins Sans Frontieres (MSF), was provided to Al Arabiya by a source in the medical aid community. The report from early March, which was not intended for public release, projected that in the best conditions 638,074 people out of Lebanon 6 million population-including Syrian and Palestinian refugees – could be infected by COVID-19 over a five-month period.
Krystel Moussally, regional epidemiologist for MSF who was contacted by Al Arabiya to comment on the leaked report explains that it was developed to plan the emergency response and that figures are now dated.
Adjusted figures at the end of March show that cumulative total cases, including registered cases as well as undetected and asymptomatic cases could total 34,300 across Lebanon, with total reported cases reaching 5,150. In the latter projection, 240 ICU beds could be needed.
Without statistics from Lebanon, MSF adopted numbers from Italy to create a worst-case scenario and from China to create a best-case scenario for their early March analysis.
“The case fatality rate reported globally is different for each country. It is affected by many factors such as the demographics of the population and age distribution of the cases – knowing that elderly are the most severely affected,” Moussally said.
“In Italy, over 35 percent of the cases are older than 70 years, in comparison with around 13 percent in Lebanon, and the majority of deaths has been in this age category,” she continued. “Other factors might affect the case fatality rate and the need for hospitalization such as the prevalence of underlying risk factors of the population.”
Moussally added that the capacity of the health care system to cope, how fast the virus spread, and to what extent, are also factors that would affect the quality of care provided and hence affect case fatality rate.
Additionally, the Lebanese government has imposed strict confinement measures and nightly curfews, which have helped flatten curve and affect NGOs projections.
Lebanon so far has 641 cases and 21 deaths.
These measures have nonetheless been increasingly difficult to implement in impoverished areas in the cities of Beirut, Saida, Nabatieh, and Tripoli, which could lead to new flare-ups and potentially overwhelm the Lebanese healthcare system.
There are about 350 to 500 beds in intensive care units across the country according to figures provided by the Global Health Institute, while a study by Blominvest puts the number of hospital beds at around 15,000.
In the best-case scenario, over 100,000 people out of the 6 million population in Lebanon could experience mild cases, while over 17,000 people could require hospitalization and nearly 6,000 people could be expected to be in critical condition and requiring intensive care.
The fear that more relaxed social attitudes would lead to infection flare-ups is exacerbated by the ongoing repatriation of thousands Lebanese stranded abroad.
“The government has taken all measures at entry points. We trust the authorities are following procedures that will protect the country from a transmission of imported cases through expatriates, and urge the returnees to follow the rules and guidelines for the collective benefit of their communities,” said Moussally.
Yet as the population grows restless with extensive confinement measures, set against the backdrop of the country’s economic collapse, maintaining these measures could become challenging for the Lebanese government, which could end up pushing Lebanon’s pandemic to new peaks.
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