Lebanon stands on the precipice. If not worse. With countries across the globe reeling from the effects of the coronavirus-induced lock-downs which has significantly negatively impacted sectors, industries and economies around the world, for Lebanon the impact was even more serious since it piled up on top of its severely strained financial condition, at a time when its economy was already in the doldrums.
Describing the impact the COVID-19 pandemic has had on the economy, Charaf Abou Charaf, the Lebanon’s doctors syndicate opined, “It is basically from one catastrophe to another”.
Daily infection rates levels in the country have soared to the highest levels in the region, past the 6,000 mark for the first time last week on Friday. The pandemic has not only placed an enormous burden on the already collapsing economy but has also strained front-line workers, with exhausted healthcare workers themselves succumbing to the disease, said doctors at one hospital on the condition of anonymity; they went on to add, nearly 40% of the staff were either sick or in isolation.
Lebanon’s caretaker government has promised to do all it can: it has ordered and prolonged a lockdown into February, its strictest lock-down as of date. Medics have however criticized the government’s response saying the measures are too little and are too late.
With a population of around 6 million people, Lebanon has recorded 183,888 cases of SARS-CoV-2, including 1,466 deaths, since February.
Rising infection levels
According to the head of the Syndicate of Private Hospitals, Sleiman Haroun, the hospital scenario is “catastrophic”: “the 50 private hospitals in the country receiving patients with Covid-19 are now almost full”. The hospital has totally 850 beds, including 300 in intensive care units, and most are occupied.
“Patients are now waiting in line … waiting for a bed to be free,” said Sleiman Haroun.
“The problem is that once a patient is admitted to intensive care, they stay there for three weeks,” said Petra Khoury, who heads the national COVID-19 task force.
Infection levels have soared after the government relaxed lock-down rules ahead of the December holidays by pushing back nighttime curfews to 3am and allowing nightclubs and bars to reopen. Healthcare professionals had been critical of the move since it would affect hospital bed occupancy, with bed occupancy in intensive care units running already critically low.
The “gatherings and private parties” of the December holiday season have fed a dramatic rise in cases, said Khoury. He went on to add, “Over the past three weeks, the occupancy rate of intensive care units has increased by 10 percent,” pushing the occupancy of hospital beds in Beirut to over 90% of capacity.
“We have been asked by several hospitals not to transfer patients to them,” said Georges Kettaneh, president of the Lebanese Red Cross. The Red Cross is taking patients to Bekaa in the east or Nabatiyeh in the south.
A Red Cross paramedic posted a text on n his Facebook account which went viral, wherein he said that his “cellphone has been ringing since 5 in the morning with people infected with the virus and their families asking for help.” He called on “all those who are still violating the preventive and precautionary measures, to head to hospitals and watch the tragedy that they are causing.”
“We bypassed the stage of non-availability of beds to the stage of inability to go to hospitals. Doctors are examining patients in their cars in front of emergency departments,” said the paramedic.
Describing the scene in front of the hospital, the paramedic said, it is “similar to what happened after the explosion at the Beirut port on August 4, 2020. However, with the pandemic, we are living everyday a new August 4, 2020 tragedy.
“Medical staff are exhausted and orthopedic surgeons, obstetricians, and even retired doctors may have to engage in treating coronavirus patients, and we may reach a phase where we might need to choose who would be accepted to intensive care rooms,” said the paramedic. “So, please do not go out of your houses.”
During the Supreme Defense Council meeting, Hassan Diab, Lebanon’s caretaker prime minister said, “We have reached the stage of extreme danger. Some people in Lebanon think that COVID-19 is a lie. We are facing a horrific health situation. The disease has spiraled out of control because of people’s stubbornness and their insubordination to the precautionary and preventive measures. Our duty is to protect people from themselves. Either we control the situation with a full and strict lock-down, or we might be heading towards a Lebanese model worse than the Italian one.”
According to Halim Shebaya, a political analyst, the government has no clear strategy in place. It would be challenging to bring infection numbers down this late in the game.
“The main issue now is the absence of trust in the government and authorities and managing a pandemic necessitates the presence of public trust in measures taken by the authorities,” said Halim Shebaya.
Financing the vaccination drive
Lebanon has finalized a deal with Pfizer for 2.1 million doses of the COVID-19 vaccine; their arrivals are scheduled to start from early February, according to Lebanon’s health ministry.
According to the head of Lebanon’s national scientific committee for COVID-19, Dr. Abdul Rahman Bizri, although the countdown to receive the COVID-19 vaccine has begun Pfizer however “is not lenient” on the financial terms.
“The real countdown has begun to receive the vaccine in the first half of February, we could even receive it in the first quarter of the month,” said Bizri in remarks to LBCI television daily show Nharkom Said.
He went on to add, while Lebanon is set to gradually receive the shipment it requested from Pfizer and other medical companies, “but our problem is that Lebanon is still classified a middle-income country, and Pfizer is not lenient with us on the financial issue”.
Front-line responders including doctors, nurses, paramedics and other healthcare workers should be the first to get the vaccine.
On the availability of storage facilities for the vaccine, “We have a minimum of 20 refrigerators, and there is no problem with the storage capacity of Pfizer vaccines,” indicating that there is a mechanism for using vaccines within 5 days of arrival.
In a statement the caretaker government stated, the Pfizer vaccines will be complemented with another 2.7 million doses from the U.N.-led program to provide for countries in need. However it did not provide a timeline for their delivery. The agreement was signed in October 2020.
According to a lawmaker, the Pfizer deal has been negotiated at $18 a dose – a price that factors in Lebanon’s economic condition; the deal is expected to cover around 20% of the population and will be free of cost. A loan from the World Bank will cover most of the cost.
Another 2 million doses are being negotiated in coordination with Lebanon’s private sector and the other international pharmaceutical companies, including Oxford-Astrazeneca and China’s Sinopharm, that have developed the vaccines, said the ministry.
In order to make the vaccination drive effective and further curtail rising infection levels, there have been calls to extend the lock-down beyond Valentine’s Day on February 14 – a widely celebrated holiday.
According to Charaf Abou Charaf of the doctor syndicate, while the medical situation of the country was challenging, with 11 doctors having died in the pandemic, 25 in critical care and 300 in isolation across Lebanon, the latest lock-down is likely to reduce some pressure.
“This is the only remedy we have at the moment until the vaccine comes.” If the shipments will arrive one day.