Syria-Turkey border – Three doctors and a nurse tested positive for the novel coronavirus in Syria’s northwest Idlib governorate, the first cases to emerge in the region, raising fears it could rapidly spread through densely populated camps for internally displaced Syrians.
The number of people living in the sprawling camps has increased in recent months after Russian-backed Syrian government forces launched a campaign to regain control of the last rebel-held bastion in the war-torn country.
“The first case of the new coronavirus was confirmed on Thursday night. He is a doctor working in Bab al-Hawa border hospital,” Emad Zahran, media manager at Idlib’s health directorate, said on Saturday, adding the physician appeared to have contracted the virus during a visit to his family in Turkey last month.
“The patient developed symptoms including a dry cough and a high temperature last week. He was tested in Idlib and the results came back as positive. He has been quarantining since,” Zahran told Al Jazeera.
The health directorate said it immediately asked all doctors, patients, and other staff at Bab al-Hawa hospital to quarantine as tests for the coronavirus were conducted on people who visited the facility since June 25.
Maram al-Sheikh, the minister of health in Syria’s interim government, told Al Jazeera a couple of days after the first infection was confirmed, three more people tested positive. Two were doctors and one was a nurse working in Idlib.
“The new patients include two doctors who had interacted with the first case – a neurosurgeon at Bab al-Hawa hospital. The other cases are an oral surgeon and a paediatric surgeon who work at a hospital in the nearby Atmeh village. They tested positive on Friday,” he told Al Jazeera.
“The latest case emerged on Saturday – a nurse working at the emergency department in Bab al-Hawa hospital who had interacted with the first case,” he said.
The patients are all in good condition and remain under quarantine, he added.
Al-Sheikh explained that measures were already in place to ensure the coronavirus does not spread across northwest Syria.
“We have organised response teams across all of the opposition-controlled areas to ensure the containment of the virus. We are also counting on people to adhere to precautionary measures and instructions issued by local and World Health Organization in order to protect themselves and their families,” he said.
According to al-Sheikh, seven specialist health centres were set up in Idlib and Aleppo to respond to the health crisis. She said the ministry was also working with the World Health Organization (WHO) to carry out systematic testing with more than 2,000 tests conducted so far.
The news came amid repeated failed attempt by members of the United Nations Security Council (UNSC) to extend approval – which expires on Friday – for humanitarian aid to be delivered across two border crossings into Syria from Turkey for the next six months.
The 15-member council has been split, with most members pitted against Syrian allies Russia and China, who want to halve the number of border crossings to one – Bab al-Hawa crossing which serves Idlib.
They argue that areas in Aleppo near the second crossing, Bab al-Salama, can be reached with humanitarian help from within Syria.
Fears of rapid spread
Despite efforts to contain the coronavirus across IDP camps in Syria’s northwest, Mohammed Hallaj, who heads a coordination committee responding to the crisis, said concerns remain high.
“We are very worried that the number of cases in the area will rise, especially that all three confirmed cases were doctors who tend to interact with people on a daily basis, whether at hospitals or clinics,” Hallaj told Al Jazeera.
“The fact that the two last cases emerged in Atmeh hospital, which serves the sprawling IDP camps in northwest Syria, adds to our concern,” he said. “If a single case is confirmed at the camps, the spread of the virus will be rapid and very difficult to control.”
With most tents separated only about one metre (three feet) apart, social distancing measures are difficult to practice, making a potential spread of the virus quicker and more aggressive than elsewhere.
“There is a severe lack of clean water and sterilisation at the camps due to poor drainage and lack of sanitation facilities. It is a real disaster,” said Hallaj.
Idlib’s population doubled to about three million people from 1.5 million before Syria’s war broke out in 2011, as opposition forces lost territory to President Bashar al-Assad over the last few years and relocated there.
Like many fleeing the fighting, Ibrahim Darwish, a former resident of Idlib’s suburbs, settled with his family in one of the IDP camps.
He told Al Jazeera it has been difficult to adhere to health precautions since the pandemic hit.
“When the coronavirus reached neighbouring countries like Turkey, I took it upon myself to ensure that my family remained safe,” said Darwish, who now lives in Deir Hassan in northern Idlib.
“My wife, two children and I quarantined in our tent for several weeks and washed our hands five times a day. But after about a month, it became difficult to carry on. We went back to our normal ways,” he explained.
“But now that the coronavirus has reached us in Idlib, we are back to quarantining again and trying to find masks and gloves. We’re scared it will reach us at the camps. It will be a disaster,” said Darwish.
Idlib has been the target of a fierce battle for control since Syrian government forces launched a Russian-backed offensive to regain control of the opposition stronghold in late 2019.
The offensive left one million people displaced and more than 500 civilians dead before Moscow and Ankara brokered a truce in early March. Idlib continues to suffer a wide-scale humanitarian crisis.
In an investigation last week, the UN Commission of Inquiry on Syria said war crimes were committed by pro-government and opposition forces during the battle for Idlib.
Mohamed Karkas reported from the Syria-Turkey border. Arwa Ibrahim reported from Doha.