12,698	314	385,172	US$72.2 M
People with COVID-19 (active cases)	Fatalities	Samples tested for COVID-19	Request for Inter-Agency Response Plan

Situation Overview

During the reporting period, over 10,000 additional Palestinians in the oPt tested positive for COVID-19, bringing the cumulative number of cases since the start of the crisis to some 46,600. The currently active cases increased by some 14 per cent, from 11,100 to 12,700. Ninety-nine more people died during the reporting period, bringing to 314 the cumulative number of fatalities with the virus, 297 in the West Bank, including East Jerusalem, and 17 in the Gaza Strip. Thirty-four patients are in intensive care units (ICU), eight of whom require mechanical ventilation.

Conflicting trends have been observed during the reporting period across the various governorates. The Hebron district, which has been the epicentre of the pandemic, recorded a 46 per cent decline in active cases. This may be partially attributable to a decline in the number of tests performed in that area, following inconsistencies in the testing policy by the Ministry of Health (MoH), alongside an increasing tendency, particularly among the asymptomatic, to avoid testing due to the social stigma associated with infection. By contrast, the number of active cases in East Jerusalem and in the Nablus governorate doubled, while in Ramallah it increase by nearly 50 per cent.

In the Gaza Strip too, the volume of active cases has increased by over 50 per cent during the reporting period, nearly all due to the continuing community transmission, raising concern due to the longstanding fragility of Gaza’s health system. The lockdown imposed in the last week of August, following the detection of the first infection cases outside quarantine centres, has been selectively eased in less affected areas, amid a strict enforcement of precautionary measures, such as social distancing and mask wearing. 

In the West Bank, the Palestinian Authority (PA) has announced that in the coming days a differential scheme of restrictions will enter into force, based on the assignation of a colour (red, yellow or green) to each governorate, indicating their respective rate of infection and a corresponding level of restrictive measures.

In Israel, the authorities have imposed a general lockdown, applicable also to annexed East Jerusalem, starting on 18 September for an extendable three-week period. Most schools and shops are closed, as well as commercial centres, restaurants and indoor sports venues. Activities that do not involve interaction with the public, including the construction and agriculture sectors, which both employ large numbers of West Bank Palestinians, continue to operate with some restrictions.

A public opinion survey carried out between 9 and 12 September across the oPt indicates continuing high levels of satisfaction with the performance of the various Palestinian authorities in managing the pandemic, with 68 per cent approving the performance of the security forces and 57 per cent that of their respective governors. However, 55 per cent said that they are dissatisfied with the PA’s decision to halt coordination with Israel in the health sector, specifically in areas related to the pandemic. Over 60 per cent  reported that they have stopped earning an income since the start of the crisis.

West Bank

With around 1,900 active cases each, East Jerusalem and the Ramallah governorate account together for about 35 per cent of the West Bank caseload, followed by the Hebron governorate with less than 1,800 (16 per cent) and the rest of the Jerusalem governorate with some 1,100 cases (10 per cent) . 

Heightened mobility restrictions were imposed during the reporting period on several localities across the Ramallah, Tulkarm and Jenin governorates for a few days, after recording a rapid increase in the volume of cases. The Palestinian Prime Minister has reportedly instructed the police to intensify enforcement of current measures across the West Bank, including higher penalties for  violations. 

All active cases not requiring medical treatment are being referred to home quarantine. However, in preparation for a major upsurge in infection, 13 facilities across the West Bank have been placed on stand-by to receive people who tested positive but do not have suitable conditions for home isolation; ten of these isolation centres are supported by UNRWA to serve residents of refugee camps, primarily. East Jerusalem is the only area where an isolation centre has been already activated, at the Seven Arches Hotel, which is hosting 80 people. Most hospitals across the West Bank, including in East Jerusalem, have opened dedicated wards to treat people suffering from more serious symptoms.

On 20 September, 420,000 students in grades 5 to 11 returned to schools across the West Bank (except East Jerusalem); grades 1 to 4 and grade 12 began the school year between 6 and 9 September. Since then, some 90 schools have been partially or fully shut down for periods ranging from one day to two weeks, following the detection of COVID-19 cases among students or school staff. 

In East Jerusalem, on 6 September, residents of six Palestinians areas with high infection rates (Kafr Aqab, Beit Hanina, At Tur, Al Issawiya, Shu’fat Refugee Camp and Anata) were placed under a night curfew by the Israeli authorities, while some businesses and all educational institutions were closed during the day too. Since 18 September, all of East Jerusalem, including the localities above, has been subject to the comprehensive lockdown imposed on Israel, as highlighted above.  

The Barrier crossings controlling the movement of tens of thousands of Palestinian workers between the West Bank and Israel, reopened on 21 September, following a three-day closure due to a Jewish holiday, despite the ongoing lockdown. Those returning to the West Bank are not requested by the Palestinian authorities to stay in quarantine or perform a COVID-19 test.
Between 6 and 19 September, more than 1,000 Palestinians crossed into the West Bank from Jordan via the Allenby Crossing, and nearly 1,200 who departed. All such movements require prior coordination with the Palestinian Ministry of Foreign Affairs and testing for COVID-19 before crossing in either direction. 

Ahead of the start of the olive harvest season on 7 October, hundreds of Palestinian farmers have been applying at the Israeli District Coordination and Liaison (DCL) offices for the permits required to access their land located in the closed area behind the West Bank Barrier (the ‘Seam Zone’). This has reportedly led to severe overcrowding at  some of the DCLs, raising concern about possible COVID-19 contagion. In previous years, farmers  submitted their applications to the Palestinian DCLs, which since last May have halted their operations in response to Israel’s  threat  to annex part of the West Bank. 

Citing the lack of building permits, during the reporting period, the Israeli authorities demolished, forced people to demolish, or seized 20 Palestinian-owned structures in Area C and East Jerusalem, displacing 50 and affecting the livelihoods or access to services of over 150 others. Since the start of the pandemic, the Israeli authorities have demolished or seized, or forced people to demolish, at least 415 structures, representing a 56 per cent increase compared with the monthly average between 2017 and 2019 (64 vs. 41); a total of 517 people have been displaced.

Gaza Strip

In Gaza, nearly 1,200 new COVID-19 cases, 500 recoveries and 11 fatalities were recorded in the reporting period, resulting in 1,780 active cases. Gaza city and the Northern Gaza governorate account for about 85 per cent of active cases, almost all of which are attributable to transmission within the community. 

Confirmed cases displaying symptoms are being isolated in the European Hospital and the Turkish Hospital. People who have no or light symptoms, who constitute the vast majority of active cases, are sent to home isolation, or to one of two designated isolation facilities in Khan Younis and Deir al Balah. 

As part of the lockdown imposed since late August, travel between governorates remains largely prohibited and schools, as well as most public facilities, are closed. However, movement in the less affected areas within individual governorates, designated as ‘green’ and ‘yellow’, is allowed between 07:00 and 20:00, while in ‘red’ areas (parts of Gaza city and all of Northern Gaza) a full lockdown remains in place. Additionally, since 18 September, malls in ‘yellow’ and ‘green’ areas reopened, and most shops are allowed to operate three days a week, provided that they abide by the required safety measures. 

On 12 September, the health authorities in Gaza announced new criteria for discharging from isolation patients who have not shown symptoms for long enough (depending on the case), without requiring testing. Additionally, the quarantine period for Palestinians returning to Gaza via the Israeli or Egyptian controlled crossings has been reduced from 21 to 14 days. Humanitarian staff entering Gaza are required to submit to only five days of quarantine, provided they can prove that they have tested negative in the 48-hour period prior to their arrival, and after they have completed the five-day quarantine requirement and have a second negative test.  

The entry of goods continued from Israel through the Kerem Shalom Crossing, which reopened on 1 September following the end to the recent escalation, as did imports from Egypt via the Rafah Crossing. The Erez passenger crossing with Israel was also open for the movement of a small number of exceptional cases (mostly patients), while the Rafah passenger crossing with Egypt remained closed for passengers; the last opening of Rafah was between 11 and 13 August.

Coordination

The Inter-Agency COVID-19 Task Force, led by the Resident/Humanitarian Coordinator (RC/HC), as well as the Inter-Cluster Coordination Group (ICCG), continues to convene on a weekly basis, to set policies and coordinate the implementation of various responses to the crisis.

Since 6 September, the World Health Organization (WHO) is operating a temporary coordination mechanism to support Palestinian patients and companions from Gaza to apply for Israeli exit permits to access essential health services in hospitals in the West Bank and Israel. As of 20 September, 68 permit applications have been submitted, 47 of which were approved, and the remainder were not answered by the time of the medical appointment. Referrals are made according to medical need, as decided by the Palestinian MoH. This temporary measure has been taken to mitigate the impact of the PA halt of coordination with the Israeli authorities, adopted since May.

In the same context, the UN Country Team has continued to operate a Logistics Cluster, led by the World Food Programme (WFP), to support the import of supplies and the receipt of donations needed for the COVID-19 response. Its main task is to mediate between the Customs Directorate in the PA Ministry of Finance and the Israeli authorities (COGAT and the Israeli Customs Office) to ensure the approval of the documentation required to allow the shipment of imported supplies into the oPt, through the various Israeli ports of entry. The cluster is currently processing 85 requests from UN agencies and international NGOs, of which 66 have been approved by both sides. Four requests are still pending PA Customs approval and ten are pending approval by the Israeli authorities. 

The Health Cluster is tracking the procurement and delivery of critical medical supplies by cluster partners against the immediate needs identified in the COVID-19 Inter-Agency Response Plan, and in line with the State of Palestine’s National Response Plan. The table below highlights the availability of the most needed medical items needed.[1] All partners are encouraged to subscribe and submit their requests for procurement of medical supplies for laboratory testing, case management and infection prevention and control through WHO’s global COVID-19 response coordination portal.

Of note, during the reporting period, the Government of Germany donated to the Palestinian MoH 50 ventilators, which are expected to arrive in the coming weeks and enhance the preparedness of hospitals to treat the most severe cases.

As part of the Risk Communication and Community Engagement (RCCE) plan, nearly 40 partners are distributing information on how to prevent the spread of COVID-19 or deal with misinformation. To address the sudden surge in Gaza, the campaign has broadcast radio messages daily on six channels in Gaza; and released an Emergency Media Pack with social media materials, videos, brochures and radio resources to media and NGOs in Gaza, among other measures. RCCE materials are available online.

Supply Category	Medical item	Estimated Response Plan needs (by unit)	Delivered	Pipeline/procured	Current Gap
Case Management	Ventilator, medical, invasive, adult/child	250	54	166	30
	Patient Monitor (vital signs)	250	40	189	21
	Oxygen Concentrator	250	15	159	76
	ICU Hospital Beds	250	-	166	84
	Patient Beds	400	86	264	50
Infection Prevention and Control (IPC)	Surgical Mask	4,000,000	1,460,150	216,550	2,323,300
	N-95 Respirator	300,000	52,748	168,380	78,872
	Surgical gloves	8,000,000	3,934,000	1,633,800	2,432,200
Laboratory Testing	COVID-19 PCR Tests	500,000	38,208	9,600	452,192
	Swabs / Medium, sample collection	500,000	44,500		455,500

Funding

The initial COVID-19 Inter-Agency Response Plan for the oPt, which requested $42.4 million to support an immediate response to the crisis and the efforts led by the Government of Palestine, covered interventions through the end of June. In August, the Plan was extended until the end of 2020 and the financial requirement updated to $72 million.

During the reporting period, an additional contribution of $1 million was received from Germany for the Health Cluster, to support the delivery of services and the procurement of supplies. This brings to $33.6 million the funding raised since the start of the crisis, or 46 per cent of the amount requested in the Response Plan. Including resources contributed outside the Response Plan, a total of $52.5 million have been mobilized in support of COVID-19 response activities in the oPt.

Total funding for COVID-19 response by cluster (in Million US$)

Developments, concerns and funding status by cluster

Health

• While the number of confirmed COVID-19 cases has continued to rise, as the fatality rate remains 0.7 per cent, lower than the global average. More than two-thirds of all the newly reported cases in the West Bank are in the Hebron and Jerusalem governorates. 
• In Gaza, contagion within the community remained of serious concerns, because of the low capacity of the health system. Health cluster partners continue to address key priorities, including to scale-up testing and contact tracing; case management capacity; and risk communication and community engagement. The protection of frontline health workers continues to be prioritized by ensuring enough personal protective equipment (PPE) and the dissemination of knowledge and skills in infection prevention and control (IPC). 
• More than 280,000 people benefited from activities carried out by Health Cluster partners during the reporting period. Partners continue to support the MoH with laboratory testing kits and supplementary equipment to conduct more than 10,000 tests in the Gaza Strip, in addition to some 500 tests using GeneXpert, an alternative and more rapid way of testing for COVID-19. Another 45 frontline health workers benefitted from capacity building in case management and IPC, while five triage kits, intended to support 5,000 patients and 500 healthcare workers, were delivered to the five main hospitals. The local health authorities in Gaza received 5,000 overalls and eight life-saving medical equipment, including ventilators, oxygen concentrators, suction machines and sphygmomanometers. In the West Bank, 15 continuous positive airway pressure (CPAP) machines were delivered to hospitals, while 13,000 N95 masks were distributed amongst suspected COVID-19 cases as part of PPE.

Protection

• Protection Cluster partners continue facing impediments to the delivery of child protection, legal, and mental health and social support (MHPSS) services for vulnerable children, adolescents, and caregivers in restricted areas, particularly those with disabilities. This is primarily due to the restrictions put in place by the Palestinian authorities.
• During the reporting period, cluster partners were able to provide remote and in-person psychosocial support to some 1,100 vulnerable people. Awareness-raising messages related to COVID-19 were disseminated, in line with the RCCE taskforce, to nearly 3,000 people. In Gaza, 27 children received support through specialized case management. 
• In the West Bank, nine cases of rape of women and girls aged 16-35 and 12 cases of attempted suicide among adolescents were recorded by the Sawa helpline (a Protection Cluster partner) in August. This marks an increase compared with July. Another partner held nearly 500 counselling sessions in August and recorded over 105,000 engagements on a social media campaign to raise awareness of the helpline’s counselling service. Another 300 phone consultations, including 100 related to gender-based violence (GBV) were provided during the reporting period, while UNRWA handled over 370 GBV and child protection cases.

Education

• As of 20 September, all children across the West Bank have returned to schools. With the support of the Education Cluster, all schools in the oPt received cleaning and hygiene kits, copies of the safe schools and health protocols, and related training. Since the start of the school year, about 90 schools were either temporarily or fully closed for a period of one to 14 days, following confirmed COVID-19 cases among pupils or school staff. The current situation is poses additional challenges to ensuring face-to-face education. 
• After the MoH diagnosed the first cases of COVID-19 in the community in Gaza, the authorities closed all education facilities. 
• The Education Cluster is working with the Ministry of Education (MoE) and UNRWA to support and coordinate interventions related to distance learning, MHPSS, IPC measures, the provision of hygiene kits, and the rehabilitation of water and sanitation facilities.

Shelter & NFI

• During the reporting period, Shelter Cluster partners distributed over 650 NFI kits, including over 160 COVID‐19 family hygiene kits, to vulnerable households lacking proper hygiene facilities in the Gaza Strip. Another 500 hygiene kits were distributed to people in isolation centres. 
• The Cluster continue to monitor and update the needs of and gaps at the 13 new isolation centres across the West Bank, which are on stand-by to receive people. Approximately 9,000 different NFIs are required, including mattresses, blankets, pillows and dignity kits. Cluster partners will procure the required items in coordination with UNRWA and the PA.

Water, Sanitation and Hygiene

• The WASH Cluster reached over 15,600 people during the reporting period. In the Gaza Strip, four partners delivered nearly 88,000 bottles of water to people in quarantine. In the West Bank, PPE, solid waste management and disinfection materials were provided to 55 health clinics and facilities, and operation and maintenance materials were provided to 19 WASH service providers. 450 households in Area C of the West Bank and the H2 area of Hebron received hygiene kits and WASH items. 
• The ongoing lockdown of the Gaza Strip is delaying or otherwise affecting WASH Cluster partners’ operations and projects, including COVID-19 response. Cluster partners, field staff, and suppliers are facing multiple challenges during their outreach to targeted communities and households, including in needs and technical assessments and in delivering WASH materials and goods, as well as the suspension of construction work in WASH facilities. 
• According to the Palestinian Water Authority, the water demand in Palestinian communities increased by four percentage points compared with the same period last year (from 12 to 16 per cent). The increase is attributed to the measures adopted by households and water providers to tackle the spread of COVID-19.

Food Security

• Emergency food distribution is severely impaired by COVID-19 restrictions, particularly in Gaza, increasing people’s struggles to meet their basic food needs.
• As input price stabilization is reported in the West Bank, agriculture and livelihoods continue to be severely affected in the Gaza Strip. There, farmers are facing difficulties in procuring items; cash is scarce; market-chains are not functioning due to movement restrictions; fishers are facing restrictions; and the construction sector has nearly halted. 
• The Food Security Cluster is providing immediate assistance to facilitate food access for the most vulnerable families. There is an urgent need to provide cash support, specifically to those households who have lost their main source of income. The cluster is emphasizing the importance of buying products directly from farmers as a form of direct assistance.

COVID-19 response funding in the oPt (through and outside the Inter-Agency Response Plan) in US$

Total funding for COVID-19 response by donors

Donors	Through the Response Plan	Outside the Response Plan	Total in US$
Austria		229,564	229,564
Canada	2,215,757		2,215,757
CERF	527,000		527,000
DFID	1,148,789		1,148,789
ECHO	3,720,950	6,491,0001	10,211,950
Education Cannot Wait	555,000	1,550,000	2,105,000
Foreign Disaster Assistance (OFDA)	225,000		225,000
France	1,005,415		1,005,415
Germany	3,512,383		2,512,383
GIZ	530,471	43,000	573,471
Ireland (Irish Aid)	235,200		235,200
Islamic Relief Worldwide	307,800		307,800
Italian Agency for Development Cooperation [AICS]	152,008	10,970	162,978
Japan	878,506		878,506
Kuwait	747,500	8,252,500	9,000,000
Norway	70,000	91,083	161,083
OPT Humanitarian Fund2	6,734,970	347,768	6,990,332
Other sources3	1,461,198	180,155	1,641,353
Private Sector Fundraising	386,786		386,786
Qatar Fund for Development		562,455	562,455
Qatar Red Crescent		410,000	410,000
Save the Children4	326,435		326,435
Start fund	251,000		251,000
Sweden (SIDA)	500,000		500,000
Swiss Agency for Development and Cooperation “SDC”	1,450,000	268,000	1,718,000
UNESCO		150,000	150,000
UNFPA Humanitarian Thematic Fund	332,000		332,000
UNICEF	792,000		792,000
USAID	250,000		250,000
War Child Holland5	252,000	85,000	337,000
WFP (loan)	5,000,000		5,000,000
World Vision International		304,658	304,658
Grand Total	$33,568,167	$18,976,153	$52,544,320
1 Attribution to the Inter-Agency COVID-19 Response Plane under verification. 2 As of today, oPt Humanitarian Fund has received generous contributions from Germany ($13.8m), Belgium ($4.3m), Sweden ($2.1m) Switzerland ($2m), Norway ($0.9m), Iceland ($0.4m), Ireland ($0.3m), Korea ($0.3m), and Cyprus ($12,500). 3 Funding contributions below $150,000 including funding towards and outside Covid-19 Response Plan, received from: Action Aid, AECID, African Women Development Fund, AICS, Cantabria 19, Care International Emergency Fund, Christian Aid&ACPP, Denmark, DRO, EIHDR, Federal Ministry for Economic Cooperation and Development (BMZ), Fridresh Nauman Foundation, Gazze Destek (GDD), Global fund for women, Grass Roots, HEKS, Holland, ICO-UAE, International Charity Organisation, IR – Canada, IR – UK, Italy (IADC), Jerrahi Order of America, Kvinna Till Kvinna, Luxemburg government - ARDI Program, McNulty Foundation, Medico International, Mennonite Central Committee, Mixed funds (German, Italian, Spanish and Dutch), NCA, DCA, NMFA, Norwegian Representative Office to the Palestinian Authority, Nous Cims, NRC, Open Society Foundation, Oxfam, PHG, Private Donors, Rawa Funds, Representative Office of Switzerland in Ramallah, Secours Islamique France, SIDA+DFAT, StartNetwork, Suisse Cooperation, Trocare, UN Trust Fund, UNDP, United Palestinian Appeal, UNWOMEN HQ, Urgent Action Fund, WELFARE (Taawon), WHO, World Vision USA. 4 This includes contributions of Save the Children individual and pooled funds.  5 This includes contributions of War Child Holland and War Child Holland Head Office

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[1] For a more comprehensive list, please contact the Health Cluster Coordination Team: [email protected] and [email protected].