25,068	131,037	1,156	137
Active cases	Cumulative Cases	Fatalities	Patients in ICU

Situation Overview

The reporting period witnessed a continuing rise in COVID-19 cases in the oPt, with over 25,000 additional Palestinians testing positive, according to the Palestinian Ministry of Health (MoH). However, the number of active cases rose only slightly, from 23,336 to 25,068, due to the recovery of some 25,400 people. The cumulative number of cases has now reached 131,037. The number of patients in intensive care units (ICU) surged from 67 to 137, including those requiring mechanical ventilation, from 14 to 39. 

A total of 302 people died, bringing to 1,156 the cumulative number of fatalities due to the virus, 936 in the West Bank, including East Jerusalem, and 220 in the Gaza Strip. On 12 December, 33 deaths were recorded in the oPt, the highest daily toll since the start of the pandemic. The Case Fatality Rate (CFR), the proportion of deaths among confirmed cases, is approximately 0.9 per cent in the oPt, similar to Israel, but lower than Jordan (1.3 per cent), and Egypt (6.7 per cent).

The availability of testing kits remains a major challenge. On 7 December, testing was interrupted in Gaza, until the World Health Organization (WHO) was able to deliver additional testing kits. WHO, which has been a main supplier of testing kits to Gaza, advises that additional resources are needed from the international community to address priority gaps and that further support is required from the Palestinian Authority (PA) to ensure the equitable and timely delivery of essential medical supplies and equipment to Gaza. 

Gaza accounts for 35 per cent of all active cases in the oPt, followed by the governorates of Nablus (16 per cent), Hebron (eight per cent), Jenin (7.6 per cent), Ramallah (7.6 per cent) and the East Jerusalem area (5.8 per cent). The continuing rise in infections has led to new restrictions in both the West Bank and Gaza, as detailed below. 

The World Bank has released its latest report on the economic situation in the oPt.  Although 121,000 Palestinians became unemployed in the second quarter of 2020, some 50,000 of these regained their jobs the third quarter. Overall, 28.8 per cent the labour force was unemployed by the end of the third quarter, with a stark contrast between Gaza, 48.5 per cent, and the West Bank, 18.2 per cent. The poverty rate is estimated to have increased from 24 per cent in 2018 to 27.5 per cent in 2020. Overall “the outlook for the Palestinian economy looks grim, especially after the second wave of the COVID-19 outbreak” with GDP for 2020 expected to contract by about eight per cent. The World Bank predicts a “modest bounce back” in 2021 with growth returning to about 2.5 per cent, with “consumer and business confidence expected to improve on the assumption of vaccine roll out in the second half of 2021.”

Vaccines

WHO and UNICEF are providing technical support to the PA MoH to complete preparatory efforts for the introduction of a COVID-19 vaccine. On 7 December, the PA submitted its application to receive financial support from the global risk-sharing mechanism for the pooled procurement and equitable distribution of COVID-19 vaccines (the Gavi COVAX AMC Facility). This will cover vaccination for at least 20 per cent of the population in the oPt, including frontline health workers, the elderly, and those with underlying health conditions. 

With the support of UNICEF, WHO and UNRWA, work continues across the oPt to finalize an assessment of the cold chain capacity for COVID-19 vaccination and to prepare an application to support the upgrade of the cold chain system. The MoH, with support from partners, is proceeding with the development of the COVID-19 National Deployment and Vaccination Plan, which will outline costed strategies for the deployment, implementation and monitoring of COVID-19 vaccines in the oPt, including transportation and storage, training of health staff and communication outreach. More details are available at the COVAX Facility website.

West Bank

The number of active cases in the West Bank, including East Jerusalem, increased by some 30 per cent in the reporting period (from 13,336 to 17,217). Nablus governorate again witnessed the largest increase, accounting for the largest proportion of active cases (4,096) after Gaza. Significant increases were also recorded in the Hebron, Jenin and Ramallah governorates. Five villages in Jenin (Maythalun, Jaba’, Silat al Harithiya, Al Yamun and Deir Ghazaleh) are under a four-day lockdown until 17 December, while two schools in Haris, Salfit and Jayyus, Qalqiliya are under a 14-day closure.  

In response to the rise in cases, on 7 December, Palestinian Prime Minister Shtayyeh announced a complete closure of the Bethlehem, Hebron, Nablus and Tulkarm governorates from 10 to 17 December. The night curfew from 19:00 to 06:00, already in place since 29 November, as well as the weekend lockdown, from Thursday 19:00 to Sunday 06:00, continues in all governorates until 17 December. All retail and service stores in the designated areas and times are closed except for pharmacies, bakeries, supermarkets and grocery stores, and teaching is being conducted remotely. Travel between governorates is prohibited, except for the transportation of agricultural, service and food products. All government, civil and private institutions are operating at a reduced capacity of a maximum 30 per cent. 

In Hebron, several protests against the lockdown were held. A large demonstration on 11 December evolved into clashes with Palestinian Security Forces and resulted in several injuries on both sides.

Following the surge in cases in both the West Bank and Israel, the Israeli authorities announced that, as of 10 December, Palestinian workers will be required, on a random basis, to undergo testing at the checkpoints controlling access to Israel. Those who refuse will be prohibited from entering Israel. So far, there are no reports of these tests being implemented. 

Citing the lack of building permits, during the reporting period, the Israeli authorities demolished, seized, or forced people to demolish at least 21 Palestinian-owned structures in the West Bank, including East Jerusalem, displacing 28 people, including 17 children. More than half of the targeted structures were seized without prior notice, a practice that has been on the rise recently. This practice does not require the authorities to provide prior notice about their intention to seize a property, thus preventing affected people from objecting in advance. The targeting of structures amidst the ongoing COVID-19 pandemic remains of serious concern, with the vulnerability of people affected further compounded by the onset of winter.

Gaza Strip

In Gaza, nearly 8,000 new COVID-19 cases were recorded in the reporting period. The number of active cases declined by some 11 per cent (from 10,000 to 8,851), while the cumulative caseload since the start of the pandemic exceeded 30,000. One hundred and two people died, bringing the overall death toll to 220. 

The decline in the number of active cases is attributed to a 36-hour suspension in testing around 7 December (see above) and to new the testing criteria in operation since 1 December. Although testing for people displaying COVID-19 type symptoms continues, those who have been in contact with confirmed positive cases are only tested if they are above 50 years of age, and younger people only if they have known underlying health conditions. 

The severity of cases is also rising, increasing demand for more specialized care. The overall occupancy rate of dedicated COVID-19 hospital beds is 70 per cent, with 364 of 520 beds occupied. Of the 70 ICU beds, 48 or 62 per cent are occupied, including 46 patients on ventilators.

Of the active COVID-19 cases, approximately 1,500 persons are currently being isolated in the two designated hospitals and in the eight designated isolation facilities. Another 7,200 people are in home isolation, in addition, some 25,600 people are in home quarantine. 

As part of new movement restrictions imposed by the local authorities to slow the spread of the disease, a weekend curfew from 18:30 Thursday to 07:00 Sunday is in place from 11 December until the end of the month. Schools, except for Grade 12, universities, mosques, markets are closed and all public funerals and weddings are prohibited. The authorities have also designated 68 out of the 96 geographic areas in Gaza as ‘red’, where no movement is allowed.

On 6 December, the MoH announced that it has resumed non-urgent services through primary health care centres and NGOs. However, on 10 December, the authorities again suspended all non-urgent services, and clarified that that during curfew periods only emergency services (urgent surgeries and deliveries) will be provided, including in NGO and private health institutions. With funding from Germany, the MoH in Gaza is hiring 213 health professionals to support the COVID-19 response. 

Since November, people entering Gaza through the Rafah or Erez crossings, including international staff/foreign delegations, are not required to undergo home quarantine, if they can present a negative PCR test result taken within 48 hours prior to entry. Those unable to present the test result on arrival can be tested at the border, but they are required to undergo home quarantine until the results are issued. 

The Rafah Crossing remains closed for pedestrian traffic. The entry of goods continued from Israel through the Kerem Shalom Crossing, as did imports from Egypt via the Rafah Crossing. The Erez passenger crossing with Israel was also open for the exit of a small number of exceptional cases, mostly medical patients. The number of Palestinians entering Gaza through Erez has been relatively consistent, at approximately 250 people per week. 

For an interactive map of isolation and quarantine facilities in Gaza see OCHA’S WEBSITE.

Coordination

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

During the reporting period, the RC/HC’s Access and Coordination Unit (ACU) facilitated the movement between East Jerusalem and the remainder of the West Bank for 161 UN, international NGO and diplomatic staff, in addition to five trucks with medical, education and other vital equipment. The ACU also facilitated the entry into Israel of two international NGO staff. Due to the tightening of restrictions in the Gaza Strip, the ACU coordinated 22 critical UN missions with the authorities, in addition to a total of 24 UN and Diplomatic missions into and out of Gaza. 

The Logistics Cluster, led by the World Food Programme (WFP) has stopped facilitating the processing of humanitarian shipment requests, in light of the resumption of coordination between the PA and Israel. The cluster will continue providing information management services to other UN agencies and international NGOs, and identify critical gaps in services or bottlenecks in the supply chain that need to be addressed.

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, in line with the State of Palestine’s National Response Plan. The table below highlights the availability and gaps regarding the top ten 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.

The Risk Communication and Community Engagement (RCCE) campaign continues to target media outlets and governorates in COVID-19 hotspots to encourage people to follow protective measures. Messaging focused on supporting the Elimination of Violence against Women during COVID-19, preventative measures for children supporting World Children’s Day, and encouraging people to make wearing masks socially acceptable. 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	95	125	30
	Patient Monitor (vital signs)	250	70	174	6
	Oxygen Concentrator	250	40	134	76
	ICU Hospital Beds	250	37	129	84
	Patient Beds	400	86	264	50
Infection Prevention and Control (IPC)	Surgical Mask	4,000,000	1,555,750	829,050	1,590,200
	N-95 Respirator	300,000	297,148	68,380	(65,528)
	Surgical gloves	8,000,000	5,408,323	1,563,800	1,027,877
Laboratory Testing	COVID-19 PCR Tests	500,000	146,592	9,600	343,808
	Swabs / Medium, sample collection	500,000	211,500		288,500

Funding

Following several updates since its initial inception in April 2020, the overall funding requirements for the implementation of the COVID-19 Inter-Agency Response Plan for the oPt until the end of 2020 stands at nearly US$78 million.

During the reporting period, the Government of Italy has provided $488,000 towards the activities of the Health Cluster. This brings the cumulative amount raised as part of the Response Plan to $45.5 million, or 58 per cent of the requirement. Including resources outside the Plan, $64.5 million have been mobilized in support of COVID-19 response.

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

Developments, concerns and funding status by cluster

Health

• With support from Health Cluster partners, the MoH is developing a COVID-19 Vaccination Plan, outlining costed strategies for the deployment, implementation and monitoring of the vaccination process in the oPt. As part of the plan, the MoH is finalizing an assessment of the cold chain capacity for COVID-19 vaccines across the oPt and preparing an appeal for financial support to upgrade the current capacity.
• Health Cluster partners delivered critical COVID-19 medical equipment and supplies to multiple facilities across the oPt. Partners procured and delivered supplies for the conduct of over 18,000 tests (all in the Gaza Strip), 15 ventilators, 20 oxygen concentrators, five patient monitors, pharmaceuticals, disposables and laboratory items to support the management of COVID-19 patients in severe and critical condition. 
• More than 38,000 people benefitted from interventions by Health Cluster partners supporting essential health services. The interventions included support for the provision of elective surgeries, cancer treatment, primary health care consultations, mother and child healthcare interventions and remote Mental Health and Psychosocial Support Services (MHPSS) and Gender-Based Violence (GBV) counselling sessions.

Protection

• The lockdown across the oPt has disrupted efforts by GBV service providers to reach women and girls in need. The closure of schools and the related presence of children at home have resulted in the reduced participation of women and girls in remote GBV counselling sessions.
• In Gaza, cluster partners have reported incidents of stigmatization and bullying of people confirmed or suspected of having COVID-19. This resulted in a tendency among affected people not to seek support or services, including protection and MHPSS.
• In November, a cluster partner operating a MHPSS helpline (SAWA) recorded 22 calls reporting suicide intentions across the oPt, with 75 per cent of calls coming from Gaza. During the month, 779 counselling sessions were provided by Protection and MHPSS partners, compared with 559 in October.

Education

• Following the surge in COVID-19 cases, all education facilities in the Gaza Strip and in four West Bank governorates (Hebron, Bethlehem, Nablus and Tulkarm) have been closed until further notice. The closure in the Gaza Strip started on 5 December, except for Grade 12 students, and on 12 December in the West Bank. 
• Since the start of the academic year, more than 220 schools across the oPt were either temporarily or fully closed from one to 14 days, following confirmed COVID-19 cases among pupils or school staff, or due to their being located in ‘red areas’. With the support of Education Cluster partners, all schools across the oPt have received cleaning and hygiene kits, copies of the safe schools and health protocols, and training for children and staff.  
• The Education Cluster is working with the MoE and UNRWA to support the delivery of distance learning, MHPSS, Infection Prevention and Control (IPC) measures and the provision of hygiene kits and rehabilitation of Water, Sanitation and Hygiene (WASH) facilities.

Shelter & NFI

• In the Gaza Strip, Shelter Cluster partners provided Non-Food items (NFIs) to all active quarantine/isolation facilities. These included bedding sets, individual hygiene kits and dignity kits. 
• In the Gaza Strip, Shelter Cluster partners supported over 700 vulnerable households (4,000 people) in home quarantine, with COVID-19 hygiene kits. 
• In the West Bank, Cluster partners continue supporting families suffering from overcrowding, unhygienic or otherwise inadequate living conditions, particularly in Area C, and stand ready to support quarantine centres.

Water, Sanitation and Hygiene

• During the reporting period, WASH Cluster partners reached around 3,400 people across the oPt. In the Gaza Strip, this included the delivery of 11,500 bottles of water to 1,700 people in isolation centres, in addition to hygiene kits for 300 families in home isolation. 
• In coordination with the MoH, WASH Cluster partners developed a specialized training programme about the management of infectious solid waste in healthcare facilities. Healthcare workers at 18 facilities in the Hebron governorate have so far participated the training programme.
• A recent survey in Gaza indicated that some 36 per cent of people in home isolation have limited access to basic WASH materials to apply the required COVID-19 mitigation measures. In addition, 15 per cent of the assessed families have limited access to sufficient drinking water. WASH Cluster partners are taking measures to cover these gaps.

Food Security

• The provision of food assistance in the Gaza Strip continues, with over 1,500 daily meals distributed to 25 quarantine and isolation centres. So far, more than 46,100 meals have been provided.  
• As a direct result of increased movement restrictions across both the West Bank and Gaza during the reporting period, poultry prices decreased to NIS 7.5 per kilogramme, while no significant changes were recorded for other meat items or for vegetables. Food Cluster partners will conduct follow up activities in the coming period.

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	1,423,772		1,423,772
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	4,878,042	43,000	4,921,042
Ireland (Irish Aid)	235,200		235,200
Islamic Relief Worldwide	307,800		307,800
Italian Agency for Development Cooperation [AICS]	640,008	65,970	705,978
Japan	878,506		878,506
Kuwait	747,500	8,252,500	9,000,000
Norway	70,000	91,083	161,083
OPT Humanitarian Fund2	16,125,930	347,768	16,473,698
Other sources3	1,558,588	283,955	1,842,543
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
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
	834,000		834,000
World Vision International		304,658	304,658
Grand Total	$45,488,688	$18,984,953	$64,473,641
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), Switzerland ($4.2m), Sweden ($3.2m), Finland ($1.2m), Norway ($0.9m), Spain ($0.7m), Italy ($0.6m), Iceland ($0.4m), Ireland ($0.3m), Korea ($0.3m), Cyprus ($12,500), United Nations Foundation ($3,461). 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, Ana-GEGHT, 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

For more information including a detailed list of activities by cluster in both Gaza and the West Bank and for detailed maps of the Quarantine Centres please visit the COVID 19 Webpage found on the OCHA Website.  Please go to the OCHA Website: 

OCHA COVID-19 DEDICATED WEBPAGE

DETAILED LIST OF ACTIVITIES BY CLUSTER

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