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An epidemiologist’s view of COVID-19 in Palestine

In a departure from my usual Muzzlewatch focus on efforts to censor BDS and more “pro–Palestinian” and anti-Zionist points of view, I’m putting on my day job hat as a spatial/social epidemiologist to talk about certain aspects of the COVID-19 pandemic as it plays across Palestine and Israel. This will be an ongoing series that will track the effects of the pandemic in Israel/Palestine. Clearly, this worldwide event will have repercussions that are far reaching and very unpredictable.

The first thing to understand is that we are in extremely early days for the pandemic. As of this writing, there are 6,360 cases in Israel, 33 deaths while in Palestine, 155 cases, 1 death. This will increase very rapidly on both sides of the green line. Obviously, the resource drained West Bank and the open air prison Gaza are at terrible risk as has been discussed here at length, but as is obvious, borders are really not something COVID-19 recognizes.

Age pyramid for the West Bank and Gaza Strip
Age pyramid for the West Bank and Gaza Strip

The most important issue has to do with medical care capacity, and Palestine simply does not have the resources to deal with any kind of serious surge in emergency care, intensive care, and follow-up recovery care. At this writing, most of the serious cases and deaths are in older populations, and in this regard the population age pyramid for the West Bank and Gaza may actually be favorable. When compared to the age of Israel’s population we can see that there are far more young in Palestine. At this writing, older people have a far higher risk of serious illness and death compared to younger populations, (although, it does appear that relatively younger adult populations, ages 25-44 are also at risk of hospitalization in the U.S.). On the other hand, although younger people may have mild illness or be asymptomatic, these people still remain infectious. We don’t know exactly what this will mean as the pandemic proceeds.

Age pyramid for Israel
Age pyramid for Israel

The larger issue, however, has to do with the artificial borders and the micro-spatial control of Palestinian movement. Bad enough in “normal” times, the inability for Palestinians to deploy medical resources as needed; to properly organize the population per the requirements of social distancing and rational quarantine; and to properly track and test people, will predictably result in excess serious illness and death, above and beyond what might occur in a less obstructed scenario. If Israel slaps a hard curfew/quarantine on Palestine, similar to what occurred in 2002 during the second Intifada, it will become extremely difficult to respond to the developing pandemic, even to the point of not allowing ambulance/EMT freedom of movement.

A walled-off population, whether the permeable membrane of the West Bank or the prison context of Gaza, will function to make the coronavirus much worse for Palestinians, as well as for Israelis because there will be this massive reservoir of disease that can easily be passed between the contiguous populations. The patchwork nature of the West Bank shows how actual separation will be very difficult to maintain as Palestinians and Israelis essentially live side-by-side. This situation will be made worse by the lack of medical resources available in Palestine. Serious Palestinian illness is often treated in Israel proper and we can easily imagine a situation where a “hard” quarantine makes such healthcare unavailable. In addition, as Israel’s health care system gets overwhelmed, there will be even less capacity for all people across Israel and Palestine.

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https://english.alaraby.co.uk/english/news/2020/4/1/israeli-forces-steal-coronavirus-food-aid-for-palestinians

“Israeli forces steal coronavirus food aid for needy Palestinians, beat aid workers”
The New Arab, April 1, 2020

“Occupying Israeli forces have confiscated food and medical aid trucks being sent to Palestinians under COVID-19 lockdown in occupied East Jerusalem.

“Israeli forces on Tuesday evening withheld a convoy of food aid for Palestinian families in need who have been left without income as a result of the coronavirus pandemic.

“The food truck was delivering aid to families in the southern Jerusalem town of Sur Baher, before it was raided by Israeli forces.

“After stealing the aid, the army distributed the food between themselves and other policemen, a volunteer told The New Arab’s Arabic language service.

“Four of the volunteers were arrested and were beaten by the occupying forces.

“East Jerusalem is in Area C, which means it is under full Israeli administrative and military control.

“Palestinian Jerusalemites have repeatedly complained of Israeli neglect during the coronavirus crisis.

“Because the Palestinian Authority is unable to coordinate, Jerusalemites have launched civilian relief initiatives for those under lockdown.

“Israeli forces regularly confiscate aid meant for Palestinians.

“Last week, Israeli authorities entered a Palestinian village in the northern West Bank to confiscate materials designated to build a clinic to deal coronavirus.

“Officials from the Israeli Civil Administration came to the village of Khirbet Ibziq with a military escort, bulldozer and two trucks equipped with cranes on Thursday morning to demolish community clinic and emergency housing, according to Israeli human rights monitor Btselem.

“According to the group, the officials seized poles and sheeting designated to form eight tents, two for a field clinic, two for a mosque, and four for emergency housing for people evacuated from their homes. A power generator, as well as supplies of sand, cement and cinder blocks to be used for the floor of the tents were also confiscated.

“Ongoing illegal occupation”
“Israel has occupied the West Bank illegally since 1967, and commits various abuses against Palestinian civilians, human rights groups say.

“More than 600,000 Israeli Jews live in settlements in the occupied West Bank and East Jerusalem, in constructions considered illegal under international law.

“The Oslo agreement of 1995 divided the occupied West Bank into three: Area A, Area B and Area C.

“Area A is under the administrative and security control of the Palestinian Authority (PA). Area B’s administration is controlled by the Palestinian Authority, with Israel controlling security. Area C is under full administrative and security control of Israel.

“Israeli forces and settlers routinely harass Palestinians in the occupied territories through harming and killing civilians, demolishing homes, poisoning livestock, vandalising property and other forms of violence.”

The Palestine Liberation Organization, Press Release, April 3, 2020

Dr. Ashrawi: “Israel deliberately undermining Palestinian efforts to combat COVID19 pandemic”

“Israel´s detention of Jerusalem Minister Fadi Hidmi is an outrageous act of willful sabotage of the Palestinian government’s concerted efforts to combat the COVID-19 pandemic in Palestine. He must be released immediately. Instead of focusing its efforts on oppressing Palestinians and preventing the Palestinian government’s efforts to provide Jerusalemites with assistance and needed healthcare to combat the spread of the virus, Israel must honor its obligations as an occupying Power under international law towards the Palestinian population under its illegal control.

“Since the beginning of the outbreak, Israeli occupation authorities have been deliberately derelict of their obligations to carry out vigorous testing of the Palestinian population in and around Jerusalem. This criminally negligent behavior is compounded by Israeli occupation authorities obstructing all Palestinian efforts to disinfect neighborhoods, raise awareness, and provide assistance to families financially affected by the crisis. Repressive Israeli measures have sharply increased, especially those targeting Palestinian neighborhoods and villages in and around Jerusalem, including nightly raids and arbitrary detentions, as well as harassment and detention of volunteers.

“The United Nations Secretary General has called on all countries to silence the guns and focus on collectively saving humanity from this vicious pandemic that is ravaging societies around the globe. However, Israel has taken advantage of this global crisis to entrench its illegal occupation and increase its human rights violations. Israel’s occupation regime and illegal practices are the most dangerous and damaging factors undermining Palestinian efforts to confront the COVID-19 pandemic, threatening the lives of tens of thousands of vulnerable Palestinians in Jerusalem and beyond.

“Combating this pandemic requires global cooperation and solidarity. It also requires vigilance and accountability for human rights violations. We call on all responsible states to stand up to Israeli violations so that we can all focus our energies on saving lives.”

https://www.juancole.com/2020/04/safeguard-palestinian-prisoners.html

“Despite Covid-19 Dangers, Israel ignores Pleas to Safeguard the Health of Palestinian Prisoners (Many Uncharged) in its Jails” Informed Comment, April 3/20 by Ramona Wadi.

“Unsurprisingly, Israel has not heeded requests to safeguard the health of Palestinian prisoners in its jails. Besides recommending ‘precautionary measures’, which are likely to provide no protection in confined spaces, it seems that Israel will persist with its medical neglect strategies, which have resulted in Palestinian prisoners dying. Yet again, there have not been, and nor are there likely to be, any repercussions from the international community.

“The initial appeal by the prisoners has been followed up with a petition launched by the Palestinian Prisoners’ Society asking for international intervention. The petition calls for the release of over 1,000 Palestinian prisoners — the most vulnerable or susceptible to illness — given that Israel routinely disregards the health concerns and conditions of the people it puts behind bars. Two Israeli prison officers have already contracted the coronavirus Covid-19, and a recently released Palestinian prisoner has also tested positive, thus raising concerns about the spread of the virus while Israel, true to its extermination by stealth tactic, does nothing.

“Appealing for urgent humanitarian action is unlikely to prompt UN action against Israel. Bureaucratic statements and recommendations have failed to put an end to Israeli practices such as administrative detention — jailing someone indefinitely with neither charge nor trial — and the abuse of minors in prison; the deprivation of rights, including family visits; and both timely and appropriate medical attention.

“The fear of medical neglect among prisoners is justified. Since 1967, 222 Palestinian prisoners have died after Israel refused treatment for life-threatening illnesses, including cancer. If Israel deprives Palestinians of treatment for illnesses which are not contagious, how will it act when faced with the possibility of a pandemic spreading which has the potential to wipe out the stalwarts of Palestinian resistance to its military occupation?

“On both political and humanitarian grounds, the UN should intervene to safeguard all Palestinian prisoners from the possibility of dying as a direct result of Israel’s withholding of treatment. However, the UN’s agenda is divested of protection for human rights, in particular those in association with colonial violence. The pandemic will not reduce international support for Israel and Palestinians risk becoming collateral damage in a political system which has lost its penchant for statements attesting to the illusion of international protection for human rights. The coronavirus has exposed an international political failure to protect the most vulnerable; Palestinian prisoners, forgotten until a coordinated hunger strike or a death makes headlines, are about to experience the collective intent to ignore a catastrophe in the making.

“Palestinians have been forced into cooperation with the Israeli authorities to halt further contagion. As in other examples where their leaders work with and for Israel, however, the Palestinians are the least likely to reap the benefits, in particular if there is an increase in surveillance on behalf of Israel and the Palestinian Authority.

“As each country focuses on its concerns at home, global solidarity with Palestinians at a crucial moment is at an all-time low. For Palestinian prisoners, the consequences of such international disinterest are heightened. Double standards as regards the sense of urgency which the pandemic is evoking are being applied; Israeli cases of coronavirus are juxtaposed against security when it comes to speaking about Palestinians who have contracted the virus. Palestinian prisoners simply don’t matter as far the pedlars of Israel’s security narrative are concerned, even in the middle of the coronavirus pandemic.”