An epidemiologist’s view of COVID-19 in Palestine

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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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