Coronavirus in Lebanon: can the health system cope?

Text by: Eliott Brachet

So far, strict containment measures have helped control the spread of the virus in Lebanon. But hospital staff fear a sudden explosion of contamination. A catastrophic scenario that would shake up a health sector already strained by the major economic crisis in the country.

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According to the latest report from the Ministry of Health, Lebanon recorded 368 cases of contamination including "only" 6 deaths. " The country is not doing too badly compared to others, even if it is impossible to have exact figures ," said Zahi Abdul Sater, researcher at the Global Health Institute at the American University of Beirut. " The containment measures have been fairly well respected and the Lebanese population is young, " he explains. In Lebanon, only 12% of the population is over 60, according to UN figures.

If most of the cases listed are concentrated around Beirut, concern spreads to the rest of the country. In the Bekaa plain, several villages previously untouched by the coronavirus barricade themselves. Residents have set up roadblocks and blocked roads to deny access to outsiders. Lebanon is preparing for an extension of the "general mobilization" and in certain cities of the country, the armed forces have reinforced their patrols to enforce containment.

" State of emergency "

For the moment, the treatment of contaminated patients across Lebanon is operational. 150 Lebanese Red Cross teams are mobilized to provide transfers to hospitals designated by the government. But for two weeks, the services of the Rafic Hariri government hospital have been saturated. The government has therefore asked private hospitals, which represent 82% of the hospital supply in Lebanon, to position themselves in the second line. At the Hôtel Dieu de France, you expect and prepare for the worst. " In the coming weeks, what we fear is that the peak of the epidemic is still only at its beginning and that it is slow to come. And especially that it is very short. That is to say that we were in the situation of having many patients in intensive care without enough beds to accommodate them because of this peak in attendance, ”warns Martine Orio, the director of the hospital.

The resuscitation service is starting to fill up. The healthcare teams are " on alert." There is real staff fatigue. Resuscitation care is heavy. We lack protective equipment for caregivers, ”she continues. To make up for the lack of resources, the hospital calls for Lebanese solidarity via an online kitty. Protective equipment is not produced in Lebanon and its importation is made very difficult because of the economic crisis.

Lack of equipment

80 kilometers from Beirut, in the hospitals of Tripoli, the big city in the north, hospital staff are also on the warpath. Forty cases of coronavirus have been confirmed in the region, but this number is already expected to explode. On the front line, anxious nurses like Amine Al Khatib. “ Every day, almost 150 people come to the hospital to get tested. But honestly, our possibilities are limited. Masks are scarce in the country. We need basic equipment like respirators. But there are only about ten per hospital. Honestly, if the number of cases suddenly explodes like in Italy or in other countries, we will not be able to control the situation, ”worries the 22-year-old Tripolitan.

In addition to the permanent stress, Lebanese nurses are seeing their wages decrease visibly. Prime Minister Hassan Diab on Monday promised measures to protect hospital staff. But in a country in default, the promises ring hollow in the face of an economic crisis which is now coupled with a health crisis. Hospital staff are wondering how the Lebanese state will foot the bill, when the Ministry of Health's budget has been cut by 7% this year. But for now the emergency is elsewhere: we must treat more and more patients.

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