Lakhasly

Palestinian territories are located on the eastern coast of the Mediterranean Sea. The remaining area from Palestine is divided into two geographically distinct regional units, the West Bank (WB) and the Gaza Strip (GS), while East-Jerusalem (EJ) and areas classified as “C” are under the control of Israel. According to the Palestinian Central Bureau of Statistics, the total population in 2017 was about five million, among them two million throughout the last 14 years locked in the Gaza Strip (GS). With its 365 km2, the GS is one of the most densely populated areas in the world (5,324 people per square kilometer) to be 10-fold higher than the WB population density (1). In one of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) camps, population density reaches over 80,000 per square kilometer (2).

Palestinians are facing the pandemic while they are the only occupied country in the world and have no control for the health of the Palestinians in EJ. Such catastrophic situations created a variety in the spread of the COVID-19 pandemic in the different territories. In this study, we tried to demonstrate the fight of the Palestinians to ensure control of the pandemic under challenging circumstances.

In December 2019, a respiratory coronavirus emerged from a large metropolitan area in China's Hubei province, Wuhan. Most cases present with fever, dry cough, and tiredness, although clinical presentation ranges from asymptomatic to atypical severe pneumonia (3). By March 11, 2020, the WHO declared the COVID-19 pandemic (4). Preventive measures are the only solution to save lives and provide the countries with more time to prepare for the arrival of the virus (5). However, within a short time, the disease spread to include most of the countries in the world. In Palestine, the first case was reported in Bethlehem city in the WB on March 6, 2020. The effort focused on the complete isolation of the town and the closure of markets, schools, universities, mosques, churches, and a ban of major social gatherings. In Gaza, the first two cases appeared 3 weeks later than in the WB (March 26, 2020), which allowed time to prepare the same regulations.

This study aimed to explore the variation in COVID-19 spread, risk factors, and intervention activities in the three Palestinian territories: West Bank, East-Jerusalem, and Gaza Strip to learn from current gaps, to overcome the current pandemic, and face future emergencies.