On May 17, 2021, Israeli airstrikes damaged the main Covid-19 testing center in Gaza City, in the occupied Gaza Strip. The Middle East Eye reported that four people were injured in the attack, including one doctor from the Palestinian Ministry of Health. According to reports, this airstrike hit a residential building and caused extensive damage to other buildings including an orphanage, a high school, and the Palestinian Ministry of Health offices.
Ashraf Al-Qidra, the spokesman for the Health Ministry, said in 2021 that the strikes “threaten to undermine the efforts of the health ministry in the face of the Covid pandemic.” According to Business Insider, the May attack caused the center to stop administering tests at a time when there was a high positivity rate and a low vaccination rate in Gaza. And just days before, a separate Israeli airstrike killed Dr. Ayman Abu al-Ouf, one of the leading doctors who oversaw the response to the coronavirus pandemic at Al-Shifa Hospital, alongside 12 members of his family.
Now, two and half years later, Gaza faces severe healthcare collapse after more than 20,000 civilians have been killed by Israeli forces since October 7, 70% of them women and children. As many as 50,000 other civilians have been injured, disabled, and face health risks due to supply blockades and destroyed infrastructure in the territory in widespread attacks that historical scholars are calling a potential genocide.
As the Covid-19 pandemic still surges around the world, it is almost impossible to track in Gaza due to a lack of testing resources, attacks on healthcare facilities, and hundreds of murders of healthcare workers. The coronavirus adds long-term health consequences to the more immediate, more urgent injuries from bombings, shootings, bulldozers, waterborne diseases, and starvation, the latter of which the Human Rights Watch says is being used as a weapon of war by Israel.
One sign of Covid-19’s continued minimization as a health threat in Gaza is that the disease has been largely ignored by Western media’s coverage. The Sick Times analyzed coverage of Gaza in The New York Times, The Washington Post, and The Wall Street Journal from December 10 to December 18 and did not find any mention of “Covid-19” or “coronavirus.” Without acknowledgment of this threat, along with the more immediate health challenges exacerbated by the humanitarian crisis in Gaza, it will be harder to hold Israel accountable for later death and disability.
Healthcare infrastructure destruction
Since October 7, Israeli airstrikes have targeted 124 health facilities in Gaza, according to the human rights group Euro-Med Monitor. These strikes have included 22 hospitals, 55 clinics, and 46 ambulances, by the group’s count. Out of 24 hospitals that operated in the territory before the aggression, only four are now functioning, per the World Health Organization (WHO): Al-Shifa Hospital is “partially functional” and three other facilities are “minimally functional.”
Staff at Al-Shifa Hospital are working under “unbelievably challenging circumstances,” according to WHO staff who visited the facility during an aid mission on December 16. The hospital’s emergency department is a “bloodbath,” the WHO team said, with patients arriving regularly to find only basic trauma care available thanks to limited supplies, staff, and space.
In addition to the injuries from bombings, Gaza residents have crowded into the remaining hospitals and other public spaces — creating ideal conditions for illness to spread. The Palestinian Ministry of Health reports more than 130,000 upper respiratory tract infections in Gaza as of December 13. “[They] could easily be #COVID,” doctor Osaid Alser recently posted on Twitter, “but with the lack of testing kits no one knows.”
“We’re seeing significant increases in infectious diseases, including diarrhea, acute respiratory infections, skin infections, and outbreaks like hepatitis,” said aid group Doctors Without Borders in a statement to The Sick Times. “With dwindling supplies of safe food, clean water, and health services, and without adequate shelter, children and adults, including the elderly and people with disabilities, are living in deplorable conditions, and are at heightened risk of disease.”
Alice Rothchild, a member of the Jewish Voice for Peace (JVP) Health Advisory Council, spoke with The Sick Times over the phone. She writes frequent health updates for JVP and has tracked the coverage of Covid-19 in Palestine and Israel over the course of the pandemic. Recently, she has seen “zero” coverage of Covid-19 in Gaza as the healthcare system has been completely overwhelmed, she said. The healthcare system “took a big hit from Covid and now it’s being bombed into smithereens.”
As Israeli forces continue to target the healthcare system, and facilities become even more overwhelmed by injured civilians, disease spread, malnutrition, and more, it will make it even more difficult to recognize Covid. “That doesn’t mean it’s not happening,” Rothchild said, “And it doesn’t mean the conditions aren’t ripe for it to happen, but it’s not going to be noticed or treated.” Distinguishing upper respiratory infections from one another right now would be difficult, Rothchild said.
These added stressors may also lead to worse health outcomes later on, said Abdullah Shihipar, a writer and health researcher at Brown University. Due to health disparities, “people who already have a greater burden of disease are generally more impacted by Covid and other infectious diseases,” he said. For people who are infected by any disease, the blockade on Gaza contributes to a greater lack of nutrition in Gaza, which can lead to a more severe disease prognosis, he said.
“When you’re fighting an infectious disease,” Shihipar said, “you need even more calories, you need even more water. People in Gaza, they don’t have that. They’re drinking contaminated water.”
Lack of acknowledgment, long-term harm
While Covid-19 is not the most immediate threat to life in Gaza, the disease can amplify harm from other health issues, such as injuries from Israeli airstrikes and shootings, malnutrition, and untreated chronic conditions. But media coverage of the humanitarian crisis has failed to acknowledge the ongoing pandemic and, in turn, minimizes the scope of the violence.
To evaluate Western media’s coverage of the crisis, The Sick Times scraped articles from one week of reporting at three major U.S. newspapers: The New York Times, The Washington Post, and The Wall Street Journal. Our analysis included articles in each paper’s Middle East section from December 10 through December 18, totaling 70 articles from the Times, 49 from the Post, and 26 from the Journal.
Not a single article published in this timeframe mentioned the threat of Covid-19 in Gaza. Even articles that discussed the broader disease threat in the territory, such as this article on December 11 from the Times and this one on December 17 in the Post, fail to discuss SARS-CoV-2 as a virus that may compound the harms of other health problems.
Undiagnosed coronavirus infections during the current humanitarian crisis will likely add to the disease burdens of some Gazans with injuries and chronic conditions while leading to Long Covid for others. One study of Long Covid in Palestine, published in Scientific Reports in March 2023, found that about 42% of confirmed Covid-19 patients followed from a hospital in the West Bank city of Nablus had symptoms for up to three months. Such studies are impossible in Gaza right now, but long-term symptom rates may be similar in the future — not to mention infection-associated chronic conditions from other diseases or exposure to toxins like asbestos from the rubble.
Covid-19 also adds to the burden of accessing healthcare in Gaza, which is incredibly difficult even during ceasefires. Danya Qato, an epidemiologist and health services researcher who has studied health in Palestine, described the challenges on a 2022 episode of the Death Panel podcast: “People in Gaza who need advanced, for example, oncologic care, are denied permits to leave Gaza. And even when their medical permits are approved to leave Gaza to seek care… their companions aren’t approved to leave with them.” Gazans are isolated, denied both access to care and access to supplies, such as Covid-19 tests, that make it possible to identify illness, she said.
The coronavirus is just one of many health risks leading to fatal and long-term consequences for Gazans. But without acknowledging these risks, the true toll of death and disability from Israel’s violence and blockades will be difficult to grasp. As Nerdeen Kiswani, an activist with the New York City-based Palestinian group Within Our Lifetime, said at a rally on December 16: “When you hear that 20,000 Palestinians died, that doesn’t even scratch the surface.”
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