The arrival of the coronavirus in the Gaza Strip, an impoverished enclave where the health care system has been gutted by years of conflict, and Syria, which has been devastated by nine years of civil war and sanctions, raised fears Sunday that the pandemic may soon prey on some of the most vulnerable populations in the world.
Authorities in Gaza, which has been under an Israeli and Egyptian blockade since the Islamic militant group Hamas seized power from rival Palestinian forces in 2007, confirmed its first two cases overnight, in returnees who had come from Pakistan.
An outbreak could wreak havoc on the Palestinian territory, which is home to over 2 million people, many living in cramped cities and refugee camps.
In Syria, where the civil war is grinding on through its 10th year, Health Minister Nizar Yazigi announced the first confirmed coronavirus case Sunday. The 20-year-old woman came to Syria from a country that has an outbreak of the virus, but Yazigi did not specify which country.
The conflict in Syria has left millions of people internally displaced, and led to rampant poverty and barely functioning medical facilities.
There are similar concerns about a catastrophe if the virus turns up in Libya or Yemen, which are both divided by civil wars that have ruined their healthcare systems. Afghanistan reported its first death on Sunday, a man in his 40s. The war-ravaged country has reported 34 confirmed cases.
The virus causes only minor flu-like symptoms in most people, who recover in a matter of weeks. But it is highly contagious and can cause severe illness or death in some patients, particularly the elderly and those with underlying health problems. Severe cases are often only able to breathe with respirators.
Gaza's isolation due to the blockade likely delayed the arrival of the coronavirus, which has infected more than 300,000 people worldwide and killed more than 13,000. More than 90,000 people have recovered.
Abdelnasser Soboh, director of the World Health Organization's Gaza office, said the territory only has 62 ventilators, with all but 15 already in use. He estimates the territory needs 50 to 100 more to address an outbreak.
With its current capacity, he estimated Gaza's hospitals can handle the first 100 cases if they come in gradually. “If there is a spread to hundreds, this will cause a challenge to the health care system," he said.
Hundreds of Gazans have returned home in the past two weeks, but only 92 people have been examined. More than 1,270 people have been quarantined at hospitals, hotels and schools after crossing into Gaza from Israel and Egypt.
The Health Ministry said the two who tested positive had been isolated at a field hospital upon arrival and did not mingle with others in quarantine.
Several countries in the Middle East have sealed their borders and ordered the closure of nonessential businesses. On Friday, Hamas ordered the closure of wedding halls and weekly street markets, after earlier closing Gaza's schools.
Despite not have announced any cases before, Syria has said it's taking strict measures to limit the spread of the pandemic in government-controlled areas, including closing down all restaurants and cafes and scaling back the work of government ministries.
Backed by Russia, Assad's government has largely won the war militarily, with only one remaining rebel stronghold in the country's northwestern Idlib province.
But Syria has for years been under sanctions by the U.S. and the EU. In the past year, living conditions in Syria have become steadily worse as the Trump administration tightened sanctions, after also re-imposing crushing sanctions on Syria's chief regional ally Iran. Last week, a statement by the Syrian Foreign Ministry called for the immediate lifting of these sanctions to allow countries like Syria and Iran to deal with the outbreak.
In Libya, rival governments have been at war for almost a year, displacing tens of thousands in and around the capital. The dueling governments are each taking measures to prevent an outbreak, suspending public transportation, closing mosques, schools and shops, and imposed a nightly curfew.
Libya has been mired in chaos since the 2011 uprising that toppled and killed Moammar Gadhafi. The North African nation also hosts an estimated 50,000 refugees and migrants from other countries hoping to cross the Mediterranean to Europe. Many are detained in squalid, overcrowded detention centers.
Yemen is also a source of concern. The country is already reeling from five years of civil war as well as cholera outbreaks that have infected more than 2 million people and killed nearly 4,000 since 2016. The World Health Organization has identified only two facilities in the country of 29 million people for quarantine and diagnosis of the coronavirus.
The Houthi rebels — who control the capital, Sanaa, and much of the north — on Sunday banned all gatherings of more than eight people and said 80% of civil servants and public sector employees could work from home.
The worst outbreak in the region is in Iran, where the government has reported more than 21,600 cases and 1,685 deaths.
Ayatollah Ali Khamenei, Iran's supreme leader, on Sunday refused U.S. assistance to fight the new coronavirus, citing an unfounded conspiracy theory that the virus could have been created by Americans.
U.S. sanctions have devastated Iran's economy. But officials there have also come under heavy criticism for not imposing stricter measures early on to curb the spread of the pandemic.
Neighboring Iraq has extended a country-wide curfew until March 28. It has the highest virus death toll in the region after Iran, with 20 fatalities among 233 confirmed cases. The country is still recovering from the costly war against the Islamic State group.
Aji reported from Damascus, Syria and Krauss reported from Jerusalem. Associated Press writers Aya Batrawy and Jon Gambrell in Dubai, United Arab Emirates; Bassem Mroue in Beirut; Samya Kullab in Baghdad; Samy Magdy in Cairo; Mohammed Daraghmeh in Ramallah, West Bank; Omar Akour in Amman, Jordan, and Rahim Faiez in Kabul, Afghanistan contributed.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.