Highlights:

• As of 31 July 2020, there are 3,691 confirmed cases and 74 COVID-related deaths nationally with significant increases in Tripoli, Sebha and Misrata.

• Socioeconomic impacts of COVID-19 continue to affect people’s food security and livelihoods, exacerbated by electricity and water cuts.

• More than 243,000 people have been reached with humanitarian assistance through the HRP since the beginning of 2020.

• Humanitarian access remains a persistent challenge across the country, compounded by COVID-19 restriction measures.

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Cases of COVID-19 on the Rise

COVID-19 cases in Libya continued to significantly increase in July, with 2,867 new cases recorded, representing an increase of 348 per cent since June. The lack of adequate testing across the country indicates that reported cases are a glimpse at the overall rate of infection. As of 31 July, the National Centre for Disease Control (NCDC) reported 3,691 confirmed cases and 74 COVID-related deaths. Municipalities with the highest number of confirmed cases are Sebha (793), Tripoli (985), Misrata (699) and Zliten (235). While the highest proportion of cases are in the West (63 per cent), the South remains a hotspot, representing 33 per cent of confirmed cases, while only representing eight per cent of the country’s population.

The Libyan authorities have outlined the top challenges in combatting COVID-19 as the fragmentation of health sector institutions, poor governance, extreme shortages of medical supplies and health care workers, ongoing insecurity and shortages of allocated funding. Furthermore, the continued closure of more than 50 per cent of healthcare facilities, particularly in rural areas, has further reduced people’s access to health services, either in relation to COVID-19 or for other medical assistance.

There are a total of 64 health facilities, with a combined capacity of 800 beds, engaged in the COVID-19 response. However, many of these facilities require additional staff. There are 15 functional labs across eight municipalities (Al-Jufra, Benghazi, Gharyan, Misrata, Sebha, Tripoli, Zawia, Zliten), although the majority of tests are still conducted in Tripoli and Benghazi, but are increasing in Misrata and Sebha.

The South remains a significant concern, particularly Sebha, where cases continue to increase rapidly. Limited health resources have been further stretched, with many health care staff testing positive for COVID-19, mainly due to poor infection prevention and control (IPC) practices in health facilities. Most patients are self-isolating at home, but compliance is poor and compounded by weak coordination among local health authorities. In addition, some members of communities in the South are refusing to be tested due to fears of contracting the disease. Only the Sebha Medical Centre has the capacity to treat patients, but it has acute shortages of staff, with many health workers refusing to report for duty because of fears of contracting the virus and insufficient personal protective equipment.

While health Rapid Response Teams (RRTs) have been deployed to the region, they lack logistic support and the region suffers from a lack of equipment and supplies for testing, which contributes to delays in the detection of cases. In response to severe shortages of swabs for testing, health authorities in Tripoli have sent a further shipment of 20,000 swabs to Sebha in July and WHO continued to advocate with national health authorities to send available stocks to cover gaps until new supplies arrive. WHO is also finalising an agreement with the Ministry of Health to deploy WHO-supported COVID-19 mobile teams to rural areas to support testing, tracing and patient referrals, and humanitarian organizations continued to support training for health workers in case management and IPC.

Targeted risk communication and community engagement for COVID-19 continued to be scaled up. A recent update on COVID-19 mobility tracking by IOM’s Displacement Tracking Matrix (DTM) demonstrates that 94 per cent of assessed municipalities’ key informants reported that at least some level of local awareness campaigns against the spread of COVID19 were being undertaken. However, these activities remained a priority for health authorities and humanitarian organizations given recent rates of transmission. This included meeting with NCDC representatives to review optimal ways of disseminating health promotion materials through TV, radio and other channels, and how to improve community engagement in risk communication activities.

Containing the pandemic, particularly in the South, is complicated by sub-standard living conditions of many people, lack of access to basic health and WASH services, either due to insecurity or years of neglect in public service infrastructure and delivery. Fuel shortages and daily electricity cuts of more than 18 hours also affected the functioning of health facilities, as well as affecting water supplies. Furthermore, insecurity typified by armed robberies and tribal clashes in the South have been increasing, further impacting people’s ability to access services and medical assistance.