COVID-19 spreads across the country, overwhelming the health system
Following the confirmation of the first COVID-19 case in Libya on 24 March, the country has seen a steep increase in the number of confirmed cases. At the end of year, Libya had recorded 100,746 confirmed cases of COVID-19 and 1,487 deaths, according to the National Centre for Disease Control (NCDC). Every mantika (province) has reported confirmed cases, with Tripoli, Misrata and Jabal al Gharbi municipalities reporting the largest number of confirmed cases with Sebha and Benghazi reporting lower numbers of confirmed cases, although that is largely due to the lower number of tests conducted in those cities due to a lack of supplies.
An acute shortage of testing kits and cartridges, adequate health facilities to isolate and treat confirmed cases and a limited ability to conduct contact tracing has further obscured the full scale. According to testing, by the end of the year, Libya had 1,479 confirmed cases of COVID-19 per 100,000 population, which was the highest in the North African region, with 22 deaths per 100,000 population, second only to Tunisia in the region.
To prevent the spread of COVID-19, national and local authorities introduced a series of preventive measures, including curfews, the temporary closure of all air, land and sea borders, restrictions on movement between municipalities, suspension of large gatherings and the closure of schools.
The capacity of the health system to effectively respond to the pandemic was negatively affected by more than nine years of conflict. Of the remaining health facilities open in 2019, half were closed in 2020, especially in rural areas, mainly due to security threats and insufficient government funding. Health facilities that remained open did not have enough supplies, equipment or human resources to care for COVID-19 patients while also maintaining routine health services. Many healthcare staff refused to report for duty because they had no personal protective equipment or because salaries had not been paid. Many hospitals across the country regularly suspended operations due to high rates of COVID-19 infection among staff and patients or due to a lack of supplies, or electricity.
The UN and humanitarian partners scaled up to support the authorities in responding to COVID-19 by supporting increased capacity for lab testing, contact tracing and case treatment through deployment of emergency medical teams, as well as training health Rapid Response Teams. Partners continued to provide essential COVID-19 supplies, including testing kits and personal protective equipment, as well as capacity-building and training of health staff. This includes technical support and recommendations on strengthening case management by mapping isolation centres, updating and disseminating COVID-19 guidelines, supporting triage centres/isolation centers and emergency mobile teams, and establishing COVID-19 treatment units in public hospitals in addition to isolation centres. Partners also supported with sterilization, fumigation and disinfection at displacement sites, migrant detention centres, hospitals and schools, as well as at disembarkation and border points. Hygiene kits were also provided to vulnerable and low-income households.
There was a significant scaling up of risk education and community awareness raising, including support of national and regional campaigns. The UN and partners disseminated more than 300,000 posters and other communication means, including social and mass media reaching about 4.8 million people. COVID-19 risk communication activities also targeted specific vulnerable groups and at-risk locations, such as displaced people in collective shelters, migrants in official detention centres, health facilities, points of entry and disembarkation points, as well as healthcare staff and personnel working in such locations.