The ‘besieged’ Syrian province at risk of falling to vaccine skepticism

When Covid-19 first began spreading across the globe, fears about outbreaks were especially high in the world’s most conflict-ridden regions.

Idlib was widely viewed as “one of the most vulnerable places in the world for infection”, said The Washington Post. The “impoverished rebel-controlled province in northwestern Syria” is “filled with people displaced by war” and relies on a “perilously underequipped” medical system.

But “Idlib’s borders are largely sealed, and for much of the pandemic, isolation was a virtue, sparing the province from the worst ravages of the outbreak”, the paper added. Then the delivery of Covid vaccines from Britain and China triggered a wave of conspiracy theories that are proving potentially deadly as Idlib is hit by another new arrival – the Delta variant.

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Viral surge

In late September, Idlib reported a surge in infections that took its Covid-19 rate to “the worst levels of the pandemic”, Al Jazeera reported at the time.

The increase was sparked by the arrival of the highly infectious Delta variant and was “a particularly devastating development in a region where dozens of hospitals have been bombed and that doctors and nurses have fled in droves during ten years of war”.

New infections “repeatedly” shot past 1,500 a day in the “overcrowded” rebel-held enclave, which is home to an estimated four million people, the news site added.

Channel 4 News reported that children “starved and weakened after years of war” were especially “susceptible to the virus”. And with just “six hospitals for Covid patients” – equating to “124 intensive care beds” for the entire population – “often it takes a death to free up a space”, said the broadcaster.

Dr Ammar Kisoum, a doctor at Idlib’s Al-Zeraa Hospital, said that “to say the situation is tragic is an understatement, no words can express it”.

“We have 70 beds, all of them are occupied, and there is no space in other hospitals and intensive care wards,” he told Channel 4.

Local man Mohammad Yassin said his mother was “on her last breath”, following his unsuccessful attempts to get her admitted to hospital. “You are asking me why I am shouting and why I am angry, she is dying in my arms,” he said.

His mother was later admitted to a hospital, but only after another patient died.

Oxford University tracking shows that as of the end of October, just 2.7% of the Syrian population had been fully vaccinated against Covid, while a further 1.7% had received one dose.

The low vaccination rate is not down to a shortage of jabs, however.

The Washington Post reported that “large quantities of vaccine doses started arriving in April”, when the “besieged province” received “more than half a million vaccine doses, manufactured by AstraZeneca and Sinovac”.

But the deliveries triggered “conspiracy theories circulated on social media, YouTube and WhatsApp groups” that the vaccines were “either deadly or a tool in nefarious and unspecified foreign plots”, the paper said.

What followed was a “nightmare scenario that public health officials had long warned about”.

‘Death at the doorstep’

Idlib and the surrounding area have reported “78,000 infections since the beginning of the pandemic”, according to The Washington Post. “But 51,000 of them – and half of the more than 1,400 covid-related deaths – have occurred” since 1 August.

Officials fear the “crisis could worsen as winter approaches”, the paper added. And “doubts about Covid vaccines” remain, to the despair of doctors, who have “not seen similar scepticism towards vaccines for other diseases”.

Medecins Sans Frontieres (MSF) warned in mid October that the virus was “fast outpacing limited oxygen supplies” and that “the health system is already unable to cope”.

Just 16 out of 33 Covid-19 treatment centres in northwest Syria were functioning, added the humanitarian organisation, and the only lab able to perform virus testing might “have to halt all testing within weeks” because of a lack of equipment.

MSF’s Syria mission head, Francisco Otero y Villar, said: “We see people in desperate need of oxygen or intensive care stuck in queues because no beds or ventilators are available, which is leading to higher mortality compared with previous waves.”

The past ten days have seen “a slight increase in Idlib’s vaccination rate”, The Washington Post reported yesterday. The “rising death toll may be starting to chip away at the conspiracy theories,” the paper suggested.

But doctors are “struggling against a sense of fatalism that had taken hold in a population that has faced death so many times and in so many ways over the past decade”.

Caroline Masunda, an MSF nurse stationed in Idlib, told the paper that “people think, ‘We will manage without the vaccine.’ Coupled with low mortality, people didn’t take it so seriously.

“Now there is death at the doorstep.”