Lebanon’s COVID-19 surge: What went wrong?

Beirut, Lebanon – For more than two months, Lebanon has been sliding into a worsening coronavirus outbreak that is now threatening to overwhelm the country’s fragile healthcare system. More than half of the country’s 48,377 cases and 433 deaths occurred in the past month alone, according to a tally by Johns Hopkins University. On Thursday, Lebanon recorded 1,459 COVID-19 cases – its highest daily total to date. For the first few months of the outbreak, crisis-hit Lebanon introduced a total lockdown that kept daily cases in the single or low double-digits. But health policy experts say the absence of a long-term strategy and poor implementation of the country’s post-lockdown reopening are largely to blame for the sharp recent increase in cases. Firas Abiad, the director of the country’s prime coronavirus treatment facility, Beirut’s Rafik Hariri University Hospital (RHUH), told Al Jazeera while the country had initially imposed a lockdown effectively, it had struggled since. “What we don’t know how to do is ease a lockdown, to give subsidies and incentives to people and businesses,” Abiad said. As the number of new cases spike, deep mistrust of the government, coupled with poor communication and sometimes-contradictory policies, mean new measures have often been resisted and flouted. Experts say Lebanon now has to move decisively to contain an outbreak that could bring more misery to a population that this year has already suffered the effects of an economic collapse and the huge port explosion on August 4, which left some 200 people dead, 6,500 wounded and 300,000 homeless. There will be no quick fix anytime soon. Assem Araji, the head of Parliament’s health committee, told Al Jazeera he expected a COVID-19 vaccine would arrive in Lebanon by mid-2021 at the earliest, even if production abroad begins at the end of this year. From lockdown to uptick When Lebanon recorded its first cases in late February, the country quickly moved towards lockdown. There was big public buy-in from a population that feared their politicians would mismanage this crisis just as they had done with so many others in the country. Lebanon in the past year has been sucked into a maelstrom of economic and political turmoil that has left more than 50 percent of the population below the poverty line while the country’s notoriously fractious politicians have resisted implementing much-needed reforms. But by April, cracks had begun to show. Scattered protests took place as the government fumbled the provision of meagre aid to the families most in need during the lockdown. “We want to eat, we want to live,” was a popular chant. The provision of aid was so delayed its dollar-value was sliced almost in half between the time it was announced and the time it began being distributed, as the currency depreciated. Cases were frequently in the double digits by May. By mid-June, Lebanon had completed a staggered reopening process and in early July, the airport reopened. Confirmed cases quickly began regularly exceeding 100 a day by mid-July as quarantine regulations were ignored. “While testing capacity expanded in this time period and initial response, one might argue there were little other protective measures in place once the phased approach was complete,” Sara Chang, a Beirut-based public health consultant told Al Jazeera. “The number of daily domestic cases continues to rise. This is due in part to the multiple crises faced by residents of Lebanon, who have already been dealing with a financial crisis, political instability, and fallout from the Beirut explosion for months on end,” she said. style="width: 100%; height: 100%; position: absolute; top: 0; bottom: 0; right: 0; left: 0;">