The impact of armed conflict on the epidemiological situation of Coronavirus disease (COVID-19) in Libya, Syria, and Yemen

Abstract

Background: Since the Arab uprising 2011, Libya, Syria, and Yemen have gone through a major armed conflict. This resulted in a high rate of mortality, injury, and population displacement with a collapse of the health care system. Furthermore, it was complicated by the emergence of, COVID-19 as a global pandemic which made the population of these countries strive under unusual conditions to tackle both the pandemic and the ongoing wars. The objectives of this study were to determine the impacts and influence of armed conflicts on the epidemiology of Novel Coronavirus (SARS-CoV-2) within these war-torn countries and outline the needed strategies to combat the spread of the pandemic and its upcoming consequences. Methods: The official and public data regarding the dynamics of armed conflict and the spread, of SARS-COV-19 in Libya, Syria, and Yemen were collected from all available sources. Starting from the early emergence of the COVID-19 in each country until the end of December 2020. Datasets were analyzed through a set of statistical techniques and the weekly resolved data were used to probe the link between the intensity levels of the armed conflict and the spread of the pandemic.Results; Data indicated that there is an increase in the intensity of violence levels at an early stage from March to August reached up to two folds in the three countries particularly in Libya. In this violent period, few cases of COVID-19 were reported ranging from 5-53 cases/day. From September to December, a significant decline in the level of the armed conflict was accompanied by steep upsurges in the number of reported COVID-19 cases reached up to 500 cases/day. The highest accumulative cases of COVID-19 were reported in Libya, Syria, and Yemen respectively.Conclusions: Our analysis demonstrates that the armed conflict has provided an opportunity for SARS-COV-19 to spread. At the early weeks of the pandemic that coincided with high levels of the armed conflict few cases were officially reported indicating a vast undercount, which may suggest a hidden mitigating spread at an early stage. Then the pandemic increased immensely as the armed conflict decline to reach the highest by December. A full-blown transmission of the COVID-19 pandemic in these countries is expected. Therefore, urgent national and international strategies should be implemented to combat the pandemic and its upcoming consequences.