The World Health Organisation (WHO) has warned that Gaza’s healthcare system is at the point of collapse due to Israel's suffocating siege and the rise in COVID-19 cases.

Abdelnaser Soboh, the WHO’s emergency health co-ordinator in Gaza, said, “Within a week, we will become unable to care for critical cases.” Severely ill patients would not be able to get a bed in intensive care units and would likely die.

Gaza has confirmed around 15,000 cases, 65 deaths, and 79 critical cases. All but four cases occurred since August after the strict lockdown restrictions set in place in March were lifted. One fifth of tests were coming back positive, many from people aged over 60.

Dr Fathi Abuwarda, adviser to the minister of health, explained that 300 of Gaza’s European Hospital’s 360 beds were already occupied. Although there were a further 350 COVID-19 hospital beds, as well as respiratory triage centres at five more hospitals, “these hospitals can’t accommodate all cases.”

Abdelraouf Elmanama, a member of Gaza’s pandemic task force, said that 79 of the 100 ventilators available for COVID cases were already taken up.

Dr Basim Naim, head of international relations in the Hamas government, said, “The Gaza Strip lacks oxygen-generating machines, ventilators, protective gear, and hygiene materials. Thirty-two percent of basic drugs and 62 percent of drugs and materials for medical laboratories are not available.”

There is also an acute lack of coronavirus testing kits, as well of reagents--the main ingredients of chemical-based tests to detect the coronavirus, making it difficult to track and contain the spread of the virus.

Dr Abuwarda said, “The best solution is a full lockdown for 14 days, which will allow medical teams to control and combat the virus, with only shops that provide food supplies kept open.”

However, Gaza’s government, led by the bourgeois Islamist party, Hamas, has thus far introduced only limited restrictions, banning movement in the worst-hit areas, closing shops at 5pm, instituting a 12 hour curfew from 8pm to 8am, and banning indoor visits of more than 15 people. Such measures are totally inadequate to contain the virus.

Gaza, with its 2.1 million population living in an area just 40 kilometres long and 10 kilometres wide, is one of the most densely populated places on the planet, making community spread all but inevitable. It has been subject to a criminal siege by Israel for more than 13 years, resulting in serious shortages of the most basic commodities required for human existence. Israel made no secret of its objective. Dov Weisglass, an adviser to Israel’s then Prime Minister Ehud Olmert, said in 2006, “The idea is to put the Palestinians on a diet, but not to make them die of hunger.”

Gaza has become an open prison, not unlike the Warsaw Ghetto. Subject to repeated military assaults by Israel—most notably in 2008, 2012 and 2014, that killed thousands of Palestinians, wrecked Gaza’s already weak infrastructure and made hundreds of thousands homeless—Gaza has rarely seen a day pass without Israel’s soldiers, warplanes, drones and gunships harassing, intimidating, and killing its citizens.

The Palestinian Authority, dominated by Fatah, a rival Palestinian faction, has collaborated with Israel. It has cut the salaries of its employees in Gaza, forced 30,000 to take early retirement, reduced the number of medical permits to receive treatment abroad, and cut medicines and medical supplies. Fatah limited and then ended financial transfers to Gaza and called on Israel to cut back electricity supplies that has affected access to clean drinking water and all but stopped the operation of the sewerage system.

In 2018, the Trump administration ended its $300 million a year contribution to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) $1.1billion annual budget. The budget provides essential services to the Palestinian refugees who fled or were made homeless by the 1948-9 war—following the establishment of the state of Israel and the 1967 Arab-Israeli war—and their descendants. Some 80 percent of Gaza’s population are dependent upon UNRWA.

Egypt’s military junta under President Abdel Fattah el-Sisi has intensified the blockade, keeping the crossing at Rafah shut and using its control of the border to reinforce Israel’s diktats.

In July 2017, a UN report concluded that the situation in Gaza was deteriorating “further and faster” than forecast in 2012 when the UN declared that it expected Gaza to become “unliveable” by 2020. Robert Piper, the UN Coordinator for Humanitarian Aid and Development Activities in the Occupied Palestinian Territory, said, “Every indicator, from energy to water to healthcare to employment to poverty to food insecurity, every indicator is declining. Gazans have been going through this slow-motion de-development now for a decade.”

According to a November 25 report by the UN Conference on Trade and Development (UNCTAD), the cumulative economic cost from 2007–2018 of the Israeli occupation on Gaza is estimated at $16.7 billion. It estimates that without the closure and military assaults Gaza’s poverty rate in 2017 would have been 15 percent compared to the current 56 percent.

Israel has intensified its military attacks, hindered all efforts by activists, NGOs and the Palestinians to keep the enclave minimally habitable and tightened the closures following the onset of the pandemic. Even those who had permits to work in Israel were not allowed to leave. Last month, a group of nurses staged a protest in Gaza because an Israeli travel ban had led the Makassed Hospital in East Jerusalem, where they had worked for 20 years, to fire them.

Despite the WHO’s warnings, Israel’s minister of science and technology and Blue and White party member Izhar Shay told Army Radio, “We are not giving Hamas any 'coronavirus discounts'… We will continue responding as appropriate.”

While another Israeli official claimed that Israel had since the pandemic allowed 60 ventilators to be taken into Gaza as well as nine polymerase chain reaction (PCR) coronavirus testing devices, Palestinian officials say that despite Egyptian mediation, Israeli is still refusing to allow ventilators into Gaza. Israel is making this conditional upon the return of soldiers’ bodies held by Hamas since Israel’s 2014 war on Gaza.

Public transport is paralysed. The construction sector is at a standstill and less than half of Gaza’s industrial workers have been able to return to their jobs. Nickolay Mladenov, the UN Special Coordinator for the Middle East Peace Process, said, “Eight months into the pandemic, Palestinian unemployment levels are alarmingly high–121,000 Palestinians lost their jobs in the wake of the first lockdown and employment figures declined by 17 per cent in Gaza.”

The Palestinian General Federation of Trade Unions in Gaza put the figure at 160,000 and said that workers were competing to work for up to 10 to 13 hours a day for wages that range from $4.50 to $10.50 a day, in the best conditions. Around 40 percent of Palestinian households lost more than half their income and food insecurity rates have soared, leaving people to search through rubbish to find food.

According to a survey of more than 2,000 labourers carried out in September by Islamic Relief, wages had plummeted from $244 to $29 per month, with 92 percent saying they had not received any government assistance or non-governmental assistance. They were having to forego medicines to buy food. These conditions are an indictment not just of Israel, but the imperialist powers and the Arab bourgeoisie that have backed Israel’s siege and paved the way for a catastrophe.