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WHO Libya: Health response to COVID-19 in Libya, update # 20 (Reporting period: 12 to 25 November 2020)

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o Libya has 11 523 confirmed cases of COVID-19 (the highest in the North African region), with 161 deaths per 1 million population (second only to Tunisia in the region). Over the past two weeks, there has been a 13% increase in the number of cases of COVID-19 compared to the two weeks covered by situation update # 19. This brings the cumulative number to 79 797 since the first case of the disease was reported in the country on 24 March 2020.

o Of the cumulative number of cases, 27 758 people remain actively infected and 50 914 have recovered. During the reporting period, new deaths increased by 16%, bringing the cumulative number to 1125. The national case fatality rate of 1.41% remains difficult to interpret given the low rate of testing and Libya’s weak mortality surveillance system.

o The municipalities reporting large numbers of confirmed cases over the past two weeks include Tripoli (3870), Misrata (918), Benghazi (223), Azzawya (264) and Janzour (127). While only 67 new cases were reported in Sebha, this reflects the low number of tests conducted (laboratories in Sebha have acute shortages of test kits and many laboratory workers are not reporting for duty because they have no PPE).

o Over the past two weeks, a total of 50 661 specimens have been tested in 27 laboratories in Tripoli (37 822 (75%)), Misrata (5206 (10%)), Benghazi (1215 (2%)) and Sebha (573 (1%)). The total number of specimens tested is 430 912 and the cumulative positivity rate is 18.5 %, much higher than the threshold of 5%. This calls for stricter public health and social measures and a rapid scale up of COVID-19 testing across the country.

o The persistent political and security crisis in Libya and the onset of COVID-19 have affected the mental wellbeing and living standards of Libyans, migrants, and refugees, while also exposing them to substantial protection risks. WHO estimates that mental health conditions more than double when populations are affected by conflict. It is likely that one in seven Libyans – approximately one million people – need mental health care for conditions such as depression, anxiety and post-traumatic stress disorder.

o A WHO survey conducted in 2019 showed that mental health services were available only in five cities (Tripoli, Benghazi, Sebha, Ajdabiya and Misrata). Even before the conflict began, only six hospitals, one clinic and four primary health care (PHC) facilities were providing mental health services. Following decades of neglect, it will take years to build services that can cope with emerging needs. There is only one specialized mental health professional for every 300 000 people in Libya (neighbouring Tunisia has one mental health professional for every 100 000).

o WHO will shortly begin implementing a two-year project to strengthen mental health services throughout the country.