The global spread of the Coronavirus (COVID-19) poses grave risks and major challenges to the Palestinian people under Israeli occupation. Goverments around the world have mobilized their full healthcare and economic potentials, and pledged trillions in fiscal support to contain the pandemic. As for the Palestinian Authority (PA), it has very weak capabilities, while Israel controls land and maritime borders and the airspace, in addition to the exports and imports, while the Gaza Strip (GS) is under a suffocating siege depriving Palestinians of their most basic rights and necessities. Despite the spread of the virus and its risks to Palestinians, Israel is still primarily driven by security rather than humanitarian or other considerations.
The spread of the pandemic in the Palestinian territories has not reached a critical point yet. Palestinians are still managing their affairs within available means, however, the possibility of an epidemic spread at dangerous and accelerating rates remains, especially in the densely populated areas of GS. This calls for more support for the Palestinian people, and more pressure on Israel.
If the independent sovereign countries are fighting fierce and exhausting health, political, economic and social battles against the dangers of the Corona pandemic, the Palestinian community is fighting it while subject to Israeli restrictions. For when it comes to dealing with Palestinians, who are facing the epidemic, Israel is primarily driven by all sorts of security considerations rather than humanitarian ones.
First: Palestine’s Current Status
a. The Situation in the West Bank (WB) and Gaza Strip
According to the reports of the World Health Organization (WHO) in the occupied Palestinian territories, the latest updates concerning the coronavirus are as follows:
Table 1: The Spread of Coronavirus in the 1967 Occupied Territories 5/3–3/4/2020 
|Confirmed cases||117||Cases recovered||21||Deaths||1||Quarantine||14,092|
|Confirmed cases by sex||Male||Female|
|Geographic locations of cases||WB 159||GS||Governorates with 0 cases|
|Confirmed cases by age||0-17||18-29||30-39||40-49||50-59||60+|
|Availability of adult ICU beds with ventilators||WB 213||GS 87|
Note: Ministry of Health (MoH), and Intensive Care Unit (ICU).
The table indicates the following:
1. Despite the fact that the occupied WB population is 1.5 times the GS population, the number of cases in the occupied WB is 13 folds that of GS, knowing that the population density in GS is 10 folds that of WB. In addition, the population pyramid of both sides vary with no statistical significance. This means that what varies between the two areas is the occupation variable, as we will show this quantitatively.
2. When comparing the health infrastructure of WB where there is direct occupation with that of GS, we find that the MoH adult ICU beds with ventilators are 27.23% of total beds, while in GS it is 72.41%. This is despite that fact that the PA economic conditions are better than those of GS.
3. It is noticed that the Palestinian locations that have higher number of cases are those that have more contact with Israeli society and settlers. In GS, where contact is low, only 12 cases exist, which is 7% of total, while the other 93% is in WB. These numbers are inconsistent with the population difference between the two areas. In addition, the largest cluster of settlements is in East Jerusalem, it has more than five folds of the cases in GS, confirming the relation between the increase of case number and the proximity to Israeli communities.
b. Situation Inside the Green Line (1948) or Israel
The spread of the coronavirus in the Israeli society is as follows:
Table 2: The Spread of Coronavirus in Israel Until 6/4/2020 
|Active cases||Mild condition||7,834||98|
|Serious or critical||141||2|
|Total active cases||7,975||100|
|Closed cases||Recovered/ discharged||585||92|
|Total closed cases||636||100|
Upon reviewing the rate of coronavirus spread in the Israel community, it is clear that there is a clear increase that began mid-March of this year, and by analyzing the available data, we notice the following:
• Death rate is similar to European ones.
• A correlation exists between the increase of cases and the orthodox communities “haredim.” 
c. The Role of Occupation in the Increase of Coronavirus Cases in WB Compared to GS
It is necessary to monitor Israeli policies in dealing with the coronavirus spread in WB, especially that WB is divided into three areas (A, B and C), where area C (more than 60% of WB) is under Israeli administrative and military authority. Area B is controlled by both Israel and the PA, while area C is under the PA control. This means that movement and gatherings are linked in all regions to the Israeli side, and this is clear in the following WHO indicators: 
1. Israeli Restrictions on the Movement of Patients and Medical Teams
a. Difficulty of accessing Palestinian health facilities due to Israeli measures
A report published by WHO in 2018 indicated that the life expectancy in the 1967 occupied Palestinian territories is 73.9 years whereas in Israel 82.5 years. Child mortality rate in WB and GS is six folds that of Israel (20.9 vs 3.6 per one thousand births). Maternal mortality rate is nine folds (27 per hundred thousand in WB and GS, while 3 in Israel). WHO explains these differences by referring to the limited “provision of and access to healthcare.”
To explain further, 9.4% of the WB population lives behind the Separation Wall, which hinders the access of Palestinians to Palestinian healthcare facilities. If we added that 60% of WB is under direct Israeli civil and military control, the movement of Palestinian health staff becomes further difficult. Moreover, there are over 300 thousand Palestinians living in East Jerusalem and are given “resident” status, which exposes them to being discriminated against in health care priorities by Israeli facilities.
b. The Problem of Getting Movement Permits for Treatment
There are over 100 types of Israeli-issued permits for Palestinians. These movement restrictions extend to patients, patient-companions and health staff for whom specific types of Israeli-issued permits exist. MoH faces substantial barriers to timely healthcare provision. 35% of the Area C population) are dependent on mobile health clinics. By the end of 2018, there were 15 mobile health clinics operating in Area C, knowing that 300 thousand Palestinians are living there. Each mobile clinic serves 20 thousand Palestinians, while taking into consideration that the movement of the mobile clinic is not always available, for it moves as Israeli security measures dictate.
In GS, the land and naval blockades, effective since 2007, have resulted in severe limitations on movement in and out for Palestinians. Exit from GS is possible only via two crossings: through Beit Hanoun/Erez checkpoint to the north and Rafah border crossing to Egypt in the south. In 2018, 70% of GS referrals needed access via Beit Hanoun/Erez – to Palestinian hospitals in WB, including East Jerusalem, and Israeli hospitals. All these patients required Israeli-issued permits to cross in order to access healthcare. The approval rate of 61% for patient applications in 2018 represents the second lowest recorded by WHO (i.e., 40% could not get a treatment). In 2018, Israel continued its requirement for the submission of non-urgent patient permit applications 23 working days in advance of any hospital appointment, increased from 10 working days in 2017. This period is sufficient for the patient to be exposed to danger, especially in cases such as the coronavirus, whose incubation period is far less than the period of obtaining the permit, not to mention getting treatment.
WHO carried out survival analysis for cancer patients referred for chemotherapy and/or radiotherapy, and it found out that patients delayed permits from 10 to 23 days were nearly 1.45 times less likely to survive.
From 2014 to May 2019, Palestine had acceded to 97 international conventions, agreements and optional protocols, including those containing commitments relevant to the right to the highest attainable standard of physical and mental health. However, the effectiveness of these agreements is very limited, due to the Israeli policy that places the security factor above the humanitarian factor.
c. The Extensive System of Fixed and Flying Military Checkpoints 
WHO estimates that in 2018 there were 140 fixed checkpoints and 2,254 flying checkpoints in WB, meaning that every 2.3 km2 there is a checkpoint, assuming they are operating at full capacity. Consequently, this almost paralyzes patients’ transportation, in fact, some deaths have been recorded at some checkpoints.
d. Problems facing Palestinian Workers in Israel or the Settlements in WB 
The International Labour Organization (ILO) has estimated the number of employees in Israel and the settlements in WB and East Jerusalem at 117 thousand, of whom 29,795 work with a work permit in the settlements. These have direct contact with settlers, which makes them vulnerable to transferring the virus into settlements or to bringing it from the settlements to their residence. It is noted that there are 800 thousand settlers, including in East Jerusalem, distributed over 145–150 settlements. 
The International Committee of the Red Cross (ICRC) called on Israel to reduce the number of Palestinian prisoners in Israeli prisons due to the coronavirus outbreak. Studies have showed that a coronavirus patient can infect another 2.8 individuals.  If around 5,700 Palestinians are currently detained in Israeli prisons, and some prisons include 400 prisoners in one place, then the chances of being infected with the coronavirus is very high, especially that 90% of prisoners have become ill while in prison due to poor conditions and negligence which may have exacerbated their health, hence their immunity. Reports indicated that a number of prisoners have been diagnosed with coronavirus, which means that the risk of infection for the rest of the prisoners has grown dramatically. 
Palestinian civil society organizations in Israel sent a plea to Israeli officials calling for an investigation into the low coronavirus diagnoses among the Palestinian population of the 1948 territories. The Palestinian-Israeli Citizen Rights Association stated that “The concentration of medical resources is limited to Jewish towns and is absent in the Arab towns.” For until the end of March 2020, out of 3,865 reported coronavirus cases in Israel, only 38 are Israeli-Palestinian, despite that 20% of Israeli citizens being Palestinian. Media has portrayed Arab citizens as refusing tests due to an alleged stigma about the disease among their community – a claim utterly rejected by the association.
It is known that The Nation State Law, enacted in July 2018, defines Israel as a “nation-state of the Jewish people.” This effectively downgrades Israel’s Palestinian population to a second tier of citizenship. One clear example of Israeli negligence is in the Negev, where there are no clinics and Israeli ambulances don’t even enter the highly populated Palestinian region. 
First: The Medical Impact
We have mentioned that there is lack of data and unusual security and administrative restrictions, and also there is discrimination in Israeli treatment (according to WHO) between Palestinians and Israelis in conducting tests and the availability of hospital beds. Therefore, while applying some predictive models on Israel to put a plan for the coronavirus is possible, in the Palestinian case it’s quite difficult, even when applying the simplest model SIR, which is predictive of infectious diseases.  Therefore, the measures to prevent and control the spread of the epidemic become more complicated, which is the case now.
This situation calls for additional Palestinian, Arab and Islamic efforts to make international bodies quickly provide a great deal of aid, in addition to exerting continuous pressure on Israel to lift the restrictions that we mentioned at the beginning of this study.
However, Israel being led by a “caretaker government,” makes it less effective than a stable government, and there are fears that Israel will increase restrictions on the Palestinians on the pretext of preventing the transmission of the virus to it, while leaving the conditions worsen in GS. As a result, the Palestinian resistance forces would feel pressured, triggering a crisis with Israel that may turn into a military act, especially if the epidemic spins out of control.
It seems that Israel is aware that if it leaves the epidemic outbreaks without loosening its restrictions on GS and WB, the complicated conditions may result in turbulence in WB in support of GS. Moreover, the Israeli approach may have a moral aspect that would cause wide international criticism, thus leading Israel to try to reconcile between its security considerations and its international moral image. Nevertheless, Israel’s history indicates that its security is above any other variable, which increases the risks to the Palestinian health situation. There is a chance that Israel, when trying to reconcile between its security and its international image, that it would try to link between easing the conditions—especially in GS—and the issue of captured Israeli soldiers.
Second: Regional and International Political and Economic Repercussions on Israel and Palestine 
The majority of factories, commercial activities and the various forms of transport (air, land and sea) have stopped, the stock exchange indexes have plummeted, and the prices of stocks and bonds have fallen. The crisis also reached the relation between Russia and some countries in the Organization of the Petroleum Exporting Countries (OPEC), which reflected on oil prices. All of these developments had knock-on effects on international, regional and national economies, slowing down growth, wide spreading employment, while expecting sharp economic downturn. Suffice to ponder the following indicators:
a. The shares of the world stock exchanges have decreased by about 25%.
b. About a hundred countries have suspended flights, crippling or restricting tourism. This has led to a decline in the number of daily flights worldwide, from about 180 thousand trips daily to 75 thousand trips in the middle of the first week of April.
c. Economic growth is expected to slow down in 2020, where in the Euro area it would be by (less than 1%), the United States (less than 2%), China (less than 5%), and the world in general (around 2.5%). 
d. To face these repercussions, the G20 governments have promised a $5 trillion revival effort. 
This economic earthquake will have its impact on the Palestinian scene:
a. The potential of a decline in international and regional aid.
b. Increasing restrictions on the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). Its indicators began to emerge, where hundreds of Palestinian teachers were cut out, and the agency’s facilities have been complaining that they did not receive enough support to face the coronavirus. 
c. Poverty and unemployment rates would increase at least in the foreseeable future, due to Israeli measures, and expat remittances may decrease. Palestinian officials believe that if the pandemic continues for the next six months, it will cost the economy $3 billion. 
As for the Israeli economy, and according to official estimates, Israel’s Gross Domestic Product (GDP) is expected to drop by $6.5 billion, and the growth in its economy is estimated to drop by 3%, which means that the damage to the economy will amount to $12 billion by the end of this year. 
These repercussions are greatly linked to how long will the pandemic last. For the longer it lasts, these repercussions will become more severe, which may lead to a wider political and social instability, especially since the motives for migration and displacement are no longer attractive due to the outspread of the coronavirus pandemic.
1. Due to the worldwide profound social and economic impact of the pandemic, most countries will turn inward focusing on how to tackle its adverse effects, especially in the most affected areas such as Europe, the United States and China. This may affect the attention that the Palestine issue will have, whether in the international political or legal institutions. In addition, Israel may take advantage of this international change to expand its settlements, and develop its normalization with the Arab and other countries, under the pretext of cooperating to purify the “regional and international health environment.”
2. Some Arab countries may find in the period after the “pandemic” period—under many pretexts (humanitarian and economic)—an opportunity to further normalize relations with Israel, particularly the oil countries that would want to compensate for the losses caused by the epidemic regardless of the means.
3. However, a prolonged pandemic could lead to chaos and instability, which would offer a chance to Israeli and Palestinian parties to turn turmoil to their advantage. Palestinians must not exclude this possibility, as the turmoil may move to the Palestinian interior under societal pressure, especially in GS and WB.
4. Contemporary history of the Arab region indicates that if the crisis prolongs, the weakness of the Arab countries may pave the way for new political organizations to emerge and some of them may be armed. Israel may see this as an opportunity on one hand, and a threat on the other, especially if this happens in neighboring countries.
5. Undoubtedly, the coronavirus pandemic will affect in one way or another Trump’s chances of winning the next elections. If the crisis prolongs and intensifies, Trump’s term may be extended, as happened with President Franklin Roosevelt (during the Great Depression and World War II), so that the government would be able to tackle the crisis. Conversely, if he failed in handling the crisis as he did at the start, and in addition to other factors, he would lose the elections.
Consequently, the “deal of the century” may face obstacles, since one of its most important mechanisms is “financial inducements” that may not be available in the next short period.
6. The spread of the coronavirus in WB may slow the pace of settlement building, especially if the conditions in the 1948 territories improve. But if the opposite happens (the spread increase in Israel), settlement building in WB increases.
7. If the coronavirus spreads widely in Israel, the chances of social unrest between the subcultures (black/ white, eastern/ western,…) would increase. On one hand, this would be in addition to the conflict between the religious and the seculars, and on the other hand, there is an impression that the Haredim were hit more by the virus, because of what the Israeli seculars see as “slavish adherence to rabbinical rules.” As for the Palestinians inside the green line, they may be exposed to the potential of political, economic and social pressure in the context of these unrests.
8. The global pandemic may mitigate the policies of blockade and sanctions led by the US, and maybe Iran would be among the countries that benefit from this. Hence, it will be a setback for the Israeli efforts to seek further restrictions on Iran.
9. Some Israeli media claims that the coronavirus has sparked anti-Semitism in Europe, and that analogy is made between the current coronavirus and the Black Death of the 14th century, for the spreading of which the Jews were blamed for spreading. Perhaps this hides the Israeli feeling that the change in international attitudes towards Israel existed way before the coronavirus issue. Nevertheless, Israel will invest in these claims to restrict European societal attitudes, especially those hostile to the Israeli policy. 
It can be said that the Palestine issue may face in the coming days one of the toughest times in the history of the Arab-Israeli conflict, especially if the pandemic prolongs. It is imperative to rush into rebuilding the Palestine Liberation Organization (PLO) on national bases. It is important to overcome Freud’s notion “the narcissism of minor differences,” to build better integrative policies between GS and WB. The decision of the two political rivals (Benny Gantz and Benjamin Netanyahu) to set their differences aside and join forces in a national unity government, could be considered a lesson in prioritizing the country’s higher strategic interests, even if this lesson were from the enemy himself.
* Al-Zaytouna Centre thanks Prof. Dr. Walid ‘Abd al-Hay for authoring this strategic assessment.
 World Health Organization (WHO), occupied Palestinian territory, Coronavirus disease 2019 (COVID-19), issued 3/4/2020, https://who18.createsend.com/campaigns/reports/viewCampaign.aspx?d=j&c=99FA4938D049E3A8&ID=0BC8EC6C6F19B9312540EF23F30FEDED&temp=False&tx=0&source=Report
 See site of Worldometer, Coronavirus, Israel, https://www.worldometers.info/coronavirus/country/israel/
 The Jerusalem Post newspaper, 3/4/2020, https://www.jpost.com/Diaspora/Brooklyns-Orthodox-neighborhoods-have-high-rates-of-coronavirus-623455; and The Jerusalem Post, 3/4/2020, https://www.jpost.com/Israel-News/How-has-the-coronavirus-pandemic-made-Jerusalemites-lives-more-difficult-623459
 See site of The Cyber Shafarat – Treadstone 71, 3/4/2020, https://cybershafarat.com/2020/04/03/10-potential-negative-scenarios-in-israels-strategic-environment-following-corona-outbreak-from-the-israeli-national-security-studies/; site of BBC, 18/11/2019, https://www.bbc.com/news/world-middle-east-38458884; and WHO occupied Palestinian territory, Right to Health 2018 (WHO; 2019), http://www.emro.who.int/images/stories/palestine/documents/who_right_to_health_2018_web-final.pdf?ua=1
 WHO occupied Palestinian territory, Right to Health 2018.
 Report of the Director-General, The situation of workers of the occupied Arab territories, International Labour Conference, Geneva, 106th Session, 2017, https://www.ilo.org/wcmsp5/groups/public/—ed_norm/—relconf/documents/meetingdocument/wcms_554441.pdf
 Report of the Director-General, The situation of workers of the occupied Arab territories, International Labour Conference, Geneva, 106th Session, 2017; and BBC, 18/11/2019.
 Site of Anadolu Agency, 31/3/2020, https://www.aa.com.tr/en/latest-on-coronavirus-outbreak/red-cross-urges-israel-to-reduce-palestinian-inmates/1787022
 Site of The Palestine Chronicle, 20/3/2020, https://www.palestinechronicle.com/israeli-authorities-deny-palestinian-prisoners-tested-positive-for-coronavirus
 The Palestine Chronicle, 19/3/2020, https://www.palestinechronicle.com/four-palestinian-prisoners-infected-with-coronavirus-in-israeli-jails/
 Diana Alghoul, Negligence in crisis: Palestinian citizens of Israel ‘not being tested for coronavirus’, site of The New Arab, 30/3/2020, https://english.alaraby.co.uk/english/news/2020/3/30/palestinian-israelis-are-not-being-tested-for-coronavirus
 The model consists of three compartments: S for the number of susceptible, I for the number of infectious, and R for the number of recovered or deceased (or immune) individuals. These numbers and their changes during a certain period are studied in order to project future changes. For more, see Anatoliy Swishchuk and Mariya Svishchuk, “Endemic SIR model in random media with applications,” site of The MedCrave, 13/3/2018,
 Itai Brun and Yael Gat, “The Corona Crisis and Israel’s National Security,” The Institute for National Security Studies (INSS), 17/3/2020, https://www.inss.org.il/publication/coronavirus-discussion/; and Infected: The impact of the coronavirus on the Middle East and north Africa, site of European Council on Foreign Relations (ECFR), 19/3/2020, https://www.ecfr.eu/article/commentary_infected_the_impact_of_the_coronavirus_on_the_middle_east_and_no
 BBC, 3/4/2020, https://www.bbc.com/news/business-51706225
 5 Charts that Show the Global Economic Impact of Coronavirus, site of The World Economic Forum, 31/3/2020, https://www.weforum.org/agenda/2020/03/take-five-quarter-life-crisis/
 Site of Felesteen, 27/3/2020; and Quds Press International News Agency, 25/3/2020.
 Al-Quds newspaper, 2/4/2020.
 Site of The Times of Israel, 16/3/2020, https://www.timesofisrael.com/liveblog-march-16-2020/
 The Jerusalem Post, 3/4/2020, https://www.jpost.com/Diaspora/Antisemitism/Coronavirus-crisis-in-France-sparks-antisemitic-conspiracy-theories-623458