Top Lebanese Hospitals Fight Exhausting Battle against Virus

A medical staffer looks at a COVID-19 patient at the intensive care unit of the Rafik Hariri University Hospital in Beirut, Lebanon, Friday, Jan. 22, 2021. (AP)
A medical staffer looks at a COVID-19 patient at the intensive care unit of the Rafik Hariri University Hospital in Beirut, Lebanon, Friday, Jan. 22, 2021. (AP)
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Top Lebanese Hospitals Fight Exhausting Battle against Virus

A medical staffer looks at a COVID-19 patient at the intensive care unit of the Rafik Hariri University Hospital in Beirut, Lebanon, Friday, Jan. 22, 2021. (AP)
A medical staffer looks at a COVID-19 patient at the intensive care unit of the Rafik Hariri University Hospital in Beirut, Lebanon, Friday, Jan. 22, 2021. (AP)

Death stalks the corridors of Beirut's Rafik Hariri University Hospital, where losing multiple patients in one day to COVID-19 has become the new normal. On Friday, the mood among the staff was even more solemn as a young woman lost the battle with the virus.

There was silence as the woman, barely in her 30s, drew her last breath. Then a brief commotion. The nurses frantically tried to resuscitate her. Finally, exhausted, they silently removed the oxygen mask and the tubes — and covered the body with a brown blanket.

The woman, whose name is being withheld for privacy reasons, is one of 57 victims who died on Friday and more than 2,150 lost to the virus so far in Lebanon, a small country with a population of nearly 6 million that since last year has grappled with the worst economic and financial crisis in its modern history.

In recent weeks, Lebanon has seen a dramatic increase in virus cases, following the holiday season when restrictions were eased and thousands of expatriates flew home for a visit.

Now, hospitals across the country are almost completely out of beds. Oxygen tanks, ventilators and most critically, medical staff, are in extremely short supply. Doctors and nurses say they are exhausted. Facing burnout, many of their colleagues left.

Many others have caught the virus, forcing them to take sick leave and leaving fewer and fewer colleagues to work overtime to carry the burden.

To every bed that frees up after a death, three or four patients are waiting in the emergency room waiting to take their place.

Mohammed Darwish, a nurse at the hospital, said he has been working six days a week to help with surging hospitalizations and barely sees his family.

“It is tiring. It is a health sector that is not good at all nowadays,” Darwish said.

More than 2,300 Lebanese health care workers have been infected since February, and around 500 of Lebanon's 14,000 doctors have left the crisis-ridden country in recent months, according to the Order of Physicians.

The virus is putting an additional burden on a public health system that was already on the brink because of the country's currency crash and inflation, as well as the consequences of the massive Beirut port explosion last summer that killed almost 200 people, injured thousands and devastated entire sectors of the city.

“Our sense is that the country is falling apart,” World Bank Regional Director, Saroj Kumar Jha, told reporters in a virtual news conference Friday.

At the Rafik Hariri University Hospital, the main government coronavirus facility, there are currently 40 beds in the ICU — all full. According to the World Health Organization, Beirut hospitals are at 98% capacity.

Across town, at the private American University of Beirut Medical Center — one of Lebanon’s largest and most prestigious hospitals — space is being cleared to accommodate more patients.

But that's not enough, according to Dr. Pierre Boukhalil, head of the Pulmonary and Critical Care department. His staff were clearly overwhelmed during a recent visit by The Associated Press, leaping from one patient to another amid the constant beep-beep of life-monitoring machines.

The situation “can only be described as a near disaster or a tsunami in the making,” he said, speaking to the AP in between checking on his patients. “We have been consistently increasing capacity over the past week or so, and we are not even keeping up with demands. This is not letting up.”

Boukhalil's hospital raised the alarm last week, coming out with a statement saying its health care workers were overwhelmed and unable to find beds for “even the most critical patients.”

Since the start of the holiday season, daily infections have hovered around 5,000 in Lebanon, up from nearly 1,000 in November. The daily death toll hit record-breaking more than 60 fatalities in in the past few days.

Doctors say that with increased testing, the number of cases has also increased — a common trend. Lebanon's vaccination program is set to begin next month.

Darwish, the nurse, said many COVID-19 patients admitted to Rafik Hariri and especially in the ICU, are young, with no underlying conditions or chronic diseases.

“They catch corona and they think everything is fine and then suddenly you find the patient deteriorated and it hits them suddenly and unfortunately they die,”

On Thursday night, 65-year-old Sabah Miree was admitted to the hospital with breathing problems. She was put on oxygen to help her breathe. Her two sisters had also caught the virus but their case was mild. Miree, who suffers from a heart problem, had to be hospitalized.

“This disease is not a game,” she said, describing what a struggle it is for her to keep breathing. “I would say to everyone to pay attention and not to take this lightly.”

A nationwide round-the-clock curfew imposed on Jan. 14 was extended on Thursday until Feb. 8 to help the health sector deal with the virus surge.

“I still have nightmares when I see a 30-year-old who passed away,” said Dr. Boukhalil. “The disease could have been prevented.”

“So stick with the lockdown ... it pays off,” he said.



What Happens When Russian Gas to Europe Via Ukraine Stops?

A view shows a board with the logo of Russian gas producer Gazprom at the St. Petersburg International Economic Forum (SPIEF) in Saint Petersburg, Russia June 5, 2024. REUTERS/Anton Vaganov/File Photo
A view shows a board with the logo of Russian gas producer Gazprom at the St. Petersburg International Economic Forum (SPIEF) in Saint Petersburg, Russia June 5, 2024. REUTERS/Anton Vaganov/File Photo
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What Happens When Russian Gas to Europe Via Ukraine Stops?

A view shows a board with the logo of Russian gas producer Gazprom at the St. Petersburg International Economic Forum (SPIEF) in Saint Petersburg, Russia June 5, 2024. REUTERS/Anton Vaganov/File Photo
A view shows a board with the logo of Russian gas producer Gazprom at the St. Petersburg International Economic Forum (SPIEF) in Saint Petersburg, Russia June 5, 2024. REUTERS/Anton Vaganov/File Photo

Austria's energy company OMV was informed by Gazprom that the Russian gas producer would halt deliveries of natural gas via Ukraine to OMV from 0500 GMT on Nov. 16 following OMV winning an arbitration case. Supplies of Russian gas to Europe via Ukraine may completely stop from Jan. 1 2025 after the current five-year deal expires as Kyiv has refused to negotiate the new terms of the transit with Moscow during the war.
Here is what happens if Russian gas transit via Ukraine is completely turned off and who will be affected most, according to Reuters.
HOW BIG ARE THE VOLUMES?
Russian gas supplies to Europe via Ukraine are relatively small. Russia shipped about 15 billion cubic meters (bcm) of gas via Ukraine in 2023 - only 8% of peak Russian gas flows to Europe via various routes in 2018-2019.
Russia spent half a century building its European gas market share, which at its peak stood at 35%.
Moscow lost its share to rivals such as Norway, the United States and Qatar since the invasion of Ukraine in 2022, prompting the EU to cut its dependence on Russian gas.
EU gas prices rallied in 2022 to record highs after the loss of Russian supplies. The rally won't be repeated given modest volumes and a small number of customers for the remaining volumes, according to EU officials and traders.
UKRAINIAN ROUTE
The Soviet-era Urengoy-Pomary-Uzhgorod pipeline brings gas from Siberia via the town of Sudzha - now under control of Ukrainian military forces - in Russia's Kursk region. It then flows through Ukraine to Slovakia.
In Slovakia, the gas pipeline splits into branches going to the Czech Republic and Austria.
Austria still receives most of its gas via Ukraine, while Russia accounts for around two-thirds of Hungary's gas imports.
Slovakia takes around 3 bcm from energy giant Gazprom per year, also about two-thirds of its needs.
Czech Republic almost completely cut gas imports from the east last year, but has started taking gas from Russia in 2024.
Most other Russian gas routes to Europe are shut including Yamal-Europe via Belarus and Nord Stream under the Baltic.
The only other operational Russian gas pipeline route to Europe is the Blue Stream and TurkStream to Türkiye under the Black Sea. Türkiye sends some Russian gas volumes onward to Europe including to Hungary.
WHY DOES THE UKRAINIAN ROUTE STILL WORK?
While remaining Russian gas transit volumes are small, the issue remains a dilemma for the EU. Many EU members such as France and Germany have said they would not buy Russian gas anymore but the stance of Slovakia, Hungary and Austria, which have closer ties to Moscow, challenges the EU common approach.
The countries, who still receive Russian gas, argue it is the most economic fuel and also blame neighboring EU countries for imposing high transit fees for alternative supplies.
Ukraine still earns $0.8-$1 billion in transit fees from Russian gas transit. Russia earns over $3 billion on sales via Ukraine based on an average gas price of $200 per 1,000 cubic meters, according to Reuters calculations.
Russia's gas pipeline export monopoly Gazprom plunged to a net loss of $7 billion in 2023, its first annual loss since 1999, because of the loss EU's gas markets.
Russia has said it would be ready to extend the transit deal but Kyiv has repeatedly said it won't do it.
Another option is for Gazprom to supply some of the gas via another route, for example via TurkStream, Bulgaria, Serbia or Hungary. However, capacity via these routes is limited.
The EU and Ukraine have also asked Azerbaijan to facilitate discussions with Russia regarding the gas transit deal, an Azeri presidential advisor told Reuters, who declined to give further details.