Lebanon is seeing a dramatic increase in the spread of the coronavirus since last month's massive explosion at Beirut's port, which damaged much of the capital city. Since the Aug. 4 blast, the number of COVID-19 cases has increased by some 220%, according to an assessment by the International Rescue Committee.

"This is on top of everything else that people have to contend with," Matias Meier, the country director for the aid group, said in a statement. After the blast, many people "lost both their home and their source of income in an instant."

In the early months of the pandemic, Lebanon managed to keep the infection rate low by quickly imposing stay-at-home orders that were well enforced and included a strict curfew. Those orders were lifted and then reimposed several times.

The number of people infected per day remained in the dozens. But the country has been registering between 500 and 600 cases almost every day since mid-August. Lebanon's Ministry of Public Health has registered 18,375 cases since the start of the pandemic and puts the death toll at 172.

"There are multiple clusters which is making it even harder to slow the spread," Meier said.

This comes as Lebanon's health care system has also been treating some 6,000 people wounded in the blast, while also coping with the blast's damage to medical facilities.

Three of Beirut's major hospitals were forced to close following the explosion, and three others were partially damaged, according to the World Health Organization. In all, the WHO found, approximately 500 hospital beds were lost.

The country's interim health minister, Hamad Hasan, told local media last month that Lebanon's health system was "on the brink" of being overwhelmed, with both public and private hospitals being close to full because of the needs of blast victims and COVID-19 patients.

Lebanese authorities responded by trying to impose a new lockdown in the second half of August. But for the 300,000 or so city residents who officials say were made homeless in the explosion, as well as for thousands of others whose homes have shattered windows and doors blown off hinges, such orders are hard to follow.

Government officials then loosened the restrictions after owners of restaurants, cafes and nightclubs refused to abide by them. They shortened the curfew, allowing people to leave their homes after 6 p.m., and ruled that most businesses, including restaurants, could reopen at 50% capacity.

Even before the explosion, these sectors were hard hit by the country's economic crisis, which sent poverty rates soaring. The crisis is widely blamed on political corruption and mismanagement.

Popular anger compounded as it emerged that the explosion of some 2,750 tons of ammonium nitrate at the city's port was likely the result of years of government negligence.

"For us, the state vanished with the blast," Tony Ramy, head of the syndicate of owners of restaurants, cafes, nightclubs and pastry shops, told crowds at a rally protesting the stay-at-home orders.

International donors have sought to help ease the crisis. The World Health Organization has sent almost 25 tons of personal protective equipment, and French President Emmanuel Macron, who visited Lebanon this week, announced more than $8 million in assistance for Rafik Hariri University Hospital, the main public health institution caring for COVID-19 patients.

Firass Abiad, the head of that hospital, took to Twitter this week to warn of the dangers of the current coronavirus response.

"Lockdown helps contain the virus, but puts the pressure on businesses," he wrote. "A strategy with clear tradeoffs, based on science and collective before personal interests, endorsed by all, is needed. Then all have to comply, or else. Otherwise, it will be a harsh winter."

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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