A hidden coronavirus problem is causing discontent in Damascus as residents face overflowing public hospitals, restricted access to testing and case numbers that are many times higher than those recorded by the government. Data published last week by Syria in Context, a platform which researches and analyses developments in Syria, found that Damascus alone may have between 60,000 and 100,000 active cases of the virus. As of August 20, government controlled Syria had 2,008 cases of Covid-19 and 82 deaths, according to a tally kept by the World Health Organisation based on reports from the Syrian Ministry of Health. Damascus and Rural Damascus had 730 and 256 cases, respectively. According to the Syrian Ministry of Health records, 76 healthcare workers tested Covid-19 positive, the majority in Damascus. The capital also accounts for more than half the deaths reported. However, local Facebook groups have been littered with death notices and Syrians complaining about the government's handling of the crisis, with one calling the ministries “intellectually impaired”. “[They] are in partnership to intensify the corona infection … they have all agreed to reduce the population density,” one Facebook post read. Abeer, a coronavirus patient in Damascus whose last name has been withheld for security reasons, told <em>The National </em>there were far more cases and deaths from coronavirus in the capital than the health ministry was reporting. “We do not trust it at all … there are far more deaths than reported,” she said via an encrypted messaging app. WHO’s Syria representative, Dr Akjemal Magtymova, said the occupancy rate in the capital's Covid-19 wards was usually more than 90 per cent. “In general, there are limited ICU beds and ventilators,” she said. Dr Magtymova said only 300 to 400 tests are conducted each day in Damascus. According to Syria in Context, of this number, 300 tests, charged at $100 each, are reserved for Syrians wishing to leave the country, with the rest possibly kept for officials high up in the government. Emma Beals, Syria in Context co-author, said the government was using the pandemic to generate money amid an economic crisis. “There’s definitely a focus on the paid testing, that is the government’s priority,” she said. “There is very little other testing available anywhere, either through private hospitals, clinics or other means.” Abeer, confronted with overflowing government hospitals and no access to testing, turned to a private hospital for treatment. One night in a private hospital can cost between 200,000 (Dh1,435) and 300,000 Syrian pounds – out of reach for the majority in a country where the average<strong> </strong>state salary<strong> </strong>is about 50,000 pounds<strong>.</strong> An alternative is to buy an oxygen tank and pay for a nurse to care for you at home, but as cases started to spike about a month ago businessmen allegedly associated with the Syrian regime monopolised oxygen supplies. Since then the price of an oxygen tank has doubled to 300,000 pounds. “If you don’t have any money then you’re not getting any help,” said Ms Beals. To try to bridge the gap in medical care, doctors have started providing online assessments of symptoms; however, they can only go so far as suggesting medication plans, which include taking the over-the-counter painkiller Panadol. Abeer said it was hard to find medicines in Syria, but she was able to take antibiotics as part of her treatment. “Praise be to God cortisone [and] analgesic are available,” she said, adding that she had been in a lot of pain since contracting coronavirus. Abeer said she was afraid about the level of safety in public hospitals. “I have a relative who works in a public hospital and they don’t provide protective equipment or masks to staff,” she said. Dr Magtymova said the WHO had delivered 4.4 million pieces of personal protective equipment to Syria, including 1.5 million medical masks. The regime blames the sanctions put in place by the US for not being able to adequately respond to the pandemic, but the embargo does not restrict medical aid. Ms Beals said the difficulties faced in Damascus were only the beginning, as the virus would spread more severely to other areas of the country. “There isn’t any room for complacency,” she said. Considering Syria has few allies after a decade of war, extra pressure is placed on the UN and partner countries like Iran, Russia and China to provide assistance with the Covid-19 response in Syria. “Even if it’s just intervening to protect the medical workers to keep them alive to be able to deal with this, that would be something.”