The explosion in the capital Beirut on 4 August 2020 came at a time when Lebanon was already struggling to cope with its outbreak of COVID-19. News articles written before the explosion paint a picture of a country's health system already on the brink of collapse, a situation that has now inevitably worsened. (1) (2)
Lebanon and COVID-19
At the time of writing Lebanon has recorded 6,812 cases of COVID-19 and 80 deaths. It took over four months (from 21 Feb to 8 Jul) to reach the first 2,000 cases. It has taken only one month (9 Jul to 10 Aug) to register a further 4,500. The rate is now increasing exponentially and Lebanon has not yet reached the peak of its outbreak. (3)
Figures for both cases and deaths should be viewed with caution as the true numbers are likely to be higher. Many migrant workers in Lebanon are undocumented and do not have access to COVID-19 testing. (4)
Lebanon is also home to nearly 2 million Palestinian and Syrian refugees living in camps throughout the country. The first confirmed case of COVID-19 in one of the camps was in April 2020. Further cases have since been confirmed but accurate figures are not available. The poor conditions within the camps will facilitate transmission of the virus and with agencies such as MSF (Medecins San Frontier) unable to enter the camps because of lockdown restrictions this can only have exacerbated the situation. (5) (6)
Lebanon first began to go into lockdown on 28 February 2020 with the closure of schools and universities. By 15 March 2020 the country was in full lockdown with shops, businesses and places of worship also all closed. (7)
Restrictions began to be lifted from 4 May 2020 but in light of the rapidly increasing case numbers full lockdown was reimposed on 27 July 2020. (8) (9) (10)
Lockdown was to be reviewed on 10 August 2020 but on 4 August a huge explosion at the docks in Beirut led the country even deeper into crisis.
Beirut Explosion
The explosion of ammonium nitrate in Beirut on 4 August 2020 resulted in a massive release of nitrogen dioxide gas (NO2). This is one of the most lethal gases to humans, is the major cause of pollution from traffic and has the distinct reddish-brown colour seen in the plumes of gases from the explosion.
The World Health Organisation (WHO) has set a worldwide standard for NO2 levels, annually they should not exceed an average of 40 μg/m3 and in any given hour they should not exceed 200 μg/m3. Short term exposure to levels above 200 μg/m3 causes significant problems to the lungs and airways. (11)
In the UK there should be no more than 18 occurrences per year of the hourly 200 μg/m3 limit. (12)
Beirut was already a city known to have high levels of pollution but unfortunately the country no longer releases data on its air quality. (13) (14)
It is reasonable to assume that the air quality has deteriorated further since the explosion. What is known is that the air quality in Cyprus (164 miles away to the west) has not yet been affected. The head of the Cyprus air quality department, Dr Chrysanthos Savvides, said the level of NO2 in the air in Cyprus was not above average because the prevailing wind at the time of the blast was in a north-easterly direction. This does mean that Syria and parts of Turkey will have been affected. A change in wind direction could mean that Cyprus may yet be affected. (15)
Some of those killed instantly at the time of the blast (but not by the force of the blast itself) will have died from the suffocation caused by NO2 because people cannot survive exposure to huge amounts of NO2. For others further away from the epicentre, the higher concentrations of NO2 can cause lung damage that is not apparent for the first 24 to 48 hours after exposure. This damage predisposes the individual to future respiratory diseases such as bronchitis and also increases the susceptibility to infection which is of significant concern in the light of COVID-19. For those with pre-existing respiratory complaints the high NO2 levels will exacerbate them.
The Lebanese government has not disseminated any information or guidance for Beirut residents about the health impact of the NO2. Instead residents have been advised by agencies such as the US embassy and Greenpeace to stay indoors where possible and wear a mask. (16) (17) (18)
Both COVID-19 and NO2 exposure require the same type of hospital treatment, namely intensive respiratory support, and the already struggling hospitals were ill-placed to cope with a disaster on this scale. 300,000 people have been left homeless and three hospitals were severely damaged in the explosion and had to be evacuated. Some victims of the blast had to be taken to hospitals over 50 miles away from Beirut. (19)
Some scientists have theorised that the explosion was so powerful that a lot of the NO2 will have been projected extremely high. It is possible that this will allow it to disperse at a higher level with less toxicity to the city. (20)
The surrounding land and rivers however will become contaminated with knock-on effects on crops and wildlife as NO2 is one of the main components of acid rain. This is likely to affect not just the immediate vicinity but neighbouring countries as well. (21)
Also of note is that a huge grain silo was caught up in the explosion. Silo explosions are a threat in their own right and release sizeable amounts of NO2. The Beirut silo can hold up to 120,000 tonnes of grain across 100 separate cells. The silo walls are still standing in places and the grain can be seen on the surrounding ground. Authorities in Lebanon are claiming that there were only 15,000 tonnes of grain currently stored. Given the footage available this claim will most probably be verified or discredited in the near future. The silos at Beirut store up to 85% of the country's grain and any that has survived the explosion is unlikely to be fit for human consumption. (22) (23)
At the time of writing, protesters have taken to the streets of Beirut for the last three nights and on 10 August 2020 the entire Lebanese government resigned. On the same day Lebanon recorded its highest daily count of COVID-19 cases at 295, a figure likely to keep rising. As a country that was already struggling before the events of 4 August, Lebanon will be unable to rebuild itself without substantial help from the rest of the world. (24)
(3) https://www.worldometers.info/coronavirus/country/lebanon/
(4) https://www.aljazeera.com/news/2020/03/undocumented-struggle-access-coronavirus-tests-lebanon-200328114859620.html
(5) https://apnews.com/14b031bac52e45dfebda490fd8351619
(6) https://timep.org/commentary/analysis/no-funding-and-no-policy-lebanons-refugee-population-amid-covid-19-and-an-economic-crisis/
(7) https://www.the961.com/lebanon-restaurants-closed-down-coronavirus/
(8) https://www.arabnews.com/node/1669066/middle-east
(9) https://www.aljazeera.com/news/2020/07/lebanon-reimposes-covid-19-lockdown-infections-spike-200727192106912.html
(10) https://www.reuters.com/article/us-health-coronavirus-lebanon/lebanon-reimposes-covid-19-restrictions-as-infections-spike-idUSKCN24S2FV
(11) https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health
(12) https://www.gov.uk/government/publications/air-quality-statistics/ntrogen-dioxide
(13) https://www.anera.org/stories/beirut-air-pollution-causes-allergies-illness/
(14) https://aqicn.org/country/lebanon
(15) https://cyprus-mail.com/2020/08/05/potentially-harmful-fumes-released-in-beirut-blast-have-not-reached-cyprus/
(16) https://www.hrw.org/news/2020/08/06/lebanon-set-impartial-expert-probe-beirut-blast
(17) https://www.greenpeace.org/mena/en/guidelines-emissions-beirut-port/
(18) https://lb.usembassy.gov/security-alert-u-s-embassy-beirut-lebanon/
(19) https://www.washingtonpost.com/
(20) https://www.sciencemediacentre.org/expert-reaction-to-beirut-explosion/
(21) https://www.web24.news/u/2020/08/how-a-chemical-explosion-devastated-beirut.html
(22) https://www.youtube.com/watch?v=es-WvbfHM6c (why silo explosions are so deadly in their own right)
(24) https://www.aljazeera.com/news/2020/08/blood-lebanese-demand-change-gov-quits-200811091228350.html
