“The virus does not respect travel bans, closed borders, and a cessation of trade. The grave reality is that if and when COVID-19 sweeps through Idlib, it will likely prolong the suffering of Syrians, Lebanese, Jordanians, Turks, Iranians, Russians, and Europeans,” said Cook.

Syria has so far reported just five cases of the coronavirus, yet it is only a matter of time before it comes to Idlib – likely spread by the many actors involved there, such as Iranian fighters, Turkish troops, Russian military personnel, European journalists, or foreign aid workers.

Some one million civilians have been displaced and are living in dire conditions near the Turkish border since December as Russia-backed Syrian government forces have intensified an offensive to seize territory from Turkey-backed Syrian rebels in Idlib, marking the worst humanitarian crisis in the nine-year war.

Idlib already lacks even the most basic medical care, never mind the medical infrastructure necessary to deal with an outbreak of the coronavirus pandemic. Syrian government forces and their Russian allies have deliberately targeted hospitals in the area. Some COVID-19 test kits have been made available in Idlib, which are then sent back to Turkey for analysis, but not enough.

“When the outbreak accelerates [in Idlib] and becomes obvious, it will be horrific,” said Cook.

As Idlib is a war zone, containment measures are unlikely to be effective or even implemented. “It is thus hard to imagine that the virus has not already slipped the borders of Idlib into Turkey, the rest of Syria, Lebanon, Jordan, and Iran. The Idlib outbreak will compound the problems these countries are already having dealing with a highly infectious and deadly virus,” he wrote.

Syria is also close to Europe by way of Turkey, and seemingly healthy diplomats, global health experts, border agents, cargo pilots, and soldiers who can still move around during the pandemic can spread the virus, and compound the global crisis.

Cook said that, in a normal world, global powers would marshal the resources and expertise necessary to launch a concerted effort to tackle the virus, including in Syria. But with the United States and China arguing over responsibility for the coronavirus and many leaders likely choosing to stand aside, as they have done throughout much of Syria’s civil war, the world will watch COVID-19 explode all over Idlib and then ultimately other countries, said Cook.

“As a result of this inaction, they will bear moral responsibility for deaths in Syria, the Middle East, and Europe that did not have to happen,” he said.

Reporter’s code: 50101