As coronavirus cases surge in Libya, medics and officials working with a health system wrecked by years of division and war are warning that the pandemic could be slipping out of their control. The conflict has also restricted movement within Libya, and confirmed cases remained low during the first months of the outbreak. Now, infections are jumping by up to several hundred per day to reach a total of nearly 8,200, including more than 150 deaths. Hotspots include the capital Tripoli and the large port city of Misrata in the west, and the city of Sabha in the south. Medics say the virus is spreading because people have carried on attending large gatherings including weddings and funerals, and are not practising physical distancing. Ahmed al-Hasi, spokesman for the state medical committee responsible for countering the virus in eastern Libya, said the public needed to take precautions, or else medical staff with limited resources would become overwhelmed. “They need to know that the virus is real, the casualties are real, the deaths are real,” Hasi said. In Hay al-Andalus, an upscale suburb of Tripoli, Mayor Mohamed al-Fataisi told reporters the situation had become “dangerous”, adding: “We are unable to contain the disease.” Night-time curfews across the country are often not respected, and there is a requirement to wear face masks in public spaces in western Libya but not in the east. The two parts of the country are run by separate administrations. A sharp fall in living standards has anyway left many struggling to afford even minor expenses, including masks. “People are asked to wear masks and use (santitising) alcohol, but no one knows that they have not been paid salaries,” said Abduladeem Mohamed, a Tripoli taxi driver. “I prefer to buy bread for my children.” Libya’s National Centre for Disease Control, which operates across the country, could not be reached for comment. CONFLICT’S TOLL Libya’s health facilities have long been weak. But a stop-start conflict that has split the country into rival camps has destroyed or damaged some medical facilities and left others struggling to function. Frequent power cuts during summer months add to the challenges. Rick Brennan, the World Health Organization’s regional emergency director in the Middle East, said the agency had faced serious logistical constraints in Libya, including “major challenges bringing the PPE in, the testing kits”. “I think there’s a reasonable understanding of what’s needed, it’s just having the capacities to deliver that’s the problem,” he said. Marwa Abdulkader Alhudhairy, a resident of Sabha, said her 70-year-old father started developing coronavirus symptoms on July 8, but was only able to find a PCR swab test on July 23. Despite suffering from heart problems, he self-treated at home because “he is well aware of the lack of protective equipment and means available to deal with coronavirus”, she said. Though he eventually recovered, “we went through very difficult moments as we almost lost him”, Alhudhairy said. In eastern Libya, controlled by rival authorities to the internationally recognised government in Tripoli, officials fear they will be unable to cope with a surge in serious cases. “We worry that there will come a time, and that time is not far away, when the healthcare system is unable to receive patients that need ventilators,” said Fadi Farag al-Fortas, a doctor at the Benghazi Medical Centre.