The Israeli-Palestinian conflict could trigger a third Covid-19 wave in Gaza. Some say it’s already here.

Rasha Abu Askar tested positive for Covid-19 less than two weeks ago. So too did her husband, Musa Abu Askar, leaving the couple unable to look after their four young children, a situation that many parents around the world have dreaded during the pandemic.

But this couple live in Gaza and their problems are bigger than childcare arrangements. Two days after they sent their children to their grandparents’ apartment — which is conveniently in the same building as theirs — the worst violence in years erupted on their doorstep between Israel’s powerful military and Palestinian militant group Hamas, armed with rockets and mortars.

Musa Abu Askar says that he and his wife have no access to health services, despite their worrying symptoms, and they are struggling with the separation from their children — aged ten, eight and two four-year-old twins — as Israeli airstrikes pound nearby.

“I am still sick. I can’t see my children — they are at their grandparents’ place. My wife is infected too, and we’re not receiving any services from the Health Ministry. We only have some medicine,” he told CNN by phone from his home.

Rasha Abu Askar can’t help but think of the worst — even though her children are so close by, she worries she may never see them again.

“The fear of losing one of your children and the idea of not being around them in this hard time is so terrifying. I keep calling them to calm them down and tell them that I am beside them,” she said.

While death and destruction has occurred on both sides, it’s Gaza that is being decimated. According to the Israeli military, Hamas has fired over 3,750 rockets toward Israel, killing twelve people, including two children. According to Gaza’s Ministry of Information, Israel has carried out more than 1,800 airstrikes there, destroying buildings and infrastructure. More than 220 Palestinians, including more than 60 children, have died in the bombing campaign, according to the Hamas-run Gaza health ministry.

On Monday, an airstrike that the Israel Defense Forces (IDF) say was targeting Hamas also damaged a nearby Gazan Ministry of Health building, shattering its windows and cutting its power. In the building was one of Gaza’s main testing coronavirus centers and labs, the ministry said.

On Wednesday, the facility was still out of action, its power still turned off, according to the undersecretary of the Ministry of Health, Dr. Yousef Abu Al-Reesh. He said authorities were now turning to privately-run labs to process a very limited number of tests available only to people fleeing to Egypt via the Rafah crossing.

The IDF denies deliberately targeting the building, and the Israeli air force on Sunday accused Hamas of purposely installing its operational centers near civilian populations.

The center was just one of many facilities and services that have ground to a halt in Gaza in this latest round of violence.

A UN report citing Health Ministry data in April showed a 60% increase in active Covid-19 cases in Gaza, though infections appeared to be abating by the end of the month.

Less than 2% of Gaza’s population had received at least one dose of a Covid-19 vaccine at the end of April — a stark contrast to Israel, which has outpaced most of the world in vaccines, inoculating more than 60% of its people with at least one dose so far.

Now Gaza residents, authorities, medical staff and humanitarian agencies are worried the enclave could be hit by a third wave of Covid-19, especially in the dozens of schools run by the UN’s relief agency for Palestinian refugees (UNRWA), which have been transformed into shelters for most of the 72,000 Palestinians who have been displaced by the bombing. The Ministry of Health believes the wave is already here.

“The third wave of Covid has already started, with 30% of people being tested proving positive,” the ministry said in a statement, adding that more than 100 people were being treated for the disease in intensive care units.

Dr. Rami Al-Abadlah, the ministry’s director for the Safety and Infection Control Unit said the health system was under enormous strain and that services were collapsing.

“Things are getting harder. Schools are so crowded with people, there’s no social distancing — we are definitely going to face a health catastrophe. We’re simply not able to get to all infected people,” he said.

UNRWA says it is struggling to meet the needs of so many people while preventing the coronavirus’ spread.

“We are very worried about UNRWA schools-turned-shelters becoming super spreaders, given the overcrowding. In 2014, UNRWA schools did serve as shelters to Palestine refugees in Gaza who were running for their lives, and who slept for days or weeks in UNRWA schools because they expected the schools to be safer than their homes,” Tamara Alrifai, an UNRWA spokeswoman, told CNN.

“This time around the situation is made much more complex by Covid-19 — the high (infection) rates in Gaza and the low rates of vaccination,” she said.

Perhaps the only factor preventing an even bigger health crisis is that Gaza’s population is very young.

UNRWA was administering vaccines in several of its centers in Gaza, but has put a pause on them since violence flared.

“My colleagues in Gaza described a nightmare scenario already on the first day of the conflict, saying the worst thing that can happen is to have people whose homes are destroyed rush to our schools in the middle of this pandemic. Sadly this is what happened.”

On top of the usual provisions — food, clean water, sanitary systems and beds — the agency now has to source enough personal protective equipment to keep the shelters safe.

“Such organizing is extremely difficult in the absence of a ceasefire, let alone in the middle of major destructions of buildings, factories, and health centers,” Alrifai said.

Mahmoud Saleh, a nurse working in a specialized Covid-19 medical center in Gaza, said that they too were pausing vaccinations and that testing was near impossible.

Getting infected people to keep isolating is also a challenge, he said.

“We cannot impose a rule that prevents infected people from leaving their houses. They have to run from the ongoing attacks on Gaza, and find a shelter or any safe place to hide with their families.”