The first COVID-19 case has been confirmed in Syria’s war-torn Idlib province. Humanitarian organizations working in northwest Syria have long feared an outbreak could severely hurt the population there that is contending with massive displacement and the ongoing war between government and rebel forces.

Conditions in Idlib make it susceptible to a large outbreak, a nongovernmental organization official said. “The millions who live in this region are often residing in close quarters, may not have enough clean water for drinking and handwashing, and frequently lack the necessary resources to protect themselves,” Mercy Corps’ Syria director Kieren Barnes said in a statement sent to Al-Monitor today.

The first case of the novel coronavirus in Idlib was confirmed by local health authorities, Mercy Corps said, and reported by various local and international outlets.

Idlib is largely controlled by the Hayat Tahrir al-Sham rebel group. Hayat Tahrir al-Sham follows an extremist version of Islamism and used to be al-Qaeda’s affiliate in Syria. Idlib is one of the last rebel strongholds in Syria. Turkish-backed rebels also control parts of the north.