Northwest Syria is suffering from shortages of COVID-19 testing kits and oxygen amid an outbreak, a leading humanitarian organization said Wednesday.

The International Rescue Committee’s Syria director said the situation is worsening to levels of the previous coronavirus outbreak at the end of 2020.

“We are sincerely hoping that the severity of the situation in the first wave is not repeated, but already some patients are being turned away from community treatment centers and others are being admitted to non-COVID hospitals, increasing the risk of an outbreak in these facilities,” said Tanya Evans in a statement sent to Al-Monitor.

Northwest Syria is mostly controlled by Syrian rebels. The strongest group is the former al-Qaeda affiliate Hayat Tahrir al-Sham, which dominates the Idlib province. The hard-line Islamists have been accused of human rights abuses and recently created a morality police force. The area has been severely damaged by years of fighting with the government. Two million Syrians displaced from other parts of the country live in Idlib among a total population of more than 3 million.