Health authorities in the territory of two million people are concerned over the potentially disastrous combination of poverty, densely-populated refugee camps and limited hospital facilities in dealing with an outbreak, Reuters reported.

A government spokesman said four cases of the coronavirus were confirmed in a single family in a refugee camp, the first in Gaza that did not involve people quarantined in facilities after crossing into the coastal enclave from Egypt and Israel.

Citing security concerns, both Egypt and Israel maintain tight restrictions at the enclave, leaving Gazans with little access to the outside world for years.

With businesses, schools and mosques ordered closed late on Monday for at least 48 hours, Gaza’s streets were largely deserted. But some people scrambled to stock up on essentials in groceries and bakeries, a limited number of which were allowed to remain open.

Police vehicles used loudspeakers to urge Gazans to abide by the lockdown.

The health crisis came amid heightened tensions along the Israel-Gaza fence.

“No war has ever forced the people into a strict curfew (but) a weak virus has confined two million in the Strip,” Freih Abu Middain, a Gaza-based former justice minister, wrote on social media. “All of (Israel’s) F-16s, missiles and tanks couldn’t do that.”

Gaza’s Health Ministry said the four COVID-19 cases were uncovered after a woman traveled to the West Bank, where she tested positive. It said it was carrying out contact tracing to stem the spread of the infection.

The ministry said there have been 110 cases of the coronavirus inside quarantine facilities and one death since the world pandemic began.

Last month, the Gaza director of the World Health Organization, Abdelnaser Soboh, said the territory’s health system could deal with only 500 positive cases at one time.

The coastal sliver of land has been under a siege by Israel since 2007 and witnessed three wars since 2008.

It has also been the scene of deadly tensions since March 30, 2018, which marked the start of the Great March of Return protests, with protesters demanding the right to return for those driven out of their homeland by the Israeli occupation.

Israel’s 13-year blockade of the strip has gutted the coastal enclave’s economy and deprived its roughly two million inhabitants of many basic commodities.