Lebanon has faced numerous challenges in the last three decades that have greatly impacted its health-care system, which has been historically disjointed first by the civil war (1975-1990), and second by the arrival of significant numbers of Palestinian and Syrian and refugees (1). Although Lebanon has tried to absorb these systemic shocks and recover, its health system has continued its slow decline and highlighted by events in 2020.

The fragility of health-care systems worldwide were demonstrated by the COVID-19 pandemic that emerged in 2020 (2). Protective measures that are essential to a health-care system (ie standardization of processes, analysis of adverse events, accreditation, etc.) are insufficient for handling unforeseen events (3). Lebanon suffered a hattrick of simultaneous events during 2020–the economic crisis, the Beirut blast and the COVID-19 pandemic–which sorely tested its ability to orchestrate recovery efforts. These events have accelerated the slow demise of the Lebanese health-care system into a disastrous free fall.