In the ragged displacement camps of northern Syria, where families huddle together under tattered tarps to try to keep warm, few say they worry about getting Covid-19, much less a vaccine.
Omar Kurde, 39, is one of 900,000 people displaced by the Syrian war in rebel-held Idlib. Having fled his home town of Aleppo, he now lives in a camp near the Turkish border in the Harem district.
For him, the hardships of surviving the day are more worrying than a virus he can do little about.
"I, and many Syrians, do not care about the virus killing me here with my family. Starvation and poverty are our daily struggle and may kill us faster than Covid-19," he tells The National.
But one message is clear – after years of Russian support for Bashar Al Assad's regime, those in the last rebel-held region are reluctant to take a vaccine delivered by Moscow.
After years of war, many in theregion find it hard to separate the geopolitics of the conflict from the Covid-19 pandemic.
When asked, Omar says he would consider taking the Russian vaccine only if he was "on the verge of death".
Syria is yet to secure a vaccine for Covid-19. If and when it does, it is unclear if there will be a unified national campaign or whether the divided country will end up with parallel systems.
In October, Russia said it would supply Damascus with its Sputnik V and EpiVacCorona vaccines. But there has been no announcement on how this could be distributed or when it may arrive.
Damascus could launch one drive while in the rebel-held areas of Syria’s north-west, drugs could be brought in through the Turkish border town of Gaziantep.
But people would refuse to take a Russian-made vaccine, two doctors and a humanitarian worker in Idlib tell The National.
This sentiment is a worry to local doctors and to bodies such as the World Health Organisation who are concerned Idlib residents are downplaying the risks of Covid-19.
“When your house is bombarded, [people are] losing limbs, or you experience a long period of hospitalisation or even suffering due to bad weather and seeing that most people with Covid-19 are recovering or asymptomatic, you begin feeling that the coronavirus is just a flu, undermining the true severity of it,” says Mahmoud Daher from the WHO office in Gaziantep.
Mr Daher says that for many, it is hard to separate the geopolitics of the Syrian war from their view of the virus and a cure.
“Linking the sources of the vaccines with those who contributed to their suffering, and taking prevailing political dimensions into consideration, means people are affiliated with different countries across Syria and link their support to vaccine manufacturers with their political alliances,” Mr Daher says.
Dr Mahmoud Shahem, an internist specialist who works at Idlib national hospital’s quarantine unit, echoes the view.
“People feel that there’s no way that the same pro-regime Russians would provide them with a vaccine that could save them from the virus,” he said.
With a shattered health system in north-east Syria, Covid-19 is already taking a toll.
The Assistance Co-ordination Unit (ACU), a Syrian opposition NGO funded in part by USAID and the UK’s DFID, is one of the few sources of data on the coronavirus situation in north-west Syria.
They reported 18,774 cases in north-west Syria alone as of December 14 even though the whole country officially has only 9,302 cases.
A situation where many choose to shun a vaccine could be catastrophic.
With what the WHO describes as a decimated healthcare sector, only half of north-west Syria’s healthcare facilities are working and, more starkly still, about 1,000 doctors cater to the area’s population of four million.
While the civilian population there struggles to reconcile with a reality where an effective Russian vaccine could be a viable option, some of the few frontline workers in north-west Syria believe that medical solutions should be perceived apolitically.
Harem Hospital’s Dr Hosam Mohammad puts it succinctly.
"I think that medication should be neutral and not subjected or drawn into political labelling or shaming since its ultimate goal is to heal and help, which is what north Syria needs most," he says.
