By the end of January, 2020, UNRWA had already begun to prepare and respond to the COVID-19 pandemic. Given the densely populated, poor living conditions in Palestine refugee camps, UNRWA was deeply concerned about the high potential for rapid flareups of COVID-19 outbreaks in these camp settings. Therefore, as the provider of primary healthcare services for over 5.6 million Palestine refugees across 141 health centres in Jordan, Gaza, West Bank, Lebanon and Syria, UNRWA began to implement measures to protect Palestine refugees and frontline workers. This report outlines the initial UNRWA COVID-19 health response from January until May 2020.