UNITED NATIONS — A report says Venezuela’s broken health system is “grossly unprepared” to deal with the COVID-19 pandemic, warning overcrowding and limited access to water in hospitals and homes make it likely the coronavirus illness will rapidly spread.

The report by Human Right Watch and Johns Hopkins University’s Centers for Public Health and Human Rights and for Humanitarian Health says the massive exodus of Venezuelans and crossing of the country’s borders due to the pandemic is increasing the risk of spread.

The report says on Monday, Venezuela had 1,121 confirmed cases of COVID-19 and 10 deaths. But “the real number is almost certainly much higher, given the limited availability of reliable testing, limited transparency, and the persecution of medical professionals and journalists who report on this issue.”

Human Rights Watch and Johns Hopkins urged U.N. Secretary-General Antonio Guterres and U.N. humanitarian chief Mark Lowcock to lead efforts to address this “humanitarian emergency.”

They called on the Lima Group of mostly conservative-run regional countries seeking to defuse the crisis in Venezuela as well as the United States and the European Union to press Maduro to “immediately open doors to a full-scale, U.N.-led humanitarian response to prevent catastrophic spread of COVID-19.”