Timbuktu, a notoriously difficult town to reach in the Sahara Desert, has reported hundreds of coronavirus cases in recent weeks as health officials worry that the virus could spread to other remote areas controlled by extremist groups.

With no commercial flights to Timbuktu, its remote location has long made the town's name synonymous with the ends of the Earth.

Health officials say the global pandemic has managed to reach there all the same. Already there are more than 500 cases including at least nine deaths, making it Mali's largest outbreak outside the capital.

In this photo taken Thursday, May 21, 2020, a delegation led by Mali's Minister of Health Michel Sidibe, right, visits the isolation tent for patients with the coronavirus in Timbuktu, Mali. COVID-19 has made its way to Timbuktu, a town whose name has long been synonymous around the world with remoteness. (AP Photo/Baba Ahmed)

At the local hospital, a cluster of tents set up outside housed more than 30 COVID-19 patients on Wednesday. There isn't a single ventilator available, and temperatures regularly soar above 113 degrees Fahrenheit, adding to the patients' misery as they battle fever.

COVID-19 first arrived in Mali back in March. By April, the virus had made its way 620 miles from the capital city of Bamako to Timbuktu, a more than 24-hour journey by road.

The official death toll has reached nine, but at least six others who died later tested positive, too.

So far the hospital there has had enough oxygen tanks to treat its patients battling COVID-19. But having enough nurses to administer it remains a struggle, especially now that there are 32 patients too sick to recover at home under confinement.

Few medical specialists remain to treat those with the coronavirus, whose complications have baffled doctors around the globe. There are no radiologists to read the chest X-rays, no lung specialists with experience in respiratory diseases or doctors specialized in kidney issues, which have emerged as one of COVID-19's grave complications.

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"We don't have a public health doctor, let alone an epidemiologist," said Djibril Kassogué, the regional health director for Timbuktu.

The location isn't an easy one, either, when it comes to recruiting more health professionals. The risk of violence remains high in this region where Westerners have long been kidnapped for ransom by extremist groups. Regular U.N. peacekeeping patrols are a daily reminder of just how unstable northern Mali still is more than seven years after Islamic extremists were chased from power there.

From the surrounding desert, extremists continue to plant roadside bombs across the north, adding to the isolation. The U.N. mission does run flights to and from Bamako, and often transports COVID-19 tests from distant locales to the capital. When that's not possible, local health officials have resorted to sending them aboard public buses.

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This month, Mali's health ministry sent a mobile laboratory to Timbuktu with a team capable of conducting more than 100 tests a day.

The Associated Press contributed to this report.

Coronavirus spreads to Timbuktu, despite its remote location

Since first arriving in Mali in March, the coronavirus has infected at least 500 people and counting.