Protecting refugee camps from COVID-19: the case of NW Syria
Empowering the crowd: Feasible strategies to minimize the spread of COVID-19 in high-density informal settlements
Over one million people living as refugees in about 1,000 camps in the north-western region of Syria are especially vulnerable to the coronavirus pandemic.
An international group of scientists has modelled the risks COVID-19 poses to these settlements, and the potential beneficial impacts of a few simple interventions. Their results show that, if left unchecked, COVID-19 could kill up to 10% of the people living in the refugee camps. However, implementing a combination of simple non-medical measures could drastically reduce the impact of a coronavirus outbreak in the camps, and be beneficial to those living in the vicinity of the camps, reducing pressure on their already burdened health systems.
Other areas of Syria with high concentrations of refugee camps, such as the North/Northeast (under the control of the Kurdish autonomous administration) and South/Damascus suburbs (under the control of the Syrian government) may also benefit from this research. The researchers believe that similar strategies could and should be adopted in other settings with informal settlements around the world, potentially benefiting up to 2 billion people living in informal settlements and slums worldwide.
The research is the result of a collaboration between the Pax Syriana Foundation, a social purpose civil society organization, and a group of volunteer scientists recruited by Crowdfight Covid-19, a non-profit online platform where thousands of scientists offer their time and skills to help fight the coronavirus pandemic.
Three levels of protection
An average of 5.5 people live in each tent in the refugee camps of NW Syria. There is a high prevalence of comorbidities among the refugees, who are challenged by inadequate access to healthcare, and poor sanitary conditions. In these conditions, enforcing a strict lock-down is infeasible.
The first strategy modelled by the researchers is self-distancing, that is, encouraging residents to reduce physical contact with others, wear masks, and wash hands regularly, similar guidelines to what the World Health Organization has been recommending since the beginning of the pandemic.
The researchers estimate that reducing the number of contacts by 20% to 50%, could reduce mortality up to about one third.
A second strategy consists of isolating potentially symptomatic cases as early as possible, even in the absence of validation by a diagnostic test that can detect the SARS-CoV-2 virus that can cause COVID-19. Simple temperature checks alone would considerably impact the fate of a camp. A realistic and affordable intervention would involve equipping each camp of 1,000 persons with 10 to 25 individual tents, typically igloo washable tents, where persons suffering from any symptom could self-isolate until three days after the disappearance of their symptoms. Such an intervention would require the local community to ensure aid and care are provided to self-isolated persons.
The third strategy consists of splitting a camp into two zones: an exposed zone where most of the residents of the camp would stay, and a smaller “safety zone” where 10 to 30% of the camp would be protected and self-organized. The safety zone would protect the fraction of the population that is highly vulnerable to COVID-19, i.e., the elderly, persons with chronic diseases, and a limited number of accompanying family members to ensure appropriate care for those in need. Meetings between both sides of the camps could be organized in a “buffer zone”, simply consisting of an open tent, as long as simple measures such as mask wearing and social distancing are adhered to. The local community will have to organize for the provision of food and all necessary aid to the protected population.
Most strikingly, when all three non-medical measures are applied, the researchers’ model indicates that most lives could be saved, potentially up to 85,000 lives in NW Syria alone.
Contact for Syria-related enquiries:
Dr Chamsy Sarkis,