Protecting Refugees from COVID-19 in Preparation for a Second Wave...

The demolition of the COVID-19 Isolation Facility, image courtesy of KH volunteer Patrick Lee, August 2020.

All that coughs is not Covid, so how do you screen for and prevent an outbreak in a refugee camp setting?

“Stay home, save lives.”

What if your home is a tent in an overcrowded refugee camp?

“Wash your hands frequently.”

What if you live in an olive grove without access to running water?

“If you develop a cough or fever, self-isolate for 7 days. If you have contact with anyone with

these symptoms, self-isolate for 14 days.”

What if you need to queue three times a day to get meals? And share a bathroom with hundreds of others? And most people you encounter have a cough?

We have no access to blood tests, no access to imaging, a very limited availability of COVID swab processing on the island, cannot tell anyone to self-isolate, and it is near impossible to implement social distancing. Handwashing facilities are few and far between, many people here suffer from chronic respiratory diseases and nearly everybody has a risk factor for vulnerability.

So, how are Kitrinos and the NGOs in Moria working to help prevent an outbreak?

Up to 200 patients used to queue at the Kitrinos clinic in Moria in the early hours of the morning every day. Now, a central triage area has been built outside of the camp where patients must go to be seen. Here, all patients have their temperature checked, and are screened for any respiratory symptoms. If they’re in the clear, they can queue in small numbers in order to help social distancing.

Every patient is given a mask and washes their hands when they enter the clinic, which is fully disinfected at the start and end of every shift. In our emergency room, where it is not possible to screen patients for possible Covid-19 symptoms, our patients are now able to enter via a newly-built separate door, and all our doctors and nurses treating them wear full PPE.

What about patients who are displaying symptoms?

It can be difficult to ascertain the cause of respiratory symptoms, as respiratory tract infections are incredibly common and there are many patients who suffer from TB, asthma, bronchiectasis, and allergies. Until its closure last week, I was supporting our colleagues to staff the Lesvos Covid-19 isolation centre. This facility was a safe way for us to isolate patients in the camp who may have symptoms of COVID-19, whilst we carried out a swab, waited for the result, and provided any medical care the patients needed during their isolation. This often included antibiotics, medications for fever, and we were also able to offer a psychological service. There was a doctor on-site 24 hours a day, 7 days a week and the centre was a vital service to keep the residents of Moria safe.

Earlier this month, the isolation centre was forced by Greek authorities to close. It was incredibly sad to see such an important structure demolished so prematurely, particularly at a time when COVID-19 cases on the island of Lesvos are rising. We have not been given any alternative isolation facility for patients with possible COVID-19 symptoms, increasing the likelihood of spread within the camp, where conditions remain crowded and unsanitary. The isolation facility had enabled us to test up to 16 patients at a time, and should positive cases be identified, the structure was suitable for 40 patients, removing a large burden from the local hospital services.

Patients who we are concerned may have COVID-19 can be referred to the hospital in Mytilene, however with such a large camp and also the island population at risk, the local hospital could be quickly overrun. For now, we must rely on prevention measures to reduce the risk of COVID-19 spreading inside Moria. Strict use of PPE from staff, frequent handwashing, installing more handwashing facilities and distributing hygiene equipment are all helping Kitrinos keep Moria safe.

You can donate to the Kitrinos Healthcare Emergency COVID-19 Response Appeal here.

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