Africa: Have Refugee Camps Escaped Mass Covid Infections?

Roughly two years into the COVID-19 pandemic, no massive outbreaks have been reported in refugee camps to date. Health experts have some theories about why, but they also urge continued wariness against “the very real and present danger of widespread transmission” in camps, as the World Health Organization has cautioned.

The U.N. refugee agency, or UNHCR, “had been fearing — and preparing for — large outbreaks at refugee camps, which fortunately did not happen,” spokeswoman Aikaterini Kitidi acknowledged in an email exchange with VOA.

“However, this doesn’t mean we are out of the woods yet,” she said. With new variants such as omicron, “which are far more infectious, we may very well see more cases. We must remain vigilant and scale up surveillance and testing, as well as the equitable distribution of vaccines.”

UNHCR estimates that roughly 80 million people worldwide have been forcibly displaced by persecution and conflict, with most living in low-resource countries with frail health systems. Millions of them live in camps — some formal, some informal — with limited water and sanitation facilities. They also face overcrowding, making social distancing a challenge.

Yet comparatively few COVID infections have been reported in the camps: 55 Central African refugees tested positive in the Democratic Republic of the Congo, for instance, as UNHCR reported in a global COVID-19 response update of December 20.

Because of population density, “early on, we were concerned that [COVID-19] transmission would be very high and so would deaths, even with the younger demographics” of refugee camps, said Paul Spiegel, an epidemiologist who directs Johns Hopkins University’s Center for Humanitarian Health. “That hasn’t been the case that we’re aware of — but then data have been very poor.”

Undercounting is a real possibility, Spiegel said. “There could be scenarios where it [COVID] actually has gone through the refugee camps at a high level” but symptoms weren’t severe enough for the infected people to seek care. He added that there hasn’t been enough blood testing “to know the extent that COVID has actually been transmitted in these settings. … It takes a lot of time and money to be able to do this.”

Individual circumstances

Transmission rates ultimately may vary depending on the individual camp or other setting, said Spiegel, a former UNHCR senior official who has responded to crises in the Middle East, parts of Africa and Asia. He was on a team that, early in the pandemic, advised the United Nations, governments and humanitarian groups on best responses.