SITUATION REPORT #49 / 05 April 2021 Reporting Period: 23/03

EMERGENCY RESPONSE TO COVID-19 in Mixed Migration Context in Bosnia and Herzegovina

SITUATION REPORT #49 / 05 April 2021 Reporting Period: 23/03 – 05/04/2021 http://drc.ba/covid19_resources

BIWEEKLY HIGHLIGHTS UPDATES:  176,252 cases of COVID-19 confirmed in BiH, 6,947 deaths and 133,190 recovered patients.1 143 PoCs exhibiting  143 PoCs exhibiting COVID-19-like symptoms monitored by PHC and DRC medical symptoms and teams in TRC Blazuj (34), TRC Usivak (7), TRC Miral (82) and TRC Sedra (16) and TRC isolated in Borici (4). reception facilities  109 positive PoCs isolated and monitored by PHC and DRC medical teams in TRC 1,351 PoCs Blazuj (9), TRC Usivak (7), TRC Miral (82) and TRC Sedra (11). screened in  192 new PoCs exhibiting COVID-19-like symptoms referred to symptomatic reception facilities isolation in reception centers: 90 in TRC Miral, 43 in TRC Sedra, 4 in TRC Borici, 13 in TRC Usivak and 42 in TRC Blazuj. 176 new PoCs  1,140 PoCs screened for COVID-19 symptoms: 366 new arrivals to temporary confirmed positive for COVID-19 reception facilities in BiH during the reporting period; 774 examinations of PoCs experiencing symptoms.

CUMULATIVE:  40 PoCs monitored in preventive isolation by DRC Medical Officers (39 in TRC Borici and 1 in TRC Sedra). 265 PoCs positive for COVID-19  74 PoCs referred to preventive isolation in reception facilities.  868 PoCs tested for COVID-19, 176 results confirmed positive. 68,851 COVID-

19 screenings in reception facilities KEY DEVELOPMENTS AND CHALLENGES and in out-of-site locations  Following the rise in COVID-19 cases among PoCs accommodated in TRC Miral, blanket PCR testing was performed for the entire population of this center. Out of 698 tested PoCs, 137 were positive for SARS-CoV-2 (19.6%). All positive cases were

1 Official statistics for Federation of BiH, Republika Srpska and Brcko District

1,591 PoCs asymptomatic or had a mild form of the disease. The recommendations of Public tested for COVID- Health Institute of USC – which had been implemented by DRC and other actors 19 after the first reported positive cases – were extended until 12.04.2021. The existing isolation capacities were increased in order to accommodate all positive cases and contacts, currently reaching approx. 200 beds.

 Additionally, PCR testing was performed on 155 service providers, out of whom 21 were positive for SARS-CoV-2. All positive staff members were informed by DRC, advised to self-isolate and take necessary measures, and to contact local PHC for further support. A short epidemiological assessment was conducted in order to trace potential contacts inside the TRCs, and with the support of Public Health Institute of USC appropriate actions were taken. All positive cases are currently asymptomatic or presenting a mild form of the disease.  11 confirmed cases of COVID-19 were reported in TRC Sedra (out of 43 tested individuals), all coming from the already accommodated population. DRC, with the support of IOM, PHC medical team, and following the recommendations of PHI of USC, has taken necessary actions to prevent the spread of COVID-19 infection inside TRC Sedra, as well towards other reception centers in USC – including lockdown of TRC Sedra from 26.03.2021. Blanket PCR testing of 152 service providers was conducted as per PHI USC recommendations, pending results.

 9 confirmed cases of COVID-19 were reported in TRC Blazuj, and 7 in TRC Usivak, all within the already accommodated population. Upon contact tracing and further epidemiological investigation, appropriate actions were taken in order to prevent the spread of COVID-19 infection inside both TRCs.

 Two cases of COVID-19 were reported in the Tuzla Safe House. Following recommendations of the PHI TC, the Safe House was placed under quarantine for 14 days, with strict IPC measures to be followed. Additionally, blanket testing of 19 service providers was conducted, with only 1 positive for SARS-CoV-2.

 After 3 weeks, on Monday 29.03.2021, the lockdown was lifted for TRC Borici. Isolation was extended for 10 positive cases, as per recommendations of the PHC medical team. As of 05.04.2021, there have been no more active cases of COVID-19 inside TRC Borici.

 Due to the rise in numbers of COVID-19 among PoCs, as well as among service providers, it is urgently needed to improve compliance with infection prevention and control (IPC) measures recommended by health authorities, namely properly wearing a mask, keeping physical distance, practicing hand and respiratory hygiene, as well increasing capacity of preventive and symptomatic isolation and activities of health promotion related to COVID-19 prevention. Furthermore, blanket screening and testing of all beneficiaries, as well service providers, needs to be performed as

part of the COVID-19 Emergency and Preparedness Plan for People of Concern in Temporary Reception Centres in BiH.

 A total of 53 PoCs were discharged from preventive isolation in all TRCs in BiH, and 113 PoCs from symptomatic isolation, on expiry of the isolation and monitoring period. In the same period, 33 PoCs left preventive and 46 PoCs left symptomatic isolation of their own will.

PREVENTIVE ISOLATION OVERVIEW 25 23

20 16 15 13 11 9 10 7 6 5 4 4 5 5 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 22-Mar 23-Mar 25-Mar 26-Mar 27-Mar 29-Mar 30-Mar 31-Mar 1-Apr 2-Apr 3-Apr

# of PoCs referred to isolation area (new arrivals/ pushbacks/ exposed to COVID-19) on the date of reporting* Discharged from preventive isolation Left preventive isolation

SYMPTOMATIC ISOLATION OVERVIEW 50 41 38 40 30 30 26 27 20 20 12 12 10 8 8 8 8 7 7 6 10 4 4 4 5 2 3 3 0 0 0 1 0 0 0 0 22-Mar 23-Mar 25-Mar 26-Mar 27-Mar 29-Mar 30-Mar 31-Mar 1-Apr 2-Apr 3-Apr

# of PoCs referred to isolation, exhibiting symptoms of COVID-19 on the date of reporting** Discharged from Symptomatic isolation Left Smytomatic Isolation

 Outreach response: o Due to the high number of positive cases among service providers, as well increased workload inside quarantined TRCs, DRC Outreach medical teams were allocated to support the activities inside TRCs.

OPERATIONAL PREPAREDNESS AND RESPONSE

 COVID-19 Response in TRCs in BiH: o As the number of COVID -19 cases among PoCs is on the rise, capacity of symptomatic isolation areas has been increased. At the moment, a total of 152 beds in TRCs in USC are available for preventive isolation and a total of 384 beds for POCs with COVID-19 symptoms.

OVERVIEW OF DESIGNATED ISOLATION AREAS (COVID-19) 5 APRIL

2000 1771 1800 1600 1400 1200 1000 748 800 661 600 400 257 178 100 114 113 200 0 44 0 50 20 6 0 0 Usivak Blazuj Miral Borici Sedra Current no of PoCs in TRC Isolation for Preventive monitoring Isolation for COVID-19 expressed symptoms

 Coordination with authorities and health actors: o Following the reports of COVID-19 confirmed cases inside TRC Sedra, the PHI of USC has shared with DRC a set of recommendations in order to prevent further spread of COVID-19 in the reception centers: - Quarantine of TRC Sedra, which includes the isolation of all PoCs who are currently accommodated there, for a period of 14 days since the first reported case (until 07.04.2021.); this includes a ban on the exit of beneficiaries, and a ban on admission of new beneficiaries in the TRC; - COVID-19 blanket screening of the entire population accommodated in TRC Sedra, and isolating and testing the suspect cases as per protocol. - Suspension all collective activities for a period of 14 days. - Daily measurement of the body temperature of all PoCs accommodated, for the next 14 days; separate and test febrile ones according to the protocol.

- All PoCs to wear a mask, as well maintain physical distance and practice hand hygiene during the next 14 days, especially during close contact activities (dining, using the bathroom, etc.); - Daily disinfection of all rooms, during the next 14 days. - Ventilation of all the rooms of the TRC as often as possible (according to the weather conditions), during the next 14 days. - PCR testing of all service providers working in the TRC Sedra after 7-10 days (if conditions allow) in order to prevent further spread of the infection among general population, and vice versa. - In addition to the obligatory wearing of a protective mask and gloves and maintaining physical distance, all service providers to monitor their health condition on a daily basis and report possible symptoms to health institutions. - Service providers to ensure fix teams and to avoid the rotation of the teams between the TRCs, in order to reduce the possibility of transmitting potential infection to other TRCs in the USC.

- Suspension of all unnecessary visits of officials and other actors who are not involved in the direct provision of services to PoCs in TRC Sedra during the next 14 days, except in case of emergency. o The medical teams of the Public Institution of the Primary Health Center Sarajevo Canton (JUDZKS), which successfully carried out most of health care activities in TRCs with DRC, have not been present in reception centers Blazuj and Usivak for the last 3 weeks due to: 1. overburdening with COVID-19 response in CS, 2. no modality available to engage additional staff from the labor market due to temporary status of medical units in TRCs and 3. preparatory activities for immunization (COVID-19) for general population. Currently, the delivery of health care in TRCs Blazuj and Usivak relies exclusively on Danish Refugee Council medical staff. DRC has organized a number of meetings ministries of health at federal and cantonal level and relevant health actors and based on the circumstances, DRC has been recommended to contractually engage with private health sectors until further notice and in such a way reduce public health risks. - As of 5 April, DRC has engaged a private clinic from Canton Sarajevo (two teams of general practitioners and nurses) to resume the delivery of primary health care services in TRCs Blazuj and Usivak until further notice. The CCCM of TRC Blazuj and Ušivak have been informed about the circumstances in order to adjust the operational modalities within the TRCs.

 Measures related to humanitarian staff: o Following the increased numbers of confirmed COVID-19 cases among service providers, humanitarian staff working in the reception centers and out of site locations should continuously

self-monitor2. In case humanitarian staff have been in contact with persons confirmed positive for COVID-19, they should inform their health provider and follow the suggested measures. Staff exhibiting COVID-19 like symptoms, including fever, should suspend their presence from the reception centers until fully recovered. Additionally, information needs to be shared with DRC medical teams, to ensure contact tracing and mitigating the risk of spread of COVID-19 infection.

MEASURES ANNOUNCED BY BIH AUTHORITIES

The Government of FBiH, during the coordination meeting held on 22nd of March, confirmed the already imposed orders, as well restricting movement in the Federation of BiH from 9 pm to 5 am, as well as mandatory wearing of protective masks. http://www.fbihvlada.gov.ba/bosanski/aktuelno_v2.php?akt_id=9175

MEDIA REPORTING

1. Bosnia reports 636 new coronavirus cases and 66 fatalities Bosnian health officials reported 636 new Covid-19 cases on Monday, along with 66 virus-related fatalities. Bosnia reports 636 new coronavirus cases and 66 fatalities - N1 (n1info.com) 2. Protest against new restrictions in Bosnia's Republika Srpska region (VIDEO) Hospitality workers gathered in central Banja Luka, Bosnia's second-largest city and administrative centre of Republika Srpska entity, to raise their voice against the new anti-epidemic measures. Protest against new restrictions in Bosnia's Republika Srpska region (VIDEO) - N1 (n1info.com) 3. Minister Ćemalović about the situation in TRC Borići We have 50 COVID-19 positive migrants, most of them are in Borići. Every person who works in this center has been tested and we have 12 positive cases. VIDEO: Ćemalović za USKinfo.ba: Imamo 50 pozitivnih migranata, većina u Borićima - Testirani svi radnici, 12 je pozitivno - USKinfo.ba 4. Vaccines are finally arriving in Bosnia and Herzegovina through COVAX mechanism The long-awaited news from COVAX arrived at the address of the Ministry of Civil Affairs of BiH yesterday. “The arrival of 24,000 doses of diluent is expected on March 23, while 23,400 doses of BioNTech/Pfizer vaccine arrive on March 24” the Ministry of Civil Affairs of BiH announced. Vaccines are finally arriving in Bosnia and Herzegovina through COVAX mechanism - FENA.NEWS

2 The Federal Institute for Public Health has made available the online self-assessment test on COVID-19, available at https://www.zzjzfbih.ba/covid-19/ 6

5. Hayat TV: Nicola Bay, DRC Country Director about health care for migrants (…)The Danish Refugee Council in BiH – with funding from the European Commission Directorate-General for European Civil Protection and Humanitarian Aid Operations (DG ECHO) – focuses on improving access to primary and secondary health care, including psychosocial and mental health services, for refugees, migrants and asylum seekers, as well as on enhancing the overall protective environment, primarily for the most vulnerable persons of concern, including the survivors of SGBV (Sexual and Gender Based Violence). (…) COVID- 19 testing is included in medical care provided to people on the move as well as treatment within temporary reception centers under medical surveillance or – in case of severe health conditions – treatment in medical institutions, all in accordance with WHO and local health authorities’ recommendations, and with the same level of treatment that is available for the local population. DO SADA BILO ZARAŽENO SAMO 45 MIGRANATA: DIREKTOR DANSKOG VIJEĆA ZA IZBJEGLICE O ZDRAVSTVENOJ NJEZI RANJIVIH KATEGORIJA | Hayat.ba 6. HC Velika Kladuša for USKinfo.ba - Situation under control - Vaccination of employees completed; we plan to test migrant in TRC Miral “Although the epidemiological situation has worsened, the situation at the HC Velika Kladuša is under control… In cooperation with the DRC, we plan to test all migrants in the camp Miral,” said director Okanović for USKinfo.ba Direktor DZ Velika Kladuša za USKinfo.ba - Stanje pod kontrolom - Izvršena vakcinacija radnika - U planu testiranje u Miralu - USKinfo.ba 7. Turković: People's Republic of China to provide 50,000 doses of vaccines for BiH The Government of the People's Republic of China has provided 50,000 doses of coronavirus vaccines for Bosnia and Herzegovina, said this morning Chinese Ambassador to Bosnia and Herzegovina Yi Ping in a conversation with BiH Foreign Minister Bisera Turković. Turković: People's Republic of China to provide 50,000 doses of vaccines for BiH | FENA 8. Restriction of movement from 9 pm to 5 am in entire FBiH as of today At yesterday’s emergency, telephone session, the FBiH Government took note of the information on the epidemiological situation in the Federation of BiH until March 22, and the orders and recommendations of the Crisis Staff of the FBiH Ministry of Health, adopted with a validity period of 14 days, starting from March 24, 2021. Restriction of movement from 9 pm to 5 am in entire FBiH as of tomorrow - FENA.NEWS 9. Serbian President donated respirators to hospitals in Republika Srpska The President of Serbia, Aleksandar Vucic, presented Milorad Dodik, the Chairman of the Presidency of Bosnia and Herzegovina, with 30 clinical respirators, five transport respirators and 10,000 masks, a donation intended for the Republika Srpska.

Serbian President donated Respirators to Hospitals in Republika Srpska - Sarajevo Times 10. Bosnia receives first doses of Covid vaccines through COVAX system After several delays, Bosnia and Herzegovina received on Thursday the first batch of Covid-19 vaccines it purchased through the COVAX system. The delivery contains 23,400 Pfizer/BioNTech doses, while the second shipment is expected later during the day. Bosnia receives first doses of Covid vaccines through COVAX system - N1 (n1info.com) 11. COVAX delivers first round of AstraZeneca vaccines for Bosnia A shipment of AstraZeneca vaccines purchased under the COVAX facility was delivered at the Sarajevo International Airport Thursday night, Bosnia’s Civil Affairs Ministry announced. COVAX delivers first round of AstraZeneca vaccines for Bosnia - N1 (n1info.com) 12. Turkey's donation of 30,000 Sinovac vaccines arrives in Bosnia Turkey’s donation of 30,000 doses of the Sinovac vaccine against COVID-19 has arrived in Bosnia on Sunday morning. Turkey's donation of 30,000 Sinovac vaccines arrives in Bosnia - N1 (n1info.com) 13. European Commission announces 650,000 Pfizer vaccines for the Balkans in April Chairman of the Council of Ministers of Bosnia and Herzegovina Zoran Tegeltija spoke by phone with European Commission President Ursula von der Leyen about the current epidemiological situation caused by the COVID- 19 pandemic. European Commission announces 650,000 Pfizer vaccines for the Balkans in April | FENA 14. Minister Vranic: Epidemiological Measures give good Results in Sarajevo The Assembly of the Sarajevo Canton is considering the information on the epidemiological situation in the Sarajevo Canton caused by the coronavirus epidemic at an emergency session today, and the results of the epidemiological measures introduced against the coronavirus give good results. Minister Vranic: Epidemiological Measures give good Results in Sarajevo - Sarajevo Times 15. Mass Immunization to finally start in the Federation of Bosnia and Herzegovina? Vaccination with “Pfizer” vaccine can officially start in the Federation of Bosnia and Herzegovina (FBiH). The Agency for Medicines has issued a positive finding, which has established the quality, so it can be used in the immunization process. While the population is still waiting for mass immunization, BiH has so far received 89 thousand and 6 hundred vaccines. Half of that came through the COVAX system, and half are donations. Mass Immunization to finally start in the Federation of Bosnia and Herzegovina? - Sarajevo Times 16. EU has set aside EUR 7 million to support Medical Institutions in BiH in the fight against Coronavirus

The European Union has set aside a total of EUR 7 million to support medical institutions in BiH in the fight against coronavirus. EU has set aside EUR 7 million to support Medical Institutions in BiH in the fight against Coronavirus - Sarajevo Times 17. Sarajevo Canton publishes vaccination registration app against Covid-19 The citizens of the Sarajevo Canton (KS) have the opportunity to register for vaccination against COVID-19 via the web application which was made public on the evening hours of March 30, 2021. Sarajevo Canton publishes vaccination registration app against Covid-19 - N1 (n1info.com) 18. Bosnia gets another donation of Covid vaccines, Malaysia sending 50,000 doses The Government of Malaysia decided in a session on Wednesday to send the first shipment of 50,000 Covid-19 vaccines to Bosnia and Herzegovina, learns Fena news agency. Bosnia gets another donation of Covid vaccines, Malaysia sending 50,000 doses - N1 (n1info.com) 19. March 2021 was the deadliest COVID-19 month in Bosnia so far According to the Civil Affairs Ministry, March 2021 was the deadliest month in Bosnia and Herzegovina in terms of COVID-19 victims so far, and more people passed away due to the disease in the country in this month than in the first eight months of the pandemic. March 2021 was the deadliest COVID-19 month in Bosnia so far - N1 (n1info.com) 20. Official: Over 100,000 Pfizer Vaccines to arrive in Bosnia in April The Ministry of Civil Affairs of Bosnia and Herzegovina was informed that a new delivery of coronavirus vaccines for Bosnia and Herzegovina will follow in the second quarter. These are 100,620 doses of the Pfizer/BioNTech vaccine. Official: Over 100,000 Pfizer Vaccines to arrive in Bosnia in April - Sarajevo Times 21. Ambassador Sattler hands over a valuable donation to General Hospital Head of the EU Delegation to BiH Johann Sattler handed over a donation today to the General Hospital 'Prim. dr. Abdulah Nakaš' in a form of two ventilators worth 79,000 KM, which was financed by the European Union within the framework of assistance to Bosnia and Herzegovina in the fight against the Covid-19 pandemic. Ambassador Sattler hands over a valuable donation to General Hospital | FENA 22. Nicola Bay: Migrants in BiH have access to health care (VIDEO) According to the estimations, there are currently about 8,000 migrants, refugees and asylum seekers in our country. The Danish Refugee Council in BiH focuses on improving access to primary and secondary health care, including psychosocial and mental health services, for refugees, migrants and asylum seekers, as well as on enhancing the overall protective environment, primarily for the most vulnerable persons of concern, including the survivors of Sexual and Gender Based Violence. Only during 2020, DRC medical teams together with Primary

Health Centre (PHC) teams have provided 97,217 medical examinations and 24,143 direct medical interventions within temporary reception centers. 2,184 referrals to secondary healthcare institutions have been ensured. Bay: Migranti u BiH imaju pristup zdravstvenoj zaštiti - N1 (n1info.com) 23. Due to the Delay in the Procurement of Vaccines, the Citizens announced Protests Due to growing dissatisfaction with the delay in vaccine procurement, a group of citizens announced a protest in the capital of Bosnia and Herzegovina (BiH), symbolically on the Day of the City of Sarajevo on April 6th. Due to the Delay in the Procurement of Vaccines, the Citizens announced Protests - Sarajevo Times

Stay informed – find the latest information from WHO or related sources: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/ https://www.who.int/emergencies/diseases/novel-coronavirus-2019 https://www.epi-win.com/

We thank you for your responsible behavior in the interest of your own health, but also in the interest of the health of all the citizens of Bosnia and Herzegovina.