SITUATION REPORT #47 / 08 March 2021 Reporting Period: 22/02 – 08/03/2021

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

SITUATION REPORT #47 / 08 March 2021 Reporting Period: 22/02 – 08/03/2021 http://drc.ba/covid19_resources

BIWEEKLY HIGHLIGHTS UPDATES:  137,291 cases of COVID-19 confirmed in BiH, 5,297 deaths and 118,720 recovered patients.1 33 PoCs exhibiting  33 PoCs exhibiting COVID-19-like symptoms monitored by PHC and DRC medical symptoms and teams in TRC Blazuj (4), TRC Usivak (2) and TRC Borici (27). isolated in  11 positive PoCs isolated and monitored by PHC and DRC medical teams in TRC reception facilities Borici (9) and TRC Usivak (2). 723 PoCs  36 new PoCs exhibiting COVID-19-like symptoms referred to symptomatic isolation screened in in reception centers: 2 in TRC Miral, 16 in TRC Sedra, 12 in TRC Borici, 2 in TRC Usivak reception facilities and 4 in TRC Blazuj.

 161 PoCs referred to preventive isolation in reception facilities. 11 new PoCs confirmed positive  723 PoCs screened for COVID-19 symptoms: 609 new arrivals to temporary for COVID-19 reception facilities in BiH during the reporting period. 114 PoCs, beneficiaries of TRC Borici, underwent COVID-19 screenings after new cases were confirmed within the CUMULATIVE: center.

45 PoCs positive  86 PoCs monitored in preventive isolation by DRC Medical Officers (10 in TRC Miral for COVID-19 and 76 in TRC Sedra).  36 PoCs tested for COVID-19. Out of 36, 11 results were confirmed positive. 66,149 COVID-

19 screenings in reception facilities KEY DEVELOPMENTS AND CHALLENGES and in out-of-site locations  9 confirmed cases of COVID-19 were reported in TRC Borici (out of 27 tested individuals), all coming from already accommodated population. DRC, with the support of IOM, PHC medical team, and following the recommendations of PHI of

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

483 PoCs tested USC, has taken necessary actions to prevent the spread of COVID-19 infection inside for COVID-19 TRC Borici, as well towards other reception centers in USC.  2 confirmed cases of COVID-19 were reported in TRC Usivak, both coming from already accommodated population. Upon contact tracing and further epidemiological investigation, actions were taken in order to prevent the spread of COVID-19 infection inside TRC Usivak.

 Due to the rise in numbers of COVID19 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.

 A total of 82 PoCs were discharged from preventive isolation in all TRCs in BiH, and 15 PoCs from symptomatic isolation, on expiry of the isolation and monitoring period. In the same period, 38 PoCs left preventive isolation on their own.

PREVENTIVE ISOLATION OVERVIEW 60 36 39 40 20 18 16 12 15 13 13 12 12 20 8 10 8 8 11 4 7 4 2 2 3 1 0 0 2 3 0 0 1 0 0 1 0 22-Feb 23-Feb 24-Feb 25-Feb 26-Feb 27-Feb 2-Mar 3-Mar 4-Mar 5-Mar 6-Mar

# 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

40 29

20 4 4 0 0 1 3 0 1 1 0 0 0 0 0 0 3 1 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 22-Feb 23-Feb 24-Feb 25-Feb 26-Feb 27-Feb 2-Mar 3-Mar 4-Mar 5-Mar 6-Mar

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

 Outreach response: o PoCs in out-of-site locations are provided with medical assistance by DRC and RC teams visiting the sites, delivering First Aid and performing medical screening of PoCs for COVID-19 symptoms. o Due to improved weather conditions, the number of PoCs at informal settlements is slightly increasing. DRC outreach teams are performing more COVID-19 symptoms screening, delivering health educational sessions regarding COVID-19 preventive measures, and referring and reporting any suspect case towards health authorities. It is still challenging to monitor the epidemiological situation in outreach, due to frequent movements of PoCs, as well overcrowded preventive isolation areas inside TRCs.

OPERATIONAL PREPAREDNESS AND RESPONSE

 COVID-19 Response in TRCs in BiH: o At the moment, a total of 152 beds in TRCs in USC are available for preventive isolation and a total of 140 beds for POCs with COVID-19 symptoms.

OVERVIEW OF DESIGNATED ISOLATION AREAS (COVID-19) 08 MARCH

2500

1941 2000

1500

938 1000 566 500 237 309 104 0 42 0 50 20 18 28 6 24 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 report of one COVID-19 confirmed case inside TRC Borici, as a part of several recommendations made by the PHI of USC, a blanket screening for COVID-19 like-symptoms was conducted by the PHC medical team from Bosanska Krupa, under joint coordination of DRC, IOM, SCI and CWS. A total of 114 PoCs were screened, including 51 children. Six PoCs were found

exhibiting symptoms similar to COVID-19 and were referred with their families to symptomatic isolation. All 16 newly isolated PoCs, including 9 direct contacts of the first positive PoC, were tested, and 8 of them were positive for COVID-19. All positive cases are experiencing a mild form of the disease, and are under daily close monitoring of the medical team. Due to this unexpected cluster inside TRC Borici, the PHI of USC has shared recommendations in order to prevent further spread of COVID-19 in the reception center: - Quarantine of TRC Borici, which includes isolation of all PoCs who are currently accommodated there, for a period of 14 days, including a complete lockdown. - Suspension of all group activities for a period of 14 days. - Daily measurement of the body temperature of all PoCs accommodated, for the next 14 days, and separation of febrile persons according to the protocol. - All PoCs to wear a mask, 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. - Ventilate of all the rooms of the TRC as often as possible (according to the weather conditions), during the next 14 days. - Serological testing of all PoCs after 7-10 days (if conditions allow). - 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 fixed teams and to avoid rotation of teams between TRCs, in order to reduce the possibility of transmitting potential infection to other TRC in 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 Borići during the next 14 days, except in case of emergency. o As part of organizational efforts to implement recommended IPC measures, the capacities of the isolation areas in both TRC Borići and Sedra were temporarily increased in very short time.  Measures related to humanitarian staff: o Following the increased numbers of confirmed COVID19 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

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/ 4

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 Federal Ministry of Health issued a press release on the 26th of February, confirming all previous orders are still in place, following the Decision of the Constitutional Court of Bosnia and Herzegovina related to the Order of the Crisis Staff of the Federal Ministry of Health, which restricts movement in the Federation of BiH from 11 pm to 5 am, as well as mandatory wearing of protective masks. https://covid19.fmoh.gov.ba/uploads/files/Naredbe_260221- 7337f0d7d5d41cc2b28aed34327cdf2aa36b75a3.pdf Following the deteriorating epidemiological situation in Sarajevo Canton, the Cantonal Ministry of Health has issued a new order, limiting the number of private people gathering up to 10 persons: https://mz.ks.gov.ba/sites/mz.ks.gov.ba/files/naredba_1.pdf The Government of the Federation of BiH will form an ad-hoc team for negotiations with vaccine manufacturers, in which representatives of several relevant authorities will be appointed: http://www.fbihvlada.gov.ba/bosanski/aktuelno_v2.php?akt_id=9139

MEDIA REPORTING

1. Bosnia reports 393 new coronavirus cases and 38 fatalities Bosnian health officials reported 393 new Covid-19 cases on Monday, along with 38 virus-related fatalities. https://ba.n1info.com/vijesti/novi-crni-dan-u-bosni-i-hercegovini-cak-38-preminulih-od-koronavirusa/ 2. Sarajevo Canton doubles down on existing measures: People have relaxed too much Sarajevo Canton's (KS) Prime Minister Edin Forto said after an emergency session on Monday that the data indicate an increase in the number of infected people from the new coronavirus in the canton, but that the measures will not be tightened. Instead, the supervision over the existing ones will be strengthened. “We are strengthening the supervision of the existing measures, we are increasing the capacity of health institutions, we are allowing the inspection to employ more people, the police to control the violation of measures. We’re not going into extra measures, but I’m terribly worried because it feels like the people have let their guard down. We are tired of all the measures over the past year, but we have to persevere and go through this. We do not see an end to the pandemic at this time. We are the only country whose authorities are not working on the procurement of vaccines. The only one. The vast majority of vaccine manufacturers only talk to other states,” Forto explained. Sarajevo Canton doubles down on existing measures: People have relaxed too much - N1 (n1info.com)

3. Forto: There will be no tightening of Restriction Measures Due to the growing number of people infected with coronavirus in CS, a special session of the Government of CS and the Crisis Staff was held yesterday. “We are stepping up the control of current measures, we are increasing the capacity of health institutions, we are allowing the inspection to have more workers and the police to control the violation of determined measures. We are not introducing additional measures, but I am really worried because it feels like people are too relaxed. We are tired of all these measures in the past year, but we have to endure and go through this. We do not see an end to the pandemic at this point. We are the only country whose authorities do not work in order to procure vaccines,” Prime Minister Forto pointed out. Forto: There will be no tightening of Restriction Measures - Sarajevo Times 4. Sarajevo Canton tightens measures amid new coronavirus surge The authorities of Sarajevo Canton announced on Wednesday a set of measures to contain a new surge in the coronavirus spread, which among other restrictions include the public gathering ban for more than 30 people and allowing the groups of ten or less in private gatherings. Among other measures, the authorities also set as the mandatory wearing of face masks that would cover mouth and nose both outdoors and indoors, except for the children below the age of seven, the primary school students from 1st to 5th grade during the class, the persons with disabilities and those doing sports or other activities in sports facilities. A two-metre physical distance remains mandatory both outdoors and indoors. The hospitality businesses, cinemas, theatres and museums were ordered to adjust their work to the measures, with a special accent on the number of those allowed in a building. It was also recommended that all religious services, when possible, are performed via TV or radio or any other way that would enable the faithful to attend without gathering in the religious buildings. Sarajevo Canton tightens measures amid new coronavirus surge - N1 (n1info.com) 5. Number of global new Cases reported continues to fall The number of global new cases reported continues to fall for the sixth consecutive week, with 2.4 million new cases last week, an 11% decline compared to the previous week. The number of new deaths also continues to fall for the previous three weeks, with nearly 66 000 new deaths reported last week, a 20% decline as compared to the previous week. This brings the global cumulative numbers to 110.7 million cases and over 2.4 million deaths since the start of the pandemic. Number of global new Cases reported continues to fall - Sarajevo Times 6. Goletić: Ten different coronavirus strains currently circulating in FBiH Head of the Laboratory for Molecular Genetic and Forensic Research at the Faculty of Veterinary Medicine, University of Sarajevo, Teufik Goletić, warned at press conference of the Crisis Staff of the FBiH Ministry of

Health that ten different coronavirus strains are currently circulating in the Federation of BiH, while British and Czech strains stand out in particular. Goletić: Ten different coronavirus strains currently circulating in FBiH | FENA 7. Scandalous delay in the process of vaccines procurement, COVAX has failed us The COVAX mechanism has failed in the procurement of vaccines for Bosnia and Herzegovina, most likely because it is possible to sell vaccines on a commercial basis at higher market prices than those agreed for BiH, said the Presidency of BiH today regarding the problem of procurement of vaccines against Covid-19 for BiH citizens. Scandalous delay in the process of vaccines procurement, COVAX has failed us | FENA 8. Vucic in Sarajevo on Tuesday to deliver donation of Covid-19 vaccines Serbian President Aleksandar Vucic will arrive in Sarajevo on Tuesday where he will deliver a donation of 5,000 vaccines against Covid-19, a spokesperson for the SNSD party Radovan Kovacevic told N1. Vucic in Sarajevo on Tuesday to deliver donation of Covid-19 vaccines - N1 (n1info.com) 9. Will stricter Restrictions be introduced in Bosnia and Herzegovina? The increasingly difficult epidemiological situation in Bosnia and Herzegovina (BiH) threatens the introduction of stricter restriction measures which were announced in several cantons. “So far, every twentieth person of those who has been diagnosed with covid has died, so it is formally registered that they died from covid. That is 50.000 people per million inhabitants. If it has happened so far, before Jahorina, and we know that this mountain is a covid bomb in January, not only for BiH but for the whole of Europe, you will see what will happen in the following months when all these people separate and go away, ” doctor from the General Hospital Sarajevo, Dragan Djokanovic pointed out. Will stricter Restrictions be introduced in Bosnia and Herzegovina? - Sarajevo Times 10. Members of BiH Presidency spoke with WHO Director General Bosnia and Herzegovina (BiH) meets all the technical conditions to immediately accept, store and distribute the amount of one million vaccines of all manufacturers which are operating under the COVAX program, as was stated at an online meeting of members of the Presidency of BiH with the head of the World Health Organization (WHO). Chairman of the BiH Presidency, Milorad Dodik, and other two members Zeljko Komsic and Sefik Dzaferovic, spoke with the Director-General of WHO, Tedros Adhanom Ghebreyesus. Difficulties and delays in the delivery of vaccines to BiH through the United Nations (UN) COVAX mechanism were discussed. The BiH Presidency members stressed that BiH fulfilled all its financial and other determined obligations in the last year and that it expects the same from the COVAX program and vaccine manufacturers that operate within this program. Members of BiH Presidency spoke with WHO Director General - Sarajevo Times

11. 108.000 Doses of AstraZeneca Vaccine to arrive in BiH by the End of May? 108.000 doses of AstraZeneca vaccine should be delivered to Bosnia and Herzegovina (BiH) by the end of May, according to a distribution plan announced by the international COVAX mechanism. 108.000 Doses of AstraZeneca Vaccine to arrive in BiH by the End of May? - Sarajevo Times 12. Bosnia's coronavirus daily count on the rise, officials discussing new measures Bosnia and Herzegovina has recorded another 910 cases of infection with the novel coronavirus - the highest daily count in weeks, and 26 fatalities among Covid-19 patients, the healthcare authorities confirmed on Wednesday. The new results came out of 4,232 lab tests performed among those who reported infection symptoms. Bosnia is seeing another surge in new infections that some healthcare experts call the country's third pandemic wave. The situation is particularly worrying in the Sarajevo Canton, which is recording three-digit figures in coronavirus cases during the past week – averagely, 357 cases a day. The situation prompted cantonal authorities to react and announce new measures to contain the virus spread. The Canton Government is in a meeting on Thursday and is expected to present the new conclusions on the epidemiological situation in the afternoon. The country reported a total of 134,892 coronavirus cases since the epidemic outbreak. To this date, 117,643 patients recovered – 247 in the last 24 hours. The coronavirus death toll stands at 5,200. Currently, there are 12,049 active cases throughout the country. Bosnia's coronavirus daily count on the rise, officials discussing new measures - N1 (n1info.com) 13. Council of Ministers meets additional condition for COVAX vaccine delivery Bosnian state government endorsed on Thursday the amendments to 'Commitment agreement – committed purchase arrangement' with the Global Vaccine Alliance (GAVI), unblocking the arrangement with the COVAX system for the vaccine delivery. “While expecting to get the first doses of previously arranged and paid vaccines through COVAX system, BiH was set a new condition in mid-February and asked to sign amendments to the agreement,” the Council of Ministers recalled following the Thursday session. Council of Ministers meets additional condition for COVAX vaccine delivery - N1 (n1info.com) 14. Forto: If the Number of Infected continues to grow, the Canton Sarajevo may be closed completely In the continuation of the emergency session of the Government of the Canton Sarajevo (CS), due to the worsened epidemiological situation, new conclusions were reached. For now, there will be no decline in the working hours of catering facilities. In the first part of the session, the Government of CS adopted few conclusions that directly concern the health sector, more precisely the strengthening of hospital capacities, and the provision of better services to patients infected with the coronavirus. Furthermore, economic entities and (non) compliance with measures were discussed, Klix.ba writes.

“The situation is dramatic. In the first part, we are dedicated to strengthening the health system, the better response of health services in the service of citizens, and strengthening the primary health level,” said Prime Minister Edin Forto. He said the authorities are planning to significantly strengthen the implementation of existing measures. “If the number of infected people continues to grow, it is possible that there will be a complete closure. I call on the citizens and the business community to follow the measures and to take care of themselves and their loved ones,” he added. These are the new measures: Isolation is ordered for confirmed cases and members of the infected for 14 days. Shopping malls, retail stores, caterers, and other service activities are ordered to hire covid supervisors who will monitor the implementation of measures. Catering facilities, cinemas, and theaters are ordered to put notices on the number of people who can stay in the space according to the area, calculating that 7 square meters are needed for each person. Disinfection of public transport vehicles twice a day and ventilation between rides is ordered. The presence of covid supervisors in public transport vehicles is ordered. It is ordered to increase the number of workers who will be tested in health care and schools through rapid tests. Full support is given to employees of inspection entities. “We ask the Council of Ministers of Bosnia and Herzegovina (BiH) to adopt a measure of mandatory possession of a negative PCR test, not older than 48 hours, for all persons entering BiH,” Forto added. He said that a proposal to close all caterers, hotels and similar activities was on the table yesterday. “The profession says that the most hotspots are found there. We call on the business community to help us,” told Forto. Forto: If the Number of Infected continues to grow, the Canton Sarajevo may be closed completely - Sarajevo Times 15. Bosnia's FBiH entity in third pandemic wave, experts ask for drastic measures The Federation (FBiH) is in a state of emergency and is seeing the third pandemic wave, prime minister of Bosnia's semi-autonomous entity Fadil Novalic told media following an urgent meeting with cantonal authorities on the situation concerning surge in new coronavirus cases in this region. “We talked about what to do next in terms of this situation, with the focus on two groups of problems – epidemiological measures and vaccines,” Novalic told media, noting that authorities at all levels in this part of the country are actively cooperating in the fight against coronavirus. Bosnia's FBiH entity in third pandemic wave, experts ask for drastic measures - N1 (n1info.com)

16. New Respiratory Center opened for Covid Patients in Sarajevo Sarajevo University Clinical Center (in Bosnian: KCUS) on Friday opened the Special Respiratory Center of the Clinic for Anesthesia and Resuscitation for extremely severe Covid-19 patients in the area of old surgery. This Center has 23 beds and has already filled more than 85 percent of its capacity. We are working on expanding the capacity for another 21 beds, which would mean that the capacity would be 44 beds, and in the next seven to ten days we would make an additional expansion in the area of the transfusion center for another 23 beds, as was announced by the KCUS. New Respiratory Center opened for Covid Patients in Sarajevo - Sarajevo Times 17. Minister: AstraZeneca may sell 200,000 vaccines to Canton Sarajevo The Health Minister in Canton Sarajevo (KS) confirmed that the company AstraZeneca is in the process of reviewing the biographies of him and the KS Prime Minister to reach an agreement on procuring 200,000 vaccines for KS. Minister: AstraZeneca may sell 200,000 vaccines to Canton Sarajevo - N1 (n1info.com) 18. Diplomacy supports BiH healthcare system: Swiss Embassy reliable partner and donor The Ambassador of Switzerland to BiH Daniel Hunn and the Director of the Swiss Agency for Development and Cooperation, Patricia Danzi, paid a visit to the city of Bihać and the Cantonal Hospital “Dr. Irfan Ljubijankić ”, on the occasion of the rehabilitation and equipping of the Department of Infectious Diseases. The project, which will create better conditions for the treatment of patients and the work of medical staff, was jointly funded by the Government of Switzerland and the Cantonal Hospital Bihać and implemented by the Danish Refugee Council. DIPLOMATIJA UZ BH. ZDRAVSTVO: AMBASADA ŠVICARSKE POUZDAN PARTNER I DONATOR ZDRAVSTVENOM SEKTORU U NAŠOJ ZEMLJI | RTVUSK.ba

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.