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

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EMERGENCY RESPONSE to COVID-19 in Mixed Migration Context in Bosnia and Herzegovina EMERGENCY RESPONSE TO COVID-19 in Mixed Migration Context in Bosnia and Herzegovina SITUATION REPORT #48 / 22 March 2021 Reporting Period: 09/03 – 22/03/2021 http://drc.ba/covid19_resources BIWEEKLY HIGHLIGHTS UPDATES: 154,627 cases of COVID-19 confirmed in BiH, 5,938 deaths and 125,343 recovered patients.1 96 PoCs exhibiting 96 PoCs exhibiting COVID-19-like symptoms monitored by PHC and DRC medical symptoms and teams in TRC Blazuj (9), TRC Miral (15), TRC Sedra (2) and TRC Borici (70). isolated in reception facilities 53 positive PoCs isolated and monitored by PHC and DRC medical teams in TRC Borici (45), TRC Miral (5) and TRC Blazuj (3). 1,351 PoCs 103 new PoCs exhibiting COVID-19-like symptoms referred to symptomatic screened in isolation in reception centers: 20 in TRC Miral, 6 in TRC Sedra, 48 in TRC Borici, 8 in reception facilities TRC Usivak and 21 in TRC Blazuj. 276 PoCs referred to preventive isolation in reception facilities. 44 new PoCs confirmed positive 1,351 PoCs screened for COVID-19 symptoms: 1,008 new arrivals to temporary for COVID-19 reception facilities in BiH during the reporting period; 343 already accommodated individuals experiencing symptoms. CUMULATIVE: 57 PoCs monitored in preventive isolation by DRC Medical Officers (13 in TRC Miral 89 PoCs positive and 44 in TRC Sedra). for COVID-19 240 PoCs tested for COVID-19. Out of 240, 44 results confirmed positive. 67,500 COVID- 19 screenings in KEY DEVELOPMENTS AND CHALLENGES reception facilities and in out-of-site Following the rise in COVID-19 cases among PoCs accommodated in TRC Borici, a locations blanket PCR testing was performed for the entire population of this center. Out of 199 tested PoCs, 36 were positive for SARS-CoV-2. All positive cases were asymptomatic or had a mild form of the disease. The recommendations from Public 1 Official statistics for Federation of BiH, Republika Srpska and Brcko District 723 PoCs tested Health Institute of USC implemented after the first reported positive cases were for COVID-19 extended until 27.03.2021. The third floor of TRC Borici was converted into “COVID- 19 zone”, and is currently accommodating 70 PoCs (positive cases together with their direct contacts). Additionally, it was recommended to test all service providers who had been inside TRC Borici since the start of the lockdown. PCR testing was performed on 140 service providers, out of whom 12 were positive for SARS-CoV-2. All positive cases were informed, advised to self-isolate and 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 considered asymptomatic or have a mild form of the disease. Five confirmed cases of COVID-19 were reported in TRC Miral. 3 positive cases were transferred from provisional camp Lipa, and 2 cases were identified among the TRC Miral general population. All positive PoCs are currently isolated inside symptomatic isolation, together with 5 direct contacts (who were tested negative). They all have a mild form of the disease and are in a stable condition. Three confirmed cases of COVID-19 were reported in TRC Blazuj, 2 coming from 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 TRC Blazuj. 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, a blanket screening and testing of all beneficiaries, as well service providers needs to be performed as a part of contingency plan for COVID-19 prevention. A total of 262 PoCs were discharged from preventive isolation in all TRCs in BiH, and 47 PoCs from symptomatic isolation, on expiry of the isolation and monitoring period. In the same period, 47 PoCs left preventive and 6 PoCs left symptomatic isolation of their own will. 2 SYMPTOMATIC ISOLATION OVERVIEW 60 42 40 15 20 20 6 8 6 6 6 9 5 0 0 0 0 0 0 1 1 0 2 0 2 5 0 5 1 0 1 0 2 2 2 4 3 2 0 # of PoCs referred to isolation, exhibiting symptoms of COVID-19 on the date of reporting** Discharged from Symptomatic isolation Left Smytomatic Isolation PREVENTIVE ISOLATION OVERVIEW 150 129 117 92 100 35 36 50 20 26 18 3 0 0 0 1 7 3 8 4 7 0 1 0 14 0 6 0 610 1113 123 0 3 0 0 # 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 Outreach response: o Between 8 and 12 March 2021, DRC Medical Teams medically screened a total of 1,223 PoCs in out-of-site locations in Una-Sana Canton. All recorded PoCs received some form of service, and were screened for common communicable diseases, including scabies and COVID-19. Out of all PoCs (1,223) screened, 41% did not report any health concern. If one combines the collected field data and measures the incidence across the attended population (1,223), a total of 48% of PoCs present skin related concerns. A total of 570 PoCs, or 47% of the population, have clear signs of scabies. A total of 18 locations were visited in the area of Bihac, with a total of 877 PoCs medically attended. Health concerns were reported among 65% of the population, with the majority having skin related conditions, namely scabies (53% of all poCs) and musculoskeletal complaints (4% of all PoCs). In Krajinametal, the most common health concern was related to skin infections, with 69% of all PoCs presenting clear signs of scabies. At the old nursing home the most common health concern was also related to skin infections, with 46% presenting clear signs of scabies. A total of 30 locations were visited in the area of Velika Kladusa, with a total of 301 PoCs medically attended. Health concerns were reported among 39% of the 3 population, with the majority having signs of scabies (30% of all PoCs present at sites in the area). Comparing the areas of Bihac and Velika Kladusa, it is clear that lack of access to basic services in the urban areas of Bihac, due to the current ban on service provision, including healthcare, is affecting the health of PoCs drastically. With more PoCs making their way to USC, and with already overcrowded reception centers, the individual and public health of this population will deteriorate further, to the point of possible crisis and potential negative effects on the health of the general population. 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 AREA (COVID-19) 22 MARCH 2500 1992 2000 1500 1008 1000 665 349 500 207 111 104 0 42 0 50 20 68 28 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 reports of COVID-19 confirmed cases inside TRC Miral, the PHI of USC has shared recommendations in order to prevent further spread of COVID-19 in the reception center: - Quarantine of TRC Miral, which practically means the isolation of all PoCs who are currently accommodated there for a period of 14 days, including a ban on the exit of beneficiaries, and a ban on admission of new beneficiaries in TRC; - COVID-19 blanket screening of the entire population accommodated in TRC Miral and isolation the suspect cases as per protocol. 4 - Suspension of all group activities for a period of 14 days as of today. - Daily measurement of body temperature of all PoCs accommodated, for the next 14 days, and separation of 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 bathroom, etc.) - Daily disinfection of all premises during the next 14 days. - Ventilation of all the premises of the TRC as often as possible (according to the weather conditions) during the next 14 days. - Testing of all PoCs after 7-10 days (if conditions allow). - Testing of all service providers working in TRC Miral after 7-10 days (conditions permitting). - 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 avoid rotation of teams between the TRCs, in order to reduce the possibility of transmitting potential infection to other TRCs in USC. - Suspension all unnecessary visits of officials and other actors who are not involved in the direct provision of services to PoCs in TRC Miral during the next 14 days, except in case of emergency.
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