There are over 70 million people worldwide who have been driven from their homes by war and unrest, up to 10 million are packed into refugee camps and informal settlements, and almost none have been tested for the coronavirus.
While the relative isolation of many camps may have slowed the virus' spread, none is hermetically sealed. Without testing, as the world has seen repeatedly, the virus can spread unchecked until people start showing symptoms. That could have catastrophic results among the world's refugees:
There will be few if any intensive care beds or ventilators for them. There might not even be gloves or masks.
“Testing is in short supply even in New York and Norway, but it is nonexistent in most of the countries in the (global) south for the people we try to help,” Jan Egeland, the head of the Norwegian Refugee Council, told The Associated Press.
His group recently conducted a review of all 30 countries where it operates and found virtually no testing before people became sick.
Refugees have already tested positive in Italy, Germany, Iran, Australia and Greece, where authorities said Tuesday that 150 people living in a quarantined hotel for asylum-seekers had contracted the coronavirus, and none displayed symptoms of COVID-19.
In Syria's war-ravaged Idlib province, only one tiny health facility is equipped to receive suspected coronavirus cases. In the world's largest refugee camp, in Bangladesh, aid workers are racing to build isolation facilities.
In two sprawling camps in Kenya, Somalis who survived decades of famine and war fear the worst is yet to come.
“If it's killing people daily in America, then what do you think will happen to us?” asked Mariam Abdi, a vegetable vendor in Kenya's Dadaab camp, where 217,000 people live in endless rows of tents. “We will all perish.”
Western countries, which by then may have contained their own outbreaks, will have to reckon with the fact that if the virus finds refuge among the world's most vulnerable, it could return anytime.
Some refugee camps have been around so long they have apartment blocks and paved roads. Others are little more than clusters of tents or abandoned buildings. In many, cramped conditions and poor infrastructure can make it impossible to practice social distancing and frequent hand-washing.
There are no official figures for the number of refugees who live in camps, but Egeland estimates they make up 10% to 15% of all refugees and displaced people, a population the U.N. estimates at over 70 million.
Most people who become infected experience mild to moderate symptoms. But the virus can cause severe illness and lead to death, particularly among older people and those with underlying health problems. It is highly contagious and can be spread by those who appear healthy.
The coronavirus has already appeared in Syria, where the decade-long civil war has displaced more than half of the population of 23 million. At least 350 health facilities have been bombed, mostly by the government. More than 900 medical staff have been killed and countless more have fled.
No cases have been reported yet in Syria's northwestern Idlib province, the last bastion of opposition to President Bashar Assad and where heavy fighting forced nearly a million people to flee their homes earlier this year.
Zaher Sahloul, a Syrian physician based in Chicago who heads MedGlobal, an international health NGO, calls that a “miracle.” He notes that the entire province, which is home to 4 million people, has 98 ventilators, compared to 230 in the Advocate Christ Medical Center, where he is a critical care specialist. An outbreak would be “catastrophic,” he said.
The World Health Organization has sent 5,900 testing kits to Idlib, where they are being carefully rationed. Authorities have carried out around 200 tests so far, all of which came back negative.
In Jordan, the two largest camps for Syrian refugees have been sealed since last month. In Zaatari, which has about 80,000 residents, the Jordanian government conducted 150 random tests, all of which came back negative, said Dominik Bartsch, the head of U.N. refugee agency in Jordan. Residents of Azraq, home to about 40,000, will be tested soon.
On Wednesday in Lebanon, a Palestinian woman from Syria became the first refugee living in a camp to test positive, sparking fear and a spate of testing by health officials to see if any other residents had been infected.
“We don't need the camp managers to tell us how serious the virus is. We see it in the news and read about it," said an anxious Massoud Ali, 35, who fled Syria for a camp in neighboring Iraq in October.
Refugees living outside camps are also uniquely vulnerable. Nearly 5 million Venezuelans have fled economic chaos, crossing by foot and bus into neighboring Colombia and other countries.
Many live in crowded apartments in Bogota, which has the bulk of Colombia's coronavirus cases, and work as street vendors — jobs now prohibited. During the capital city's lockdown, many have been evicted from rentals and fined for being on the streets as they struggle to put food on the table.
“All of a sudden, they've become invisible, locked away behind closed doors,” said Marianne Manjivar, International Rescue Committee director for Colombia and Venezuela.
There's been little if any testing in Cox's Bazar, in southern Bangladesh, where more than a million members of Myanmar's Rohingya Muslim minority are packed into the world's largest refugee camp.
Deccan Herald is on WhatsApp Channels | Join now for Breaking News & Editor's Picks