Covid-19 case management in a Greek migrant camp: The Hellenic Red Cross Mobile Health Unit intervention in Nea Malakasa temporary accommodation center

INTRODUCTION: Since the outbreak of the Covid-19 pandemic the scientific community had expressed its concerns about increased transmission of the virus within asylum seeker accommodation centers due to substandard living conditions and poor sanitation. Studies regarding management of Covid-19 cases in such facilities are urgently needed in order to guide international strategies on future pandemics within the humanitarian setting. Our study's paradigm of Covid-19 case management in a Greek migrant camp aims to add on existing data. DATA AND METHODS: A retrospective analysis of epidemiological and demographical data collected as part of a healthcare intervention in a Greek migrant camp during three Covid-19 epidemic waves is presented in this study. Descriptive statistics were generated using STATA 12. RESULTS: During the first wave, the camp's administration adopted a 2-month strict lockdown strategy and no positive cases were recorded. During the second wave, suspected coronavirus cases were referred for PCR testing and, in case of positivity were hospitalized. 3% (n = 28) of the camp's population were referred for PCR, with 1% of the population (n = 10) being tested positive for Covid-19 and admitted to hospital. Close contacts of positive cases were encouraged to comply with non-pharmaceutical interventions and were offered medical care if symptoms developed. During the third epidemic wave, in-camp management was decided by on-site operators, with rapid antigen testing of symptomatic individuals, daily monitoring of positive cases by the medical team and mass screening of their closed contacts. 4% (n = 33) of the camp's residents were tested positive, while none was hospitalized. 19% (n = 148) of the camp's population were considered close contacts, were advised to self-isolate and were offered mass screening with rapid antigen test, from which another 21 positive cases emerged. In total, 7% (n = 54) of the camp population, (n = 21) female adults, (n = 24) male adults and (n = 9) children, were infected with SARS-CoV-2 during the third epidemic wave, with no deaths being recorded. During the study period, only 50 residents had received one dose of Covid-19 vaccines. CONCLUSION: We recommend an in-camp Covid-19 response featuring regular follow up of positive cases and prompt referral to tertiary centers based on clinical criteria, while overemphasizing the need for equitable access to primary healthcare for asylum seekers in Greece, primarily during the current pandemic. Prolonged camp lockdowns should be avoided as they pose substantial health risks for their vulnerable population.