The consequences of COVID-19 on vulnerable refugee populations reach beyond health risks.

The COVID-19 pandemic will hit the most vulnerable of the world–the stateless–the hardest. The consequences of the novel coronavirus on refugee populations will be profound, reaching beyond the dire health impact of infections.
COVID-19 will be impossible to contain in overcrowded conditions where access to appropriate sanitation is scarce. The impacts of medical staff leaving camps and national governments tightening border security are almost equally threatening to the survival of refugees.
The most vulnerable
There are approximately 25.9 million refugees scattered across the globe in search of safety. Refugees are cross-border migrants–as opposed to internally displaced people, who stay within their country’s borders–who flee their country of origin due to “persecution, conflict, violence or human rights violations.” Most refugees stay in neighboring countries, which often struggle with poverty and unrest themselves.
The numbers are staggering: Two-point-two million refugees fled South Sudan, almost half of them to Uganda; more than five million Syrians seek safety outside the country’s borders, mainly in Lebanon, Turkey, and Jordan; Turkey alone hosts approximately four million refugees, most of them Syrian; and nearly 20 million Yemenis desperately require humanitarian assistance.
The living conditions of refugees, no matter which country hosts them, are already dire. Refugee camps are overcrowded, often with their maximum capacity exceeded several-fold. As a result, refugees spend long hours in line for basic sanitation facilities such as showers or running water. Due to limited healthcare access, some refugees, including children, face acute respiratory problems that go untreated.
Refugees depend on funding and support from governmental and non-governmental actors for survival. Recently, a new wave of citizen unrest rippled through Greece. Sections of refugee camps were destroyed and some organizations temporarily withdrew due to concern for their workers’ safety.
The news about the novel coronavirus pandemic left refugee communities in fear for their lives.
“[We have seen] a dramatic spread of the virus to some of the most well-prepared societies on Earth. Imagine then what it would cost in densely crowded refugee camps, places with little or no water, no washing facilities, little hygiene and no healthcare.” A A Doctors Without Borders spokesperson rang the alarm in an interview with Al Jazeera on March 30.
Authorities have confirmed one case of the virus in Lesbos’ Moria camp as of April 1. It is the only coronavirus case recorded in refugee communities. The number of infections is probably higher, but most go unreported because there are not enough doctors to treat refugees, even in pre-pandemic times.
Doctors in camps in Syria and Bangladesh admit they have been treating patients with symptoms that bear resemblance to COVID-19, but are unable to verify their diagnoses with no tests available.
Overcrowding and insufficient sanitation
Social distancing and hygienic precautions are nearly impossible given camp conditions. “I don’t think the people who have not been to a refugee camp can understand how horrific the conditions can be”, explained Mohammed Jamjoom, an Al Jazeera senior correspondent.
A camp built with EU funds on the Greek island of Samos is home to at least 3,745 refugees. It was built for 640. Its inhabitants sleep in packed tents. Some parts of the camp offer one water tap for 1,300 people and one toilet for 167 people. Hot water and soap are scarce. When refugees fall sick, they have no possibility for self-isolation.
Such overcrowded conditions leave refugees with no safeguard against COVID-19. Adding malnourishment and pre-existing medical conditions that are likely to go untreated, refugee communities have little chances of surviving the virus.
A volunteer doctor who visits the Greek Moria camp commented: “If you read about Spanish flu it was exactly like this that it began to spread, in overcrowded facilities where people had a viral infection that became a bacterial infection that killed them.”
A medical void
The COVID-19 pandemic will threaten refugee lives even if they do not become infected with the coronavirus. The already scarce support system for refugee camps, which consists mainly of volunteers and NGO workers, is dwindling. Some leave because they fall sick. Some, because they fear contracting the virus and spreading it to the camps. Some staff stationed in Greece left before the full-fledged crisis because of violence and protests.
Reduced staff means further limitations for already restricted facilities. In sites so dependent on external help, such limitations will have all-encompassing consequences.
In Calais, Northern France, a daycare facility had to shut down due to inadequate staffing. Since it was the only place where the inhabitants of the camp could charge their phones, they became unable to call emergency services in case of malaise.
Lack of medical support further weakens the odds for refugees to withstand the pandemic. Additionally, many health conditions unrelated to coronavirus, from diabetes to pneumonia to pregnancy, are at risk of going unchecked. The medical void increases the probability for health complications, possibly boosting mortality rate in the camps.
Excuses for barring asylum
Human rights activists are concerned that EU countries, especially Greece, will use the pandemic to suspend asylum and relocation. In February, a border dispute erupted between Greece and Turkey regarding refugee landings.
Turkey withdrew from the 2016 EU agreement without any notice, re-allowing refugees to cross its border into Greece. In return, the Greek government suspended new asylum applications and sent military troops to the Turkish border to contain the arriving migrants.
One initial governmental reaction to the deepening COVID-19 crisis was shutting down national borders. As much as this has proven an effective measure in slowing down the spread of the novel coronavirus, border shutdown may well be used as a political weapon against refugee reception. In some places, this has already happened.
On March 20, Cyprus turned away a boat of 175 asylum seekers–the term that applies before one legally becomes a refugee. According to authorities in Cyprus, all are Syrian. Sixty-nine of the 175 are children.
Cyprus shut its national borders on March 15 to all but its residents, European workers, and those with special permits. The shore authorities provided the boat with small supplies of food and diesel and supervised the boat’s return to southern Turkey. Asylum seekers’ pleas for Cypriots to take in just the women and children were not addressed.
A need for solidarity
Various authorities on human rights and refugee communities have pleaded with the international community to show solidarity with the world’s most vulnerable populations. Executive Director of UNICEF Henrietta Fore urged, “Any public health response to the pandemic should reach the most vulnerable, including refugees, migrants and those who are internally displaced.”
So far, the response has been minimal to nonexistent. Camps have been left alone to face the invisible enemy. COVID-19 puts immense pressure on every national government in terms of healthcare facilities and economic impacts.
If wealthy countries are struggling to contain the virus and deal with its consequences, the most vulnerable of the world are in desperate need.
In the words of Secretary General of the Norwegian Refugee Council Jan Egeland, “As world leaders brace for the worst within their borders, they must not abandon those living outside them.”