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Forcibly displaced populations residing in camps or camp-like settings may be particularly vulnerable to COVID-19 epidemics due to overcrowding, poor access to safe water and sanitation and limited access to health services. In the absence of control measures, camps and camp-like settings could experience very high attack rates and mortality. This would translate into an extremely large number of patients requiring intensive care over a short period of time (a few months), as suggested by modelling predictions for refugee campsin Cox Bazar, Bangladesh.

Resource-intensive containment measures imposing severe movement and contact restrictions on the entire population, such as mass ‘stay-at-home’ orders, social distancing, self-isolation and quarantine might not be appropriate for some camp or camp-like settings where such measures are unfeasible or would threaten livelihoods if applied over a long period. More generally, these population-wide measures would have to achieve very high levels of compliance in order to lower COVID-19 transmission to an appreciable extent: this is because the baseline transmissibility of the virus in overcrowded communities with poor sanitation is likely to be considerably higher than hitherto observed in high-resource settings. A more targeted approach of specifically preventing infections among groups at high risk of COVID-19 mortality within the displaced population may thus be a useful strategy to reduce mortality and pressure on health services: we refer to this approach as ‘shielding’ to denote it from more generic distancing measures.

This document provides guidance on the implementation of the shielding approach in camps and camp-like settings for refugees and internally displaced persons. It is intended for the displaced community itself, humanitarian actors and camp coordination / management authorities.

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