Identifying and isolating probable and confirmed cases as early as possible are the most important measures to control the outbreak. In many regions COVID-19 testing is unavailable or limited and testing shortages may be more likely to be experienced in camps and camp-like settings. If there is confirmed community transmission of COVID-19 in your region then suspected cases (people with COVID-19 symptoms) who cannot be tested should isolate and/or seek care through established local mechanisms (e.g in person at a health facility or via a phone-based health consultation).
Options for isolation or self-isolation will vary between contexts, and may include one of the following three scenarios:
1. Self-isolation in the home where individuals ARE able to isolate in a separate room: Suspected cases should stay in an individual room, use their own utensils and linens, and have no contact with anyone else but a caregiver who should wear a mask. If using a shared sanitation facility, the person should clean and disinfect all surfaces they use, including the toilet. To limit contact, clean and disinfect around the person only when needed. If they are able, the person should clean the room themselves. After isolation, the room should be appropriately cleaned and disinfected before other household members use the room. The Social Science in Humanitarian Action Platform has also developed a guide for ensuring that home-based care can be managed safely and acceptably.
2. Self-isolation in the home where individuals ARE NOT able to isolate in a separate room: In addition to the recommendations mentioned just above in scenario 1, suspected cases should wear a mask and allow for space (2 meters) between them and other members of the household throughout the day and night, where possible. If 2 metre distances are not possible in sleeping areas, consider adding a barrier between the suspected case and others or sleeping head to toe. Where possible, increase the airflow within the house by opening doors and windows. Visitors should be limited, and if the suspected case must leave the home, they should wear a mask and notify the health care facility that they are coming and that they have tested positive for COVID-19 or have COVID-19-like symptoms.
Scenario 3 is required when individuals requiring isolation and treatment do not have an adequate shelter and should be prioritized for facility isolation.
3. Isolation in temporary facilities or health care facilities (HCF): In most instances, there may not be sufficient space in health facilities to treat all suspected cases as well as cases. Health care facilities also still need to be preserved for the treatment of non-COVID-19 medical issues and health services. All efforts must be made to increase the capacity of any collective isolation facilities. In camps and camp-like settings, it is useful to identify empty spaces, ideally next to the local health facility, where a new (temporary) structure could be put in place for isolation and treatment. Temporary facilities may also include repurposing existing community facilities (i.e. community hall or sports area). Such facilities can be used for the isolation and treatment of mild and low to moderate risk cases as well as the isolation and monitoring of contacts of cases. If setting up new facilities make sure to plan appropriately for human resources and equipment needed for the operation of these isolation facilities.
Key considerations for all types of isolation include:
Ample communication to community members to explain why isolation is needed and continued engagement with the community to understand and address their concerns about the approach.
Preservation of family unity, particularly for young children, should remain a key principle in all isolation efforts. Where possible, children should be isolated together with a caregiver.
Look for locally-adapted approaches to support cases and their families during isolation to ensure their safety and wellbeing. This may include facilitating communication (e.g. by phone) with family and friends who are not in isolation and providing access to activities to occupy people’s time in isolation (e.g. games, reading materials, videos or drawing facilities).
Make sure there is a process for transferring cases to higher care facilities if symptoms worsen.
To aid your community engagement and communication on isolation and care-seeking behaviours, the WHO has developed a message library for use with at-risk populations which can be adapted locally for populations in camps and camp-like settings. Adaptations should take into account the culture, literacy rates, preferred communication channels and other factors such as miscommunication, community perception and prevalence of rumours. See this guide for more details “What should be considered when designing Information Education Communication (IEC) materials?” and our summary report on “Community Engagement”.
To encourage self-isolation and care-seeking behaviour, messages should:
Provide empowering behaviour-focused and forward-looking messages rather than messages that could instil fear, confusion or suspicion
Want to learn more about COVID-19 programming in camps and camp-like settings?
Author: Lauren D’Mello Guyett
Last update: 18.9.2020