Enhancing Respiratory Disease Surveillance to Detect COVID-19 in Shelters for Displaced Persons, Thailand-Myanmar Border, 2020-2021

Abstract

We developed surveillance guidance for COVID-19 in 9 temporary camps for displaced persons along the Thailand-Myanmar border. Arrangements were made for testing of persons presenting with acute respiratory infection, influenza-like illness, or who met the Thailand national COVID-19 Person Under Investigation case definition. In addition, testing was performed for persons who had traveled outside of the camps in outbreak-affected areas or who departed Thailand as resettling refugees. During the first 18 months of surveillance, May 2020-October 2021, a total of 6,190 specimens were tested, and 15 outbreaks (i.e., >1 confirmed COVID-19 cases) were detected in 7 camps. Of those, 5 outbreaks were limited to a single case. Outbreaks during the Delta variant surge were particularly challenging to control. Adapting and implementing COVID-19 surveillance measures in the camp setting were successful in detecting COVID-19 outbreaks and preventing widespread disease during the initial phase of the pandemic in Thailand.

Keywords: COVID-19; Myanmar; SARS-CoV-2; Thailand; coronavirus disease; displaced persons; infectious disease surveillance; refugees; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

Figure 1

Total number of nasopharyngeal swab specimens tested for SARS-CoV-2 by reverse transcription PCR by camp and reason for testing as part of enhanced surveillance for COVID-19 in displaced persons’ shelters, Thailand–Myanmar border, May 2020–October 2021. Travel indicates persons who had traveled outside of the camp in the previous 14 days. Resettlement refers to persons tested before international travel to a third country as part of refugee resettlement. For reference, population sizes of each camp are given in Table 1.

Figure 2

Epidemiologic curve of the total number of laboratory-confirmed COVID-19 cases per week by displaced person camp, Thailand–Myanmar border, November 8, 2020–October 31, 2021. For reference, population sizes of each camp are given in Table 1. RT-PCR, reverse transcription PCR.