Download This Paper
Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.
Spreading of SARS-CoV-2 Among Adult Asylum Seekers in Refugee Shelters in Germany
13 Pages Posted: 23 Jul 2021
More...Abstract
Background: Housing and access to healthcare pose particular challenges to asylum seekers and refugees. The study aim was to assess their infection risk during the COVID-19 pandemic.
Methods: We provide the first event-free, prospective study on SARS-CoV-2 cases among adult asylum seekers/refugees in Europe. SARS-CoV-2 genome and antibody titers were determined in adult asylum seekers/refugees living in shared accommodation in Lübeck, Germany at two time-points and compared to the results from a local population-based cohort.
Findings: In November/December 2020, we detected 2/97 PCR- (2·1%; 95% confidence interval [CI]: 0·4-6·3%) and 4/97 (4·1%; CI: 1·4-9·2%) seropositive asylum seekers/refugees compared to 3/2547 (0·1%; CI: 0·0-0·3%) PCR-positive and 12/2547 (0·5%; CI: 0·3-0·8%) seropositive probands in the control sample. In February 2021, 2/67 (3·0%; CI: 0·5-9·1%) PCR-, and 25/67 (37·3%; CI: 27·4-48·1) antibody-positive individuals were found in the study group in comparison to 2/2371 (0·1%; CI: 0·0-0·3% and 38/2371 (1·6%; CI: 1·2-2·1%) in the control group. Age, sex, or facility equipment did not impact the results. "Living-with-own-children-in-the-shelter” was significantly positively correlated with infection risk. Importantly, none of the PCR-positive refugees were aware of their infection. Only 32·9% of the asylum seekers were willing to be vaccinated compared to 85·5% in the control population.
Interpretation: Refugees residing in shared accommodations represent a high-risk group for SARS-CoV-2 infection and transmission. The present study suggests a need for (i) tailored testing strategies, (ii) improved information of this subgroup, and (iii) high-priority vaccination.
Funding Information: The study was funded by the Federal Ministry of Education and Research.
Declaration of Interests: C.K. serves as medical advisor to Centogene for genetic testing reports in the fields of movement disorders and dementia, excluding Parkinson's disease and serves on the Scientific Advisory Board of Retromer Therapeutics. Neither activity represents a conflict of interest. Likewise, none of the other authors declares any financial conflict of interest.
Ethics Approval Statement: The ethics committee of the University of Lübeck approved the study (Az. 20-150). All participants gave written informed consent. All study materials were translated into the refugees' native languages, and interpreters were available on-site at the study center.
Keywords: SARS-CoV-2; COVID-19; refugees; shelters
Suggested Citation: Suggested Citation