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Guidance on Home Quarantine & Isolation in Overcrowded Settings

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1 Introduction

On December 29, 2019, a hospital in Wuhan, Hubei Province, China reported an outbreak of severe unexplained viral pneumonia. The Chinese government notified World Health Organization (WHO) about the outbreak after verification. On January 8, 2020, the pathogen of this outbreak was identified as the novel coronavirus 2019 (2019-nCoV), and its gene sequence was submitted to WHO. On 30 January 2020, the World Health Organization (WHO) declared the 2019 coronavirus disease (COVID-19) outbreak a public health emergency of international concern (PHEIC)[1] and on March 11, WHO declared COVID-19 as a pandemic. In Lebanon, on 21 February 2020, the first case of COVID-19 was confirmed. Since then, more cases have been reported with history of travel or contact with confirmed cases with a travel history.

Home isolation/ quarantine is a public health technique employed to tackle the spread of disease.

The transmission of COVID-19 can be greatly reduced by keeping a confirmed or suspected individual separated from the rest of the population. The ability to use this technique in overcrowded settings is particularly challenging, where the space in homes and shelters is limited and typically shared by many people. Overcrowding is defined as a situation in which a person is living in a space that is less than 4.5m2 per person. This situation is applicable across shelter and settlement types (residential, non-residential and non-permanent structures) however, is most apparent in informal settlements and collective shelters (CS). It is estimated that 19% of refugees live in Informal Settlements1 (IS), 11% in non-residential building, among which 42 % are overcrowded, and 26% are in residential shelters.1 Overcrowded settings can be in urban and semi-urban areas and host a diverse population, including nationals and non-nationals.

The purpose of this document is to provide guidance on how quarantine and isolation can be achieved if there is a suspected or confirmed case in an overcrowded setting. It will focus on informal settlements and collective shelters, but the guidance can be applied in non-refugee settings as well, such as detention centres and crowded neighborhoods. This guidance aims to support a coordinated and efficient response. It supports detailed planning at the regional level and is meant to be adapted to the local context. Households residing outside of these shelter types will be expected to follow the self-isolation circular provided by the MoPH. It is preferable, whenever feasible, that people are supported to remain in their homes. This guidance note will be continuously adapted as needed from the National level.