01, June 2020 | Bangladesh
Authors:Truelove S. Abrahim O. Altare C. Lauer S.A. Grantz K.H. Azman A.S. Spiegel P.
Background COVID-19 could have even more dire consequences in refugees camps than in general populations. Bangladesh has confirmed COVID-19 cases and hosts almost 1 million Rohin- gya refugees from Myanmar, with 600,000 concentrated in the Kutupalong-Balukhali Expansion Site (mean age, 21 years; standard deviation [SD], 18 years; 52% female). Pro- jections of the potential COVID-19 burden, epidemic speed, and healthcare needs in such settings are critical for preparedness planning. Methods and findings To explore the potential impact of the introduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Kutupalong-Balukhali Expansion Site, we used a sto- chastic Susceptible Exposed Infectious Recovered (SEIR) transmission model with param- eters derived from emerging literature and age as the primary determinant of infection severity. We considered three scenarios with different assumptions about the transmission potential of SARS-CoV-2. From the simulated infections, we estimated hospitalizations, deaths, and healthcare needs expected, age-adjusted for the Kutupalong-Balukhali Expan- sion Site age distribution. Our findings suggest that a large-scale outbreak is likely after a single introduction of the virus into the camp, with 61%–92% of simulations leading to at least 1,000 people infected across scenarios. On average, in the first 30 days of the out- break, we expect 18 (95% prediction interval [PI], 2–65), 54 (95% PI, 3–223), and 370 (95% PI, 4–1,850) people infected in the low, moderate, and high transmission scenarios, respec- tively. These reach 421,500 (95% PI, 376,300–463,500), 546,800 (95% PI, 499,300– 567,000), and 589,800 (95% PI, 578,800–595,600) people infected in 12 months, respec- tively. Hospitalization needs exceeded the existing hospitalization capacity of 340 beds after 55–136 days, between the low and high transmission scenarios.
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