Table 2.

Recommendations for healthcare settings and providers serving recently resettled refugees in the United States or Canada during the COVID-19 pandemic

Recommendation	Summary	Details
1 Demographic data collection and analysis	Gather data about the sociodemographic and clinical characteristics of the refugee community served by your health center	Data can include: • Proportion of refugee patients in clinic overall • Proportion of refugee patients who tested positive for SARS-CoV-2 • Date of arrival • Countries of origin • Spoken languages • Employment, if known • Dates of last health care visits • Presence of underlying medical or mental health conditions • When immunizations or key follow up visits are needed • Groups who may be disproportionately affected within the refugee patient population, e.g., pregnant women, older adults, single parents, unaccompanied refugee minors, and those with limited English proficiency, who have underlying health conditions, or who resettled within the last year If certain data is missing, begin collecting and/or partner with other local groups for aggregated data about refugees resettled in the area
2 Develop refugee-specific outreach plans	Develop refugee-specific outreach plans that include contact information, preferred method of communication and a plan for communication once someone becomes ill with COVID-19	• Tailor each plan’s messaging and purpose based on the needs of the particular refugee group being addressed • Have knowledgeable individuals within the relevant refugee community assess the plans before implementing • Develop plans in partnership with local refugee-serving organizations who may be already engaged in this work but may need additional guidance on clinical information • Ensure that outreach plans delineate how and when patients will be contacted and what information will be provided about COVID-19 symptoms, prevention, self-management and how to safely access care
3 Identify and leverage community influencers	Use available culturally and linguistically appropriate resources (Table 1), accessible virtual platforms, and members of the refugee community (e.g., community and faith leaders and community health workers) to continue to educate refugees about the impact of COVID-19, how to stay protected, the importance of contact tracing and what successful contact tracing requires, and how to manage and access care for COVID-19 and other health needs	• Partner with traditional collaborators such as resettlement agencies and local community organizations serving refugees • Ask patients and community leaders about non-traditional partners with influence within the refugee communities (e.g., formerly resettled refugee health professionals, other community leaders) • Consider virtual platforms such as social media to educate and inform refugees • Identify resources that may not be available in culturally and linguistically appropriate formats and work with community members and health departments to make them available
4 Make every encounter count	Seek to understand and resolve barriers that prevent refugees from following COVID-19 prevention recommendations and accessing care	• Use each contact with refugee patients to inform on and mitigate risks of SARS-CoV-2 • Ensure that medical interpretation is available at every patient encounter and identify situations when it is not • Identify ways to accommodate refugee patients’ needs e.g., booking longer appointments for COVID-19 counseling or designating specific staff for outreach and education • Use each encounter to identify high-risk situations needing immediate action, such as domestic violence