The urgent need to transfer vulnerable migrants from Europe’s largest migrant hotspot

Jacqueline Bhabha and Vasileia Digidiki discuss the current covid-19 situation in Greece, the migrant hotspot Greek islands, and what the EU should be doing to help the crisis. 

Lesvos, the small Greek island notorious as Europe’s primary landing point for forced migrants from Asia and Africa since 2015, confirmed its first covid-19 related death on 30 March. Testing across the island quickly confirmed 10 cases among the local population,1 spreading fear of an uncontrollable outbreak in the densely and overcrowded migrant and refugee camps on the island.

We were expecting this news. One of us is a Lesvos native. Both of us have worked on its refugee crisis for several years. We are painfully familiar with the conditions facing the refugee and migrant population on the island, and the particular dangers they currently pose. Although Greece responded more promptly to the pandemic outbreak than other southern European countries, thus controlling the spread of the virus2  and achieving one of the lowest rates of infection in Europe, this commendable past conduct does not assure a safe and healthy future. In fact, despite the efforts, on 21 April it was revealed that a total of 150 asymptomatic refugees living in an accommodation facility in a small town in southern Greece tested positive for covid-19.3

As states across the EU scramble to protect their populations, how should they treat asylum seekers and other forced migrants on their territory? This is a particularly acute question where these populations live in overcrowded and unsanitary conditions, that pose exacerbated health risks to themselves and to neighbouring locals. In mid-March, Greece joined the growing cohort of governments closing their borders. In addition, as of 23 March it severely restricted non-essential movement and limited gatherings in open spaces to no more than two people at a time. These restrictions were also applied to camp populations across Greece. But in a camp setting, are these measures appropriate, humane and just?

Moria camp, the decommissioned army camp that became Europe’s first migrant hotspot in 2015, has a holding capacity of 3,000; it currently has more than 22,000 migrants. Among them are people with chronic and untreated diseases, elderly persons, babies and pregnant women, all living in conditions unseen in recent European history. People are forced to brave the winter sleeping on mats and in cardboard boxes, without sanitation, running water or adequate food. Many report respiratory complications, the consequence of months spent inhaling fumes from makeshift fires used to cook and stay warm. Amidst the covid-19 pandemic, Moria is a ticking time bomb that could spell disaster for all Lesvos inhabitants, migrants and locals alike. 

In Moria, on the richest continent on earth, Europe’s willful disregard of its humanitarian obligations has allowed thousands fleeing poverty, conflict and persecution to face the same challenges as slum-dwellers in Mumbai and Sao Paolo. Without basic hygiene, camp residents have to wait in lines to access sanitary latrines and rationed amounts of soap and clean water. These conditions have already created a fertile ground for outbreaks of chicken pox, respiratory illness, and seasonal flu.4 Chronic, untreated diseases is a further concern. Just a month before the covid-19 outbreak, health workers documented 140 cases of serious illness, including heart disease, diabetes and asthma, among migrant children.5

In recent days, aid organizations have been banned from entering Moria to combat the spread of the virus.6 Meanwhile local medical facilities are rudimentary. On Lesvos, there are only 6 intensive care beds in the island’s only hospital for a current population of 125,000. Until now, there is one contingency plan for this kind of situations: the quarantine of any camp should an infection be confirmed within. This plan has already been implemented in two camps in mainland Greece and one accommodation facility in southern Greece, where covid-19 cases among refugees were documented in early and late April, accordingly.

In Ritsona camp in Central Greece 3,000 refugees were quarantined for 2 weeks after 20 tested positive.7 In Malakasa camp, located close to Athens, 1,270 refugees were placed in quarantine after a male resident tested positive.8 In the Kranidi accommodation facility, a hotel run by an International NGO in a small Greek town, 470 refugees were quarantined when a pregnant Somalian refugee tested positive for covid-19, leading to consecutive testing that subsequently found 148 infections.9 But these camps and facilities are better maintained and not so overcrowded so a lockdown might indeed be the sensible solution. How can these measures be applied in a place where 22,000 people coexist without adequate space or facilities? No clear contingency plans exist for Moria camp should the health situation deteriorate. As fear increases and empathy decreases, the delicate balance between migrants and locals could very well collapse.

What should the next steps be? The EU has urged the Greek government to transfer vulnerable groups to the mainland. Following this sensible recommendation, the Greek government on April 19 announced the relocation of 2,000 vulnerable people from hotspots on the Aegean islands to mainland Greece, including 200 elderly asylum seekers and approximately 1,800 individuals and families with illness.10

But thousands will continue to remain in deplorable conditions and at risk. According to UNHCR, more than 36,000 migrants are stranded in 5 hotspots across 5 small Greek islands, built to host no more than 5,400 and only for short lengths of time.11 It is clear to us that the solution to this entrenched problem lies beyond Greece’s capacity or responsibility. The EU should substantially up its offers of migrant relocation from Greece beyond the small group already targeted. 

For a continent of 446 million, the numbers are tiny and manageable. A few thousand per EU member state, suitably quarantined and then included in collective social planning, would not present a fiscal or political challenge. Rather it would be a sign of the enlightened leadership and humanitarian commitment that the EU has long aspired to. Without effective and coordinated action, the pandemic will immobilize the Union’s most precarious and embattled member. This would spell disaster for Lesvos, for Greece and, ultimately, for the European Union as a whole. 

Jacqueline Bhabha is a Professor of the Practice of Health and Human Rights at the Harvard T.H. Chan School of Public Health. She is the director of research at the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University.

Competing interests: none.



Vasileia Digidiki is an instructor at the Harvard T.H. Chan School of Public Health and director of the child protection and migration program at the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University. She is also a native of the Greek island of Lesvos.

Competing interests: none.



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  2. Reuters. (April 13, 2020). Greece has won a battle against COVID-19 but war is not over: PM. Available at:
  3. E-kathimerini. (April 21, 2020). 150 people test positive for Covid-19 at Kranidi refugee facility. Available at:
  4. Benjeddi, H., Scholten, G. & Van de Water, M. (2018). Dutch doctors shocked by the situation in Moria refugee camp: physical and mental health under great pressure. Available at:
  5. Euronews. (January 20, 2020). At least 140 children with serious health conditions living at Moria migrant camp, says MSF. Available at:
  6. E-kathimerini. (March 17, 2020). Migrant camps on islands put on lockdown. Available at:; Refugee International. (March 30, 2020). COVID19 and the displaced: addressing the treat of the novel coronavirus in humanitarian emergencies. Available at:
  7. Reuters. (April 5, 2020). Greece quarantines second migrant camp after COVID-19 case confirmed. Available at:
  8. The Independent. (April 5, 2020). Coronavirus: Greece places second refugee camp into lockdown after migrant tests positive for Covid-19. Available at:
  9. E-kathimerini. (April 21, 2020). 150 people test positive for Covid-19 at Kranidi refugee facility. Available at:
  10. The Washington Post. (April 17, 2020). Greece to relocate ill and elderly refugees from overcrowded camp. Available at:
  11. UNHCR. (February 7, 2020). UNHCR calls for decisive action to end alarming conditions on Aegean islands. Available at: