• IOM, working with CDC, conducts COVID-19 testing for all refugees within 72 hours prior to their departure. Most refugees will be tested by SARS-CoV-2 Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). In the rare circumstance that PCR testing is not available in the country of departure, refugees may be tested using rapid antigen kits. All results will be documented on the PDMP and DS medical forms available inside the IOM bag. Refugees who test positive or are close contacts to persons who test positive will wait the CDC-recommended isolation and quarantine periods before travel. Refugees with COVID-19 will wait at least 10 days and refugees who are close contacts will wait at least 14 days.
• Prior to departure (typically within 24 hours), IOM conducts health checks for all refugees, including checking for COVID-19 symptoms and elevated temperatures prior to transporting refugees to pre-departure transit locations or airports.
• IOM is also counseling the refugees about appropriate social distancing and providing supplies for recommended hygiene measures (sanitizers, tissues, non-medical masks). In addition, IOM is counseling refugees about COVID-19 symptoms, respiratory and hand hygiene, and distributing a Welcome Booklet, developed by CDC.
• For refugees with Significant Medical Conditions (SMC), IOM medical staff provide individual counseling and ensure a pre-travel supply of medications for 12 weeks.
• On the day of departure, IOM staff will facilitate exit airport screening and ensure general observation of health condition of departing refugees. Only refugees who are deemed fit to travel during these final checks are allowed to depart on their flight.

• Refugees arriving to the U.S. are subject to the same entry requirements as any traveler.
• Refugees arrive at one of the five U.S. ports of entry (Chicago, Houston, Los Angeles, New York, and Washington, DC). Screening upon arrival depends on the origin of the flight and the traveler.
• Travelers cleared by CDC are released for onward travel to their final destination. Travelers with concerns following the enhanced screening are referred for additional assessment by staff from the CDC Quarantine Station at the airport.
• Travelers with possible signs or symptoms of COVID-19 are referred to the local clinical facility that has been pre-designated to receive arriving ill passengers from that airport. Travelers receive medical care as needed.  A traveler with possible COVID-19 would remain under local care based on the severity of illness (hospitalized if ill, or discharged to a local, pre-designated facility for those with mild symptoms) until they are fit to travel safely to their final destination.

• Refugee resettlement in the U.S. is conducted with careful adherence to safety precautions in accordance with all local and state public health guidance. Beginning with the airport reception, resettlement staff bring supplies of masks and gloves for refugees’ use. Transportation from the airport is planned to allow for social distancing through the use of large or additional vehicles.  The precise process may vary by location. For example, local RA staff or U.S. ties may provide airport transportation or coordinate a ride-share service.
• Non-medical masks, sanitizers, and tissues will be provided by IOM at departure. Some resettlement offices are providing similar sanitation materials upon arrival if necessary and available.

• CDC guidelines regarding entering the U.S. after travel abroad apply to all resettling refugees. Resettlement offices are expected to explain that CDC recommends that refugees either receive a post-arrival COVID test 3-5 days after arrival and stay at home for 7 days if the test is negative, or, if not tested, stay at home for 10 days after arrival. Regardless, refugees should continue to monitor their health for 14 days after arrival. During this time, refugees should monitor their health, practice social distancing, and seek healthcare, if needed. They should be Resettlement offices should share any additional local quarantine requirements.
• Refugees should receive counseling about the CDC recommendations after international travel.
• As a majority of refugees are resettled near or with family or friends in the U.S. (U.S. ties), the resettlement agencies inform and educate all U.S. ties regarding the stay-at-home recommendations.
• In some cases, a resettlement agency may arrange for refugees to stay in transitional housing during the stay-at-home period. Transitional housing may include hotels, Airbnb rentals, or other types of temporary accommodations, which take into safety guidelines to minimize risk of contracting COVID-19.
• During the stay-at home period, refugees can still expect to have sufficient food and groceries (sometimes provided through contactless delivery), regular contact (often by phone) with their local RA, and receive updated guidance specific to COVID-19.

• To limit the spread of the disease, governments are asking individuals to follow guidance or rules which are put in place for the safety of everyone.
• In the U.S., all individuals are expected to practice social distancing by maintaining at least six feet of space from others and wearing cloth face coverings in public areas where it may be difficult to maintain social distance.
• Additional guidance and protocols due to COVID-19 (such as stay-at-home orders, wearing cloth face coverings, accessing community services and healthcare, attending English classes, and using public transportation) will vary by location. The local RA will provide specific information to refugees upon their arrival.
• During the COVID-19 pandemic, information may change quickly and individuals are responsible for following appropriate guidance and staying informed about the situation in their communities. Refugees should follow city or state public health guidance, and consult the local RA for information.

• The vital role of the local RA has not changed due to COVID-19. Local RAs will provide information and connect refugees to other services needed to begin their new lives in the U.S. While non-urgent medical services may be delayed, refugees will have access to health care for urgent medical needs.
• Due to COVID-19, many physical offices may be temporarily closed and resettlement staff may be working from their homes, providing services remotely (via phone or messaging apps) or modifying in-person contact to ensure social distancing, such as meeting outside refugees’ homes. This will vary based on location.
• Refugees are responsible for staying in close communication with their local RA. Interpretation will be provided in accordance with usual program guidelines.
• The amount of direct assistance provided through the Reception & Placement Program has not changed. As always, refugees may be eligible for other assistance depending upon their eligibility.

• COVID-19 has not specifically impacted housing to a large degree. In some parts of the U.S., pre-COVID-19 housing shortages that existed may still persist.
• For all arriving cases, the local RA will counsel refugees to adhere to the stay-at-home recommendations. As previously noted, in some locations this may mean that refugees are placed in transitional housing during the quarantine period. Transitional housing may include hotels, Airbnb rentals, or other types of temporary accommodations, which take into consideration safety guidelines to minimize the risk of contracting COVID-19.
• The use of donations for refugees varies by location. In some locations, donations may still be used after proper disinfecting per CDC protocols. At this time, many local RAs are primarily using items donated pre-COVID-19 and are no longer accepting new donations.

• Facilitating medical handover or immediate medical hospitalization upon arrival may require additional time and coordination at this time. IOM US is aware of these challenges and will be ensuring more time for this coordination of medical arrivals.
• Receiving medical care in the U.S. varies by location and based on local guidelines. The local RA is an important point of contact for specific questions, including inquiries about existing health conditions, what to do if someone exhibits COVID-19 symptoms, and scheduling of health screenings.
• Health screenings are still required and taking place. However, the timeline may vary in some locations and occur after the 30-day time period. Obtaining medical care for non-urgent issues will vary by location. For instance, in some locations, it may not be possible to schedule in-person medical appointments, but there may be telehealth options available. Urgent medical care is still being addressed and refugees will be able to access prescriptions.
• Testing for COVID-19 varies by location and may not be widely available. During the stay-at-home period, the local RA will stay in contact with refugees and provide guidance on monitoring for symptoms and any additional steps to take per CDC guidance. Some of the local RAs may also facilitate COVID-19 testing. For example, in one location, the agency partnered with the city department of public health to host a free testing day targeting refugees and immigrants, including providing interpretation.
• Medicaid coverage has not changed under COVID-19 and reports from local RAs are that COVID-19 tests and, if necessary, treatment is covered.

• Finding employment remains a critical aspect of the refugee resettlement process and the local RA will connect refugees to employment services, taking into account local restrictions related to COVID-19. Refugees play a central role in finding and keeping a job and should be prepared to actively pursue employment as soon as they arrive in the U.S.
• The impact on employment as a result of COVID-19 varies by location. For example, in some areas, the types of jobs available have changed. There are additional safety precautions in the work environment and social distancing guidelines in place. Guidance and information may change during the pandemic, so it is important for refugees to remain in contact with their local RA.

The impact on school enrollment and attendance as a result of COVID-19 varies by location. For example, in some locations there may be delays in school enrollment, some schools may be closed, and other schools have transitioned to a distance learning model. The local RA will provide refugees with information and guidance about enrollment and attendance of school upon arrival, including remote learning. Guidance and information may change during the pandemic, so it is important for refugees to remain in contact with their local RA.

Refugees receive additional information about COVID-19, including prevention, community spread, respecting rules, and adhering to CDC guidance through the local resettlement staff. This information is incorporated as a part of pre-departure CO, provided during IOM counseling sessions, included in the CDC Welcome brochure and again, explained in more detail, upon arrival to the U.S.

Enrollment and attendance in English classes varies by location and is based on state or local regulations on stay-at-home orders and business opening guidelines. The local RA will provide refugees with information about access to English classes upon arrival. As appropriate and possible, RAs may provide refugees with additional resources to learn English. Guidance and information may change during the pandemic, so it is important for refugees to remain in contact with their local RA.

The amount of direct assistance provided through the Reception & Placement Program has not changed.  As always, refugees may be eligible for other assistance depending upon their eligibility.

Consistent with regulations prior to COVID-19, the nature of eligibility rules, types of benefits, and benefit levels vary based on location. COVID-19 may cause delays or changes in processing applications for public assistance; the impact of the changes varies by location. For example, in some instances, social security cards may be delayed depending upon the local Social Security Administration’s office; applications for public assistance may be processed online rather than in-person. The local RA will work with refugees to ensure they are able to access public assistance as appropriate.

Prior to COVID-19, access to public transportation varied by location. While this is still the case, in some areas, the level of public transportation may be reduced. Upon arrival, the local RA will provide refugees with information about public transportation in their area. Refugees may still use public transportation; however, use may be limited to essential activities such as grocery shopping and going to work. Social distancing and use of face masks will be required on public transportation

The local RA will provide refugees with information related to restrictions and guidelines specific to COVID-19 upon arrival, including information on possible fines and consequences for not adhering to local restrictions. Guidance and information may change during the pandemic, so it is important for refugees to remain in contact with their local RA.

• COVID-19 has caused changes to daily life in the U.S. and this will influence refugees’ initial resettlement period. Refugees should be informed of the recommendation that they either receive a COVID test 3-5 days after arrival and stay at home for 7 days if the test is negative, or, if not tested, stay at home for 10-days upon arrival. The local RA will assist refugees in staying informed about changes to daily life, for instance, requirements to follow restrictions for large gatherings with family and friends and delays in accessing in-person services.  Public transportation guidance may also vary, including social distancing and wearing face coverings.
• In spite of changes to daily life in the U.S., local RAs are taking steps to innovate and create a sense of community to assist refugees during their initial resettlement period. These activities vary greatly by location but may include virtual activities, increased use of video communication, attention to building digital literacy skills, and connections with volunteers or other community members through social messaging apps, like WhatsApp.