The new coronavirus could be spreading undetected through camps across Somalia hosting some 2.6 million displaced people, the Red Cross warned on Tuesday, as floods and conflict swelled the numbers fleeing into overcrowded settlements.
Almost 500,000 people have been forced from their homes by recent floods in central Somalia, the United Nations said, putting further pressure on some 2,000 camps across the Horn of Africa nation, which has been mired in conflict since 1991.
"We are concerned that many COVID cases are going undetected, especially in the internal displaced camps," said Ana Maria Guzman, health coordinator for the International Committee of the Red Cross (ICRC), in a statement.
"Because of the ongoing conflict in Somalia, and also we are facing floods right now in Somalia, there is an increase in the number of internal displaced population into urban areas and this creates the perfect environment for infectious disease."
Somalia, which has a population of about 15 million people, has recorded more than 2,600 coronavirus cases and about 90 deaths, according to a tally by Johns Hopkins University.
Aid workers said the virus could spread undetected in the camps - where maintaining a safe distance and regular hand-washing are a challenge - with particular concern for the capital Mogadishu, host to some 800,000 displaced people.
Officials from Somalia's health ministry were not immediately available for comment.
"So far, no COVID-19 case was registered at the camps in Mogadishu," government spokesman Ismail Mukhtar Omar told the Thomson Reuters Foundation.
"The government has taken strong, important measures to curb the virus and raise awareness amongst internally displaced people ... the Somali government has managed to provide preventive materials, like hygiene kits, to the displaced."
Impoverished Somalia regularly suffers prolonged droughts and flash floods - threatening peoples' livelihoods and worsening hunger amid ongoing conflict between its Western-backed government and the Islamist militant group al Shabaab.
Most internally displaced people (IDP) live in congested camps in towns and cities across Somalia, dependent on daily wage labor and with limited access to quality healthcare and sanitation services.
Acute watery diarrhea and measles have already been reported in some clinics, said Guzman.
The ICRC is working with Somali Red Crescent volunteers to disinfect the camps, test people and trace contacts, she said, adding that it was a complex task as many people could not provide contact details or did not have mobile phones.
"It seems incredibly likely to me that there are cases going undetected in IDP camps," said Suze van Meegen, global advocacy advisor for the Norwegian Refugee Council, which recently conducted a study on the impact of COVID-19 in Mogadishu camps.
"We spoke with community leaders ... nine of them reported to us that they thought there had been recent deaths as a result of COVID-19. This is just a perception but I think it's indicative of the likelihood that there are cases in the camps."