Refugees unprotected against COVID-19 risks in Greece

Clinically vulnerable refugees in Greece face acute health risks due to the absence of protective measures against the COVID-19 pandemic, as illustrated by the case of an elderly asylum seeker with a severe medical condition on the island of Lesvos, who falls within the categories of people at high risk from the virus.[1]

From her arrival in November 2019 until January 2021, the applicant was never referred from the competent authorities for a medical examination to a primary care structure or to the hospital on account of her diabetes, even though her medical condition had been stated during her registration and indicated on her medical card. In addition, her vulnerability assessment form in early 2020 recommended access to “better reception conditions”. Nevertheless, the applicant was only identified by the authorities as belonging to the vulnerability category of elderly persons.

Although the RSA lawyers representing the applicant had officially informed the Reception and Identification Centre (RIC) of Lesvos several times about her vulnerability and her need for proper reception conditions, the applicant was forced to weather the entire COVID-19 pandemic exclusively in wholly unsuitable conditions in camps whilst suffering from uncontrolled diabetes for over a year. Since her arrival, the woman remained in overcrowded, squalid conditions in Moria until the camp was destroyed by fire in September 2020, resulting in her becoming homeless and with no access to food, water and medicine. She subsequently entered the new temporary facility established in Kara Tepe, where she resided without access to the necessary conditions for her subsistence.

Although her geographical restriction on the island was lifted in August 2020 in view of her transfer out of Greece under the family provisions of the Dublin Regulation, she was forced to continue living under inappropriate conditions in the camps as the authorities did not transfer her to suitable accommodation either on Lesvos or on the mainland . Throughout this time, she had no possibility to maintain social distancing or to sufficiently cater for personal hygiene inside the camps, and she never received the necessary medicine or food adapted to her dietary requirements.

The applicant’s legal representatives intervened on several occasions before the Greek authorities, already in April 2020. Moreover, RSA mediated in order for the applicant to undergo the necessary medical examinations and then to receive appropriate medication for diabetes, as the Greek authorities never referred her for medical examinations. The Ombudsman also intervened twice in this case: first in October 2020 to request that the applicant be given appropriate accommodation and health care due to her acute vulnerability in accordance with applicable legal standards, and then in January 2021 to request again that the RIC re-assess her vulnerability due to diabetes and that the applicant be transferred to appropriate accommodation. [2] However, the woman was never placed in appropriate living conditions suitable to her condition until February 2021, after her legal representatives triggered a request for interim measures at the European Court of Human Rights (ECtHR).

Today, the applicant is under medication for diabetes and needs to undergo monthly medical re-examination. However, there is a risk that she will not be able to undergo the necessary examinations in the next period as her Provisional Foreigner’s Insurance and Health Care Number (PAAYPA)[3] has ceased to be active, in the context of general obstacles arising since the beginning of 2021 with regard to PAAYPA for most of the asylum seekers in Greece.

The case reflects acute health risks stemming from palpable omissions on the part of the State. The competent authorities not only failed to discharge their duty to promptly and thoroughly assess the asylum seeker’s special reception needs throughout a period exceeding one year from her arrival, but also took no measures to protect a person at high risk during the COVID-19 pandemic.

Earlier this year, ECtHR communicated several cases relating to risks of inhuman or degrading treatment on the islands of Lesvos, Samos, Chios and Kos. The Court has also issued interim measures to safeguard individuals against inhuman living conditions in Moria and Kara Tepe during the pandemic, in cases represented by RSA.


  1. Article 1 Joint Ministerial Decision ΔΙΔΑΔ/Φ.64/346/9011/2020, Gov. Gazette B’ 1856/15.05.2020 and Article 2 Joint Ministerial Decision ΔΙΔΑΔ/Φ.64/420/16446, Gov. Gazette B΄4011/18-09-2020
  2. Articles 39(5) and 58 International Protection Act; Articles 21 and 22 Reception Conditions Directive.
  3. Article 1 Joint Ministerial Decision 717/2020, Gov. Gazette B’ 199/31.01.2020

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