Exploring the Mental, Social and Lifestyle Effects of COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study

Abstract Background: The fear of testing positive for COVID-19 infection has created panic among patients and families and discouraged some people from being tested and receiving medical care. Migrants and refugees are among the vulnerable populations that suffered disproportionately from the COVID-19 crisis. However, their experiences with COVID-19 positivity status have not been investigated. This study aimed to explore the physical, mental, and psychosocial impact of a positive COVID-19 diagnosis on Syrian refugees living in Jordan.Methods: Using a qualitative approach, twenty phone interviews were conducted with ten adult Syrian refugees living within the camp and ten refugees living in non-camp (host-community) settings. A follow-up interviews with five health care providers in the refugee camp were conducted to explore the services and support given to the refugees with COVID-19 infection. The findings were thematically analysed using Braun & Clarke's six-phase framework. Results: Physical effects of a positive COVID-19 status varied according to the seriousness of the condition but affected most participants' lifestyle by adopting more precautionary measures and caring for their physical health. Self-isolation and fear to infect others were common themes identified among all participants living within community settings. Resorting to friends and family members for mental and psychological support was the only option available for all participants. Refugees living within the community preferred to manage their condition at home utilizing traditional remedies and avoided being tested for financial reasons, poor healthcare access and fear of being identified. Refugees living within camps had better access to testing, healthcare, and disease management and did not experience fear of being deported. They did not display worries and feelings of shame and guilt, which were feelings expressed by refugees living within the community. Both groups suffered mental and psychosocial health impacts, as well as social isolation and fear of death and disease complications.Conclusions: COVID-19 infection has negatively impacted refugees’ well-being with noticeable disparities across the different living conditions. While mental health impact seems to be standardized, refugees living within host-community may need more support into managing their condition, accessibility to free testing as well as treatment and healthcare services.