Responding to overlapping crises: local authority public health perspective in resettling of Afghan nationals during the COVID-19 pandemic in England

We present our experience of addressing a novel challenge of managing COVID-19 during the pandemic among Afghan nationals who arrived in the United Kingdom. Various schemes were introduced to resettle Afghan nationals who supported UK Forces in Afghanistan. The initial Ex-Gratia Scheme was expanded in December 2020 to the Afghanistan Relocation and Assistance Policy. In January 2022, the Afghan Citizens Resettlement Scheme was launched. Many Afghan nationals were granted 5 years’ leave to enter the UK. Local authorities in England were required to organise ‘Bridging Hotels’ and provide support for 18 months, coinciding with the ongoing COVID-19 pandemic from December 2020. Kent County Council established three bridging hotels, and policies were implemented to prevent and contain the spread of COVID-19. We describe how the Council and the UK Health Security Agency overcame this novel challenge with an integrated monitoring system. We also outline the successes and challenges experienced in protecting these nationals and managing outbreaks during the pandemic. Daily Lateral Flow testing was introduced, later reduced to 3 times a week. Reporting mechanisms were set up to manage positive cases and outbreaks promptly. Training was provided to staff and Afghan nationals to self-test and register the results. There were ten confirmed cases of COVID-19, five Afghan nationals and five staff members. An outbreak occurred in 2 hotels, with no hospitalisations or deaths. The challenges, included cultural and language barriers. For comparison, we briefly review the experience of resettling Afghan nationals by the United States Government. Our work has shown that close collaboration and adopting a system-wide approach, combined with technical expertise, will likely produce the best possible results even in a global emergency. We highlight the importance of leadership provided by local authority public health departments, with the Director of Public Health at the helm for such incidents.