Background

In late December 2019, a cluster of pneumonia cases of unknown origin was detected in Wuhan, People´s Republic of China. In early January, the pathogen was identified as a novel coronavirus (COVID-19) and genomic characterization and test method development were ensued. On January 30, the outbreak was declared a Public Health Emergency of International Concern (PHEIC) and as of 24 February, more than 79000 cases and over 2600 deaths worldwide (see here for daily updated figures), have occurred. Early evidence suggests that COVID-19 is less severe than SARS and MERS but more contagious ¹

Participation of MediPIET fellows and alumni in the COVID-19 outbreak

Since January 2020, all MediPIET countries are undertaking activities to prepare for possible COVID-19 cases. In an online survey, fellows and alumni have shared the details of the activities they carry out. Out of a total of 30 alumni and 15 current fellows, 10 and 15 respectively responded (56% overall response rate). The majority (23/25, 92%) is involved in their countries’ preparedness and response to halt the spread of COVID-19. In two countries, alumni are International Health Regulations focal points. Their work portrays how this regional training program contributes to enhanced national applied epidemiology capabilities and to improved health security in the Mediterranean and Black Sea regions.

Country level coordination, planning, and monitoring
Most countries have activated a multisectoral mechanism to support preparedness and response at national level, in the form of a Commission or a Committee liaising with Rapid Response Teams at regional and peripheral levels. In seven countries, 9 MediPIET fellows/alumni are members of Preparedness and Response Committees.

Risk communication and community engagement
In countries, 15 fellows/alumni are involved in risk communication and community engagement activities. Since it is critical to communicate to the public what is known about COVID-19, what is unknown, what is being done and share on a regular basis on actions, national risk-communication plans have been developed. Fellows/alumni are involved in preparing communication materials (also translating WHO guidance), including details of anticipated public health measures to raise awareness about COVID-19 and combat false rumours and misinformation. Efforts are also been devoted to working with media (taking part in national hotlines to answer inquiries, TV statements, press conferences, sharing updates in social networks, information kits for journalists).

Surveillance, rapid response teams, early detection and laboratory capacity, case investigation and clinical management recommendations
As of 24 February 2020, one COVID-19 case has been detected in Lebanon, one of the MediPIET countries with alumni and fellows. A total of 17 MediPIET fellows/alumni are involved in active case finding and event-based surveillance. Enhanced surveillance is done at national and regional level, in close coordination with the rapid-response teams. WHO/ECDC TESSy case-based report form has been adopted and adapted.

Six fellows/alumni are also contributing to adapt existing surveillance to enable long-term monitoring of COVID-19 transmission, for example, adapting sentinel ILI/ARI and SARI surveillance and implementing real-time integrated syndromic surveillance of acute lower respiratory diseases using e-health system. Procedures for daily monitoring of health status of arrived passengers from the affected areas in China and protocols for contact tracing have also been developed.

In addition, in two countries fellows/alumni are also involved in preparing laboratory capacity to manage large-scale testing for COVID-19, for example in the procurement of reagents, utensils and laboratory consumables.

Points of entry
A total of 8 MediPIET fellows/alumni participate in the conception and implementation of points of entry plan for thermal screening and management (assessment/isolation and transport to designated health facilities) of ill passenger(s) travelling back from affected areas. This also includes management of collected data and development of information materials for travellers.

Conclusion / way forward

In order to support MediPIET Alumni and Fellows efforts and also other senior public health officials in participating countries, MediPIET project organizes a series of activities related to COVID-19 including: (i) a 3-day Training of Trainers module in February 2020 on risk management cycle, assessment and communication with a special focus on COVID-19, (ii) a specific COVID-19 session during the next MediPIET module in March 2020, (iii) a series of webinars to first update our knowledge of coronavirus with the latest evidence, second to discuss specific aspects of containment measures and last, for countries in the network with COVID-cases to share their experience.

About MediPIET

The Mediterranean and Black Sea countries Programme for Intervention Epidemiology Training -MediPIET- is a regional competency-based on-the-job training programme (learning by doing) with a strong national and international mentoring component. Since 2014, 18 countries participate in the Programme and the following have 22 Alumni and 15 fellows: Albania (3 alumni and 1 fellow), Armenia (2 fellows), Georgia (2 fellows), Kosovo (2 alumni and 1 fellow), Lebanon (4 alumni and 1 fellow), Moldova (2 alumni and 1 fellow), Montenegro (1 alumni), Republic of North Macedonia (4 alumni and 1 fellow), Palestine (2 fellows), Serbia (2 alumni and 1 fellow), Tunisia (4 alumni and 1 fellow) and Ukraine (2 fellows).

(Published 25th february)

 

1^ Chinese Center for Disease Prevention and Control (CCDC). China CDC Weekly Bulletin. Vol 2. February 2020.