Field Notes from FETPs Fighting COVID-19
Indonesia Field Epidemiology Training Program (FETP) alumni are involved in the Public Health Emergency Operations Center and staffing a hotline for sharing public information on COVID-19. They are also conducting health education and risk communications activities. Trainees have been involved in epidemiological investigations of COVID-19 cases, contact tracing, active surveillance, and at Soekarno Hatta International Airport to manage health alert cards, conduct thermal screenings and epidemiological investigations, and communicate about COVID-19 to travelers and airplane cabin crews. There, they also play a role in managing ill passengers and preparing and managing quarantine and isolation facilities.
FETP alumni are dedicated to epidemiological investigations of COVID-19, contact tracing, active surveillance, drafting and disseminating national guidelines, transporting and treating suspected and confirmed cases, and providing surveillance assistance in emergency and reference hospitals. Alumni also have been involved in specimen testing at the National Institute of Health Research and Development at the Indonesian Ministry of Health.
Nearly 85 percent of the residents and alumni of the China Field Epidemiology Training Program (FETP) have been involved in the response to COVID-19. Residents and alumni are involved in the Emergency Operations Centers at the national, provincial, prefecture and county levels. More than 50 serve as spokespeople to the press, more than 120 are conducting health promotion via social media, and more than 160 are involved in public health education.
Residents from all three tiers (Frontline, intermediate, and advanced) are involved in surveillance, situation analysis, risk assessment, case investigation, contact tracing, disinfection practices, infection prevention and control, passenger management at points of entry, laboratories, and operational support and logistics. More than 230 China FETP alumni have provided professional trainings on COVID-19. The program has also provided epidemiological assistance to other countries, including Iran.
The program has developed “Guidelines for COVID-19 Epidemiological Investigations” (available in English here) and distributed them, along with training videos and slides of the guidelines, to provincial, prefecture, and county-level centers for disease control.
Residents and alumni of the Ghana Field Epidemiology and Laboratory Training Program (FELTP) are involved in the COVID-19 response in Ghana as well as The Gambia, Liberia, and Sierra Leone.
In Ghana, 72 residents and alumni currently are participating in the response. FELTP resident Eunice Baiden Laryea trained 24 contact tracing teams comprising nurses, laboratory technicians, physician assistants, and disease control officers recruited from district health facilities. She assisted the district in creating case management teams including doctors, pharmacists, nurses, and laboratory technicians. Eunice was part of a team identifying all community-transmitted COVID-19 cases, working with the contact tracing teams who are dispatched into the communities where there is transmission to collect samples from all local contacts.
In The Gambia, four FELTP residents and four alumni have been involved in investigating the country’s COVID-19 cases. FELTP resident Mary A.A. Grey-Johnson visited Banjul International Airport to observe the level of preparedness and screening for incoming passengers into The Gambia. The team visited the Banjul International Airport temporary holding center for suspected cases of COVID-19.
In Liberia, five FELTP residents and five alumni are actively involved in the response. FELTP resident Musand Melody Kromah is part of the Epi Surveillance Pillar on the National Response Team and serving as case investigator and contact tracer. Lily Sanvee Blebo, another resident, is developing training materials for contact tracers and case investigators, among other activities.
In Sierra Leone, three FELTP residents and four alumni are involved in the response. Resident Kassim Kamara has been appointed as lead for the surveillance and quarantine pillar at the Lungi International Airport. Kamara is responsible for coordinating the surveillance and quarantine pillar at the Lungi command center, improving the quality of data generated on passengers entering the country, and submitting timely reports on quarantine to the command center coordinator. Resident Desmond Maada Kangbai currently serves as chairman of the District Emergency Operations Center (DEOC). He ensures that the DEOC provides essential functions to support decision-making and implementation, coordination, and collaboration.
Central America Regional FETP
Residents and alumni of the Central America Regional Field Epidemiology Training Program (FETP) are involved in country-level coordination, planning, and monitoring as national surveillance officers and delegates for regional networks and commissions including the Central American Field Epidemiology Network, REDCEC. They update national COVID-19 guidelines and prepare contingency plans, provide service at call centers, prepare daily bulletins, and create messaging for communication campaigns. They are involved in surveillance, rapid response teams, and case investigation through fieldwork, contact tracing, case finding and sampling (including sample transport), and in surveillance activities at the local and national levels.
They are involved in surveillance and case investigation at points of entry and preparing repatriation protocols. Some FETP alumni work in national laboratories (including in the Dominican Republic, Guatemala, and Honduras) to confirm COVID-19 cases.
Across Central America, FETP residents and alumni provide health assistance and training to members of local hospital teams on use of personal protective equipment (PPE), standard precautions, and sampling. In the Dominican Republic, they provide technical assistance for clinical management guidelines.
The FETP was involved in developing a COVID-19 dashboard for the Central American Integration System (Sistema de la Integración Centroamericana, or SICA), accessible here.
South Africa FETP
The South Africa Field Epidemiology Training Program (FETP) responded to the first case of COVID-19 in the country, a citizen returning from travel to Italy. Second-year resident Hellen Kgatla and recent graduate Mzimasi Neti engaged in preparedness activities at the Emergency Operations Center housed at the National Institute for Communicable Diseases (NICD).
FETP residents conduct event-based surveillance, prepare inputs for daily situational reports, and monitor preparedness of healthcare facilities. The FETP is managing the national data team and liaising with national tracing and clinical management teams, capturing persons under investigation (PUI) forms, and managing COVID-19 national master database (cleaning datasets, analyzing data daily through data extraction from multiple databases and compiling reports).
At the national level, residents and alumni are tracing contacts of confirmed cases, capturing and monitoring contacts, alerting provincial epidemiologists about contacts that need to be monitored and symptomatic contacts that need to be swabbed. They are monitoring contacts for symptoms for 14 days, deploying clinical teams to collect swabs for testing from symptomatic contacts, following up with private laboratories when incomplete contact line lists are provided, and reporting data from district to provincial to national public health authorities.
The FETP is developing response plans and standard operating procedures at provincial and district levels, processing data captured on screening forms from ports of entry, monitoring and evaluating levels of readiness of healthcare facilities, and training healthcare workers and military personnel.
Residents and alumni are staffing the national 24-hour hotline and answering frequently asked questions in local languages (Afrikaans, Thsivenda, and Sepedi). Their responses are shared through the NICD social media accounts to raise public awareness. Residents have translated Information, Education and Communication (IEC) materials into local languages as well. They are also training essential service workers (such as grocery store workers) on COVID-19 protective measures.
The FETP is housed within the National Health Laboratory Services, which provides laboratory services to the public health facilities in South Africa. Testing capacity has increased over the time of this response, and as such, data management has become complex. FETP residents are crosschecking, cleaning, and merging laboratory data with clinical and contact tracing data.
27 out of 32 residents of the Ukraine Interventional Epidemiological Service (IES) are involved directly in the COVID-19 response. At the regional and district levels, they investigate cases, identify and monitor contacts, and screen travelers at points of entry.
At the national level, residents participate in the COVID-19 PHC Response Team by assisting in national-level coordination, planning, and monitoring. They lead the analytical team in daily data cleaning and analysis and in preparing summary reports to inform response strategy planning by PHC leadership and the Ministry of Health. In addition, they answer hotline calls from the Emergency Operations Center and assess laboratory and testing capabilities in order to identify needs and gaps in the COVID-19 testing process.
In addition, residents will collaborate with the World Health Organization (WHO) on a special study describing the early cases of the disease in Ukraine.