N-STOP Pakistan Is On the Front Lines to Respond to the Threat of COVID-19

The eradication of polio remains a public health priority for Pakistan, where the disease is still endemic. As of April 14, 2020, the country has reported 37 cases of wild poliovirus type 1 (WPV1) this year. However, the urgency of the COVID-19 pandemic has meant that public health leaders in Pakistan, while simultaneously fighting polio, have needed to shift resources to battle the new threat of COVID-19. These include human resources from the National Stop Transmission of Polio (N-STOP) program and the Pakistan Field Epidemiology and Laboratory Training Program (FELTP), from which many N-STOP officers have graduated. Given polio workers’ extensive experience in tracking and raising awareness of poliovirus in communities, they are well-positioned to support the government’s COVID-19 response.

“Our provincial and district Emergency Operations Centers (EOCs) are maintaining their essential polio functions,” says Brigadier (R) Dr. Kamal Soomro, the National Coordinator for N-STOP Pakistan. “Certain polio supplementary immunization activities have been postponed until June 1, 2020 but the N-STOP team is still supporting both polio and COVID-19 with 61 N-STOP officers in 59 high-risk districts, six officers in provincial EOCs, and seven within divisional task forces across Pakistan.”

Regarding COVID-19, N-STOP officers are supporting Pakistan’s response by strengthening surveillance, contact tracing, raising awareness of the disease via risk communication and community engagement, training health professionals, and supporting new data systems to track the disease. As an integral part of EOCs, the N-STOP program works closely with the national EOC in response planning, strategy development and implementation and in applying these response plans and strategies at the provincial, divisional and district levels. Due to the movement restrictions enacted to contain COVID-19, the N-STOP program, like so much of the world right now, is engaging its field staff through videoconference calls.

On the data front, improved data management helps support decision-making for Pakistan’s COVID-19 response. The N-STOP team is supporting the gathering and entering of available data on COVID-19 in the Integrated Disease Information Management System (IDIMS) for real-time analysis and display.

In terms of training, N-STOP officers have facilitated 519 training sessions (with 8,990 total participants) for health workers supporting COVID-19 response activities. In addition, they have conducted 418 orientation and sensitization sessions on COVID-19 attended by 8,036 participants, including, but not limited to, community elders, school teachers, medics and paramedics, health managers, line department officers, and frontline polio workers.

N-STOP officers have traced 13,506 contacts and have identified and isolated 1,383 symptomatic travelers. In addition, they have investigated 1,018 suspected cases and facilitated sample collection from 607 suspected cases. At quarantine camps established in Quetta, Sukkur, and Dera Ismail Khan, N-STOP officers are facilitating and supporting screening, interviewing, and filing of risk assessment forms.

Several N-STOP officers are serving as team leads of various Rapid Response Teams (RRTs) and other teams supporting the response. Divisional task force N-STOP officers are leading divisional RRTs or serving as focal persons at divisional quarantine and isolation facilities, directly supporting the establishment of these facilities, training of their staff, and development of standard operating procedures.

“The N-STOP program is an important, sustainable human resource solution for future public health interventions including the integration of disease surveillance systems and the strengthening of outbreak response systems in Pakistan,” says Dr. Soomro.

N-STOP in Pakistan is a collaborative initiative of the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Pakistan Field Epidemiology and Laboratory Training Program (FELTP), and National Expanded Program on Immunization, as well as the federal Ministry of Health and provincial health departments in the country.