How Paraguay's Field Epidemiology Training Program (FETP) is Responding to COVID-19

Dr. Malvina Paez, Coordinator, FETP Paraguay

On January 30, 2020, the Director General of the World Health Organization (WHO) declared the COVID-19 outbreak a Public Health Emergency of International Concern (PHEIC) in accordance with the International Health Regulations (IHR 2005). On March 11 of the same year, the WHO determined that COVID-19 could be characterized as a pandemic.

Paraguay's health system is segmented, fragmented, and receives one of the lowest investments in the South American region. Despite these disadvantages, under the leadership of the Ministry of Public Health and Social Welfare (MSPBS in Spanish), the country made timely decisions based on science and evidence to implement successful strategies to face the COVID-19 pandemic.

The Paraguayan government implemented measures to curb COVID-19 transmission in the country. For example, at the country's points of entry, travelers could quarantine in shelters or health hotels. These establishments successfully housed thousands of Paraguayan citizens who returned to Paraguay from countries with high COVID-19 transmissibility. It was an important and effective sanitary measure to reduce community transmission and prevent more people from becoming infected. In addition, people who tested positive for COVID-19 and do not have the opportunity to isolate at home, or have breached the required isolation measures, must complete a supervised isolation. These mitigation measures have been some of the most cost-effective during the first months of 2020.

The General Directorate of Health Surveillance (DGVS in Spanish) houses Paraguay's Field Epidemiology Training Program (FETP -- PEEC in Spanish) whose purpose is to strengthen the country's surveillance and epidemiology capacities at all levels of the public health system. During the pandemic, FETP graduates help test and care for suspected and confirmed COVID-19 cases and, ultimately, reinforce the health network's Rapid Response Teams.

Graduates from the program strengthen local epidemiology teams and contribute to vital public health responses. They helped guide health professionals and monitor outbreaks at first-level care facilities, conduct COVID-19 outbreak investigations, and collect and analyze information about COVID-19 for the Ministry of Health.

Paraguay FETP trainees helped conduct a population-based COVID-19 seroprevalence project and trained health professionals on sample collection and proper use of personal protective equipment (PPE). The objective of the study was to determine how many people were infected with COVID-19 and how this varied by age in the Asuncion and Central Paraguay health regions. After surveying 735 households (126 in Asuncion and 609 in the Central Department) and testing 1,699 people (324 in Asuncion and 1,375 in the Central Department), the trainees determined that 23 percent of people in Asuncion and 28 percent in the Central Department had tested positive for COVID-19. Of these, about 14 percent had a high risk of serious illness, with high blood pressure and diabetes being the most commonly reported.

Below are photos of the FETP trainees during their fieldwork activities responding to the COVID-19 pandemic.