Residents of the Ethiopian Field Epidemiology and Laboratory Training Program (FELTP) have been assigned to different pillars of emergency response and have participated actively in preparedness and response activities in the region, including point of entry screening and surveillance of suspected cases, conducting preparedness assessments, developing protocols and guidelines for surveillance, infection prevention and control, and risk communication and community engagement activities.

Pictured: An FELTP resident from Bahir Dar University, one of the FELTP's training sites, monitors a 24/7 toll-free hotline for delivering health messages and receiving questions and reports of suspected cases. (Photo credit: Ethiopia FELTP)

Pictured: FELTP residents conduct surveillance at airports and land points of entry. (Photo credit: Ethiopia FELTP)

Now, Egypt FETP residents and graduates are tracing contacts of confirmed cases and working on case management and infection prevention and control (IPC) measures.

They are increasing public awareness of COVID-19 by conducting orientation sessions on the disease and distributing communications materials in schools, universities, clubs, airports, and hospitals. In addition, the Egypt FETP has been conducting training for central and peripheral level health educators and surveillance officers.

Pictured: The Egypt FETP participated in the quarantine process of Egyptians evacuated from Wuhan, China, for a timeframe of two weeks to prevent the possibility of transmitting the infection. (Photo credit: Egypt FETP)

On February 15, 2020, Egypt became the first country on the African continent to report a case of COVID-19. Prior to this, the Egypt Field Epidemiology Training Program (FETP) participated in a simulation exercise to practice the country’s readiness to face COVID-19 cases.

Prior to the outbreak, FETP residents and graduates also worked on developing case definitions for COVID-19, activating acute respiratory infection (ARI) surveillance systems in Egypt, developing and updating the standard reporting forms for COVID-19 cases and their contacts, developing a national plan for COVID-19 prevention and spread, and developing a risk communication strategy, among other activities.

Pictured: Egypt FETP participates in a COVID-19 simulation exercise. (Photo credit: Egypt FETP)

As of April 6, 2020, Paraguay has 113 confirmed cases of COVID-19 and five deaths. The epicenter of the epidemic is the country’s capital, Asunción, and the Central Department which surrounds it.

The Paraguayan Field Epidemiology Training Program (FETP) has participated in different levels of preparedness and response. Five trainees from the fourth cohort of the program’s advanced level are conducting household sampling and surveying of suspected cases. Thirteen graduates of the first, second, and third cohorts are conducting telephone follow-up of cases, mobilizing in the situation room, monitoring points of entry such as airports and land crossings, and supporting the surveillance of quarantined returnees from countries with viral circulation. In addition, they are preparing daily reports for national authorities and developing recommendations for health teams.

(Photo credit: Paraguay FETP)

Trainees and supervisors of the Brazilian Field Epidemiology Training Program (known as EpiSUS) have been involved in activities related to COVID-19 since the beginning of the emergency. In February 2020, the Brazilian government announced "Operations Return," the repatriation of Brazilians living in Wuhan, China. On February 9, two aircraft carrying 34 returnees landed at the Brazilian air base in Anápolis. EpiSUS monitored these returnees in quarantine. None developed symptoms, and all tested negative for the virus.

EpiSUS trainees and supervisors have been involved in activities for pandemic preparedness and response; guidance and mentoring of trainees in activities to answer epidemiological questions about COVID-19 (outlining studies, seeking scientific evidence, creating repositories, etc.); collaborating with other technical areas and preparing scientific manuscripts, among other activities.

Pictured: The EpiSUS investigation team monitoring the returnees from Wuhan who were quarantined under Operation Return. (Photo credit: EpiSUS-Advanced collection)

From participating in the national bushfire response since early January 2020, faculty and scholars of the Master's of Philosophy in Applied Epidemiology (MAE) program at the Australian National University (Australia's field epidemiology training program) pivoted to supporting the state and territory, national, and global response to COVID-19. They are actively involved in raising situational awareness, drafting clinical and public health guidelines, participating in briefing and planning meetings with hospital clinicians and managers, and developing templates for outbreak response and fact sheets for clinicians and the public (among other activities).

Pictured: Australian MAE (FETP) scholars test masks and personal protective equipment (PPE) prior to being deployed with the Ministry of Health in Cambodia to conduct contact tracing. (Photo credit: Australia MAE)

Pictured: Australian MAE (FETP) scholar Chhim Srean trains contact tracing teams while deployed with the Ministry of Health and Center for Disease Control in Cambodia. (Photo credit: Australia MAE)

Fellows and graduates of the Pakistan Field Epidemiology and Laboratory Training Program (FELTP) are at the forefront of the national government's response to COVID-19, and the FELTP team is included in the COVID-19 national core committee.

In January 2020, FELTP graduates at the National Institute of Health (NIH) in Islamabad activated the Emergency Operations Center (EOC). They prepared advisories and guidelines for COVID-19 preparedness and response at the national level. At the provincial level, the health departments notified the FELTP-trained Technical Support Officers at the Disease Surveillance and Response Units (DSRUs) as the focal persons for COVID-19. The FELTP-DSRUs became the provincial hubs for Rapid Response Trainings, which were conducted all over Pakistan. The FELTP trained health staff on screening at points of entry along the country's borders.

FELTP fellows and alumni contributed to forming case definitions as well as to conducting provincial disease surveillance of regional units. They have been working with hospitals to develop protocols for isolation and infection prevention and control (IPC). FELTP alumni gave IPC trainings at all of the major hospitals in their respective provinces.

Pictured: FELTP Technical Support Officer, Dr. Larik, at the Pakistan-Iran border for case detection. (Photo credit: Pakistan FELTP)

The majority of cases of COVID-19 in Pakistan were reported in pilgrims coming from Iran. FELTP alumni were involved in IPC trainings at the Taftan (Pakistan-Iran) border. Later, the government transported these pilgrims to notified quarantine facilities. FELTP alumni are involved in these quarantine facilities, along with the government organizations, in identification of cases, testing, and isolation of cases. They are responsible for maintaining data, including line listing of the pilgrims at the quarantine facilities.

Pictured: FELTP Technical Support Officer Dr. Watto prepares a team for sample collection at a quarantine facility. (Photo credit: Pakistan FELTP)

Pakistan FELTP fellows participate in screening passengers using scanners installed at points of entry. Fellows also are involved in helping airport health authorities screen and follow up with travelers. At the Pakistan-India border, the FELTP team visited the Kartarpur corridor to assess screening and IPC procedures. FELTP alumni also visited the Pakistan-Afghanistan border to monitor the screening of travelers.

National and provincial health departments are utilizing the FELTP-DSRUs to carry out COVID-19 surveillance activities. FELTP fellows are leading case detection, case notification, contact tracing, testing, and case management along with national and international partners.

The FELTP has also set up an event- and case-based surveillance mechanism at the federal DSRUs for contact tracing and screening of all suspected cases.

Pictured: FELTP alumnus Dr. Ghanghro leads the response at the quarantine facility in Sindh, Pakistan. (Photo credit: Pakistan FELTP)

Seven graduates of the Mozambique FELTP deployed to five priority provinces within the country to conduct rapid health evaluations at points of entry, such as airports and ports. The FELTP graduates examined the data quality, stability, and utility of the systems they evaluated.

Pictured: An FELTP graduate conducts a rapid health evaluation at a point of entry in Pemba province, Mozambique. (Photo credit: Mozambique FELTP)

In the context of coronavirus preparedness, residents of the Mozambique Field Epidemiology and Laboratory Training Program (FELTP) developed a protocol to strengthen surveillance of acute respiratory infections in public and private sentinel surveillance health facilities in Maputo.

Residents also worked to improve existing data collection forms and developed six new documents based on World Health Organization (WHO) technical guidance on surveillance, case investigation, and rapid response teams.

Pictured: On the left, FELTP residents work on the acute respiratory infection surveillance protocol. On the right, residents work on evaluating and improving forms. (Photo credit: Mozambique FELTP)

In late February, a three-day Training of Trainers workshop, "Strengthening Country Capacities on Preparedness and Response for Public Health Cross-border Threats Focusing on COVID-19" gathered 16 MediPIET supervisors and National Focal Points from 10 partner countries to discuss COVID-19 priority public health measures and actions in light of available evidence in Tunis, Tunisia.

Participants shared their countries’ experiences, facilitated by an expert from the National Coordination Center for Health Alerts and Emergencies of the Ministry of Health of Spain, an academia and hospital expert from Spain, and a World Health Organization (WHO) expert working on preparedness and readiness. A virologist from Institut Pasteur's MediLabSecure project updated the audience on laboratory tests and diagnostics. In addition, risk management, risk assessment and risk communication strategies were tackled thanks to WHO facilitation. The need to open up new channels for real-time information sharing and coordination among countries was highlighted.

Pictured: Risk communication exercise during "Strengthening Country Capacities on Preparedness and Response for Public Health Cross-border Threats Focusing on COVID-19" Training of Trainers in Tunisia (February 26, 2020) (Photo credit: MediPIET)

MediPIET, the Mediterranean and Black Sea Program for Intervention Epidemiology Training, is an international project funded by the European Commission and led by Instituto de Salud Carlos III, under the scientific leadership of the European Centre for Disease Prevention and Control (ECDC) and supported by FCSAI (State Foundation for Health, Childhood and Social Welfare). MediPIET includes 18 partner countries: Albania, Algeria, Armenia, Bosnia and Herzegovina, Egypt, Georgia, Jordan, Kosovo, Lebanon, Libya, Moldova, Montenegro, Morocco, Palestine, Serbia, the Republic of North Macedonia, Tunisia, Ukraine

Most current fellows participate in different pillars of the response: as members of the COVID-19 task force and/or rapid response teams, in strengthening early case detection and surveillance, epidemiological information collection and analysis, surge of laboratory capacity, risk communication and community engagement, and points of entry. From drafting protocols, procedures and recommendations to implementing actions in the ground, MediPIET fellows are key pillars of their countries’ readiness and actual response.

"We must do everything for our citizens," says MediPIET fellow Dr. Arayik Papoyan, pictured above.

(Pictured: MediPIET fellow Dr. Arayik Papoyan screens passengers boarding a repatriation flight with Armenian compatriots stranded in Rome, Italy (March 2020). (Photo credit: MediPIET)

Australian National University epidemiologist and professor Martyn Kirk, who currently serves as the interim chairman of the TEPHINET Advisory Board, assisted in the repatriation and quarantine of Australian passengers from the Diamond Princess cruise ship.

"When I was involved in this medical assistance mission to repatriate Australians from the Diamond Princess, I didn't realize how many outbreaks of COVID-19 there would be. It turned out that this experience helped me understand all the outbreaks that followed. I was privileged to take a small part in the global response to COVID-19."

(Photo credit: ABC Radio Darwin – Conor Byrne)

Trainees and graduates of the Malaysian Epidemic Intelligence Program (EIP) have been involved in COVID-19 preparedness and response including risk communication and country, state and district level coordination, planning, and monitoring. Several have been involved in repatriation missions, operational support, and logistics for the response, while others are involved in surveillance, screening, sampling, rapid response, case investigation, contact tracing, management of quarantine centers, training, and points of entry.

Pictured: An EIP trainee helps manage the transfer of a patient under investigation for COVID-19 from a rural area (Mulu) to Miri Hospital. (Photo credit: Malaysia EIP)

Together with the Division of Infectious Diseases and Epidemiology, the Liberia Field Epidemiology Training Program (FETP) worked to build surge capacity by training 138 medical and MPH students. Intermediate trainees and graduates are working on a rapid survey on community risk perception of COVID-19, where they hope to interview 1,000 people.

Pictured: Intermediate cohort 4 participants working with the infection prevention and control (IPC) rapid assessment team at the port of Buchanan, Grand Bassa. (Photo credit: Liberia FETP)

Together with the Division of Infectious Diseases and Epidemiology, the Liberia Field Epidemiology Training Program (FETP) worked to build surge capacity by training 138 medical and MPH students. Intermediate trainees and graduates are working on a rapid survey on community risk perception of COVID-19, where they hope to interview 1,000 people.

Pictured: Intermediate cohort 4 participants working with the infection prevention and control (IPC) rapid assessment team at the port of Buchanan, Grand Bassa. (Photo credit: Liberia FETP)

Kenya confirmed its first case of COVID-19 on March 13. The number of cases escalated to 28 by March 26, resulting in many contacts, prompting the Ministry of Health (MOH) to direct, through the COVID-19 national task force, that the FELTP support the response efforts at the country’s Emergency Operations Center (EOC). Residents of cohorts 14, 15 and 16 deployed to the EOC to support different key technical areas including coordination, surveillance, contact tracing, data management, and screening at the points of entry (POE).

To strengthen response, MOH deployed FELTP Deputy Director Wako Gofu to the EOC as its operations chief. His responsibility includes rapid response team (RRT) coordination, contact tracing, laboratory, and POE. In total, 40 FELTP residents are currently involved in contact tracing, rapid response, and data management activites.

Pictured: Kenya FELTP residents join a COVID-19 training in Nairobi conducted by Washington State University (March 2020). (Photo credit: Kenya FELTP)

Residents and graduates of the Tanzania Field Epidemiology and Laboratory Training Program (FELTP) raise awareness of COVID-19 and sensitize members of the public and staff at schools, points of entry, bus terminals, churches, and mosques, among other locations. They have been involved in daily reporting and preparing tools such as daily passenger follow-up forms and interim case reporting forms for confirmed and probable cases. The FELTP has also conducted a risk assessment including an assessment of isolation units in at-risk regions.

Pictured: A Zimbabwe FETP resident shares key messages from a moving truck during a roadshow to raise awareness of COVID-19.

Pictured: A Zimbabwe FETP resident attaches a COVID-19 poster to a vendor cart in the community.

The Zimbabwe Field Epidemiology Training Program (FETP) has been a critical player in assisting the Ministry of Health and Child Care with risk communication and community engagement. From March 23-27, FETP residents participated in a community awareness and health education campaign in four high-density suburbs in Harare, where residents conducted door-to-door health education activities. The program also developed and distributed 20,000 flyers, 500 posters, five banners, 450 branded t-shirts, 1,500 pens and 1,500 rulers at shopping centers, beer halls, recreational centers, and households. A total of 1,600 households were reached during the door-to-door awareness campaign.

In residential areas unreached by this campaign, the program conducted a roadshow using a moving truck to distribute key information on COVID-19.

In addition, the FETP conducted a knowledge, attitudes and practices (KAP) survey to determine the level of COVID-19 awareness among the residents of Harare. This will assist policymakers in implementing tailor-made COVID-19 prevention and control measures.

Pictured: A Zimbabwe FETP resident provides community education on COVID-19.

As of April 6, 2020, Paraguay has 113 confirmed cases of COVID-19 and five deaths. The epicenter of the epidemic is the country’s capital, Asunción, and the Central Department which surrounds it.

The Paraguayan Field Epidemiology Training Program (FETP) has participated in different levels of preparedness and response. Five trainees from the fourth cohort of the program’s advanced level are conducting household sampling and surveying of suspected cases. Thirteen graduates of the first, second, and third cohorts are conducting telephone follow-up of cases, mobilizing in the situation room, monitoring points of entry such as airports and land crossings, and supporting the surveillance of quarantined returnees from countries with viral circulation. In addition, they are preparing daily reports for national authorities and developing recommendations for health teams.

(Photo credit: Paraguay FETP)

Pictured: Alumni screen and check the travel documents of arriving passengers at Entebbe International Airport in order to identify those coming from category A (high-risk) countries, who must be placed under quarantine (March 20). (Photo credit: Makerere University School of Public Health MPH Program - Uganda FETP)

Pictured: Institutional quarantine team members update the Chinese ambassador and his team concerning the safety of 36 Chinese nationals under quarantine. (Photo credit: Makerere University School of Public Health MPH Program - Uganda FETP)

In partnership with the Ugandan Ministry of Health, the African Field Epidemiology Network (AFENET) and the Centers for Disease Control and Prevention (CDC), Makerere University School of Public Health has deployed 28 alumni and residents of the Ugandan FETP (the Master of Public Health Program) to support the Ministry of Health in the COVID-19 response.

The alumni and residents are involved in case management of COVID-19 patients in Mulago National Referral Hospital, contact tracing, following up people under quarantine, conducting epidemiological investigations, and data management, among other activities to control the pandemic. Alumni and residents are providing their time and expertise on a voluntary basis as service to their country. With support from AFENET and CDC, the alumni and residents are being supported with transport in the field and are also provided some supplies including sanitizers, face masks, and gloves for their safety.

They started their deployments on March 15, supporting preparedness efforts like airport screenings and follow-up of high-risk travelers. Since the confirmation of the first COVID-19 case in Uganda on March 21, the deployed alumni and residents have been integrated into the National Rapid Response Team (NRRT) and are working directly under the Ministry of Health.

Pictured: Resident Ian Amanya (with goggles) offers support to the Surveillance and Laboratory Team while taking a sample from a contact at a quarantine site. (Photo credit: Makerere University School of Public Health MPH Program - Uganda FETP)

South Africa recorded its first COVID-19 case on March 5, 2020. Since then, confirmed cases have risen to 1,280 with two recorded deaths as of March 30. In an effort to curb the spread of infection, the South African government has instituted a number of preventative measures including a national lockdown from March 26 to April 16, 2020. The South African Field Epidemiology Training Program (SAFETP) alumni and residents are working closely with the Emergency Operating Center (EOC) of the National Institute for Communicable Diseases (NICD) and national and provincial departments of health to intensify the surveillance, preparedness and response activities for COVID-19. Two of the trainees are also involved in surveillance activities at their own placement sites at the provincial level. The graduates of the frontline (basic) epidemiology courses are participating in surveillance and contact tracing in their respective provinces and districts.

Pictured: Graduates of the South African Frontline FETP, accompanied by an FETP epidemiologist, are ready to collect swabs in eThekwini district, KwaZulu-Natal province (March 2020). (Photo credit: South Africa FETP)

Activities of the South African FETP residents and alumni include:

• Participation in the development of COVID-19 technical resources, such as guidelines for case finding, diagnosis, management, and public health response
• Extensive work in contact tracing
• Daily symptoms monitoring of close contacts of the confirmed cases
• Epidemiologic data management activities
• Conducting in-service training of healthcare professionals
• Raising community awareness about modes of transmission and prevention measures using mass media
• Capturing data
• Deploying staff to the field for swabbing and contact tracing

Pictured: Graduates of the South African Frontline FETP visit a contact of a confirmed COVID-19 case for throat and nasal swabbing in eThekwini District, KwaZulu Natal (March 2020). (Photo credit: South Africa FETP)

Pictured: Graduates and current second-year residents of the South African FETP deployed to the Emergency Operations Center (EOC) at the National Institute for Communicable Diseases in March 2020 to assist with data management and daily symptom monitoring of contacts. (Photo credit: South Africa FETP)