Field Epidemiology Training Program Response to COVID-19 During a Conflict: Experience From Yemen

Abstract

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and investigated in a timely and effective manner. During the COVID-19 pandemic, the Yemen FETP's response has been instrumental through participating in country-level coordination, planning, monitoring, and developing guidelines/standard operating procedures and strengthening surveillance capacities, outbreak investigations, contact tracing, case management, infection prevention, and control, risk communication, and research. As the third wave is circulating with a steeper upward curve than the previous ones with possible new variants, the country will not be able to deal with a surge of cases as secondary care is extremely crippled. Since COVID-19 prevention and control are the only option available to reduce its grave impact on morbidity and mortality, health partners should support the Yemen FETP to strengthen the health system's response to future epidemics. One important lesson learned from the COVID-19 pandemic, especially in the Yemen context and applicable to developing and war-torn countries, is that access to outside experts becomes limited, therefore, it is crucial to invest in building national expertise to provide timely, cost-effective, and sustainable services that are culturally appropriate. It is also essential to build such expertise at the governorate and district levels, as they are normally the first respondents, and to provide them with the necessary tools for immediate response in order to overcome the disastrous delays.

Repercussions and Legacy of the COVID-19 Pandemic in Manaus, Brazil: The Health Managers’ Perspective

“…The experiences reported in the Iranian health system showed the intensification of screening of people at their homes or at the nearest BHUs, which operate for up to 16 hours/day, in addition to daily monitoring of people by a health care professional in each territory, enabled a rapid response in cases of symptomatic individuals, contributing to mitigating contagion (Hammad et al, 2019). Similar strategies were also adopted by Vietnam and Yemen (Minh et al, 2021) (Al Serouri et al, 2021).…”

Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic

“…A total of 17 lessons, derived from 47 studies [8][9][10]12,15,16,[20][21][22][25][26][27][29][30][31]36,37,43,44,[47][48][49]55,57,58,60,70,[72][73][74][75]77,80,81,87,[101][102][103][104][105][106][107][108][109][110][111][112] and quoted on 167 single occasions, were referred to this pillar: among them, 30 citations referred to AFRO region, 16 to EMRO region, 25 to EURO region, 52 to AMRO region, 29 to SEARO, and 15 to WPRO region (see Figure S3).…”

“…A total of 7 lessons, derived from 59 studies [10,12,[14][15][16][17]20,22,25,30,31,36,37,45,47,48,51,55,62,64,65,69,70,[72][73][74]76,[79][80][81][82][83][84]86,88,90,102,[106][107][108][111][112][113]116,[121][122][123][124][125][126][127][128]<...…”

“…A total of 7 lessons, derived from 29 studies [9][10][11][12][13]20,27,28,31,45,55,64,67,70,72,73,75,78,84,85,87,111,112,122,134,[136][137][138][139] and quoted on 50 single occasions, were referred to this pillar: among them, 8 citations were referred to AFRO region, 4 to EMRO region, 10 to EURO region, 15 to AMRO region, 11 to SEARO, and 2 to WPRO region (see Figure S7).…”

“…A total of 10 lessons, derived from 61 studies [7,8,[10][11][12][14][15][16][17]19,20,23,25,28,30,33,39,43,45,[48][49][50][51]54,55,57,58,60,63,65,67,[71][72][73]78,82,83,85,91,96,101,116,118,[121][122][123]129,131,[136][137][138][140]…”