PASADENA, California — The novel coronavirus quickly devastated the globe upon its arrival. In order to adapt to the pandemic, countries use existing technology or innovative new solutions, such as COVID-19 surveillance. Thailand, Cambodia and Tanzania are some of the countries that made use of COVID-19 surveillance technology to help with disease prevention and tracking.
Thailand and a COVID-19 Detection App
One of the first countries to detect a case of COVID-19 in Bangkok was Thailand on January 13, 2020. As the outbreak spread within the early weeks of 2020, the main challenges in confronting the virus resulted from a lack of medical infrastructure, proper hospital staffing, testing/mortality data and creation of a COVID-19 pandemic surveillance system. However, Thailand acted quickly when it came to organizing data and acting upon COVID-19 surveillance. Government officials in Thailand quickly created and passed the Communicable Diseases Act. The Act opened up formations of Communicable Disease Control Units (CDCU) to open COVID-19 related investigations with a team of reliable professionals.
The Chiang Mai University of Public Health housed and maintained technologies for disease prevention and control. Ultimately it contributed its resources to develop a self-screening application to detect COVID-19 for people initially in the Chiang Mai province, which was on high alert in January 2020. The application followed a simple procedure, mainly providing people with information regarding COVID-19 and the tools to make self-assessments by evaluating chances of fever, tiredness, difficulty breathing and more. The app collected data on people’s conditions, whether they were red (COVID-19 risk) or green (healthy). This helped local authorities gauge clusters of reports and improve CDCU data.
Application data gathering is not complicated. Furthermore, existing NGOs and projects have been using this process to prevent pandemics for some time. For instance, the Chiang Mai province launched a project called the Participatory One Health Disease Detection (PODD) in 2015. It accomplished this through the funding of Ending Pandemics and the oversight of Dr. Lertrak. The initiative compiled reports of relevant human and animal health through electronic submissions into the PODD applications. Volunteers handled on-site investigations and follow-ups. The PODD app is mainly for farmers in rural areas who are far away from government service centers and have reports of dead or ill animals.
Dr. Mark Smolinski from Ending Pandemics says, “So when we have a farmer who has a sick chicken who also has pigs and other animals on the farm, who may have a family member with influenza, if that pig were to get human influenza that we know spreads very quickly, if that were to cross over because that pig was also infected with the bird flu on that same farm, then that resulting could be the pathogen that we’re all worried about.”
Cambodia and Rapid Response Teams
Cambodia responded swiftly to a novel coronavirus outbreak. This was mostly due to immediate border shutdowns, support from the World Health Organization (WHO) and the 80% population that lives in rural areas with low population density. Within the first 100 days of the outbreak, Cambodia was able to detect four cases by deploying its Rapid Response Team (RRT) that reports to a health security system called the Communicable Disease Control (CDC), which reports to the WHO. The WHO ultimately trains, funds and operates Cambodia’s health response commission.
As for clinical support, Cambodia relied on The institute Pasteur Cambodia (IP-C) and the National Institute of Public Health to run tests and provide response equipment, pairing with military research departments to take care of surge capacity in hospitals. By government decree, the public received free testing and clinical care, with IP-C running its testing through WHO referral laboratory methods.
Cambodia launched a free 115 hotline in 2016 available to anyone with telephone access. Its main functions include sending health alerts for the public, reporting animal/human disease outbreaks and serving as a health surveillance tool for health workers. Within the first four years, RRTs would receive around 500 calls a day, with 15-20 calls routed to surveillance officers. The hotline contributes to Cambodia’s early response system called CamEWARN. CamEWARN compares reports and medical health records to compile information on seven disease syndromes like respiratory infections or fatigue and determines infectious hotspots within provinces.
Cambodia has made great leeway with its surveillance system. The country has mobilized through a “whole-of-society” approach under the leadership of Samdech Prime Minister. Cambodia has dialed its response to nine measurements: “incident management and planning, surveillance and risk assessment, laboratory, clinical management and health care services, infection prevention and control (IPC), non-pharmaceutical public health measures, risk communication, points of entry and operational logistics.”
Tanzania and its Digital Surveillance Tool
The Southern African Centre for Infectious Disease Surveillance (SACIDS) developed Tanzania’s AfyaData, a prominent digital tool used for surveillance. The mobile/web application AfyaData manages users, loading forms, field data, server data and allocates information to collectors or persons of interest. The application was introduced during the Ebola epidemic. It became a resource hub that opened up new jobs for people willing to train as data clerks or epidemiologists.
National Institute of Biomedical Research and the Chief Medical Officers of health zones within Tanzania all also used AfyaData. AfyaData, along with six other services, became a leading surveillance source for SACIDS. While there was ample support of COVID-19 surveillance, the Tanzanian president has claimed that the virus has been scourged from the country and data has been stalled.
The successes of Thailand, Cambodia and Tanzania make clear the use of virus and disease surveillance is vital amid COVID-19. As countries continue to fight and recover from the pandemic, these three countries exemplify solutions, both for present and future viral outbreaks.
– Matthew Martinez