Table 2.
Key interventions to consider for the COVID-19 response
| Technical area | 10th Democratic Republic of the Congo Ebola virus disease response | Relevance for COVID-19 response |
|---|---|---|
| Response coordination | Incident management system to improve information flow and decentralize decision-making | Use of an incident management system to support coordination of COVID-19 response |
| Under government leadership, ensure routine strategic meetings | ||
| Creation of functional groups with clear roles and responsibilities to ensure improved span of control and chain of command | Need for a multi-sectorial response | |
| Decentralized operational coordination at the subdistrict level | Development of key performance indicators to ensure corrective action for critical response interventions | |
| Monitoring framework comprehensive: inputs, outputs, outcomes, and impacts | ||
| Key performance indicator developed to ensure corrective action | ||
| Surveillance | Monitoring unit established to improve follow-up of lost contacts | Establish monitoring uni/structure to improve follow-up of contacts lost to follow-up |
| Involve community structures at early stage of surveillance activities to generate alerts | ||
| Food distribution provided to contacts | ||
| Consider food distributions to communities under isolation/quarantine | ||
| Community leaders involved in ensuring proper contact tracin | ||
| Identify individuals with field epidemiology expertise to conduct surveillance activities (including contact tracing) | ||
| Conduct rapid training of surveillance team members to investigate alerts, and collect and analyze epidemiologic information | ||
| Active case finding and door-to-door activities implemented to improve case detection coupled with community watch interventions to ensure tracking of movements (new arrivals, deaths, and illnesses) | ||
| Investigate alerts reported by households, community leaders, or health facilities and report validated alerts within 24 hours | ||
| Active case search in health facilities | ||
| Functional triage systems in health facilities | ||
| An alert monitoring and investigation platform that helped investigate cases within 24 hours | ||
| Risk communication and community engagement | Community-centered approach with feedback mechanisms to follow and address rumors | Early involvement of anthropologists and social scientists in the development of risk communication and community engagement approaches |
| Anthropologists and social scientist engaged to provide feedback on different response measures | ||
| Creation of feedback mechanisms to better target activities | ||
| Trust gained from local religious, traditional, and community leaders to mitigate community reticence | ||
| Prepare communities to play active role with other response interventions | ||
| Community structures and community health workers who speak local language used to better communicate with communities | ||
| Early identification and engagement with community leaders to mitigate community reticence to response interventions | ||
| Anthropologists and/or social scientists included in part of the response | ||
| Infection prevention and control (IPC) | Established standardized package for IPC | Define and implement a standardized IPC package |
| Capitalize on IPC tool kit and standard package for training of trainers | ||
| Implemented ring IPC with supervision (IPC focal point at health facilities) and frequent evaluations (use of IPC score card) | ||
| Target traditional healers and pharmacists | ||
| Used evidence to adapt and improve strategy | ||
| Case management and free care | Decentralized transit centers used to rapidly test and isolate cases in setting close to communities, which also improved willingness to seek care | Consider a similar model of decentralized care and testing |
| Disseminate standardized guidelines on optimized care based on existing/evolving evidence | ||
| Ensure that free-care models can cope with increased use of health services | ||
| Create SOPs and guidelines for optimized care based on existing evidence | ||
| Consider compassionate use for investigational drugs and conduct studies to look at effectiveness | ||
| Operational preparedness | Defined a package of activities for operational preparedness to reduce the risk of spreading Ebola virus disease to at-risk areas | Anticipate mechanism to increase capacity for control measures (early detection, investigation, laboratory confirmation, isolation, and treatment |
| Deployed experts to at-risk health zone to implement readiness activities and strengthen the health system | Work on mass training mechanism and prepositioning of treatment items (critical care, ventilators…) | |
| Conduct training to equip health zones based on clear protocols and package of activities | ||
| Use similar preparedness package of interventions for COVID-19 | ||
| Trained rapid response teams to investigate alerts in non-affected health zones | ||
| Analytics cell | Set up epidemiological and social sciences analysis structure to provide real-time integrated analysis | Develop integrated analysis structure to provide real-time insights and design appropriate response |
| Monitor epidemiolocal trends beyond that of the outbreak (concurrent diseases) to mitigated impacts of outbreak and response | ||
| Monitor perceptions and reported use of health services | ||
| Regularly monitoring and understanding of health behavior trends (perceptions and reported use—mixed analysis) | ||
| Used evidence to inform different response measures | ||
| Set up mechanisms to monitor and track recommendations | ||
| Donor coordination | Preparation of a unique strategic response plan, with validated unit costs for all response interventions | Ensure global donor coordination |
| Ensure alignment with national strategies | ||
| Establish processes, including eligibility criteria for hazard payments, pay scales, and payment modalities, as well as mechanisms to systematically list healthcare workers | ||
| Involvement in the planning process and continuous interaction to share challenges and gaps to be filled | ||
| Ensuring resources as well as technical support were provided just in time based on priority areas and gap filling. |