Health Ministry' Series Of Innovative Interventions With Regional, International Outreach Bags Global Acclaim To Contain

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Health ministry' series of innovative interventions with regional, international outreach bags global acclaim to contain

Ministry of National Health Services, Regulations and Coordination (MoNHSR&C) after the spread of COVID-19 initiated a series of innovative interventions with regional and global spread that has bagged global acclaim to contain the pandemic

ISLAMABAD, (UrduPoint / Pakistan Point News - 28th Apr, 2020 ):Ministry of National Health Services, Regulations and Coordination (MoNHSR&C) after the spread of COVID-19 initiated a series of innovative interventions with regional and global spread that has bagged global acclaim to contain the pandemic.

According to the National Command and Operation Centre (NCOC), Pakistan was one of the earliest responders to the potential pandemic as the Special Assistant to the Prime Minister on Health (SAPM) Dr Zafar Mirza chaired its first formal consultation with national and international experts on January 15. Prior to this, the disease spread was monitored closely by the Health Ministry.

It added that COVID-19 was first reported in Wuhan China in December 2019 and was declared Public Health Emergency of International Concern on 30th January, it was declared a pandemic on 11th March.

The formal consultation with experts initiated a chain of events in the form of interactions, advisories, initiatives, coordination and interventions during the last 104 days (28th April 2020).

The result of this level of preparedness, paired with early interventions ensured that Pakistan was the last country in the region to detect COVID-19 case, even when sandwiched between the two epicenters of the COVID-19 spread, giving Pakistan incredibly valuable time to prepare.

"This is also the fundamental reason for why Pakistan's preparedness have been touted as one of the best in the world among low and middle income countries (LMICs)".

The summary of events took place prior to the establishment NCOC till April 28, the ministry in terms of coordination was leading from the front where it established seamless unprecedented coordination at all levels pre-NCOC which included coordination with a network of international partners, experts, China and Iran.

The ministry, at first, established a core group with experts on infectious disease, epidemiology, virology and technical leads from concerned department of Health including curative, harmonization with ambassadors and Health Ministers of China and later Iran, inter-ministry meetings at multiple levels, Inter Provincial meetings and deliberations at chief secretaries and DG health level, Donor Partner Meetings and coordination via detailed deliberations on the evolving situation, Initiating and conceptualizing National security coordination meeting.

Moreover, the structural, operational and outcome based logical frame working of National coordination committee (NCC), Health Ministers Organization of Islamic Cooperation (OIC) conference, leading South Asian Association for Regional Cooperation (SAARC)s Health Ministers Meeting.

Being the lead technical ministry on health, the first and foremost responsibility of the MoNHSRC was to orient, guide and facilitate all provincial governments on latest information of the disease, its patterns and impact.

These guideline documents were vetted through an expert panel of epidemiologists, infectious disease specialists, virologists and senior management in the ministry. Furthermore, these documents were dynamic and evolving as more science was published about severe acute respiratory syndrome coronavirus syndrome 2 (SARS-COV 2).

It highlighted that the advisories, Standard Operating Procedures (SOPs) and guidelines issued till date including many of them were revised multiple times since they were first issued which started from 21st January as first advisory on COVID19 (then known as nCOV) was issued to all provinces (Revised on 25th Jan), 25th Jan- Revised advisory with Pneumonia spread was issued as well.

However, the SOPs and guidelines issued were initiated on Feb 1st for Point of Entry (PoE) at all major airports, 1st Feb- Clinical guidelines on management of COVID-19, 1st Feb- Risk Communication, 5th Feb- Covid-19 Clinical care and Prevention guidelines, 8th Feb- 1st National Action Plan on COVID19, 11th March- Advisory on Mitigation strategies, 13th March-Workplace Guidelines/Instructions for COVID-19, 13th March- 2nd National Action Plan on COVID19, 17th March- Relaxation of Import policy on Medical and Personal Protection Equipment in Wake of COVID-19, 24th March- Real-Time Polymerase Chain Reaction Diagnostic Test Guidelines, 25th March- Guidelines on establishing Quarantine Facility, 25th March- COVID19 Priority Testing, 26th March- Guidelines on Social Distancing during covid-19 spread, 26th March- Guidelines for Home isolation during covid-19 spread, 27th March- Zoning of Hospitals during COVID-19 spread, 27th March-Infection Prevention and Control (IPC) for the safe management of a Dead body during COVID-19 spread, 28th March- Guidelines for Cleaning and Disinfection of Environmental Surfaces in Health care facility, 28th March- Guidelines for Home Quarantine during COVID-19 spread, 30th March- Guidelines on Management of Stores During COVID-19 spread (Ensuring ample supplies), 31st March- Updated Clinical Management guidelines, 31st March- Preventive measurements for industries and workers against covid-19, 7th April- Health and safety guidelines for industries exempt from lock down, 8th April- Advisory on COVID-19 Medical Waste Disposal, 11th April- Health and Safety of Building and Construction Workers during COVID-19 spread, 19th April- Updated Real-Time Polymerase Chain Reaction Diagnostic Test Guidelines, 19th April- Lab referral mechanism, 19th April- SARI and ILI Surveillance and Diagnostic Guidelines.

As the COVID-19 Pandemic spreads across the globe, health professionals were discovering SARS-COV 2's evolving traits whereas with the evolving understanding of the disease, initiatives and interventions also needed to be continuously evaluated and updated.

In Pakistan the Health ministry had taken novel initiatives along with key interventions to address this enormous challenge whereas the chronological order of interventions was as follows: 22nd Jan- Creation of Emergency operation center, 23rd Jan- Establishing the most comprehensive health screening mechanism in Pakistan's history at all major airports, which later resulted in screening of more than 1.1 Million passengers, 28th Jan- Establishment of Health Information desk at arrival and departure lounges of all international airports, 1st Feb- Strengthening of PoE with human resource (HR), thermal guns and Thermal Scanners, 1st Feb- Designated hospitals for Isolation at Islamabad and facilitation to the provinces for establishing one as well, 1st Feb- Established need for personal protective equipment (PPE), 10th Feb- Establishing a help line at Islamabad for tracing and tracking of passengers coming from China and later Iran, resulting in tracing and tracking of over 20,000 passengers prior to the outbreak, 11th Feb- Acquired Laboratory diagnostic capacity for COVID-19 through National Institute of Health (NIH), one of the earliest among LMICs, 14th Feb- 1st Quarantine facility for 300 people was established at Islamabad with National Disaster Management Authority (NDMA), 15th Feb- Epidemiologic al modelling on disease burden, morbidity and mortality predictions and impact on health systems was initiated, 19th Feb- Briefing for parents of Pakistani students in China.

However, timely closure of air and land borders was also decided to control the transmission of COVID-19 whereas on 25th Feb- Closure of Iran-Pakistan border, guidance to build quarantine facility and quarantine all Zaireen was made, 26th Feb- Expansion of the 1166 National Helpline for COVID19, 27th Feb- Suspension of flights from Iran, 2nd March- Closure of Chaman border, 13th March- Final National Action Plan for COVID-19 (first draft was made on 08 th Feb 2020), 15th March- COVID 19 dashboard establishment with a common data source, 16 th March- Centralized Data Management system for COVID-19 established at National emergency operation center, 17th March- Relaxation of import policy on Medical and PPE equipment in wake of covid-19 outbreak, 2nd April- Hackathon Launch, initiating the influx of ideas to combat the covid-19 outbreak, 3rd April- WhatsApp helpline launch to increment information flow, 24th April- Yaran-e-watan launch, a portal of use for overseas Pakistanis (health officials) extending their help in the covid-19 outbreak and sharing lessons learnt across the globe.

During the entire prevalence of the contagion, one of the key challenge in such situations was information flow to the masses and ensuring that the disease basics, its spread, its influence on the day to day life and drastic measures taken to counter them at the national and provincial level such as lockdowns and inhibiting social mergence were understood and followed.

The Ministry in this regard has undertaken some major steps in ensuring the risk communication remains a corner stone of the strategy for countering COVID-19 spread. As the 1st Public service message was aired on all public and private channels as well as social mediums on the 1st of February 2020, Partnership with Dettol initiating a series of public service messages were aired on 14th Feb, 26th Feb and 28th March which had a considerable airtime, A toll-free number (1166) for interaction with public and answering their queries about the disease its symptoms etc was established on 26th February, Information, Education and Communication (IEC) material on the disease its spread, prevention and control were published multiple times and animations on symptoms and its prevention were also aired.

However, the NCOC noted that as the Pandemic would further evolve, the MoNHSRC would scale up the response and ensuring that highest level of commitment was retained throughout the period of this spread.

The Staff at MoNHSRC, especially the technical wing and underlying organizations, led by the SAPM on Health were innovating through a resource constraint environment and working around the clock for over 100 days to keep Pakistan safe.

It merits to mention here that the summary of initiatives was only presenting the highlights of activities, whereas there were hundreds of sideline meetings, consultations and deliberations which have taken place in shaping up of Pakistan's response.