Lockdown commenced at midnight on 26 March, with severe restrictions on movement to be implemented, bolstered by punitive measures enacted by police and army. Confirmed COVID-19 cases stand at over 1000 as of 27 March with two deaths.
Health Promotion (HP) and contact tracing:
- Printing Department of Health (DOH) (HP) tools for distribution
- Translation of materials into missing languages (for migrants)
- Creating HIV/COVID and TB/COVID tools
- Printing hygiene stickers for public transport
- Branding taxis with hygiene messages and providing hand washing stations
Assisting with or advocating for the decanting of clinics:
- Six months’ supply of ARVs (Department of Health are doing 4 months) and home delivery
- 12 months scripting instead of 6 months (no new enrollments in our studies)
- Giving 4 months’ treatment to PrEP patients
- Home care for Drug resistant TB patients (where possible)
MSF is and will be providing support to the DoH on contact tracing (3 nurses from Rustenburg are supporting contact training efforts in Gauteng Province, coordinated by MSF Tshwane); screening; community health promotion, facility risk assessment and the training of health care workers and community members.
MSF-supported clinic will stay open throughout lockdown.
MSF is establishing a tent for screening adjacent Eshowe Hospital, including the installation of washing hands stations and moveable toilets. Help desks in high volume clinics go live 24 March, and on 25 March hand washing points will be established in the town centre, in preparation for the welfare grant pay day next week. MSF-supported Luyanda sites (healthcare hubs in high-traffic rural locations) will function as pick up points for ART.
MSF will conduct triage trainings, and support screening activities outside facilities.
Doctors Without Borders (MSF) Global Operational Update
MSF is currently supporting three hospitals in the first epicentre of the outbreak, in Lombardia region, with infection control. Outside the hospitals we are doing outreach activities, supporting family doctors and healthcare workers assisting people under isolation at home. We have also started activities in one of the five most affected regions, Marche in central Italy, where the number of cases is increasing. We support a network of nursing homes in several cities, to prevent cases to spread in such vulnerable locations, which have no specialized medical staff to manage the patients. Today there are about thirty MSF staff involved in the response to coronavirus in Italy.
Setting up 2 temporary hospitals around Madrid to decongest other hospitals, providing IPC advice to protect healthcare workers and patients, and specifically also working with steering committees that manage homes for the elderly, to help protect the elderly: see update sent 24 March, already online: https://www.msf.org/msf-steps-covid-19-response-activities-spain
MSF’s intervention for Covid-19 has three components: 1) support to hospitals to increase their admission capacity, 2) support to nursing homes for the elderly, 3) support for vulnerable groups such as homeless people and undocumented migrants. In total, MSF is supporting 7 facilities in Belgium with human resources, technical advice, and material.
Projects for vulnerable populations, homeless and migrants, in Paris and surrounding area, with mobile clinics and aid in screening. On 24 March, 700 people were evacuated from a camp in Aubervilliers near Paris, where they were living in precarious conditions. They were dispatched on various emergency shelters located in Paris and Ile de France. MSF teams are deployed in some of these shelters to evaluate their health and identify potential COVID 19 cases.
In Geneva providing log / sanitation support to areas where vulnerable people are living targeting 1300 families in Geneva. Exchange of medical expertise with the University teaching hospital in Geneva (HUG), MSF medic detached to the HUG focusing on case management and management of medical teams. Support in the management of dead bodies (Evaluation and recommendations).
MSF is providing strategic advice and IPC support to a hospital hosting 10-12% of the hospitalized patients in Norway, situated geographically in one of the main clusters in the country.
Samos supporting Isolation for simple cases in Samos, and e-prep team to help with PHC and screening at entrance health centres. In Lesbos, MSF has prepared an emergency plan for the refugee camp of Moria should the epidemic spread on the island.
Regular activities have been stopped, we are going to support case management. 2 cases confirmed over the past weekend (21/22 March).
Training and technical support (identification and setting-up of isolation areas, patient flow design, etc.) in our supported facilities in Azaz and Idlib.
Reorientation happening in countries such as Jordan, where the hospital is being repurposed now to have the potential to receive COVID-19 patients
Case management focusing on moderate cases, not ICU care. An MSF team is intervening in a COVID centre in Baghdad, to improve IPC.
Support provided to the MoH in Aden as they set up an isolation facility.
MSF has conducted more than 20 face-to-face health promotion sessions with vulnerable groups. Due to the closures of the local service providers, we have also done health promotion through online platforms. In addition, the team has also conducted 4 workshops on “coping with stress and anxiety" to the same target groups to address their mental health needs.
After an assessment in the Afghanistan-Japan Hospital in Kabul, which is the referral hospital for COVID cases, MSF is providing IPC training. MSF intends to looking into ways to support case management in Herat.
In Timurgara, the team is running the isolation ward, waiting for the MoH to dispatch HR and share the responsibility, as well as doing screening for the OPD, ER and MCH departments.
Three explos are ongoing (in San Paolo, Rio de Janeiro, and Mina Gerais) to see about protection of health care staff, with focus on vulnerable groups.
Adaptation of current intervention to the COVID response in full coordination with the MoH, increase of ambulance services coverage & capacity in order to deal with the non-COVID cases & adaptation of mobile clinics services in neighbourhoods & potential switch to home -based care services. Also assessment status of deported people from USA & Mexico continue confined in hotels to identify needs regarding IPC/Isolation/diagnosis/treatment and define a possible response.
Patient support in Fada health center, if needed. Training of MoH staff. Surveillance as part of our regular activities and health promotion.
Authorities have asked MSF to support hospitals in Yaounde and in Buea (South West Region). Looking for isolation capacity outside healthcare facilities.
MSF supports the management of a Covid unit in Bamako, within the grounds of the hospital where it runs its oncology programme. 8 ICU beds, 100 individual IDP capacity set up by MoH. MSF provides a team (coming from its regular programme in Koutiala).
In Abidjan, MSF supported the Ministry of Health at a transit centre to screen and refer people with coronavirus symptoms to the care centre. In Bouake, training activities for health workers and screening at the different entry points to the city are already underway. Water and sanitation activities are also being implemented.
We have delivered trainings on infection control & case management to nurses & doctors in hospitals in Tripoli.