COVID-19 Response

Background:

On 27th February 2020, Nigeria confirmed its first case of COVID-19 in Lagos State. In January 2020, the Country set up a CoronaVirus Preparedness Working Group coordinated by the Nigeria Centre for Disease Control (NCDC). During this period, the National Reference Laboratory (NRL) was positioned to commence testing for SARS-CoV-2 and commenced testing on the 9th February 2020. As part of its continuous partnership and efforts at strengthening Global Health Security in Nigeria, the GU_CGHPI team supported the NCDC in the responding to the COVID-19 pandemic across several thematic areas: Surveillance (including Event Based Surveillance), Case Management, Information Technology, Laboratory and Research 

Goals:

  1. Improve the Event Based Surveillance (EBS)BS model that is interoperable across all states and feedback mechanism that employs all systems approaches in its epidemic intelligence processes.
  2. Implement a centralized secure information platform to host data from all sources to improve laboratory response and efficiency.
  3. Support NCDC’s implementation of contact tracing across affected states to detect and respond to the COVID 19 Outbreak. 
  4. Implement a COVID-19 portal to enhance public communication and data management  
  5. Support NCDC’s implementation of case management of COVID-19 in treatment centres across Nigeria
  6. Conduct ongoing research to understand the COVID -19 Outbreak 
Event Based Surveillance (EBS):

EBS forms a critical component of the NCDC connect centre which consists of a centralized structure consisting of hotlines, call center systems, social media mining tools and several process platforms. During the 1st and 2nd waves of COVID-19 in Nigeria, our team spearheaded the coordination of EBS activities through:

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  1. Mining for information through various platforms and escalating information to the Emergency Operation Cenye for action
  2. Established 24hrs EBS Team on shift to receive calls/queries and signals from the Connect Center. 
  3. Trained Response surge staff at the Connect Centre on data mining tool, use of hotlines and other process platforms as communication tool to inform response activities
  4. Supervisory role on surge staff and implementation of improvement plan on work processes at the connect centre
  5. Collaborating with the Nigerian Presidential Task Force (PTF) and UNICEF to onboard 4 additional Connect Centers in Kano, Lagos, Oyo and Enugu states
  6. Deployment of scanning tools in the 6 Geopolitical zones.
Laboratory:

With the geographical spread of COVID-19 pandemic across states in Nigeria, the NRL was saddled with the responsibility of managing the data of COVID-19 test results in the country. The GU team provided technical assistance in the Lab through:

  1. Team Lead, COVID-19 Lab Data Management Team for NRL, Gaduwa
  2. Developing a data management template for data entry and reporting used during the early phase of pandemic. This was an interim measure given the urgency brought about by the pandemic.
  3. Creation of a database for existing and future laboratory data
  4. Transitioned all existing paper-based reports and data capturing tool to electronic resulting in the transcription of over 100,000 patient line laboratory information with complete return of results. 
  5. Conceptualizing and development of a Lab Data Warehouse piloted for COVID-19 results
  6. Mentoring of identified staff on Lab Data Warehousing and Lab Data Management
  7. Development of organogram, flowchart, Standard Operating Procedure (SOP) and standardized data capture and reporting tools
Information Technology COVID 19 Microsite:

As part of the IT support provided to NCDC, GU_CGHPI collaborated with NCDC to conceptualize and design of the COVID-19 Microsite. This was originally designed as a platform for effective communication during the early response to COVID-19 pandemic. It evolved into an interactive portal  which currently integrates self-assessment BOT,  COVID-19 dashboard for analysis, guidelines and advisory module, COVID-19 document management system, COVID-19 laboratory data management system, Nigeria International Travel Portal  and was recently upgraded to host data generated from every other agencies that work directly or indirectly on COVID 19 response in other to provide insights based on the consolidated data. The NCDC COVID-19 microsite also provides a QR code technology for checking and validating COVID-19 results. The microsite was developed to adhere to highest data protection standards, good scientific practice, and open access policy. Other functions of the portal includes:

  1. Display of near to real time data and information to increase public awareness and knowledge about COVID-19. 
  2. Alignment with ICD-10 for disease classification, SNOMED-CT and LOINC for terminology of service and HL7/FHIR to support standardized data exchange and interoperability with other Health Informatic systems used during COVID 19 response within Nigeria.
  3. The microsite contains modules to manage FAQs, and resources.  
  4. It  provides a dashboard for easy representation of records and data integration from WHO
  5. The microsite provides a middleware component designed to ease interoperability between disparate information systems. 
  6. Currently interoperable with other systems (SORMAS, LIMS, Self-Assessment tool etc) and supports bidirectional flow of data 
Contact Tracing Surveillance:

The team supported NCDC to enhance community-based surveillance for COVID-19 through the development and implementation of Standard Protocol/SOP, Processes and Tool for COVID 19 Contact Tracing; trainings of field responders to improve case-finding, investigation, contact-tracing, isolation and reporting at subnational level; active surveillance and contact-tracing at subnational level to limit COVID 19 transmission. 

GU-CGHPI collaborated with he NCDC to provide technical assistance in case management of COVID-19 cases. This includes:

  1. Development of an assessment checklist for Treatment Centres managing COVID-19 
  2. Development of COVID-19 Case Management Form as a data capturing tool for the treatment centre
  3. Training of Healthcare Workers under the Ministry of Defence on Case Management for COVID-19
  4. Collation and analysis of COVID-19 data received from treatment centres
  5. Mentoring of Case managers on managing cases
Geography of Work:
  • NCDC Jabi FCT, Nigeria 
  • Glo world, VI, Lagos, Nigeria
  • NCDC National Reference laboratory, Gaduwa, Nigeria 
Research:
  • Paper on “Forecasting the spread and total size of confirmed and discharged cases of COVID-19 in Nigeria using an ARIMA model” done with Savannah Health Innovations System Limited. Submitted to Journal of the International Association for Official Statistics 
  • “Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February–6 June 2020” https://doi.org/10.1017/S095026882000206X 
  • Nigeria’s public health response to the COVID-19 pandemic: January to May 2020 www.jogh.org. doi: 10.7189/jogh.10.020399