Lao PDR Coronavirus Disease 2019 (COVID-19) Situation Report #17 Report as of 23 October 2020 12pm GMT+7 (09 – 22 October 2020) Situation Summary Highlights of Current Situation Report • 24 confirmed cases of COVID-19 have been reported. • The 24th case was reported on 20 October. The case was a 23-year old student, of Lao nationality, who arrived from Russia on 18 October via France and the Republic of Korea. He is asymptomatic and has been admitted in the hospital since his first positive result in Lao PDR. All 27 close contacts have tested negative and are undergoing quarantine. Information on this case was shared through the International Health Regulations (IHR) channel. Governance and Response • A central level Intra-Action Review (IAR) was conducted 21-22 October to identify best practices and challenges encountered for the COVID-19 response in Lao PDR. • As of 18 September, Lao PDR is officially eligible to receive official development assistance (ODA) support through the COVAX Advance Market Commitment (AMC) to receive doses of COVID-19 vaccines through the COVAX Facility. • A local governance workshop was held in Champasack and Xayaboury provinces under the leadership of the Ministry of Home Affairs (MoHA) working closely with the Ministry of Health (MOH) and partners including UNDP and WHO. The objectives of the workshop were to identify resources needs, roles and responsibilities and guide local planning for preparedness for and response to Covid-19. • The Department of Communicable Disease Control conducted a workshop to strengthen detection and response capacity for health staff at POEs on 14-15 October, with WHO providing support. The POE training for central provinces of Laos was conducted in Bolikhamxay on 20-21 October. • A meeting to prepare for a consultation on mental health impact of Covid-19 of healthcare workers and the community was held with relevant Ministries, mass organizations and development partners including UN agencies. SOPs and training materials are being developed with the support of MOH. • Environmental cleaning and disinfection materials have been procured by WHO with funding support from Australia’s Department of Foreign Affairs and Trade (DFAT) and Lux Dev. The Department of Hygiene and Health Promotion (DHHP) will distribute materials to all central, provincial and district hospitals. • DHHP, in collaboration with WHO, conducted the last training on environmental cleaning and disinfection for district health and Nam sa art staff in Bolikhamxay, Savannakhet and Sekong last 12- 20 October. Surveillance • A multisource surveillance technical working group meeting was held on 13 October to review the transmission status of Covid-19 in the country, the risk of Covid-19 importation from neighbouring countries and also the risk posed from the relaxation of travel restrictions and quarantine measures in the country. • Enhanced surveillance in Savannakhet is occurring for epidemic-prone diseases after flooding earlier this month. Influenza-like-illness and SARI cases are being monitored and reported on a daily basis to the central level. To date, no clusters of diseases have been reported. Page 1 of 8 Lao PDR Coronavirus Disease 2019 (COVID-19) Situation Report #17 Report as of 23 October 2020 12pm GMT+7 (09 – 22 October 2020) • A meeting on the establishment of a comprehensive action plan for the roll-out of SARS-CoV-2 testing using GeneXpert was conducted on 13-14 October A national specimen transportation guideline is being developed for specimens including Covid-19. • A mobile specimen collection unit has arrived in country to support specimen collection for Covid-19 testing. • Tablets have been distributed to all central hospitals for the collection of healthcare capacity indicators in hospitals using the District Health Information Software (DHIS-2). Daily data submission has started. • District health offices are conducting community engagement activities to support event detection and contact monitoring at the village level. Vientiane Capital, Xiengkhuang and Savannakhet provinces have started reporting to the central level. Communication • A nationwide review of COVID IEC materials is ongoing. Representatives from the provinces are invited to present on their experiences for the past 8 months including use of IEC materials, gaps and needs. Upcoming Events and Priorities Governance and Response • The translation and finalization of the National COVID-19 Preparedness and Response Strategic Plan is ongoing, with inputs from development partners. Discussions during the central level IAR will also be incorporated before being presented to the Deputy Prime Minister. • A follow-up high-level joint meeting on local governance in four provinces is being planned together with UNDP, MOH, and MoHA. Vice-ministers of MOH, MoHA, and Prime Minister’s Office, and four provincial governors are expected to attend. • Plans for conducting training for district hospitals on clinical management for Covid-19 are underway. A Training-of-Trainers will be conducted first for central level staff, and then for provincial level staff in each province. • High-level discussions are ongoing for the preparations for vaccine procurement and deployment. A COVID vaccine management committee, chaired by the Vice-minister, has been established. • Finalization of the hospital accreditation standards to include COVID-19 related measures such as screening and testing (“new normal”) with Department of Health Care and Rehabilitation (DHR). • The fourth version of the clinical management guidelines for Covid-19 has been approved and WHO is supporting its printing. The guidelines will be distributed to provincial and district hospitals designated to manage COVID cases. • There are ongoing efforts to develop a simplified process for procuring personal protective equipment (PPE) and streamline the approval process in MOH with support from WHO. • Subnational Training of Trainers and hospital level training for 50 hospitals implementing Safe, Clean and Green Healthcare Facilities and provision of supply and equipment are planned for 27-29 October. Surveillance • The SOP for implementing multisource surveillance at the central level is being finalized, while the provincial level SOP is being developed. Subsequent workshops for implementing multisource surveillance at the sub-national levels are planned from November, and a training of facilitators from the central level will be conducted on 29 October. Page 2 of 8 Lao PDR Coronavirus Disease 2019 (COVID-19) Situation Report #17 Report as of 23 October 2020 12pm GMT+7 (09 – 22 October 2020) • Preparations by NCLE to certify biosafety cabinets to expand mobile PCR capacity to all provinces are being undertaken. • Distribution of tablets and trainings on its use for data collection of health capacity indicators in provincial hospitals are to be conducted in the next month. • DCDC is revising the Q&A and SOPs for the 166/165 Hotline and automating data collection and analysis using DHIS-2 on tablets. A training of central level staff will be held in November. WHO is providing technical and financial support. • Training on community engagement to support event detection and contact monitoring at the village level is being rolled-out to all provinces. • There are plans to conduct training on medical certification for causes of death, including COVID-19. • A memorandum of understanding is underway with MOHA to share data on death notification. Communication • The Centre of Communication and Education on Health (CCEH) has requested WHO technical support on Risk Communication training for provincial and district levels. They plan to set up the Risk Communication taskforce in provinces, and will be developing the SOPs, TORs, and have a team of trained risk communicators that can be deployed to respond to outbreaks. • A survey to understand risk perception, knowledge, attitudes and behavioural change in relation to the new normal and also on Covid-19 vaccines will be conducted using tablets for data collection and analysis on 9-13 November. Training for CCEH staff will be held on 26 October. • Workshops on sensitization of monks for five districts in Vientiane Capital will take place from 26 October to 10 November. • Preparations for risk communication strategies for the COVID vaccination strategy have started. National Transmission Assessment: 1-Imported cases There have been twenty-four cases reported as of 22 October, with the last imported case reported on 20 October. All 27 close contacts have tested negative and are under quarantine. Nationally, weekly cases of sentinel Influenza-like illness (ILI) and Severe Acute Respiratory Infection (SARI) have remained within the range of previous years, although certain provinces have increased SARI cases. Specimen collection for ILI and SARI cases has increased. SARI cases should be managed as suspected COVID cases, but compliance on submission of specimens is still being improved. All specimens tested have so far been negative. Further, there are no reports of undiagnosed respiratory clusters or unusual deaths through event-based surveillance (EBS), and no observed increase in weekly hotline calls. Data collection on healthcare utilization from each province has started and will be monitored daily. Assessment done by Lao PDR WCO with concurrence from the Ministry of Health of Lao PDR Page 3 of 8 Lao PDR Coronavirus Disease 2019 (COVID-19) Situation Report #17 Report as of 23 October 2020 12pm GMT+7 (09 – 22 October 2020) Subnational Transmission