FELLOWSHIP REPORT Summary of work activities Raquel Medialdea-Carrera Intervention Epidemiology path (EPIET) Cohort 2018 Background The ECDC Fellowship Training Programme includes two distinct curricular pathways: Intervention Epidemiology Training (EPIET) and Public Health Microbiology Training (EUPHEM). After the two-year training EPIET and EUPHEM graduates are considered experts in applying epidemiological or microbiological methods to provide evidence to guide public health interventions for communicable disease prevention and control. Both curriculum paths are part of the ECDC fellowship programme that provides competency based training and practical experience using the ‘learning by doing’ approach in acknowledged training sites across the European Union (EU) and European Economic Area (EEA) Member States. Intervention Epidemiology path (EPIET) Field epidemiology aims to apply epidemiologic methods in day to day public health field conditions in order to generate new knowledge and scientific evidence for public health decision making. The context is often complex and difficult to control, which challenges study design and interpretation of study results. However, often in Public Health we lack the opportunity to perform controlled trials and we are faced with the need to design observational studies as best as we can. Field epidemiologists use epidemiology as a tool to design, evaluate or improve interventions to protect the health of a population. The European Programme for Intervention Epidemiology Training (EPIET) was created in 1995. Its purpose is to create a network of highly trained field epidemiologists in the European Union, thereby strengthening the public health epidemiology workforce at Member State and EU/EEA level. Current EPIET alumni are providing expertise in response activities and strengthening capacity for communicable disease surveillance and control inside and beyond the EU. In 2006 EPIET was integrated into the core activities of ECDC. The objectives of the ECDC Fellowship - EPIET path are: • To strengthen the surveillance of infectious diseases and other public health issues in Member States and at EU level; • To develop response capacity for effective field investigation and control at national and community level to meet public health threats; The views expressed in this publication do not necessarily reflect the views of the European Centre for Disease Prevention and Control (ECDC). This portfolio does not represent a diploma. Fellows receive a certificate acknowledging the 2-year training and listing the theoretical modules attended. Additionally, if all training objectives have been met, they receive a diploma. Stockholm, July 2020 © European Centre for Disease Prevention and Control, 2020. Reproduction is authorised, provided the source is acknowledged. Summary of work activities, [September 2020] EPIET REPORT • To develop a European network of public health epidemiologists who use standard methods and share common objectives; • To contribute to the development of the community network for the surveillance and control of communicable diseases. Fellows develop core competencies in field epidemiology mainly through project or activity work, but also partly through participation in training modules. Outputs are presented in accordance with the EPIET competency domains, as set out in the ECDC Fellowship Programme Manual. Pre-fellowship short biography Raquel Medialdea Carrera holds a PhD from the University of Liverpool (UK) as part of the National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections (NIHR HPRU EZI). She has worked for two years in Brazil during the Zika and Chikungunya epidemics conducting public health research, clinical investigations and community engagement activities. Raquel also worked for three months in Bangalore (India) researching about an epidemic of neurologic disease. In 2015, Raquel deployed twice to work on the Ebola epidemic response in Sierra Leone with International Medical Corps (IMC) and Public Health England (PHE) where she worked in an Ebola Treatment Center in Makeni. She holds a Masters from the University of Glasgow in Translational Research and Evidence-Based Medicine and a Masters from the University of Liverpool in Infections and Global Health. Raquel is passionate about public health communication and humanitarian emergency response. Fellowship assignment: Intervention Epidemiology path (EPIET) On the 11th of September 2018, Dr Raquel Medialdea Carrera started her EPIET fellowship at the Infectious Disease Control and Prevention Unit (IDCU) in the Health Promotion and Disease Prevention Directorate (HPDP) of the Ministry for Health in Malta under the supervision of Dr Maria Louise Borg. This report summarizes the work performed by Raquel during the fellowship. Fellowship portfolio This portfolio presents a summary of all work activities (unless restricted due to confidentiality regulations) conducted by the fellow during the ECDC Fellowship, EPIET path. These activities include various projects, and theoretical training modules. Projects included epidemiological contributions to public health event detection and investigation (surveillance and outbreaks); applied epidemiology field research; teaching epidemiology; summarising and communicating scientific evidence and activities with a specific epidemiology focus. The outcomes include publications, presentations, posters, reports and teaching materials prepared by the fellow. This portfolio also includes a reflection from the fellow on the field epidemiology competencies developed during the 2- year training, a reflection from the supervisor on the added value of engaging in the training of the fellow, as well as a reflection by the programme coordinator on the development of the fellow’s competencies. Fellowship projects 1. Surveillance Title: The roll-out and implementation of the WHO tool Go.Data for the COVID-19 outbreak response in Malta Investigation of chains of transmission and contact tracing are core public health interventions that play central roles in the control of COVID- 19. The implementation of digital health technology for collection of data from cases, contact tracing as well as investigation of chains of transmission is key to facilitate COVID-19 epidemic response activities. Go.Data is a tool focused on the management of data from cases, contacts and visualization of chains of transmission. Go.Data was designed for field data collection during health emergencies including information from laboratory, hospitalization and contact follow-up management. Malta decided to roll out and implement Go.Data, an outbreak response tool, as the core digital platform for data collection and management of the COVID-19 epidemic. Malta implemented the WHO Go.Data tool for management of data from COVID-19 cases and contacts and investigation of chains of transmission. Go.Data was launched 11 days after the first COVID-19 case was confirmed in Malta. The deployment was preceded by a phase of design, pilot and training. Short video tutorials were produced 2 EPIET REPORT Summary of work activities, [September 2020] specifically for each team involved. Go.Data was fully implemented across all the COVID-19 response teams 19 days following the notification of the first case. The COVID-19 response team in Malta focused on robust laboratory testing and surveillance systems as well as stringent contact tracing to reduce successfully case numbers and to control the COVID-19 epidemic. Go.Data was quickly rolled out, easily implemented and has proven to greatly facilitate an efficient response to rapidly control the spread of COVID-19. Go.Data is an easy-to-use tool that can help responders choose the right interventions to stop a virus such as SARS-CoV-2 from spreading. Role and outputs: Raquel was the principal investigator. Raquel supported the implementation, collaborated with the other teams involved in the response and supported the roll out across the 8 different teams involved in the COVID-19 response. Raquel conducted the training across all the teams involved and drafted a manuscript that is currently under review [4]. Supervisor(s): Dr Maria Louise Borg, Dr Hugo Agius-Muscat Title: World Health Organization - Supporting the roll-out and implementation of the WHO tool Go.Data in the Americas and Europe On 30th January 2020, the World Health Organization (WHO) declared that the newly discovered SARS-COV-2 virus, which was causing an epidemic of respiratory disease, constituted a Public Health Emergency of International Concern (PHEIC). Following this declaration, on the 12th of February 2020 WHO published operational planning guidelines to provide country-level support in preparedness and response against COVID-19. Go.Data is a tool focused on the management of data from cases, contacts and visualization of chains of transmission. The overall objectives of the mission were supporting the roll-out and implementation of Go.Data worldwide. In particular, Raquel worked supporting training both through organized Face-to-face training and online, development of training materials and technical advice and support to organizations implementing Go.Data. As part of her work supporting WHO, a range of training materials including facilitation guide, PowerPoint presentations, agendas and excel injects were prepared and adapted for the face to face sessions that were delivered in Central and South America and online training sessions. In collaboration with PAHO,