Nearly every thread of the global public health fabric has been affected by the COVID-19 pandemic, and the fight to eradicate polio is no different. The pandemic has interrupted polio immunization efforts, threatening a resurgence of the disease that has been almost eradicated, but Task Force polio experts are applying their knowledge to fight COVID-19.
The Task Force for Global Health’s Polio Eradication Surge Capacity Support Team, a partnership with the Centers for Disease Control and Prevention (CDC), halts the spread of polio by providing vaccinations, analyzing surveillance data and assessing the risk of virus spread in countries that have an outbreak. Four senior epidemiologists from the surge team were working in Africa when the World Health Organization (WHO) declared the pandemic on March 11, forcing them to return to the U.S. from Ethiopia, Ghana, and Zambia before travel restrictions tightened.
Soon thereafter, the Global Polio Eradication Initiative, which has reduced the global incidence of polio by more than 99% in the past three decades, released a notice temporarily stopping all immunization activities in order to observe social distancing practices.
While there is not yet a definitive time frame for resuming the full scope and volume of polio activities, five local consultants with The Task Force’s surge team in Ethiopia are playing a key role in COVID-19 response efforts. Their work includes case identification, contact tracing and quarantine enforcement, community risk assessment, data management and expansion of the number of laboratory testing sites.
They also are applying their knowledge of risk communications and clinician sensitization efforts from polio for the COVID-19 response and working closely with community-based organizations.
Surveillance activities for acute flaccid paralysis (or AFP, which signals a potential polio case) have been merged with surveillance for COVID-19 to improve sensitivity of both disease control efforts. The team has continued to investigate AFP cases in their regions, while also conducting healthcare worker training for AFP and COVID-19 surveillance. They have found that awareness of poliovirus circulation is low, other than in areas with active vaccine-derived polio outbreaks (a paralytic form of poliovirus that results from mutations in the oral vaccine that can occur in under-immunized communities with poor sanitation after circulating for long periods of time), and proposed refresher AFP surveillance trainings for clinicians after the COVID-19 outbreak is controlled.
Additionally, the Ethiopian surge team consultants provide expertise through their participation in local and national Emergency Operations Center meetings, which allows collaboration with public health emergency management staff, non-governmental partners, and agencies such as the WHO and the CDC. All of these organizations are facing a number of competing issues such as a cholera outbreak, flooding, shortage of necessary personal protective equipment, and lack of quality information in communities about the coronavirus pandemic.
There will be significant catching up to do when the pandemic has slowed and the surge team can resume its polio work in Ethiopia and other countries where outbreaks occur. In the meantime, they are adapting operations as effectively as possible to continue to protect children and communities within the context of current global health crisis response.
Header photo caption: Children in Ethiopia show off their purple pinkies which indicate they have received a polio vaccine.