In addition to the health sector preparedness of the Government of Sierra Leone, here are the general steps it takes to stop the spread of Covid-19
BY SOLOMON JAMIRU- NACOVERC SPOKESPERSON
The National Covid-19 Response Centre, NACOVERC was formed by President Bio to administer surveillance, contact tracing and case management of covid-19 related cases. The country had maintained the then Ebola structures and expertise intact, making the on-going management style of covid-19 cases much easier. There had been massive preparations by the Bio-led Government in curtailing the infection and spread of corona virus in the country.
Pre- Covid-19 Preparedness and Response Measures by Government
Travel restrictions were imposed on 16th March by President Bio when the country was at zero level
Ban on all public gatherings of more than 100 people.
Individuals from countries with 200 or more confirmed cases of covid from traveling into Sierra Leone.
Essential visitors were quarantined if need be.
Quarantined measures were in place for passengers from China and also from countries with local transmission of more than 50 covid cases.
Steps Taken by Government
Activation of Emergency Operation Centre to level 2.
Establishment of Inter-Ministerial Committee to guide on policy issues relating to covid.
Identify points of entry with the highest risk with particular focus on Freetown International Airport (Lungi) and major border crossing points with Guinea and Liberia.
In-country diagnostic capacity at 3 public laboratory facilities with quality assurance linkages, established with South Africa and US.
Heightened Risk Communications, training and prepositioning of supplies at strategic locations.
Political Commitment heightened as demonstrated by visit of President Bio to two of Sierra Leone’s major points of entry on assessment tour.
The leadership by the government in coordinating partners, helped to identify critical gaps and challenges as events unfold, revealed Evans Liyori, WHO Rep in Sierra Leone.
WHO has been leading the UN response with strong partnership and collaboration from UNICEF and WFP, alongside technical and financial assistance of the US-CDC, DFID, USAID, World Bank, China-CDC, diplomatic missions, among several partners, to support the government, to better position the country in readiness to respond to a potential covidoutbreak.
With Guinea and Liberia recorded their first confirmed cases, Sierra Leone had engaged community- level activities, to enhance sensitization and community awareness.
Government and Foreign Responses and Interventions
First index case was discovered on 31st March 2020, when a 37-year-old man who travelled from France on Brussels Airline and arrived the country March 16, but was quarantined among other passengers and he later tested positive.
Government of Sierra Leone activated the Public Health Emergency Operations Centre and developed a national covid-19 preparedness plan, which focuses primarily on strengthening surveillance at the three official points of entry, improving case management and conducting effective campaigns at the national, sub-national and community levels.
The Sierra Leone covid-19 Emergency Preparedness and Response Project was geared towards prevention, detection and response to the threat posed by the virus. It also financed the provision of medical supplies, laboratory diagnostic equipment, including test kits in the designated health facilities. Stretched further, it also provided optimal medical care and treatment at isolation units, as well as health facilities to staff and frontline workers on risk mitigation measures.
A COVID Fund, domiciled at Bank of Sierra Leone, was established by the government, with a Leone and foreign account. An initial Le 25billion payment into the fund, in accordance with public financial management act 2016, was effected by government toward the covid fight. President Bio, right from inception of the fund, is not in-charge in cheque collections. Payments are effected straight into the covid accounts, domiciled at the Central Bank of Sierra Leone.
Strategic meetings on covid-19 chaired by Vice President was established to coordinate activities relating to covid operations. The Vice President report directly to the President, who heads the Presidential Task Force PTF.
This structure has received commendations from international institutions, including the World Bank, when its Country Representative in Sierra Leone, Gayle Martins remarked that the” government of Sierra Leone has strengthened the health systems and preparedness in response to the global covid-19 pandemic”.
World Bank approved $7.5million IDA grant to help Sierra Leone response to threat posed by covid outbreak and strengthen national systems for public health preparedness
The funds filled critical financing gaps that have been identified due to the new emergency preparedness and response needs created by the global pandemic.
The World Bank Group rolled out a $14 billion “fast-track package” to strengthen the covid-19 response in developing countries to shorten the time to recovery.
The immediate response included financing, policy advice and technical assistance to help countries cope with the health and economic impacts of the pandemic.
The IFC provided $8 billion in financing to help private companies affected by the pandemic and preserve jobs
World Bank Group doled out $160 billion over 15 months to protect the poor and vulnerable, support businesses and bolster economic recovery.
SLAA Main terminal
CURRENT NACOVERC STATUS REPORT
Active case search and Enhanced Monitoring System
NACOVERC had commenced an active case search for two months, in a bid to ramp up testing from current average of 180 to about 400 tests daily.
This enhanced surveillance surge will firstly target the Western Area and cascade nationwide, revealed NACOVERC spokesman, Solomon Jamiru.
Western Area Urban and Westers Area Rural account for 52.9% and 12.7% respectively of total cumulative confirmed covid – 19 positive cases.
The active, enhanced surveillance will help to prevent further infections and protect Sierra Leone’s health system.
Sierra Leone’s fatality ratio is currently at 4.2%, while recoveries at 82.5% of the cumulative confirmed cases. NACOVERC remains committed to treating infected persons and focusing on contact tracing that is the core function of surveillance.
The two weeks’ active surveillance was strengthened by a new enhanced covid regulations by NACOVERC in public places of business, pleasure and worship.
Electronic Manifest System EMS
The Ministry of Information and Communications has partnered with NACOVERC and NICH Technology, to develop an Electronic Magnetic Management Information System (E-Manifest), aimed at implementing the enhanced public health regulations, following the ease of travel restrictions by H.E President Julius Maada Bio. This entails compulsory use of face mask and production of passenger manifest for all vehicles undertaking inter -district travelling.
A new digitalized passenger manifest system is in place, to ensure passengers travelling within the country, log their details into the manifest, to ensure ease of tracing in case of infections.
Opening of International Airport
President Bio, in consultation with NACOVERC and relevant health officials, has declared July 22 as the date for re-opening of the Lungi International Airport.
NACOVERC health advisories include covid status tests of passengers arriving into the country, on-the-spot test at the airport on arrival, with full digital details of passengers recorded.
Passengers are allowed to proceed home on self-isolation awaiting test results ready within 24 hours. All other relevant health protocols at Lungi Airport are in place to be strictly enforced, to passengers and airport personnel.
Following the declaration made by His Excellency Brig.(Rtd) Julius Maada Bio on the resumption of commercial flight operations on the 22nd July 2020, the Government of Sierra Leone, through the Ministry of Transport and Aviation, in collaboration with the Ministry of Health and Sanitation, Sierra Leone Civil Aviation Authority and the National COVID-19 Emergency Respond Center (NACOVERC), publishes the following safety and public health guidelines which shall be strictly adhered to by all arriving and departing passengers at/from the Freetown International Airport, Lungi.
All passengers shall produce a Negative Polymerase Chain Reaction (PCR) COVID -19 test result issued no longer than 72hrs before departure of origin.
At the check-in desk at the airport of embarkation, passengers are required to display travelers’ authorization to Sierra Leone, received through the Government of Sierra Leone travel portal (www.travel.gov.sl). The travel authorization consists of:
Negative PCR COVID-19 test result issued no longer than 72 hours before departure,
Pre-departure public health passenger locator form,
Proof of payment for COVID-19 testing on arrival, paid through the online platform
Health officials will collect temperature, basic health screening data, and seat number on arrival.
All passengers shall be subject to a mandatory COVID-19 test upon arrival:
Passengers will simultaneously have a PCR test swab and an RDT test on arrival:
If the RDT screening is negative, passengers are allowed to depart from the airport and observe public health protocols (mandatory proper mask wearing, hand washing, and physical distancing) while awaiting their PCR test result.
If the RDT screening is positive, passengers will be isolated at a hotel in Lungi while awaiting their PCR test result. Note, the cost of the accommodation at the hotel shall be borne by the passenger.
For all test results, the PRC result supersedes the RDT result.
PCR result will be disseminated via the local contact number confirmed by the passenger on arrival.
All children under 2 years shall be exempted from pre-departure and arrival PCR test requirements.
Airline crew are exempted from the pre-departure and arrival PCR test requirements and should follow airline policy for testing. Airline crew must adhere to public health protocols.
Two temperature screenings will be conducted by Port Health Services. If temperature is 37.5 degree Celsius or above, passenger will be taken aside for further observation.
All passengers shall go through a walk-through disinfectant channel/infrared temperature scanner at the entrance of the arrival hall.
All passengers with machine-readable passports shall go through the Immigration E-gate system. Passengers with Emergency Travel Certificates or non-machine -readable passports shall go through the Immigration booth.
At the Baggage Reclaim section passengers shall maintain social distancing and observe all public health protocols, including proper use of face mast at all times.
All passengers will be directed to a Reception Lounge while awaiting their COVID-19 test.
Passengers with negative RDT screening test are cleared to proceed to their destination, while awaiting their PCR result and adhering to public health protocols. PCR test results (available in no more than 48 hours) will be distribute via the contact confirmed on arrival.
If a passenger’s PCR test is positive, he/she will be contacted by public health authorities and taken to an appropriate treatment centre.
Passengers sitting near a positive case on the plane will be considered primary contacts. Self- quarantined and monitoring by public health officials will be required.
All passengers are strictly advised to observe all public health protocols (proper and directed by the Ministry of Health and Sanitation/ NACOVERS.
The same protocols shall apply to all VIP passengers.
All passengers are subjected to a mandatory Polymerase Chain Reaction (PCR) COVID-19 test with a negative result issued no longer than 72hrs before departure at the Freetown International Airport. Cost for this will be borne by the passenger.
Passengers will use the Government of Sierra Leone Travel Portal to request their pre-departure test, to pay for the test and, and for scheduling sample collection.
Passengers with positive PCR results will not be permitted to travel and must follow public health protocols for isolation and contact tracing. They will be re-tested after seven days.
Passengers who have entered Sierra Leone within five days shall be exempted from the mandatory additional test on departure.
All children under 2 years shall be exempted from PCR test requirements.
On arrival at the airport, passengers shall be directed to reception area to avoid congestion and ensure social distancing during the check-in process
All passengers are encouraged to complete their check-in online before arriving at the airport.
All departing passengers shall go through the thermal screening / disinfectant channel at the airport’s departure entrance.
All departing passengers shall have their passport/traveling document verified before proceeding the check-in counter.
Departing passengers shall proceed to the check-in counter for baggage drop and collection of their boarding pass. While at the check -in counter, they are mandated to produce their COVID-19 PCR negative test certificate or e-certificate issued within past 72 hours.
Departing passengers shall proceed to the immigration services for onward travel authorization via the e-gate or immigration booth.
All departing passengers shall go through security screening before proceeding to the departure hall.
All departing passengers shall proceed to the waiting lounge where social distancing, proper use of face mask and other health protocols shall be strictly observed.
All passengers shall proceed to the final screening and verification pit to boarding the aircraft.
Boarding procedures shall be in accordance with the approval SOPs of the respective airlines.
All passengers are strictly advised to observe all public health protocols (proper use of face mask, hand washing /sanitizing, observe social distancing) as directed by the Ministry of Health and sanitation /NACOVERC.
The same protocol shall apply to all VIP passengers.
First Digital Health Platform
President Bio has launched Sierra Leone’s first mobile digital training and support platform for health care workers in Mattru Jong, Bonthe District on 3 July 2020. He also unveiled the pilot distribution of laboratory equipment and uniforms for health workers. The launching was geared towards using digital health platform to accelerate steps towards achieving the United Nations’ Sustainable Development UNSG Goal-3, which seeks to promote healthy lives and wellbeing at all ages.
This technology will help manage risk communications during public health emergencies, thereby reducing high burden of disease, maternal and child mortality rates, through public health messaging.
This development is in line with the “New Direction” manifesto before assumption of office in 2018, with a promise that health care facility will have minimum number of technical staff, in order to equip health care staff with the requisite skills to provide high- quality patient – centered care. The overall gain is reduction of the impact of covid-19 and other health hazards to the country.