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“Stop the fire where it starts”: working with communities to ensure early detection of potential outbreaks of COVID-19

Scene from training video about community-level monitoring for outbreaks Credit: WHO / S Sihaphone

If the first warning sign we get of an outbreak is critically ill people turn up at hospital, we could already be too late to contain it” explains Dr. Phonepadith Xangsayarath, Director of National Center for Laboratory and Epidemiology (NCLE), Ministry of halth.  He is explaining why his Centre, with support from WHO, is enlisting the help of staff at local health centres and district health departments to monitor for outbreaks of respiratory illnesses.

What we are trying to do with this community engagement is catch the next COVID-19 outbreak as early as possible. Even if the first sign is just two or more people in a village suddenly getting coughs and mild fever, we want to know about it and investigate it. We have a saying in Lao that you need to stop the fire where it starts. That is what this is all about.”

Up until now, Lao PDR’s main lines of defence against the introduction of COVID-19 have been limiting the number of people who can enter the country, mandatory quarantine and COVID-19 tests for those people who do enter and testing anyone hospitalized with severe pneumonia or breathing difficulties for COVID-19. NCLE, with support from WHO, has conducted tens of thousands of laboratory tests for COVID-19 since the start of the pandemic. But as a small country with relatively limited resources, Lao PDR is not able to implement the type of mass-testing for COVID-19 seen is some richer countries. Instead, the Ministry of Health is leveraging the strength of the country’s local health workers to strengthen its defences against COVID-19.

At training sessions organized by NCLE and provincial health departments, with support from WHO, community health workers  learn how to report signals of possible outbreak immediately on a daily basis. They are taught how to use a tool for monitoring and reporting incidents. This includes how to identify potential warning signs: for example, several people in a community having fever and cough, a sudden increase in funerals or many students absent from schools at the same time. It also includes training them on when and how to report these to their local health center or district hospitals.

They are also taught that, if there are some deaths with unknown reasons or rumors of illnesses or deaths from COVID-19 in their communities, they have to report these immediately.  

“Communities play an important role, and have a major responsibility, to protect their members from COVID-19 and other severe diseases.  Reporting early via a strengthened community surveillance system is crucial to saving lives. The health authorities can only take action to control the outbreak and portect the community once someone has raised the alarm.” said Dr Howard SOBEL, Acting WHO Representative to Lao PDR.

The trainings started in Vientiane Capital and will continue around the country for the next year and a half. In parallel to this, NCLE and its partners will follow up with provinces and districts where health workers have already been trained to monitor and support progress.

Local health staff practice collecting information from communities during initial training in Vientiane Capital. Photo: WHO Lao PDR


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See a video clips about community-level monitoring for outbreaks of respiratory illness click here.