Polio teams respond to COVID-19: A conversation with Dr. Erin Stuckey
1. Since 1988, the Global Polio Eradication Initiative (GPEI) has worked with its partners to reduce polio globally by 99.9 percent — but with the spread of COVID-19 around the world, the program will be adjusting to respond to the pandemic. Why is this change happening?
The COVID-19 pandemic response requires an urgent, coordinated effort, and the Global Polio Eradication Initiative has a responsibility to use its resources to protect the most vulnerable people in communities around the world. That means using our expertise and our network to support COVID-19 preparedness and response.
It’s also important that we take into account the health of the workforce and the communities we’re serving. Our work against polio typically includes visits to each house to deliver polio vaccine — and that kind of human-to-human interaction could lead to the spread of SARS-CoV-2. We want to avoid any action that could make the problem worse.
2. What will this change look like on the ground?
Over the next several months the GPEI will use our tools, our workforce, and our laboratory and surveillance network to support countries as they respond to COVID-19. What that looks like will depend on the situation in each country and the extent of the polio operations that are up and running there — but in general, the systems we’ve built for polio eradication will help support things like coordination of response operations, surveillance of suspected cases, training for healthcare workers, and standing up data systems. I was in Pakistan at the end of February/early March when the shift started to happen, and it was impressive to see how quickly the polio team mobilized to coordinate and solve issues for COVID-19.
3. As we pull back on some of our polio eradication efforts, what will the impact be on eradication?
The fact that we do need to pull back on conducting immunization campaigns, means that we will see more polio cases several months from now.
It will also mean that the surveillance system — how we monitor the virus — won’t be working as fast is it normally does. That’s because lab staff, for instance, who process the polio samples either aren’t able to go to work or need to focus on COVID-19, and shipping samples will be disrupted because of road and/or airport closures.
4. Is there polio eradication work that will continue?
Absolutely. Wherever possible, the GPEI will continue working to slow the spread of polio, including through work to strengthen essential immunization in areas that are most at risk of polio transmission.
We’ll also continue activities that don’t require people to go house-to-house or gather in large groups, like tracking polio through a surveillance system that includes looking for symptoms of paralysis in children and collecting environmental samples. (Polio spreads through fecal matter.)
Work can also still continue on an improved oral polio vaccine. And we’ll maintain our equipment and vaccine supplies and keep all our planning in place, so that when it’s safe to restart campaigns again, we’ll be ready to go.
5. Wild poliovirus is endemic in only two countries - Afghanistan and Pakistan. Parts of those countries face some of the most challenging conditions on Earth. Do you have a sense what will happen if COVID becomes widespread in these countries?
You’re right, these are challenging places, places where there is poor water and sanitation and where the health system does not reach. They’re also places where “sheltering in place” and physical distancing are difficult options, and we don’t know what it will look like when COVID-19 comes through those communities. It’ll be really important to make sure the COVID-19 response works with communities and applies an equity and gender lens to reach everyone.
But also, the fact that we’ve been fighting polio for decades in some of the hardest-to-reach areas means that the polio program could provide access to community networks as well as some infrastructure for COVID-19 screening that might not otherwise be there. In Pakistan, for example, there’s quite a lot of work that the polio program has done alongside the Expanded Program of Immunization to identify areas that are routinely underserved.
This pandemic is highlighting the extent to which we are all connected — and it underscores the need to invest in health systems that can prepare and respond to routine needs and epidemics when they occur, including in the most underserved populations. It’s a good lesson — when we strengthen a health system to fight one disease, we strengthen that system to fight all disease. Whether the challenge is polio or COVID-19, every person deserves to live a healthy and productive life.
