Institute for Family Health Amman Jordan

COVID-19 Pandemic research on Global Public Health Policies, Interventions, and Recommendations

By Aliya Mahmoud

Background

I completed my independent project when I was abroad in Amman Jordan in Spring 2020 with School for International Training. I worked for an organization called Institute for Family Health, which is an NGO that has a major focus on refugee health and providing services to those most vulnerable. The Institute for Family Health (IFH) is an NGO founded by Queen Noor in 1985. This organization provides comprehensive family healthcare services and training for professionals and caretakers in the fields of family healthcare, child protection, and rehabilitation for survivors of gender-based violence and torture. The institute was the first health center in Jordan to provide comprehensive training for medical professionals, which initially focused on early detection and intervention for children with disabilities. IFH has a center in Zaatari Refugee Camp but has now expanded to providing services for vulnerable populations in host communities as well.

Internship Goals and Objectives

My objectives for this internship were to learn about the different global responses done by countries around the world and compare them to Jordan’s policy. By understanding different interventions, it can better help the population in Jordan. Since IFH interacts with vulnerable populations, it is their goal to continue to help these families in need, especially during this pandemic. The tasks given to me for this internship was to review, collect and summarize the latest medical articles about COVID-19 from certified sources, and from this organize strategies to fight COVID-19 to highlight the most effective anti COVID-19 strategies. With this research experience, I wanted to understand the different health policies being implemented globally in response to the recent pandemic. Additionally I chose to focus on five countries that I found to have different successful and unsuccessful responses to protecting their populations from the viral spread: China, Jordan, Italy, South Korea, and the United states. From my findings it was my goal to come up with my own recommendations on the best anti-COVID strategies that IFH could understand and use when working with their patients during this uncertain time.

Research Findings

I want to add that this research was done at the very beginning of the pandemic (February 2020) when there were fewer cases. However, as cases are still prevalent and rising today, looking at these initial methods is still relevant in limiting spread. If I had continued this research I would have continued to observe and track the various initiatives that countries were taking and why. Where my interests now align are with vaccine distribution locally, nationally, and internationally. Lastly, looking at these responses and observing which places were able to limit spread is important for when the next outbreak occurs.

CHINA

First confirmed case in Wuhan China, which quickly spread locally and nationally, putting a lot of pressure and haste towards the country.
Though first to have the most infected, quickly responded and forced heavy lockdown for months. Those infected were forced into quarantine and exposed families were isolated.
New temporary hotels were quickly built to provide more space and beds for patients. Abandoned places were also used for patient care. Mass production of supplies.

Huge outbreaks in Milan and then nearby cities. Delay in lockdown, but Italy had more than 9,000 cases and 463 deaths and as that rose, they eventually shut down public spaces, issued curfew, and monitored outings for food.
May have been too late however lockdown appears to be used globally and is showing positive results as cases decrease.
The mean population is much older and contains the target group of those most at risk. (¼ above 65)
Spread affected most by travel and tourism.

ITALY

UNITED STATES

1.56M Confirmed Cases. 92,258 Deaths--Most deaths globally by far.
The federal government has not announced significant nationwide measures to contain the spread of the virus.
Some travel restrictions from certain countries.
No uniform national changes, some state by state changes. No strict lockdowns anywhere.
Cases are not slowing down and continue to increase.

Rapid lockdown response.
Strict screening program: country with the most access to testing and most of the population has been tested (1/250).
If tested positive those exposed to the person were tracked and quarantined for 14 days. Used location services on mobile phones to track everyone.

SOUTH KOREA

JORDAN

Only 649 total cases, and 9 deaths.
Closed all borders and restricted all travel.
All those coming from international countries were in quarantine for 14 days with free medical access.
Government issued free COVID-19 care for everyone.
Strict curfew and lockdown for all except for specific times for getting food only.
Recent uplift for curfew. Modifications for EID.

Recommendations to IFH:

1. Strict lockdown and closing of borders at beginning of exposure/outbreaks. Limits spread and does not overwhelm healthcare workers

2. Quarantine those who are infected or have been in contact with one who is infected, or are entering from outside the country for 14 days

3. Slowly return people to work so they can support themselves and their families financially. Issue strict social distancing and sanitation use.

4. Protect the most vulnerable and keep those communities isolated. Allow for increased care access to at-risk populations.

5. Implement a program that provides food or money to those who have lost work and cannot afford basic needs.

Conclusions on Experience:

From my research, I had come to understand that many goals of public health intervention are not to prevent spread completely, but to limit infection so that those who are infected get treatment, and that health workers are able to treat. This differs for each country based on supplies and population, but the most successful countries issued a strict lockdown and limited all exposure and travel. Although the results of this show a decrease in cases, this isolation period can only last so long before life must go back to normal, and when this occurs a second wave will occur and the outbreak could be worse than before the lockdown. To limit this issue, it is important to ease people back into work and create some separation of contact so that exposure is slow. Although I agree with a complete lockdown as it has shown success, other issues arise. Economies are greatly affected, mental health declines, abuse increases, and hunger becomes a larger problem as people are out of work and cannot afford to pay for basic needs. Just attacking the limit of spread COVID-19 however, the most successful interventions include strict isolation and quarantine of those exposed, lockdown of borders, access to testing, and hospital availability.

References

“Breaking News, Latest News and Videos.” CNN, Cable News Network, www.cnn.com/search?q=COVID-19.

“Coronavirus Cases:” Worldometer, www.worldometers.info/coronavirus/.

“Coronavirus Disease 2019 (COVID-19).” Centers for Disease Control and Prevention,

Centers for Disease Control and Prevention, www.cdc.gov/coronavirus/2019-ncov/index.html. “Coronavirus.”

World Health Organization, World Health Organization, 2020, www.who.int/emergencies/diseases/novel-coronavirus-2019.

Courage, Katherine Harmon. “The Stark Differences in Countries' Coronavirus Death Rates, Explained.” Vox, Vox, 1 Apr. 2020, www.vox.com/2020/4/1/21203198/coronavirus-deaths-us-italy-china-south-korea.

Frank, Allegra, and Constance Grady. “Phone Booths, Parades, and 10-Minute Test Kits: How Countries Worldwide Are Fighting Covid-19.” Vox, Vox, 22 Mar. 2020, www.vox.com/science-and-health/2020/3/22/21189889/coronavirus-covid-19-pandemic-respons e-south-korea-phillipines-italy-nicaragua-senegal-hong-kong.

Gavlak, Dale. “COVID-19 Diaries: Strict Curfew in Jordan Holding Down Infections.” Voice of America, www.voanews.com/science-health/coronavirus-outbreak/covid-19-diaries-strict-curfew-jordan-ho lding-down-infections.

Hjelmgaard, Kim. “These Countries Are Doing the Best and Worst Jobs Fighting Coronavirus.” USA Today, Gannett Satellite Information Network, 31 Mar. 2020, www.usatoday.com/story/news/world/2020/03/17/coronavirus-how-countries-across-globe-respo nding-covid-19/5065867002/.

Hunt, Mia. “Lessons from the Frontline: How to Stop the Spread of COVID-19.” Government & Civil Service News, 26 Mar. 2020, www.globalgovernmentforum.com/lessons-from-the-frontline-how-to-stop-the-spread-of-covid-1 9/.

Mo, Milly. “A Closer Look at the Chinese Hospitals Built to Control the COVID-19 Pandemic.” ArchDaily, ArchDaily, 15 Apr. 2020, www.archdaily.com/937579/a-closer-look-at-the-chinese-hospitals-built-to-control-the-covid-19-p andemic.

Noor Al-Hussein Foundation -Institute for Family Health, www.nooralhusseinfoundation.org/index.php?pager=end&task=view&type=content&pageid=35.

Tadros, Amjad. “Drastic, Early Action Seems to Keep a Lid on Jordan's COVID-19 Outbreak.” CBS News, CBS Interactive, 6 Apr. 2020, www.cbsnews.com/news/coronavirus-in-jordan-seemingly-kept-in-check-by-drastic-early-lockdo wn-measures/.

Wamsley, Laurel. “Life During Coronavirus: What Different Countries Are Doing To Stop The Spread.” NPR, NPR, 10 Mar. 2020, www.npr.org/sections/goatsandsoda/2020/03/10/813794446/life-during-coronavirus-what-differe nt-countries-are-doing-to-stop-the-spread.

Wood, Johnny. “Coronavirus – This Is How the World Is Responding.” World Economic Forum, 5 Mar. 2020, www.weforum.org/agenda/2020/03/coronavirus-this-is-how-the-world-is-responding/.

Younes, Ali. “How Jordan Is Flattening Its COVID-19 Curve.” Jordan News | Al Jazeera, Al Jazeera, 22 Apr. 2020, www.aljazeera.com/news/2020/04/jordan-flattening-covid-19-curve-200422112212466.html.

Aliya Mahmoud's Bio:

I am Aliya Mahmoud, a senior at Macalester College with a double major in Biology and International Studies, a minor in Arabic (Classics), and a concentration in Community and Global Health. I am from Portland Oregon and am a member of Macalester’s Women’s soccer team. I also work in Professor Daughters research lab and am a preceptor in the International Studies Department. I love to travel and had the opportunity to study abroad in Amman Jordan last spring. In the fall I will be attending graduate school to get my Masters in Public Health. In my downtime I love to watch Netflix, make candles, and hang out with my German Shepherd Puppies!