Like many African countries now making use of Ebola and Influenza preparedness to step up their COVID-19 response, Tanzania is tapping into the skills of health workers already knowledgeable in infectious disease control, established influenza sentinel surveillance system and repurposing facilities to tackle the new virus. When the tenth Ebola outbreak erupted in the Democratic Republic of the Congo in 2018, Tanzania trained 2400 health workers. Training sessions initially planned for Ebola were reviewed to include COVID-19. More than 300 of them have now been retrained to join the frontline ranks of the country’s COVID-19 battle.

In regions that had been identified as being at high risk of Ebola, rapid response teams were formed and trained, and authorities identified isolation areas at specific health facilities in each district and health workers trained to manage those units and handle suspected cases. The health workers and the resources are now proving critical in COVID-19 response.

In addition, structures such as isolation units in district health facilities set up for Ebola preparedness are now being turned into COVID-19 units. All the country’s 26 regions have been instructed to designate isolation areas for potential COVID-19 infection, while health worker training in patient triage for Ebola readiness now counts among the assets in curbing the spread of the new coronavirus. “It is very critical to empower health care workers with the right information,” said Dr Nemes Iriya, in charge of Case Management at World Health Organization in (WHO) in Tanzania.

WHO Tanzania is working with the Ministries of Health in mainland Tanzania and in Zanzibar to build the capacity of health workers on clinical care, improving infection prevention, laboratory testing and other prevention measures. A total of 182 facilities have been designated to be able to isolate and treat COVID-19 in all district councils. The government has also identified 26 regional referral facilities to be capacitated to provide critical care. Most of the referral facilities already have staff trained in advanced care for Ebola, which included critical care.

Angelina Malugu, a nurse who was recently trained on handling COVID-19 patients, said learning about the type of personal protective equipment needed for COVID-19 was crucial. “I was worried because I did not know how to distinguish COVID-19 from Ebola in terms of my safety.” “We still had gaps in knowledge,” Said Mohamed, a junior doctor at the main hospital in Pemba island, recounted during a training session on response to the new virus that was first reported in Tanzania on 16 March. More health workers have been trained through sessions organized by the Ministry of Health in collaboration with United Nations agencies and non-governmental organizations.

Getting the right messages out 
The government has also intensified public health education, working with WHO, UNICEF, religious leaders and telecommunications firms to provide facts and debunk rumours about COVID-19. The COVID-19 response has been taken to a higher level, coordinated through the disaster committees and the task force chaired by the Prime Minister. Disaster committees have structures at national, regional, district and village level.

Public health officials and key government officials, including the President and Prime Minister, as well as religious leaders have featured on national TV and popular radio programmes to speak about the disease. Handshake greetings and crowds are avoided as much as possible – fewer buses during rush hour makes crowd-shunning difficult. “I’m doing all I can to make sure that I stay safe from any possibilities of getting the infection. I was worried … when I heard there is a case in Tanzania,” said Ashura Magongo, a resident of Dar es Salaam.

Columbus Masenga, a Dar es Salaam mechanic, said he had never used a mask or a hand sanitizer in his life until recently. “It sounded weird to hear that I must clean my hands with something that I do not know about. I bought one for my wife to keep in her handbag, but we are using soap and water at home. I think this new disease has come to force everyone to observe personal hygiene. When I got home one night my six-year-old did not hug me. He said, ‘daddy don’t touch me’,” Masenga said.

Tanzania has also made quarantine mandatory for arrivals, both national and foreigners, with travellers quarantined in designated hotels for 14 days. Large public gatherings – community meetings, rallies, sports and entertainment – were banned for a month on 17 March. Schools and universities have also been shut for a month.