Somalia expands surveillance to better track COVID-19 outbreak


Somalia continues its fight against COVID-19 which has so far infected over 2300 people and killed 83. The fragile and weakened health system is being overwhelmed by demands for patient care in light of the pandemic, and Somalia has recorded the highest death toll among East African countries.

The surveillance system’s ability to rapidly detect, trace, track and test cases is being challenged. In the absence of a functional disease surveillance system in the country, the Early Warning, Alert and Response Network (EWARN), established in 2008 and reactivated as a web-based electronic early warning system for disease outbreaks in 2017, has been expanded to early detect suspected cases of COVID-19 in in both primary and secondary level health care centres across the country.

WHO has been supporting this expansion through adding new health facilities, especially those in the private sector, to the reporting system of EWARN. Within the next couple of weeks, WHO plans to roll out the EWARN system to an additional 230 health centres from the current existing 533 reporting sites. The system reports on 14 epidemic-prone diseases on a weekly basis and by 2019, an estimated 6.5 million people, including 2 million internally displaced people, were covered by the EWARN system. With this expansion, COVID-19 will now be a reportable health condition in Somalia.

The expansion of EWARN relies on knowledge and skills of health care workers on the correct use of case definition and use of threshold values for generating alerts. Currently, a mobile app is also used to report on any suspected case of COVID-19 or any other reportable health condition in real-time, edspecially in security-compromised areas. Last week, the WHO country office conducted training of health care workers in the capital city on surveillance for COVID-19 as part of EWARN expansion. The health care workers were trained on reporting, as well as on tracking alerts using the mobile application.

In May, 127 health care workers were trained by WHO as part of the EWARN expansion programme and 50 additional health facilities have been added to the reporting system. Data from the EWARN surveillance system are regularly analyzed to better understand the progression of the disease at both national and sub-national level and monitor the effectiveness of ongoing public health interventions to combat and contain transmission. The WHO country office has also mobilized an additional 65 rapid response teams who regularly verify and investigate all alerts reported from the EWARN system. EWARN in Somalia, apart from proving its value as a real-time early warning system is the main building block in the country now for the collection, analysis and reporting of suspected cases of COVID-19.