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Views from different countries on how to leverage lessons learnt from COVID-19 pandemic for AMR

Watch Regina Berba (Philippines), Patty Garcia (Peru), Raiva Simbi (Zimbabwe), Amal Al-Maani (Oman) share learnt from COVID-19 pandemic for AMR.
REGINA BERBA: I think we’re now in the time where people are really very much more receptive to new technology, new diagnostic tests. So there must be– I think this is the right time to do it, especially with us seeing that many of our patients in the ICUs, they may actually be able to get over the initial problems related to COVID but end up with a lot of problems related to hospital-acquired infections wherein the organisms are very, very resistant. So this is the best time to introduce tests that will help with the facilitating the diagnosis of infections.
Part of the challenge that we’d like to perhaps improve post-COVID that– the feedback mechanism– us as the users of the data, especially the non-infectious disease people, like the surgeons, the family physicians– I think that’s one of the weaker parts of the programme. We don’t get the information in a timely fashion, so the communication I think backwards to the users of that kind of information would be very useful. When I was listening to the ECCMID conference just last week, there was a session that said a lot about AMS programmes not trickling down to the users. So we were starting to wonder whether that’s also true in the Philippines.
So we’re going to, perhaps in the next few months, be able to come out with a survey of other, well, physicians, medical technologists, pharmacists, whether the ones on the ground do feel that, is there a programme? And do I feel that I’m part of the programme? Or is there more that I can do to contribute to this programme? So things like that probably needs to be part of the reassessment for us as we make our way back to the AMS programme.
AMAL SAIF AL-MAANI: Diagnostic is one part that’s very important. To give you an example, to be able to carry on an infection prevention control in a hospital, you need to know whether this patient that is admitted today is colonised with an AMR pathogen that needs– that would make me allocate him in an isolation area rather than with the other patients. And for that, I need something rapid because most of the hospitals are bothered that the patient is isolated awaiting for confirmation whether he carries an resistant bug or not.
So if we manage at least to increase the capacities of all the hospitals in the different districts in the different areas of the world globally, that they have rapid diagnostics for the multidrug-resistant organism, that would really decrease the consumption of the unnecessary consumption of antimicrobials, and also would allocate the patient for a proper placement within the facilities so that to prevent the transmission to the other patients, and ending with an outbreak.
PATRICIA GARCIA: Number one, we need to do advocacy about what COVID has caused related to antimicrobial resistance. I think we need to work on strengthening the capacities of the laboratories at different levels– primary, secondary, tertiary level, hospitals– to really be able to cut to– I mean, the microbiology capacities to catch the bugs, these bacteria, and also to identify these patterns of resistance. And those should be shared and known by professionals. I mean, in general, professionals don’t manage that type of information. But I think we need also to work on the population, on the other hand, and explain people and– about antimicrobial resistance and what it means.
I think there is a need also of strengthened the capacities for surveillance of antimicrobial resistance, which is a terrible thing. I think there has to be also a plan that might be an emergency plan to reduce intra-hospital infections, especially associated with bugs that are are resistant to drugs that are starting to appear. We need to find out better diagnostics that could allow us to have much faster results that could be shown also to the people. Because people don’t understand the difference between bacteria and viruses and that viruses are do not do not respond to the antibiotics that are made for the bacteria. But with using these antibiotics against various viruses, what we’re doing is we’re making the bacterias more resistant.
So I think we need to work with both– with health professionals and with the community. And I think there has to be a very important effort on strengthen capacities of the professionals of the laboratories, and, of course, to have tools that will allow us to do better diagnostics, and to make it much clearer when we should or we should not be using antibiotics.
RAIVA SIMBI: In terms of enhancing our use of delivery, COVID also had some positive impact. You see, even the lab, for example, has been brought to the fore. Even those that didn’t know the lab, now they know it very well. And even some of us, we are now co-opted in some parts of meetings, which we never thought that would be part of that grouping because of the need to have accurate tests. So we have also taken this opportunity to say, as much as we are doing COVID-19, why can’t we enhance the laboratory to do the other auxiliary tests that might be needed, issues to do with the haematology tests, other chemistry tests that are needed?
And also, we have argued that we need to resuscitate our laboratory– the whole laboratory system– including microbiology. And even we were struggling with our labs getting to level 3 level. Then also, our biosafety, the integrated sample transportation, triple packaging, and things like that, because we had never experienced such highly infectious conditions before. But with COVID now, we know– I’m surprised with the budget that we got to do other things in the laboratory. And I’m happy to say the whole country, we now have an integrated sample transportation for samples because of COVID. The turnaround time in an outbreak like this is very critical.
BILL RODGRIGUEZ: The lessons we learned in trying to build on AMR surveillance before COVID were that it’s hard and it’s slow. And I think what we learned under COVID is that it’s hard, but it can actually go fast. And that’s the main lesson. So data sharing, which has always been seen as this major barrier because data doesn’t want to be shared, and the people who own the data don’t want to share it, we actually haven’t seen that so much.
The data is easily shared, and we’re able to work closely on the ground with people who are able to then use the data to provide real-time meaningful updates and feedback to the people who need to know what’s happening, in this case, in Zambia, but in any country. So I think the real challenge is to recognise, wow, we can actually do this much faster and much more coordinated when we turn our attention to it, and when the funding is available.
And now we just have to make sure that, ultimately, when we hope this COVID pandemic finally eases, that those systems continue to get the support they need because we can’t just pull all the funding away and say, OK, now it’s there and let it go. And I think that’s going to be the challenge is to make that conversion from this is a COVID programme to this is a health system strengthening programme. And one of the most important areas we can now apply this particular approach to is in AMR.

What are some of the lessons learnt from the COVID-19 pandemic and how can we leverage them to build stronger AMR programmes?

Hear from our faculty from around the world:

Dr Regina Berba, National AMR Programme, Philippines

Dr Amal Saif Al-Maani, Ministry of Health, Oman

Prof Patricia Garcia, Cayetano Heredia University, Peru

Dr Raiva Simbi, Ministry of Health, Zimbabwe

Dr Bill Rodriguez, the CEO of the Foundation for Innovative New Diagnostics, Switzerland

There are 3 major areas where COVID-19 and AMR have commonalities:

  • Threats to global security is real but many remain unaware of AMR as a global crisis
  • Skills honed for public health messages and effective communication about the pandemic can be shared and applied to messaging for AMR
  • Technological advances made during the COVID-19 pandemic can be applied to build better laboratory capacity and data systems for a more resilience AMR programme.
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Diagnostics for AMR: Building Back Better from the COVID-19 Pandemic

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