Activity Report Conducting The On-Site Table-Top Exercise (TTX)

based on The ASEAN Protocols on Cross-Border Contact Tracing

and Rapid Outbreak Investigation

20 – 21 June 2024  | Jakarta, Indonesia

organized by
GIZ , Ministry of Health Indonesia, ASEAN Member State (AMS)
collaboration with
Division Disaster Health Management Center for Health Policy and Management (CHPM) Faculty of Medicine, Public Health and Nursing, UGM

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Doc. MoH Indonesia “Participants TTX”

Opening Section

Opening remark from Dr. Tunggul Birowo, Deputy Director for Health Quarantine Directorate Surveillance and Health Quarantine. Tunggul appreciated all participants for engage to conduct TTX protocol cross border contact tracing and rapid outbreak investigation. He hopes after conducting TTX, participants can maintain good coordination and collaboration in order to better prepare for the next hard time. Tunggul motivated all participants together to support the protocol and give a good input to develop and implement this protocol for a better response in future pandemic. Second remark by Ms. Poucharmarn Wongsanga as a GIZ Project Director for ASEAN PHE Project. Poucharmarn said during the 2 days activities are crucial because it is a critical step to enhance region control management to prepare response PHE. All the participants know about this protocol so they can practice the protocol in future. Poucharmarn hopes AMS has a spirit of collaboration, work togetherness seemingly, and is equipped to manage future pandemics. All together contribute and have a commitment to build a resilient health system based on protocol.

Overview of Protocol: “The ASEAN Protocol of Cross Border Contact Tracing and Rapid Outbreak Investigation

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Doc. MoH Indonesia “Overview Protocol”

Randy Adrian from ASEC Health Division presented Asean Protocol for Cross Border Contact Tracing and Rapid Outbreak Investigation.Randy explained the progress, timeline and policy to conduct this protocol. Based on experience in the last pandemic, ASEAN needs to establish a cross border public health response protocol for conduct tracing and rapid outbreak investigation. ASEAN protocol in line with implementation of IHR 2005. ASEAN Protocol developed since enhancing cooperation on COVID-19 in April 2020 to coordinate cross border PH response. Then in Feb 2021 got concept notes for development of Protocol and finally the protocol was conducted in 2023 followed by a referendum consultation for review and endorsement of the protocol.

Masdalina Pane as representative an Indonesian Epidemiologist Association on behalf of the designer of the document presented an overview of the protocol. Masdalina explained the protocol, the components, objective and mechanism that manage in this protocol. This protocol describes contact tracing work flow and cross border notification. There are four possible scenarios of crossbordering mentioned, how this scenario can be used to review the operation of the protocol. The first scenario is a detected case of a confirmed case who cross bordering, the second is undetected contact who cross bordering, the third is an incoming contact of a confirmed case abroad and the last is a detected incoming case who arrived from traveling abroad.

Table Top Exercise (TTX)

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Doc. MoH Indonesia “Facilitator lead the Table Top Exercise”

TTX participants are representative from ASEAN Member State (AMS) those 6 countries (Indonesia, Malaysia, Philippine, Lao PDR, Brunei Darussalam, Cambodia, Thailand) onsite and 4 countries online. Before conducting TTX dr. Bella Donna, M.Kes as a facilitator from PKMK FK-KMK UGM explained the mechanism of TTX for two days. Scenario divided into four phases based on the protocol of Cross Border Contact Tracing and Rapid Outbreak Investigation. Phase 1 is Out Break Early Detection and Preparedness, Phase 2 is Contact Tracing, Phase 3 is Cross Border Information Sharing, Phase 4 is Rapid Outbreak Response, Investigation and Management. All participants will answer directly the question alternately and also they can fill in a questionnaire google form.

The scenario mentioned three categories countries that describe cross bordering, the first is “Your Country” means participants country, the second “Neighboring Country” means neighboring of Your Country which has land border to Your Country, the third “Other Country” means a Neighboring Country which has no land border with Your Country ether Neighboring Country so it can be accessed by air or sea.

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Doc. MoH “Participants answered the question”

Phase 1 asked how the local health authorities respond to the outbreak and the steps taken by authorities to notify PHE. Phase 2 asked how national ASEAN focal point notify the ASEAN EOC and/or ACHPEED regarding contact tracing. Phase 3 asked how government officers know and relay the information to the supervisor. Phase 4 asked about surge capacity, how to maintain the decrease of cases and de-escalation situation. Each participant responded directly and answered the question based on their experience and their health system policy. Participants also can tap the answer on questionnaire google form. TTX activities runned for approximately 5 hours.

Evaluation/Hot Wash

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Doc. MoH Indonesia “Evaluator (left) and Closing Statement for GIZ (right)”

Evaluation aims to evaluate the process TTX and highlight points that need to develop the protocol. First evaluation from evaluator, followed by the observer and the last participant. Evaluators are GIZ, MoH and WHO. They said Each country already has a plan and capacity to respond, how to communicate, how to collaborate and share information. For phase one, AMS fully understands the protocol. Public health emergency operation center emplaced in each AMS during the outbreak, on national and management will be implemented an information update to higher level. AMS knows to inform, to mention ASEAN Focal Point. So the notification was sent to neighboring countries, WHO, ACPHEED, and then published by ASEAN and WHO. Risk assessment for humans not established and also mapping outbreaks, what is the hazard needed to draft first. Input from evaluators is AMS can conduct webinar in cross country to synergize communication on SAPPHIRE and CRYSTAL and also by many countries we can have a join webinar, how to establish the protocol.

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Doc. MoH Indonesia “Observer”

Observer from ASEAN Secretariat (ASEC), ASEAN BioDiaspora Virtual Center (ABVC) and ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED) mentioned suggestions including a commitment to revise and develop protocol, explore more about public health emergencies, and through reported data and information. Collaboration is very useful for investigation, communication, coordinating, it's very encouraging. Reporting is very important now because recent data is very affecting the public. Communication is informal for follow up action, it's very good action for every country.

The last session, participants from each country said they have a good knowledge and experience from this activity. They will share and socialize this protocol to their country, especially to the government and stakeholders. They will commit together to develop and implement the protocol.

Reported by

Happy R Pangaribuan, MPH

Researcher and assistant consultant CHPM, Faculty of Medicine, Public Health and Nursing, UGM

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