By April 2020 there was considerable concern that COVID-19 would have a devastating impact across the African continent, due to its high HIV prevalence and latent TB rates. Modelling suggested that hospitals would be overwhelmed with patients requiring active respiratory support. These models predicted a massive shortage of ventilators and a lack of healthcare workers (HCWs) with the required skills to provide the respiratory support needed. The challenge was thus to rapidly upskill HCWs to meet these new demands.
With the goal of training HCWs in the the initiation and management of ventilator based treatment and active respiratory support, USAID partnered with Right to Care (RTC) and the Foundation for Professional Development (FPD). Both RTC and FPD are local South African partners, with FPD specializing in clinical education. Together they rapidly created and implemented an online learning program targeted at doctors and nurses, to allow them to develop the required competency around all aspects of respiratory support.
The course was designed as a comprehensive, 12-hour, online learning program. It is accredited for 12 continuing medical education credits (CME) and is designed to be highly interactive including video recorded demonstrations; recorded expert panel discussions; narrated presentations; further readings; and quizzes. Each module was assessed through online multiple choice questions and upon completion participants were awarded a certificate. This approach was favored as the target audience had little or no experience in initiating and managing ventilation therapy; lockdown restrictions limited residency based training; and the need for HCWs to be in service necessitated distance or online training with flexible access.
There was rapid uptake of the training program from the outset in June 2020. Although originally envisaged for South Africa, the launch resulted in numerous requests for access from HCWs across Africa. The program was thus shared with other African countries (25 in total) in July 2020, as a complementary activity to other United States government programs designed to supplement capacity to respond to severe COVID-19 cases. There were additional requests to expand access to a broader range of HCWs than doctors and nurses. The course was therefore also customized to meet the requirements of nurses working in intensive and high care; nurses providing ward based oxygen therapy; clinical associates; physiotherapists; and emergency responders. To support the development of a new generations of doctors who may have to deal with similar pandemics in the future, the course was also opened up to medical students.
The course was well received by participants and played a significant role in rapidly developing the required skills to provide respiratory support to severely ill COVID-19 patients. As one student, Dr Hailemariam Mulugeta Kasim a Lecturer from the Department of Anesthesiology at Dilla University in Ethiopa said “The course is assisting me in my daily care of patients with COVID-19 and it has refreshed my prior knowledge on respiratory therapy. Thank you for the demanding online course at this unprecedented time.” By October 2020 over 6,600 HCW had completed the training.