Subject: RE: Georgia questions
From: Tamar Gabunia </O=EXCHORGANIZATION/OU=EXCHANGE ADMINISTRATIVE GROUP (FYDIBOHF23SPDLT)/CN=RECIPIENTS/CN=E6CA04F38EC94D0CADAB9CBDF90FCDDE-TAMAR G>
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Alisa Tsuladze </o=ExchOrganization/ou=Exchange Administrative Group (FYDIBOHF23SPDLT)/cn=Recipients/cn=6c6cfa06d9a74264a5aa512b6bc62306-Alisa T>
Date: Tue, 28 Apr 2020 06:17:02 +0000

Sending some background documents. Will provide more details with subsequent e-mails.

From: Prasad, Pragati (CDC/DDID/NCIRD/ID) [mailto:[email-masked]]
Sent: 28 April, 2020 01:28
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Slayton, Rachel B. (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Hello Marika,

We wanted to provide you with our modeling technical assistance (TA) request form (below). Getting as much of this information as possible will be very helpful for the Modeling TA group to best support your work.

Modeling TA Requests

What kind of TA is needed?

Review of existing model/parameters

Resources for in-country modelers

What is the timeline of the request?

What is the testing capacity and strategy of the country?

What current community mitigation plans are in place?  And when were these implemented?

What is the desired programming language/level to use that has in-country support (software and proficiency level)?

Spreadsheet (Google Sheets, MS Excel, LibreOffice Calc, etc.)

Statistical software (Stata, SAS, R, Python, etc.)

Computer language (C++, Python, Java, etc.)

What work has the group done previously to deal with this request?

What are the current gaps with existing tools being used?

What data are available for the specific request?

Transmission-related:

Lab confirmed SARS-CoV-2 or COVID-19 case/death counts

Is there a line list? Is it managed in Excel or a formal database?

Outpatient: counts/ILI

Hospital: Hospitalizations/ICU admissions

Mobility

Response-related:

Personal protective equipment

Healthcare worker

Patient

Contact

Hospital beds

ICU beds

Ventilators

Human resources

Patient care

Contact tracing

How are these data collected?

Are data available at sub-national levels, and if so, which admin level?

Thank you!

Pragati Prasad

Modeling Task Force | COVID-19 Response

Centers for Disease Control and Prevention

1600 Clifton Rd NE MS H24-7; Atlanta, GA 30329-4027

From: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Monday, April 27, 2020 2:15 PM
To: Slayton, Rachel B. (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Prasad, Pragati (CDC/DDID/NCIRD/ID) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Dear Rachel,

Thank you for your email. The call will be very helpful to plan further activities.

I’ll be happy to collect some key information before the call. Please, let me know what kind of information would be useful.

I’ll be happy to join the call any time convenient for the team.

Thanks,

Marika

Marika (Mariam) Geleishvili

Senior Advisor, US CDC-South Caucasus Office

Tbilisi, Georgia

E-mail: [email-masked]

Mobile: (+995) 591 916 599

From: Slayton, Rachel B. (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Sent: Monday, April 27, 2020 3:51 PM
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Prasad, Pragati (CDC/DDID/NCIRD/ID) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Hi all,

We would be happy to have a call to discuss this analysis. It would be helpful to better understand what data are available for both cases and mitigation measures.

Rachel

From: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Saturday, April 25, 2020 5:29 AM
To: Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Prasad, Pragati (CDC/DDID/NCIRD/ID) <[email-masked]>; Slayton, Rachel B. (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: Re: Georgia questions

Hi Velma,

Thank you for your email and interest to provide technical support.

We will collect information on ongoing mitigation strategies and testing capacity from the MoH and share with you soon.

Thanks,

Marika

Get Outlook for iOS

From: Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Friday, April 24, 2020 8:26:06 PM
To: Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Prasad, Pragati (CDC/DDID/NCIRD/ID) <[email-masked]>; Slayton, Rachel B. (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Hi Marika –

From a quick look at publicly available case information, it looks like Georgia has about 500 COVID cases. Before you start to estimate changes to the reproductive number, I think it would be helpful to learn a little more about the mitigation work that’s ongoing in country, as well as testing strategies/capacity. Pragati and/or Rachel (Modeling TF lead, who I copied) can provide excellent guidance on how to best move forward with this!

Best,
Velma

From: Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>
Sent: Friday, April 24, 2020 11:00 AM
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Lopez, Velma (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Prasad, Pragati (CDC/DDID/NCIRD/ID) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Dear Marika,

I’m  looping in our Modeling Task Force/Modeling Advisory Group colleagues ( Velma and Pragati) to assist you with the metrics and models that might be helpful as you continue to develop your plans to estimate Rt in Georgia.

Thanks,

Ledor

From: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Friday, April 24, 2020 9:05 AM
To: Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Tamar Gabunia <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Dear Ledor,

Thank you for your prompt response. All the provided information and links are very helpful.

a.       The RT – Ro study is the highest priority for the country and we’d appreciate if you can send the study design and protocol. We can start creating the instrument for data collection as soon as you send the list of required information. Please, let me know if IRB approval is needed – usually for the outbreak-related studies IRB is not required, but in case we need it – I’ll submit the proper documents and get approval within 10 days from the National CDC.

b.       MoH has guidance on activities  for the local authorities (when the outbreak is registered in regions). The documents look  well structured and cover most of the activities for outbreak response. Let me send the translated document on Monday. Your comments and suggestions are much valuable.

Thanks again,

Looking forward to hearing from you,

Marika

Marika (Mariam) Geleishvili

Senior Advisor, US CDC-South Caucasus Office

Tbilisi, Georgia

E-mail: [email-masked]

Mobile: (+995) 591 916 599

From: Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>
Sent: Thursday, April 23, 2020 10:29 PM
To: Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Hello Marika,

1.       Epi questions:

a.       MoH-Ge needs SME support to conduct real -time monitoring of transmission of COVID-19 in Georgia. She has provided article describing the same study in Singapore. https://www.medrxiv.org/content/10.1101/2020.02.21.20026435v7 . The result of the study will assess effectiveness of the epidemiological measures that country has taken in response to the COVID-19 outbreak. For this project we’ll need to have a PI at HQ and we can provide the PI all the required information from the central and NCDC level. According to Dr. Gabunia, MoH will provide evidence based recommendations to the National Coordination Counsel on recovery and lifting restrictions.

Response:

·         This is noted. Thank you for sharing this information with us.

·         Please let the Epi team know how we can support you as you deliberate further.

b.       With the community spread of the disease, different geographical areas (region / district / villages ) are showing increased number of cases and clusters. Each district is responding to the increase in different way. Dr. Gabunia asked for a structured plan for actions at local level (e.g. is quarantine required, what additional restrictions should be in place, how long should the quarantine last – one incubation period, 2 incubation period, or based no number of cases; is population-wide thermo-screening helpful, what are the target population for lab tests, etc..). This guidance will help country to save resources and lift restrictions tamely.

Response:

·         The recommendation is for all suspected cased of COVID-19 to be tested according to the WHO case definitions

·         Testing can be expanded as resources allow when the clusters become larger as you’ve stated. In this scenario, its crucial that testing of suspected cases continues so that cases can be isolated and quarantined.

·         For areas with community-wide transmission, the focus should be on early detection and prioritization of  vulnerable patients and health care workers.

·         Testing for specific populations can give a rough estimate of transmission in the area and these data can be used to monitor trends.

·         Depending on resources available, those who are at highest risk should be prioritized and tested. More information on evaluating and testing for COVID-19 (this can be adjusted to suit your context): https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html.

·         There is no one size fits all approach but based on your risk assessment, the recommendation is to rapidly implement necessary measures for testing. The WHO guidance for laboratory testing strategy recommendations here. outlines some adaptable strategies.

·         Duration of quarantine: 14 days, if symptomatic, assume COVID-19 and extend quarantine.

o    For recovering patients who have tested negative twice, discharge after an additional 14 days in self-isolation.

Thanks,

Ledor

From: Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Sent: Thursday, April 23, 2020 11:50 AM
To: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Weiss, Jamine (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

Hi Marika,

For #3 (managing healthcare workforce during COVID-19), there are a few key messages and resources that can help. I’ve also looped in Jami, who can follow up with you.

·         Make sure there is a system for monitoring/screening healthcare workers

o    There are a number of options to do this (self-assessment before shifts, active check-ins before shifts)

o    More detailed information here (look at #5): https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/guidance-identify-hcw-patients.html

·         Plan for alternative human resources at facilities

o    Identify inactive HCW that can surge in the event of an HCW shortage (e.g. retired, private or military HCWs, HCW not working in clinical settings, volunteers).

o    Identify active HCWs that can be repurpose/redeploy to COVID-19 wards from other areas of the hospital where patient volume is low due to pandemic (e.g. staff in outpatient departments)

o    Develop a database of alternate/on-call HCWs.

o    Provide training opportunities and resources for incoming HCWs.

·         Ensure there are plans for managing exposed healthcare workers (risk assessment and monitoring)

o    A number of operational considerations are here (including how to do when there are staff shortages): https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/public-health-management-hcw-exposed.html

·         Plan systems for triage and isolation of patients presenting with respiratory symptoms

o    Set up triage system (to help protect HCWs) using this SOP as example: https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/sop-triage-prevent-transmission.html

o    Also reference this WHO guidance for maintaining health services (start at page 7): https://www.who.int/publications-detail/covid-19-operational-guidance-for-maintaining-essential-health-services-during-an-outbreak

Best,

Katie

Katie Wilson, MPH

Infection Prevention and Control Team

International Task Force

CDC COVID-19 Response

Office: +1 404.639.4333 | Mobile: +1 470.755.5720

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Sent: Thursday, April 23, 2020 9:22 AM
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Killam, William P. (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Subject: RE: Georgia questions

+ Perry

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT)
Sent: Thursday, April 23, 2020 9:22 AM
To: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Igboh, Ledor (CDC/DDID/NCIRD/ID) <[email-masked]>; Mirza, Sara (CDC/DDID/NCIRD/DBD) <[email-masked]>; Luvsansharav, Ulzii Orshikh (CDC/DDID/NCEZID/DHQP) <[email-masked]>; Wilson, Katie (CDC/DDID/NCEZID/DHQP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Hi Marika- adding my Epi, Mitigation and IPC colleagues for their input on 1a, 1b and 3, respectively!

From: Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Thursday, April 23, 2020 7:48 AM
To: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Dear Team,

I have met with the Deputy Minister Dr. Gabunia to discuss questions for CDC. Please, see summary here:

1.       Epi questions:

a.       MoH-Ge needs SME support to conduct real -time monitoring of transmission of COVID-19 in Georgia. She has provided article describing the same study in Singapore. https://www.medrxiv.org/content/10.1101/2020.02.21.20026435v7 . The result of the study will assess effectiveness of the epidemiological measures that country has taken in response to the covid outbreak. For this project we’ll need to have a PI at HQ and we can provide the PI all the required information from the central and NCDC level. According to Dr. Gabunia, MoH will provide evidence based recommendations to the National Coordination Counsel on recovery and lifting restrictions.

b.       With the community spread of the disease, different geographical areas (region / district / villages ) are showing increased number of cases and clusters. Each district is responding to the increase in different way. Dr. Gabunia asked for a structured plan for actions at local level (e.g. is quarantine required, what additional restrictions should be in place, how long should the quarantine last – one incubation period, 2 incubation period, or based no number of cases; is population-wide thermo-screening helpful, what are the target population for lab tests, etc). This guidance will help country to save resources and lift restrictions tamely.

These two projects are extremely important for recovery phase at central and local levels.

2.       Lab questions: Dr. Gabuni will have consultations with the Lab and Clinical teams and get back with coordinated request on lab side.

3.       IPC questions:  As healthcare workers are heavily affected during the pandemics globally, and Georgia is experiencing the same trends (about 20% of cases are healthcare workers), several hospitals have been shutdown due to infected staff, it is important to provide HCFs with guidance how to manage human resources:  back-up teams, additional trainings , reduce number of staff per shift and keep them “clean” in case infection spreads among the frontline HCW. So, guidance in managing HCW during the covid response is much desirable.

Please, let me know if further clarification is needed.

Looking forward to hearing from you,

Marika

Marika (Mariam) Geleishvili

Senior Advisor, US CDC-South Caucasus Office

Tbilisi, Georgia

E-mail: [email-masked]

Mobile: (+995) 591 916 599

From: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Monday, April 20, 2020 11:25 PM
To: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Thank you so much Ishani.  We are still waiting on the Ministry too so delays on both sides.

Thanks for following up,

Sarah

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Sent: Monday, April 20, 2020 1:59 PM
To: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Sorry for delay on this Sarah- I didn’t hear back after email Friday and have re-pinged them

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT)
Sent: Friday, April 17, 2020 8:33 AM
To: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Ok thanks Sarah – let me follow up with our SMEs here

From: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Friday, April 17, 2020 8:27 AM
To: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Hi Ishani,

Definitely English.  Language won’t be an issue.  We really appreciate the support.  Dr. Geleishvili, CDC’s senior med epi, will work with the Ministry next week to gather more specific information around what questions they have and better sense of when they would like have the call.

Marika, please feel free to add additional information here as you have it.

Thank you again,

Sarah

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Sent: Thursday, April 16, 2020 10:33 PM
To: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Hi Sarah,

Do you know if language will be an issue, and when they hope to do this call? We have gotten many requests like this and have typically deferred to the in-country CDC staff to liaise directly with Ministries (while our ITF SMEs work ahead of time to prepare our CDC country teams) partly because of language/time restrictions and partly because of our SME’s bandwidth supporting all countries. That said, given your circumstances and if English is ok (especially if a formal presentation is not needed), I can definitely check with our IPC and epi teams here to see if they can do this! I think would especially be great to get their questions in advance as much as possible to maximize efficiency!

Let me know thoughts and I can pitch it to our SME teams tomorrow

Ishani

From: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Sent: Thursday, April 16, 2020 6:25 PM
To: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>; Geleishvili, Marika (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Bolkvadze, Tamar (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>; Saganelidze, Nino (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Subject: RE: Georgia questions

Hi Ishani,

Thanks so much for reaching out.  As you may know, the CDC Georgia office does not currently have any USDHs at post.  I serve as the deputy director at large and, for the past year, the acting country director as we wait for US staff to relocate to post later this calendar year.  We are lucky to have a very talented group of locally employed staff, several of whom are copied here.

We have received a request from the Deputy Minister for Health to consult with COVID-19 experts by phone or video conference (request details are being finalized) in the areas of lab, surveillance, and IPC.  I’ve attached a cable highlighting the request and other COVID-19 related updates.

As we wait for details on how the ministry would like to proceed, I wanted to give your team a heads up that this request is coming in case you need additional information from us.

Thank you again for hosting these calls.  We really appreciate the information sharing opportunities.

Best,

Sarah

From: Pathmanathan, Ishani (CDC/DDPHSIS/CGH/DGHT) <[email-masked]>
Sent: Thursday, April 16, 2020 9:03 AM
To: Hedges, Sarah (CDC/DDPHSIS/CGH/DGHP) <[email-masked]>
Cc: Anaya, Gabriel (CDC/DDPHSIS/CGH/GID) <[email-masked]>
Subject: Georgia questions

SO sorry we ran out of time! How can we help you?

Ishani Pathmanathan, MD/MPH

Regional Technical Lead - Latin American/Caribbean, Eastern Europe/Central Asia, Middle East

Country Support Team - International Task Force

2019 Novel Coronavirus Response

U.S. Centers for Disease Control and Prevention (CDC)

Office: (404) 718-8387 | Cell: (404) 200-4965