Latin America – Experts from Charité assist with COVID-19 testing: Berlin Research Initiative for Diagnostics, Genetics and Environmental Factors in Schizophrenia - Charité

The German Epidemic Preparedness Team (SEEG) establishes new field missions

Anna-Lena Sander, researcher at Charité’s Institute of Virology, teaches laboratory staff in Guayaquil, Ecuador, how to prepare samples which are to be tested for the novel coronavirus. Photo: Krause/Charité.

Laboratory-based training: trainees at the Instituto Nacional de Investigación en Salud Pública (INSP) in Guayaquil, Ecuador, watch as Nina Krause, a researcher at Charité’s Institute of Virology, demonstrates the correct use of laboratory reagents during SARS-CoV-2 testing. Photo: Sander/Charité.

A joint press release by Charité – Universitätsmedizin Berlin and Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH

Working alongside colleagues from the German development agency ‘Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH’, a team of experts from Charité – Universitätsmedizin Berlin is supporting Latin American efforts to set up diagnostic procedures for COVID-19. In addition to delivering laboratory reagents and other equipment, the team’s Spanish-speaking experts from Charité’s Institute of Virology will train local laboratory staff in conducting diagnostic testing. Support missions during the current pandemic have seen the German Epidemic Preparedness Team (SEEG) visit the West African country of Benin, as well as Colombia and Ecuador. Missions to other countries will follow. The SEEG was established by the Federal Ministry for Economic Cooperation and Development (BMZ) in collaboration with the Federal Ministry of Health (BMG). The BMZ provides approximately € 1 million in funding per year to support the SEEG’s work. Charité’s experts are also involved in establishing and maintaining an open dialog with countries in Latin America and the Caribbean. The Federal Foreign Office is supporting their efforts with € 200,000.

For more than five years, SEEG teams have been supporting German development cooperation partner countries in ensuring the early detection and prompt containment of infectious disease outbreaks. Commissioned by the BMZ and BMG, the SEEG group of experts was established during the Ebola epidemic (2014 to 2016). Current COVID-19 deployments focus on countries in Latin America and Africa, where the spread of the novel coronavirus (SARS-CoV-2) affects wide swathes of the population, including numerous indigenous groups.

The early and widespread detection of COVID-19 is key to breaking chains of infection. The earlier this is done, the faster outbreaks will be contained – both locally and ultimately worldwide. Success primarily relies on comprehensive outbreak detection systems, well-equipped and functional laboratories and health care facilities, as well as qualified and dedicated specialist staff. A team of experts from Charité and the GIZ is currently on deployment across Ecuador, Peru and other Latin American countries, delivering testing material and training laboratory staff in diagnostic techniques. Following a ‘train the trainer’ concept, the team’s efforts are enabling trained staff to pass on their knowledge and expertise to staff working in local laboratories.

The team of experts, led by Prof. Dr. Jan Felix Drexler, Head of the Institute of Virology’s ‘AG Drexler – Virus Epidemiology Unit’ on Campus Charité Mitte, and Dr. Michael Nagel, the SEEG’s Head of Deployment Operations, can tap into a wealth of experience, gained through years of working together. For instance, the team were responsible for establishing Zika diagnostic testing in the Peruvian tropical rainforest, a region severely affected by the virus. These types of deployments and the ability to rely on infrastructure elements developed and tested during previous epidemics mean that the experts are able to respond quickly to the current situation. “Now that Latin America has become the global COVID-19 epicenter, we can provide particularly effective support, not only because we have been active in the region for some time, but also because of the work we did with our Latin American partners during the recent Zika outbreak,” says Prof. Drexler, GIZ’s Project Partner at Charité. In addition to close contacts with Salvador University in the Brazilian state of Bahia and local experts in Tropical Medicine, the team also boasts many members who speak fluent Spanish. “A good level of knowledge of the countries and their languages helps us to provide support to local reference laboratories and advice to local decision-makers,” emphasizes Prof. Drexler.

Over the past three months, the team has been able to provide the equipment needed to establish a total of ten laboratories, develop three reference laboratories and train large numbers of local staff to handle the virus safely. Since the launch of the project in the West African country of Benin, SEEG has increasingly responded to requests for assistance from Latin America. Following trips to Colombia and Ecuador, the team of experts plans deployments to Peru, Costa Rica and Honduras. Argentina and Chile have also expressed an interest. The GIZ’s Epidemic Preparedness Team will initially provide logistics support for the delivery of up to 100,000 test reagents and essential laboratory equipment, including large devices. Explaining details of these plans, Head of Deployment Operations, Dr. Michael Nagel, says: “We will start by delivering reagents needed for lab-based diagnostic testing. By doing so, we will help to solve the Gordian Knot of diagnostic testing problems in these countries. Once testing is more efficient and staff have been adequately trained, it will be possible to identify and isolate suspected cases. This is absolutely key, and of crucial importance for vulnerable and indigenous people.”

At a later stage, the field mission teams will provide advice on follow-on measures, such as diagnostic strategies. The aim of these efforts, which form part of a wider pandemic-related dialog being promoted by the German Foreign Office, will be to enable partner countries to better manage the epidemiological situation. Entering into a scientific dialog with countries in this region will promote the sharing of knowledge on how to best manage the current pandemic and inform decisions regarding future measures. Acting as reliable partners in a crisis, the teams will provide specialist advice which will target specific areas of need within the region. Recommendations for action will be issued based on the experts’ experiences and assessments of local developmental needs.

The German Epidemic Preparedness Team (SEEG)
One of the aims of the SEEG deployments is to improve the overall situation arising from local disease outbreaks. Another is to help strengthen the relevant country’s health care system and ensure universal health care. To achieve these aims, SEEG teams conduct their work fully integrated into existing structures. This ensures that development cooperation activity produces positive effects over both the short and long term. In an effort to capitalize on synergies and profit from existing expertise, institutions such as the Robert Koch Institute (RKI) work alongside other specialist institutions such as the Bernhardt Nocht Institute for Tropical Medicine (BNITM) and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH. For each of its missions, the SEEG will assemble the most appropriate team. Where necessary, the SEEG will draw on experts from other institutions, such as public health or academia. For more information: www.giz.de/de/downloads/giz2016-de-Factsheet_SEEG.pdf

AG Drexler – Virus Epidemiology Unit, Charité – Universitätsmedizin Berlin
Led by Prof. Dr. Jan Felix Drexler, the Virus Epidemiology team studies emerging viruses in both humans and animal reservoirs. The Unit focuses on the diagnosis of novel viruses in tropical countries and their study using evolutionary biology-based methods. While the Unit is based at the German Center for Infection Research (DZIF), much of its work involves fieldwork in Europe, Latin America and Africa. Over the past few years, the AG Drexler team has helped to elucidate key epidemiological questions on the spread and pathogenesis of the Latin American Zika virus, advanced the development of diagnostic techniques for the yellow fever virus and other mosquito-borne viruses, and contributed to the discovery of SARS-related coronaviruses in European bats.

Mission to Ecuador, June 2020
During their mission to Ecuador, a five-person-strong team of experts held a training session at the Instituto Nacional de Investigación en Salud Pública (INSPI) in Guayaquil. The experts were able to provide training to eight local laboratory staff. Most of them came from some of the smaller provinces which lack operational diagnostic laboratories for SARS-CoV-2 but are keen to establish them as soon as possible. For this, they need adequately trained staff. While the training sessions teach relevant theoretical knowledge, their primary focus is on practical training. This includes sample preparation and processing, as well as PCR-based testing for SARS-CoV-2. The newly trained members of staff will now be able to pass on their knowledge to laboratory staff at the various local laboratories. In addition to testing lab capacity, the German experts also provided assistance with further planning. Thanks to laboratory reagents and trained staff, even smaller cities will now be able to safely and reliably identify cases of COVID-19. Until now, testing had been limited to just a few cities, which resulted in long delays in diagnoses.