Polio SWAT team tackles COVID

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With the announcement today that the entire continent of Africa has been declared Polio-free, we have met a major milestone in the battle to remove the threat of this terrible crippling disease from the planet Earth.

Since March 2020, the worldwide team working on Polio has been repurposed to work instead on COVID-19.  The teamwork on the ground — with its contact-tracing, relationships with hospitals and communities, laboratories, and surveillance procedures — has been able to help coordinate the effort to control the spread of COVID in countries where without this support the effects would have been devastating.

Joyce speaks today with Michael McGovern, Rotary International Chairman of the Polio-PLUS Program to learn more about the “PLUS” in Polio-Plus — infrastructure, mechanisms, and teams to combat other biological threats as they occur — HIV, Ebola, and now COVID.

Find out more about this essential effort and how you can help.  See http://endpolio.org

African region declared free of wild poliovirus

Transcript:

Polio SWAT team tackles COVID

featuring Michael McGovern, PolioPlus, Rotary International

on Powerful Patient, August 2020

Hello. This is Joyce Graff from the Powerful Patient and today I’m glad to announce that the continent of Africa has just been declared polio free. This is a major milestone in the fight against polio. But it’s even more important today because of its implications for COVID. In fact, the polio team worldwide that has been created by the Rotary Clubs and the Bill & Melinda Gates Foundation to combat polio, and hopefully get it off the plan altogether has been since last March working on COVID worldwide. There’s a team on the ground to handle the day to day problems with completing the polio inoculations necessary to stop this epidemic.  And all of those feet on the ground have been re purposed to work on COVID. So today we’re going to talk with Mike McGovern who is the head of the Rotary International PolioPlus program. He was the vice president of Rotary International in 2007-08 and has been continuing as the chairman of the PolioPlus program globally since that time. So please help me welcome Mike McGovern.

Joyce: Let me just ask you a couple of questions. I’m very interested to know more about the Polio platform and how the people on the ground are being utilized in these times of COVID.

Mike: Yeah. It’s being used tremendously, particularly in a couple of the African countries, in Pakistan and Afghanistan, the whole polio network immediately jumped over to COVID.  That included providing surveillance in many of those countries where individuals who thought they might have COVID had someone to go see.  It also includes — for example, in Pakistan we had a Call Center for people that call with polio calls and suddenly all of those calls in that Center were transferred to COVID, and we expanded it four or five times due to the volume of calls.  The whole network really responded and you know, I, think it’s certainly not over yet. But if you look at the cases that we have in Africa and you look at the way they’ve been able to handle it in Pakistan, we saw the curve that I think we had all hoped to see here in the United States. We hope every day that things continued to straighten away but without the polio network, those countries would not have gotten head start that they did.

Joyce: So we’ve seen a sort-of bell-shaped curve come on down in Pakistan?

Mike: Yeah, you know, in Pakistan, it’s the peak. They had the cases go way up and now they’ve gone down and now they’re staying down. It’s exactly what the medical experts hoped that we might see with the face mask protections that are going on, the social distancing, and with the actual — you know, folks staying in their homes for a certain period of time, stopping big events, all those things — it’s been, knock-on-wood — success thus far.

Joyce: So what have we learned about controlling this kind of epidemic or pandemic, both from polio and from your current experience with COVID and with Ebola in the past? What does it take to get one of these things under control?

Mike: You know I think we learned an awful lot over the years from polio. One is the the importance of effective communication and you know particularly media work. For example, we have always had billboards.  You know, they don’t allow them in my state, but in many of these countries they have billboards. And these billboards, you know about the message of the importance of getting the polio drops but all of those billboards were converted over to COVID.  Similarly, radio advertising, which is still there, and in particular advertising on social media. All of these things were done in polio and they were also replicated in these countries using the same techniques for COVID that we use for polio. And we have a lot of staff in these different countries and the estimate is during the first quarter of our activities that $50,000,000 worth of polio support — directly from the partnership, not just from the country, but that which the polio partners support — fifty million dollars of that went to support COVID-19 interventions.

Joyce: So, obviously, communications, and it sounds like community corporation because if people don’t actually do it then all the communication doesn’t help.

Mike: Yeah absolutely, it’s the communications, it’s establishing testing regimen — the polio network funds about 176 laboratories in the areas that we serve.  It’s having those laboratories up and running and ready to go to analyze the COVID tests. It’s all that, but you’re absolutely right — nothing gets done without support of the individuals who live in a community. We’ve had polio resistance over the years in different places. Where it always comes around is if we can persuade the mothers and fathers in the communities.  We do that. We get religious leaders involved. We get community deciders, community influencers, and that whole habit cadre. I work in local government myself for many years, I’m a little biased, but you know the importance of the local government, the local health officials I can’t emphasize that enough. It’s everyone working together the community groups, the government people the representatives of WHO and UNICEF, and the Rotary Club, Rotary itself.  In particular in Pakistan and these African countries, there were many Rotarians who go and they assist with the different programs in polio, and they were doing it with COVID as well. The other things that Rotary has done and others — the provision of personal protective equipment, the masks, the gowns, the shields — I’ve seen more photographs of Rotary clubs out in these countries helping to provide those things.

Joyce: And obviously, we don’t have a vaccine yet for COVID. But we’ve seen with other diseases — and certainly with polio — that you go from 20,000 deaths a year to practically zero once you do have a vaccine to prevent the disease. So how do you go about getting people to accept vaccination?

Mike: Obviously people see the evil from polio. They saw what happened when kids came down with it and that that is the most effective. Secondly from that it’s making it convenient, making it easy for people to get the vaccines.  We have used celebrities in many different countries — celebrities we have never heard of the United States but in these particular areas, some of these celebrities are really, really well-known people. One of the people who has really supported vaccines is the number one person in Bollywood. And that was a big deal in India. We have a world-famous fashion model in Brazil, and Jack Nicklaus, another polio survivor, and so many people from athletes to Hollywood celebrities to fashion models, and it just never ends.  It’s all of this.  But it’s mainly the use of community-based vaccinators — you can really persuade someone to get a vaccine if it’s a neighbor who’s helping to provide that vaccine. Obviously with COVID yet we don’t know the nature of the vaccine,  we don’t know how it will be administered, but you know if you could involve more and more people in their own communities to provide the vaccine. That’s a way as well of building confidence.

Joyce: So it’s developing trust and confidence in the program and in the person who is administering it.

Mike: Absolutely.  And the other side of that is sadly you need a strategy to deal with what I would refer to as the anti-vaccine-ers.  But you just can’t let the negative forces out there control the dialogue. That’s not easy. People have their beliefs. People have their causes. But that’s why it’s important you get real community leaders out in front and particularly some of those in the religious communities in these areas.

Joyce: Right. I’ve been reading some very interesting articles. There was a really good one in the Scientific American that was very complimentary to the work that the PolioPlus people have been doing to help with COVID and I think one of the problems for many diseases is because we have cleared them up.  There’s a sort of historical amnesia about it. You know we forget how difficult they were — things like measles things, like diphtheria.  We used to have twenty thousand children a year die from diphtheria. And when was the last time you heard of somebody having diphtheria? It’s been down to single digits a year now for longer than I can remember.  I had friends with polio. So I know very keenly, and when I’ve gone to other countries I’ve seen on the streets people with twisted limbs and shriveled limbs. But we don’t see that in America. We have forgotten. So it’s so easy for people to say “Why should I bother my child was this vaccine, because it’s not so bad.”

Mike: In the United States, for kids going to school in most states it’s required that the kids have these vaccines. So in the United States it’s an injectable polio vaccine that the kids receive as part of their routine immunization. You know, it’s been a lot of years since we’ve had polio cases here in the United States and in Canada or so many places. I look at the Rotary experience, we have been at it for 35 years. Rotarians believe in eradicating polio. Many of these Rotarians are in countries that haven’t seen polio for a long, long time, like the United States. Rotarians have donated of their own money over one billion dollars to eradicating polio.  We’ve also gotten some matching monies from the Bill & Melinda Gates Foundation. They give to us and then we allocate to spend it where we feel it will do the most good. That has continued year after year. During this last Rotary year that ended on June 30, our goal was to raise fifty million dollars from Rotarians — five-oh — $50,000,000 in one year — and we did! And then the Gates Foundation gave us a hundred million. So we have a hundred and fifty million this year to allocate to polio.  I hear that. I know there is complacency, and I know particularly we have a challenge with younger reporters. I’m sixty-four now, so they’re all younger than me. And they don’t know polio. They don’t know Rotary. And as a result I get Rotarians who complain, “Oh they’re not talking about Rotary.” Well, it’s difficult because you know these 20-something reporters — they do a good job, but they’re just not into polio. So you know that is a challenge but we’ve had the persistence. We’ve had the passion. We’ve been very fortunate. One of the things Rotary does is we ask the U.S. government for money.  We ask Her Majesty’s government in the United Kingdom and other governments around the world. Just before COVID hit — the first week of March in fact — I was on Capitol Hill with some other Rotarians, and we were visiting — we had appointments all set up with some Senators and Congress-people and a lot of aides and committee aides. There was not a single person — Republican or Democrat or any other party they might have belonged to — that did not fully support this effort.  And that takes its way by the priorities. The US government provides monies through the Centers for Disease Control and through the U.S. Agency for International Development — about 240 million dollars a year.  It helps tremendously.  Again everyone was supportive of it including a lot of aides who are very young. It’s amazing the number of Senators and Congress people — including Mitch McConnell, the Senate majority leader — who had polio.  And if you see him walking on stage today, you can see he kind of moves along slowly. That’s because of his polio. And there are so many of them who have had family members, direct experiences, and obviously that helps as well. Yeah. There is some disconnect with younger people. But at the same time, you know fortunately, we have public policies in place that protect them and protect all of us from polio returning and to protect us from some of these other transmittable diseases.

Joyce: Yes. I think there are so many lessons we can learn from polio.  And one of the things that disturbs me is that measles is having a comeback in the United States.  We thought we had the policies in place where you have to get immunized and so forth. But there’s a breakdown of that happening right now and there’s more measles in California’s than we’ve seen in decades. How do we prevent ourselves from going backwards?

Mike: It’s sad that we have those outbreaks.  It’s sad that we have a few people in the media who mislead people.  Sadly, the way people are most convinced is when they suddenly see an outbreak. They see they see the harm that’s done, the damage that’s done, and they actually deal with the reality. I was over last year in the Democratic Republic of the Congo, in Kinshasa. They had had when I was there — in the previous couple months — over a thousand people died from measles. In that case, the fairly new president of the country called together all of the health experts in the country and all the governors of the different states, all of the chief health officials of the different states, and Rotary was there, the Gates Foundation was there, WHO, UNICEF — he brought together a forum.  It was determined leadership from the highest level of government that pointed out the seriousness of the problem and made sure that it was done. And it’s the same thing with measles or any of these other preventable diseases. You need that leadership and you need to talk. Sadly, there are always people who believe in science, who don’t believe in history. And people need to read the history; they need to know the history. Just as an aside, I’ve talked about different celebrities. If anyone wants to Google “polio and Elvis Presley” there is actually a great thing on YouTube of Elvis Presley back in the ’50s talking about the importance of getting the polio vaccine. Unfortunately, he took some other drugs along the way that didn’t help him too much, but anyway, there are some bright spots out there as well.  But it is bad what happened in California.  History can repeat itself if you don’t watch.

Joyce: Yes, “those of us who don’t learn from history are doomed to repeat it,” as has been said many times.

Mike: And we say in polio you know “it’s only a plane ride away” and you know it’s true. Particularly during the last decade we had some cases in Pakistan or some other places, and then suddenly they got transferred out to other countries. Thank goodness now the only wild polio virus that remains is in Pakistan and Afghanistan, and everyone’s working hard to try to squash it out there.

Joyce: To the importance of getting polio off the planet. Tell us a little bit about why it’s so important to get off the planet altogether.

Mike: You know if there’s a wild polio case anywhere, it can spread. You know we’ve seen that time after time. Fortunately, we’ve been able to go country by country. When Rotary began the effort to eradicate polio there were 350,000 cases a year. We got it down about three years ago to 22 cases worldwide. And those were only in Pakistan and Afghanistan. You know now we’ll probably end up with about 200 cases this year.  It can go back up.  It just takes one outbreak in one place, and then those people travel.  We had a — I live in Maine, and two weeks ago there a wedding in Millinocket, Maine, a community that had not had a COVID case. And someone had a wedding. Now they had it at an indoor facility. There was a lot of — you know, no one knows what really happened.  But 56 people came down with COVID and one person has passed away. In a community that had no COVID. Maybe they were a little over-confident; I don’t know the details.  I wasn’t at the wedding. But you know, polio is the same way.  All it takes is one person coming from one place, and they become spreaders, and there’s a lot of sadness that follows.

Joyce: Well, thank you so much. You said you live in Maine.  Tell me more about your own role in the international Polio effort.

Mike: Yes I joined Rotary in 1986, and it was right about that same time that Rotary began its efforts to eradicate polio worldwide. I was asked to give money back then, and that’s a lot of what returns did. But then I went on different positions in Rotary, ended up as an officer of their international board and of their International Foundation, and polio eradication is our number one humanitarian priority for Rotary. And we have an international PolioPlus committee made up about twelve people from totally around the world — from Sri Lanka, from Germany, Japan, the United States — really all over, and we oversee the polio program for Rotary. We are in joint meetings with the partners — the other ones have mentioned as well as GAVI [GAVI.org, the Vaccine Alliance] which I haven’t mentioned. We try to raise money from Rotarians, we advocate to governments around the world which has resulted in billions of billions of dollars from governments, and we allocate the Rotary monies themselves that we use to fund surveillance, we use to fund the actual immunization — a lot of personnel we fund small stipends that go to community-based vaccinators.  Rotarians are passionate about this.  People say, “Michael, it must be a tough job.” Well, you know. it does take time. But you know what? When you’ve got an organization with a million people who are passionate about something — or at least half of them are — you know you’re doing something that’s worthy of your time. Thank you. You know, we’re not there. A friend of mine in India said, the word “almost” is the most dangerous word in the dictionary. Deepak Kapur. He was the head of Rotary’s polio eradication efforts in India, and actually we were on a Zoom call on Saturday. We were chatting about it. But Rotary is “all in”. We are 100% committed to this.  We have been for 35 years, and we’re going to be in it until that Glorious Day. Not for the one person. But the Glorious Day when — I was going to say the one person, the last case, I feel for them — but the Glorious Day when are no cases and we don’t know exactly when that’s going to be. We need a few things to go right, we need to come out of this COVID experience whole and hopefully people accepting of vaccines.  There are some issues in Afghanistan with the Taliban, trying to keep them onboard allowing vaccinations.  There are a few challenges but we’re going to get it done. We’re going to get it done working together with our partners, with the support of government, and most of all with the support of the mothers and fathers in the individual villages.  We’re trying to get this done.

Joyce: Great, thank you so much! And you mentioned that Rotary is supporting laboratories around the world.  Surveillance is another key element in this right? We have to watch out for it and hopefully catch outbreaks before they get established.

Mike: Absolutely, you know if you live in a small village in Pakistan or somewhere in Africa and your kid begins to have signs of paralysis in the legs — whether it’s an infant or someone a little bit older — they need to go somewhere.  We fund these Local Surveillance Centers.  We take the samples that we need, and they go to these laboratories which are professionally run.  Two years ago I was in Nigeria and I went to a lab in Maiduguri, Borno [Nigeria].  It’s the town where Boko Haram got its start. [Boko Haram is a militant group working to establish an Islamic state in Nigeria, 2009-present] And they took us to a camp for sixty thousand internally displaced people. And to see those polio workers working there. The day before I was there, three people had been killed by a suicide bomber. These are the devoted.  A lot of them are polio survivors.  Anyway, they took us to one of those labs. It was in Maiduguri on sort of a hospital campus.  And I was in this room, and it was in this room where they found the very last cases of wild polio in Africa. And it was surreal, being there. But then you go outside and there is a sign on the building. It was named for a Rotarian from Oregon who was very devoted to polio eradication and helped to fund this. Unfortunately that last child — pretty young girl, I just saw a picture of her, she’s doing fine — Sadly the stopping of polio didn’t come soon enough for her, but we’re hoping it will for all children soon.

Joyce: Thank you very much, Mike.  Thank you for all you do, and I appreciate your time this morning. Congratulations on making Africa polio-free. And we hope that soon we will see the entire planet polio-free.

Mike: Thank you very much, Joyce.  We are getting there! Thank you.  Take care.

Joyce: Again congratulations to the Rotary Clubs and to everyone who has participated in PolioPlus worldwide — not only to conquer polio but also to create the infrastructure that we can use to combat this and other epidemics and pandemics that may come in the future. We hope that the world will soon be free of polio, and certainly hope that we will soon be on track to get COVID under control for everyone so that we can get back to the normal life that we have enjoyed in the past and beyond this current disruption. So thank you, everybody!

Be well, and always be a Powerful Patient. Take good care.