- Lao PDR’s National Games returned in December 2022, with more than 10 000 people visiting rural Xieng Khouang Province.
- The Ministry of Health, WHO and provincial officials focused on a robust preparedness programme to protect health, covering COVID-19 vaccination, disease surveillance, food safety, risk communications, and infection prevention and control in health facilities.
- The Games ended without any major outbreaks or incidents.
After a several-year hiatus, the National Games returned to Lao PDR in December 2022 in rural Xieng Khouang Province. The event brought together more than 10 000 athletes and spectators from across the country for a month of qualifiers and tournament competitions.
While an event of national significance, and a celebratory opportunity post-pandemic, any mass gathering brings health risks – particularly in a province with limited health infrastructure.
“The National Games was an amazing opportunity to come together and see the best of Lao athletes, but also an opportunity for the spread of COVID-19 and other infections, like flu or foodborne diseases,” said the Ministry of Health’s Dr Rattanaxay Phetsouvanh, Director General, Department of Communicable Diseases Control. “The Ministry of Health activated its mass gathering planning and requested WHO’s support.”
With planning and coordination funnelled via a WHO-supported Public Health Emergency Operations Centre (PHEOC), requirements to protect health were identified and responded to – including disease surveillance and outbreak response, food safety, COVID-19 vaccination, risk communications, and health facility capacity.
The priority was COVID-19 vaccination. Primary series vaccination coverage was around 66% in ethnically diverse Xieng Khouang, below the national 74%, while booster coverage was just 24% at the start of November.
Read more: Protecting 39 000 people against COVID-19 before the National Games
To address this, WHO-supported community engagement initiative CONNECT and the Ministry of Health deployed a vaccination catch-up campaign – focusing on ethnic communities, the elderly, and villages with low coverage rates.
Using various approaches, more than 39 000 people received a vaccine or a booster during the campaign, and booster coverage increased from 24% to 32%. Notably, a group of 29 “high-risk” villages saw a 246% increase in the number of people newly vaccinated compared with previous efforts.
Simultaneously, efforts began to prepare health officials for the influx of people to the province – and the potential health hazards this introduced. For WHO, this was made possible with Defense Threat Reduction Agency (DTRA) support.
Disease surveillance training was provided nearly 200 health staff, local officials and volunteers, and village leaders to enable them to better detect, identify and report potential outbreaks. This combined enhancing existing formal surveillance systems, and expanding informal reporting outside the health system (i.e. local educators could report symptoms).
“This was perhaps the most critical element,” said WHO’s Dr Otsu. “Without a clear idea of what was happening on the ground amid large crowds, the health system would struggle to respond – fortunately the teams did a superb job.
However, other challenges posed a significant risk.
“Food poisoning and food-borne disease outbreaks are common during large events and can be avoided with a few easy steps,” said Dr Bounxou Keohavong, Director General of the Ministry of Health’s Food and Drug Department.
“One of the best things about coming together to celebrate sport in beautiful Xieng Khouang Province is the wonderful food – but if you’re away from home, travelling, or competing, getting sick will stop your fun pretty fast, so, we said, ‘Safe food good health’.”
Addressing this challenge, the Ministry of Health, provincial officials and WHO launched a food safety training and inspection programme – providing refresher training to local inspectors, restaurants, markets and hotels, and supporting inspections and assessments.
While behind-the-scenes preparations were underway for the health sector, a very noticeable aspect of the games was beginning – the arrival of thousands of athletes. Many would be scattered around various school halls temporarily converted into dorms, at guest houses and hotels – and eating at temporary market stalls and dining halls between events.
Ensuring that they were COVID-19 vaccinated ahead of time, aware of food safety and general health advice – and encouraged to follow the advice – was essential.
Alongside traditional updates in national media, a WHO-led health campaign recruited nine young athletes to provide health advice via a massive social media campaign, in collaboration with UNICEF, UNFPA and UNDP.
“During the campaign, material was seen more than 17.3 million times by young people across the country, particularly those heading to the games, with trusted advice from notable athletes, delivering more than 3.96 million engagements,” said WHO communications specialist Soudaphone Viravongsa.
“This was supported by large events and promotions at major venues, QR-code posters to access health advice online, regular reminders in newspapers and, as well as promotion of a smoke-free games.”
Lastly, on the clinical side, WHO and the Ministry of Health began intensive efforts to further enhance local healthcare services – particularly infection prevention and control (IPC), a critical issue amid potential disease outbreaks.
With European Union (EU) support, WHO delivered IPC training in three hospitals in Xieng Khouang Province. This involved refresher training for 50 healthcare workers on monitoring IPC measures, developing facility-specific improvement plans to address gaps, and best practices with patient care equipment.
“We should only be getting better when accessing healthcare, but infections and the spread of disease can occur in a hospital setting,” said the Ministry of Health’s Dr Somchanh Thounsavath, Deputy Director General of the Department of Healthcare and Rehabilitation.
“This can be prevented with the right efforts and actions which, for the National Games, were deployed via training on decontamination of medical equipment and devices and use of version three of Lao PDR IPC assessment tool.”
As a result of strong preparation, the first National Games since 2014 took place with no major outbreaks or incidents.
“For Lao PDR’s first major event since COVID-19, it was a matter of refreshing, proper planning, and coordination, to ensure an effective response,” said WHO Representative Dr Ying-Ru Lo.
“The prospect of a return to normal life is exciting, but we must manage it safely – and in this case, hard work by the Ministry of Health and provincial teams ensured this was the case.”
WHO’s efforts to support the Ministry of Health and Xieng Khouang Province officials around the National Games included COVID-19 vaccination outreach efforts, disease surveillance, food safety, risk communications, and infection prevention and control in health facilities. WHO’s technical assistance was made possible due to support from EU, USAID and DTRA, with CONNECT supported by the EU, KOFIH, USAID and Luxembourg.