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WHO 2019 nCoV IPC 2020.3 Eng PDF
WHO 2019 nCoV IPC 2020.3 Eng PDF
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Infection prevention and control during health care when COVID-19 is suspected: interim guidance
wash hands with soap and water when they are HCWs should refrain from touching eyes, nose, or
visibly soiled. mouth with potentially contaminated gloved or bare
The rational, correct, and consistent use of PPE also helps hands;
reduce the spread of pathogens. PPE effectiveness depends avoid moving and transporting patients out of their
strongly on adequate and regular supplies, adequate staff room or area unless medically necessary. Use
training, appropriate hand hygiene, and appropriate human designated portable X-ray equipment or other
behaviour. 2,5,6,7 designated diagnostic equipment. If transport is
required, use predetermined transport routes to
It is important to ensure that environmental cleaning and
minimize exposure for staff, other patients and
disinfection procedures are followed consistently and
visitors, and have the patient wear a medical mask;
correctly. Thoroughly cleaning environmental surfaces with
ensure that HCWs who are transporting patients
water and detergent and applying commonly used hospital-
perform hand hygiene and wear appropriate PPE as
level disinfectants (such as sodium hypochlorite) are effective
described in this section;
and sufficient procedures.8 Medical devices and equipment,
laundry, food service utensils, and medical waste should be notify the area receiving the patient of any necessary
managed in accordance with safe routine procedures.2,9 precautions as early as possible before the patient’s
arrival;
3. Implementing empiric additional precautions routinely clean and disinfect surfaces with which the
patient is in contact;
3.1 Contact and droplet precautions limit the number of HCWs, family members, and
in addition to using standard precautions, all visitors who are in contact with suspected or
individuals, including family members, visitors and confirmed COVID-19 patients;
HCWs, should use contact and droplet precautions maintain a record of all persons entering a patient’s
before entering the room of suspected or confirmed room, including all staff and visitors.
COVID-19 patients;
patients should be placed in adequately ventilated
single rooms. For general ward rooms with natural 3.2 Airborne precautions for aerosol-generating
ventilation, adequate ventilation is considered to be procedures.
60 L/s per patient;10 Some aerosol-generating procedures, such as tracheal
when single rooms are not available, patients intubation, non-invasive ventilation, tracheotomy,
suspected of having COVID-19 should be grouped cardiopulmonary resuscitation, manual ventilation before
together; intubation, and bronchoscopy, have been associated with an
all patients’ beds should be placed at least 1 metre increased risk of transmission of coronaviruses.12,13
apart regardless of whether they are suspected to
have COVID-19; Ensure that HCWs performing aerosol-generating procedures:
where possible, a team of HCWs should be perform procedures in an adequately ventilated
designated to care exclusively for suspected or room – that is, natural ventilation with air flow of at
confirmed cases to reduce the risk of transmission; least 160 L/s per patient or in negative- pressure
HCWs should use a medical maska rooms with at least 12 air changes per hour and
(for specifications, see reference 2); controlled direction of air flow when using
HCWs should wear eye protection (goggles) or mechanical ventilation;10
facial protection (face shield) to avoid use a particulate respirator at least as protective as a
contamination of mucous membranes; US National Institute for Occupational Safety and
HCWs should wear a clean, non-sterile, Health (NIOSH)-certified N95, European Union
long-sleeved gown; (EU) standard FFP2, or equivalent.2,13 When HCWs
HCWs should also use gloves; put on a disposable particulate respirator, they must
the use of boots, coverall, and apron is not required always perform the seal check. 13 Note that facial hair
during routine care; (e.g. a beard) may prevent a proper respirator fit;13
after patient care, appropriate doffing and disposal use eye protection (i.e. goggles or a face shield);
of all PPE and hand hygiene should be carried out.5,6 wear a clean, non-sterile, long-sleeved gown and
A new set of PPE is needed when care is given to a gloves. If gowns are not fluid-resistant, HCWs
different patient; should use a waterproof apron for procedures
equipment should be either single-use and expected to create high volumes of fluid that might
disposable or dedicated equipment penetrate the gown;2
(e.g. stethoscopes, blood pressure cuffs and limit the number of persons present in the room to
thermometers). If equipment needs to be shared the absolute minimum required for the patient’s care
among patients, clean and disinfect it between use and support.
for each individual patient (e.g. by using ethyl
alcohol 70%);9
a Medical masks are surgical or procedure masks that are flat or pleated
(some are like cups); they are affixed to the head with straps.2
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Infection prevention and control during health care when COVID-19 is suspected: interim guidance
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Infection prevention and control during health care when COVID-19 is suspected: interim guidance
References (http://www.who.int/csr/resources/publications/respirat
orsealcheck/en/, accessed 17 January 2020). For the
latest information, please consult the WHO coronavirus
1. World Health Organization. Infection prevention and
webpage
control during health care for probable or confirmed
(http://www.who.int/csr/disease/coronavirus_infections/
cases of Middle East respiratory syndrome coronavirus
en/).
(MERS-CoV) infection: interim guidance (accessed
14. Adams J, Bartram J, Chartier Y, editors. Essential
17 January 2020).
environmental health standards in health care. Geneva:
2. World Health Organization. Infection prevention and
World Health Organization; 2008
control of epidemic- and pandemic-prone acute
(https://apps.who.int/iris/handle/10665/43767, accessed
respiratory diseases in health care. (accessed
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17 January 2020).
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3. World Health Organization. Guidelines on core Ansary LA, Bawazeer GA et al. Physical interventions
components of infection prevention and control to interrupt or reduce the spread of respiratory viruses.
programmes at the national and acute health care Cochrane Database Syst. Rev. 2011, 7:CD006207.
facility level. Geneva: World Health Organization; (http://onlinelibrary.wiley.com/doi/10.1002/14651858.
2016 (accessed 20 January 2020). CD006207.pub4/abstract;jsessionid=074644E776469A
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control. Geneva: World Health Organization; 2019 17 January 2020).
(https://www.who.int/infection- 16. Laboratory testing for 2019 novel coronavirus (2019-
prevention/publications/min-req-IPC-manual/en/,
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global patient safety challenge – clean care is safer care. (https://apps.who.int/iris/bitstream/handle/10665/33067
Geneva: World Health Organization; 2009 6/9789240000971-eng.pdf).
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17 January 2020). coronavirus: interim guidance (revised), January 2018.
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2008 2/WHO-MERS-LAB-15.1-Rev1-2018-
(http://www.who.int/csr/resources/publications/putonta eng.pdf?sequence=1, accessed 17 January 2020).
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7. Rational use of PPE World Health Organization; 2004
8. CDC and ICAN. Best Practices for Environmental (https://apps.who.int/iris/handle/10665/42981, accessed
Cleaning in Healthcare Facilities in Resource-Limited 17 January 2020).
Settings. Atlanta, GA: US Department of Health and
Human Services, CDC; Cape Town, South Africa:
Infection Control Africa Network; 2019.
(https://www.cdc.gov/hai/prevent/resource-
limited/environmental-cleaning.html and Acknowledgements
http://www.icanetwork.co.za/icanguideline2019/,
accessed 20 January 2020).
9. Decontamination and Reprocessing of Medical Devices The original version of the MERS-CoV IPC guidance1 was
for Health-care Facilities. Geneva: World Health developed in consultation with WHO’s Global Infection
Organization; 2016 (https://www.who.int/infection- Prevention and Control Network and Emerging Diseases
prevention/publications/decontamination/en/, accessed Clinical Assessment and Response Network, and other
20 January 2020). international experts. WHO thanks those who were involved
10. Atkinson J, Chartier Y, Pessoa-Silva CK, Jensen P, Li in developing and updating the IPC documents.
Y, Seto WH, editors. Natural ventilation for infection
control in health-care settings. Geneva: World Health This document was developed in consultation with the
Organization; 2009 WHO Global Infection Prevention and Control Network and
(https://apps.who.int/iris/handle/10665/44167, accessed other international experts. WHO thanks the following for
17 January 2020). their review (in alphabetical order):
11. Hui DS. Epidemic and emerging coronaviruses (severe
acute respiratory syndrome and Middle East respiratory Abdullah M Assiri, Director General, Infection
syndrome). Clin Chest Med. 201738:71−86. Control, Ministry of Health, Saudi Arabia.
doi:10.1016/j.ccm.2016.11.007. Michael Bell, Deputy Director of Division of
12. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Healthcare Quality Promotion, Centers for Disease
Aerosol generating procedures and risk of transmission Control and Prevention, Atlanta, USA.
of acute respiratory infections to healthcare workers: a Gail Carson, ISARIC Global Support Centre,
systematic review. PLoS One. 2012;7:e35797. doi: Director of Network Development, Consultant in
10.1371/journal.pone.0035797. Epub 2012 Apr 26. Infectious Diseases and Honorary Consultant
13. How to perform a particulate respirator seal check. Public Health England, United Kingdom.
Geneva: World Health Organization; 2008.
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Infection prevention and control during health care when COVID-19 is suspected: interim guidance
© World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-
SA 3.0 IGO licence.