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Critical Preparedness Readiness and Response Actions COVID-10 2020-03-22 - FINAL-eng PDF
Critical Preparedness Readiness and Response Actions COVID-10 2020-03-22 - FINAL-eng PDF
for COVID-19
Interim guidance
22 March 2020
- Slow and stop transmission, prevent outbreaks, and delay COVID-19 is a new disease that is distinct from other SARS,
MERS, and influenza. Although coronavirus and influenza
spread
infections may present with similar symptoms, the virus
- Provide optimized care for all patients, especially the responsible for COVID-19 is different with respect to
seriously ill community spread and severity. There is still much to
- Minimize the impact of the epidemic on health systems, discover about the disease and its impact in different contexts.
social services, and economic activity Preparedness, readiness, and response actions will continue
to be driven by rapidly accumulating scientific and public
All countries should increase their level of preparedness, alert health knowledge.
and response to identify, manage, and care for new cases of
COVID-19. Countries should prepare to respond to different The Table describes the preparedness, readiness and response
public health scenarios, recognizing that there is no one-size- actions for COVID-19 for each transmission scenario.
fits-all approach to managing cases and outbreaks of COVID- Hyperlinks to WHO Technical Guidance are provided.
19. Each country should assess its risk and rapidly implement
the necessary measures at the appropriate scale to reduce both All technical guidance for WHO can be found on the WHO
COVID-19 transmission and economic, public and social website.
impacts.
1
Critical preparedness, readiness and response actions for COVID-19: interim guidance
Table 1. Critical preparedness, readiness and response actions for each transmission scenario for COVID-19
No Cases Sporadic Cases Clusters of Cases Community Transmission
Transmission scenario No reported cases. One or more cases, imported or locally Most cases of local transmission linked Outbreaks with the inability to relate
acquired. to chains of transmission. confirmed cases through chains of
transmission for a large number of cases, or
by increasing positive tests through sentinel
samples (routine systematic testing of
respiratory samples from established
laboratories.
Aim Stop transmission and prevent spread. Stop transmission and prevent spread. Stop transmission and prevent spread. Slow transmission, reduce case numbers,
end community outbreaks.
Priority areas of work
Emergency response Activate emergency response Enhance emergency response Scale up emergency response Scale up emergency response mechanisms.
mechanisms mechanisms. mechanisms. mechanisms.
Risk communication and Educate and actively communicate with Educate and actively communicate with Educate and actively communicate with Educate and actively communicate with the
public engagement the public through risk communication the public through risk communication the public through risk communication public through risk communication and
and community engagement. and community engagement. and community engagement. community engagement.
Case finding, contact Conduct active case finding, contact Enhance active case finding, contact Intensify case finding, contact tracing, Continue active case finding, continue
tracing and management tracing and monitoring; quarantine of tracing and monitoring; quarantine of monitoring, quarantine of contacts, and contact tracing where possible, especially in
contacts and isolation of cases. contacts and isolation of cases. isolation of cases. newly infected areas, quarantine of contacts,
and isolation of cases; apply self-initiated
isolation for symptomatic individuals.
Surveillance Consider testing for COVID-19 using Implement COVID-19 surveillance using Expand COVID-19 surveillance using Adapt existing surveillance systems to
existing respiratory disease surveillance existing respiratory disease surveillance existing respiratory disease surveillance monitor disease activity (e.g. through sentinel
systems and hospital-based systems and hospital-based surveillance. systems and hospital-based sites).
surveillance. surveillance.
Public health measures Hand hygiene, respiratory etiquette, Hand hygiene, respiratory etiquette, Hand hygiene, respiratory etiquette, Hand hygiene, respiratory etiquette, practice
practice social distancing. practice social distancing. practice social distancing. social distancing.
IPC Train staff in IPC and clinical Train staff in IPC and clinical Train staff in IPC and clinical Retrain staff in IPC and clinical management
management specifically for COVID-19. management specifically for COVID-19. management specifically for COVID-19. specifically for COVID-19.
Prepare for surge in health care facility Prepare for surge in health care facility Advocate for home care for mild cases, Implement health facilities surge plans.
needs, including respiratory support needs, including respiratory support and if health care systems are
and PPE. PPE. overwhelmed, and identify referral
systems for high risk groups.
2
Critical preparedness, readiness and response actions for COVID-19: interim guidance
Laboratory testing1 Test all individuals meeting the Test all individuals meeting the suspect Test all individuals meeting the If diagnostic capacity is insufficient,
suspected case definition case definition suspected case definition implement prioritized testing and measures
that can reduce spread (e.g. isolation),
Test a subset of samples from SARI/ILI Considerations in the investigation of Considerations in the investigation of including priority testing of:
surveillance for COVID-19 cases and clusters of COVID-19 cases and clusters of COVID-19. • people who are at risk of developing
severe disease and vulnerable
Test patients with unexpected clinical Clinical management of severe acute Clinical management of severe acute populations, who will require
presentation or an increase in hospital respiratory infections when novel respiratory infections when novel hospitalization and advanced care for
admissions in a specific demographic coronavirus is suspected. coronavirus is suspected. COVID-19 (see Clinical management of
group that could be COVID-19 severe acute respiratory infections when
SARI/ILI surveillance for COVID-19 and SARI/ILI surveillance for COVID-19 and novel coronavirus is suspected).
reporting: see Interim operational reporting: see Interim operational • symptomatic health workers (including
considerations for COVID-19 surveillance considerations for COVID-19 emergency services and non-clinical
using GISRS. surveillance using GISRS. staff) regardless of whether they are a
contact of a confirmed case (to protect
health workers and reduce the risk of
nosocomial transmission)
• the first symptomatic individuals in a
closed setting (e.g. schools, long term
living facilities, prisons, hospitals) to
quickly identify outbreaks and ensure
containment measures
Case management Set up screening and triage Screen and triage patients at all points of Screen and triage patients at all Screen and triage patients at all points of
strategy2 protocols at all points of access to access to the health system; points of access to the health access to the health system;
the health system; Care for all suspected and confirmed system; Care for all suspected and confirmed
patients according to disease severity Care for all suspected and confirmed patients according to disease severity and
Prepare to treat COVID-19 affected and acute care needs; patients according to disease acute care needs;
patients; Ready hospitals for surge; severity and acute care needs; Scale up surge plans for health
Ready communities for surge, including Activate surge plans for health facilities. facilities and ad-hoc community
Set up COVID-19 hotline and by setting up community facilities for facilities, including enhancement of
referral system; isolation of mild/moderate cases. COVID-19 referral system.
Ready hospitals for potential surge.
Case management Test suspect COVID-19 cases according to diagnostic strategy1
recommendations by case Mild cases and moderate cases with no risk factors:
severity and risk factors2 Isolation/cohorting in:
• Health facilities, if resources allow;
• Community facilities (i.e. stadiums, gymnasiums, hotels) with access to rapid health advice (i.e. adjacent COVID-19 designated health post, telemedicine);
• Self-isolation at home according to WHO guidance
For moderate cases with risk factors, and all severe/critical cases: Hospitalization (in-patient treatment), with appropriate isolation and cohorting.
3
Critical preparedness, readiness and response actions for COVID-19: interim guidance
Societal response Develop all-of-society and business Implement all-of-society resilience, Implement all-of-society resilience, Implement all-of-society resilience, repurpose
continuity plans. repurpose government and ready repurpose government, business government, business continuity, and
business continuity plans. continuity, and community services community services plans.
plans.
1 For full details, see WHO’s guidance Laboratory testing strategy recommendations for COVID-19 available here: https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf
2 For full details, see: WHO Guidance: Operational considerations for case management of COVID-19 in health facility and community, available here: https://apps.who.int/iris/bitstream/handle/10665/331492/WHO-2019-nCoV-
HCF_operations-2020.1-eng.pdf
4
Critical preparedness, readiness and response actions for COVID-19: interim guidance
WHO Technical Guidance for COVID-19 • A guide to preventing and addressing social stigma associated
with COVID-19
Country-level coordination, planning, and monitoring • Mental Health Considerations during COVID-19 Outbreak
• Draft operational planning guidance for UN country teams Guidance for COVID-19 in schools, workplaces and
• COVID-19 Partners Platform based on Operational Planning institutions
Guidance
• Training modules: Operational Planning Guidelines and • Key Messages and Actions for COVID-19 Prevention and
COVID-19 Partners Platform Control in Schools
• National capacities review tool for a novel coronavirus • Getting your workplace ready for COVID-19
Surveillance, rapid response teams, and case Humanitarian operations, camps and other fragile
investigation settings
• Global Surveillance for human infection with coronavirus • Interim Guidance on Scaling-up COVID-19 Outbreak in
disease (COVID-19) Readiness and Response Operations in Camps and Camp-like
• Considerations in the investigation of cases and clusters of Settings (jointly developed by IFRC, IOM, UNHCR and WHO)
COVID-19
Operational support and logistics
• Considerations for quarantine of individuals in the context of
containment for coronavirus disease (COVID-19)
• Disease commodity package
5
Critical preparedness, readiness and response actions for COVID-19: interim guidance
WHO continues to monitor the situation closely for any this interim guidance document will expire 2 years after the
changes that may affect this interim guidance. Should any date of publication.
factors change, WHO will issue a further update. Otherwise,
© World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-SA
3.0 IGO licence.