Case management in Facilities - Revision history

Bosmana at 10:22, 21 March 2020

2020-03-21T10:22:51Z

Bosmana: /* Immediate public health interventions */

2020-03-21T10:17:20Z

‎Immediate public health interventions

Bosmana: /* Table 3 Summary of immediate public health interventions, irrespective of transmission scenario */

2020-03-21T10:16:34Z

‎Table 3 Summary of immediate public health interventions, irrespective of transmission scenario

Bosmana at 10:15, 21 March 2020

2020-03-21T10:15:28Z

Arnold at 07:48, 21 March 2020

2020-03-21T07:48:15Z

Arnold: /* References */

2020-03-21T07:47:24Z

‎References

Arnold at 07:46, 21 March 2020

2020-03-21T07:46:57Z

Arnold at 07:41, 21 March 2020

2020-03-21T07:41:16Z

Arnold: /* Table 3 Summary of immediate public health interventions, irrespective of transmission scenario */

2020-03-21T07:26:13Z

‎Table 3 Summary of immediate public health interventions, irrespective of transmission scenario

Arnold: /* Table 3 Summary of immediate public health interventions, irrespective of transmission scenario */

2020-03-21T07:24:30Z

‎Table 3 Summary of immediate public health interventions, irrespective of transmission scenario

@@ Line 25: / Line 25: @@
 =Scenarios of transmission=
-Countries or subnational areas will have to respond rapidly to one or more epidemiological scenarios. Currently, four transmission scenarios are observed:<Ref name="WHO-preparedness2020">World Health Organization. Critical preparedness, readiness and response actions for COVID-19.</ref>
+Countries or subnational areas will have to respond rapidly to one or more epidemiological scenarios. Currently, four transmission scenarios are observed:<Ref name="WHO-preparedness2020">World Health Organization. [https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2-eng.pdf Critical preparedness, readiness and response actions for COVID-19.]</ref>
 # Countries with no cases (no cases);
 # Countries with one or more cases, imported or locally acquired (sporadic cases);
@@ Line 45: / Line 45: @@
 Test suspected COVID-19 cases according to diagnostic strategy. Isolation/ cohorting in:
 * Health facilities, if resources allow;
-* Community facilities (e.g. stadiums, gymnasiums, hotels) with access to rapid health advice (i.e. adjacent COVID-19 designated health post/EMT-type 1, telemedicine)<Ref name=“4”> World Health Organization. Emergency Medical Teams Initiative: Guidance and Publications.</ref>;
+* Community facilities (e.g. stadiums, gymnasiums, hotels) with access to rapid health advice (i.e. adjacent COVID-19 designated health post/EMT-type 1, telemedicine)<Ref name=“4”> World Health Organization. [https://extranet.who.int/emt/guidelines-and-publications Emergency Medical Teams Initiative: Guidance and Publications.]</ref>;
 Self-isolation at home according to WHO guidance.
 |-
@@ Line 116: / Line 116: @@
+|
 # Undertake a health facility readiness assessment to evaluate established health facilities response capacity.
-# Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.<Ref name=“6”> World Health Organization. Infection prevention and control during health care when COVID-19 is suspected.</ref>
+# Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.<Ref name=“6”> World Health Organization. [https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125 Infection prevention and control during health care when COVID-19 is suspected].</ref>
-# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.<Ref name="who7">World Health Organization. Basic Emergency Care: approach to the acutely ill and injured.</ref>
+# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.<Ref name="who7">World Health Organization. [https://www.who.int/publications-detail/basic-emergency-care-approach-to-the-acutely-ill-and-injured Basic Emergency Care: approach to the acutely ill and injured].</ref>
 # Develop a supply procurement and distribution plan for personal protective equipment (PPE) and biomedical equipment (including oxygen, ventilators), including contingency plan for shortages.
 # Develop policies for visitor restriction, e.g. visitors to confirmed cases or visitors who are sick with acute respiratory infection (ARI), including for parents or caregivers accompanying minor patients.
@@ Line 130: / Line 130: @@
 # Strengthen measures for protection of occupational health, safety, and security of health workers – prevention of violence, addressing fatigue, and access to health care and social support.
 |-
-| Referral system readiness <Ref name="paho8">Pan American Health Organization. Prehospital Emergency Medical Services Readiness Checklist for COVID-19: Instructive.</ref>
+| Referral system readiness <Ref name="paho8">Pan American Health Organization. [https://www.paho.org/en/documents/prehospital-emergency-medical-system-readiness-checklist-covid-19 Prehospital Emergency Medical Services Readiness Checklist for COVID-19: Instructive.]</ref>
 |# Communicate the details of COVID-19 designated facilities to all command and dispatch centres for appropriate destination triage.
-# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport <ref name="who9"> World Health Organization. Rational use of personal protective equipment for coronavirus diseases (COVID-19).</ref> and that vehicles are disinfected properly.
+# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport <ref name="who9"> World Health Organization. [https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2-eng.pdf Rational use of personal protective equipment for coronavirus diseases (COVID-19)].</ref> and that vehicles are disinfected properly.
 # Consider establishing expanded screening and appropriate referral pathways in community settings (e.g. fever clinics).
 |-

@@ Line 130: / Line 130: @@
 # Strengthen measures for protection of occupational health, safety, and security of health workers – prevention of violence, addressing fatigue, and access to health care and social support.
 |-
-| Referral system readiness <Ref name="8">Pan American Health Organization. Prehospital Emergency Medical Services Readiness Checklist for COVID-19: Instructive.</ref>
+| Referral system readiness <Ref name="paho8">Pan American Health Organization. Prehospital Emergency Medical Services Readiness Checklist for COVID-19: Instructive.</ref>
 |# Communicate the details of COVID-19 designated facilities to all command and dispatch centres for appropriate destination triage.
-# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport <ref name="9"> World Health Organization. Rational use of personal protective equipment for coronavirus diseases (COVID-19).</ref> and that vehicles are disinfected properly.
+# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport <ref name="who9"> World Health Organization. Rational use of personal protective equipment for coronavirus diseases (COVID-19).</ref> and that vehicles are disinfected properly.
 # Consider establishing expanded screening and appropriate referral pathways in community settings (e.g. fever clinics).
 |-

@@ Line 117: / Line 117: @@
 # Undertake a health facility readiness assessment to evaluate established health facilities response capacity.
 # Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.<Ref name=“6”> World Health Organization. Infection prevention and control during health care when COVID-19 is suspected.</ref>
-# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.<Ref name="7">World Health Organization. Basic Emergency Care: approach to the acutely ill and injured.</ref>
+# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.<Ref name="who7">World Health Organization. Basic Emergency Care: approach to the acutely ill and injured.</ref>
 # Develop a supply procurement and distribution plan for personal protective equipment (PPE) and biomedical equipment (including oxygen, ventilators), including contingency plan for shortages.
 # Develop policies for visitor restriction, e.g. visitors to confirmed cases or visitors who are sick with acute respiratory infection (ARI), including for parents or caregivers accompanying minor patients.
@@ Line 153: / Line 153: @@
 # Develop a consultative and collaborative mechanism to establish non-urgent care priorities.
 |}
 = Key clinical and IPC activities for different transmission scenarios=

@@ Line 98: / Line 98: @@
 |}
-= Immediate public health interventions
+= Immediate public health interventions=
 ==Table 3 Summary of immediate public health interventions, irrespective of transmission scenario ==
@@ Line 117: / Line 117: @@
 # Undertake a health facility readiness assessment to evaluate established health facilities response capacity.
 # Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.<Ref name=“6”> World Health Organization. Infection prevention and control during health care when COVID-19 is suspected.</ref>
-# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.7.
+# Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.<Ref name="7">World Health Organization. Basic Emergency Care: approach to the acutely ill and injured.</ref>
 # Develop a supply procurement and distribution plan for personal protective equipment (PPE) and biomedical equipment (including oxygen, ventilators), including contingency plan for shortages.
 # Develop policies for visitor restriction, e.g. visitors to confirmed cases or visitors who are sick with acute respiratory infection (ARI), including for parents or caregivers accompanying minor patients.
@@ Line 130: / Line 130: @@
 # Strengthen measures for protection of occupational health, safety, and security of health workers – prevention of violence, addressing fatigue, and access to health care and social support.
 |-
-| Referral system readiness8
+| Referral system readiness <Ref name="8">Pan American Health Organization. Prehospital Emergency Medical Services Readiness Checklist for COVID-19: Instructive.</ref>
 |# Communicate the details of COVID-19 designated facilities to all command and dispatch centres for appropriate destination triage.
-# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport9 and that vehicles are disinfected properly.
+# Dedicate transfer vehicles and ambulances for all suspected or confirmed COVID-19. Ensure that IPC measures are always respected during patient retrieval and transport <ref name="9"> World Health Organization. Rational use of personal protective equipment for coronavirus diseases (COVID-19).</ref> and that vehicles are disinfected properly.
 # Consider establishing expanded screening and appropriate referral pathways in community settings (e.g. fever clinics).
 |-
@@ Line 227: / Line 227: @@
 =References=
 <References/>

@@ Line 1: / Line 1: @@
 Date: 19 March 2020
 Source: WHO
 =Background=

@@ Line 220: / Line 220: @@
 =References=
-</References>
+<References/>
 Not referred:

@@ Line 39: / Line 39: @@
 Test suspected COVID-19 cases according to diagnostic strategy. Isolation/ cohorting in:
 * Health facilities, if resources allow;
-* Community facilities (e.g. stadiums, gymnasiums, hotels) with access to rapid health advice (i.e. adjacent COVID-19 designated health post/EMT-type 1, telemedicine)<Ref name=“4”>ref 4</ref>;
+* Community facilities (e.g. stadiums, gymnasiums, hotels) with access to rapid health advice (i.e. adjacent COVID-19 designated health post/EMT-type 1, telemedicine)<Ref name=“4”> World Health Organization. Emergency Medical Teams Initiative: Guidance and Publications.</ref>;
 Self-isolation at home according to WHO guidance.
 |-
@@ Line 76: / Line 76: @@
 # Care for all COVID-19 patients in the designated treatment area, according to disease severity and acute care needs according to the recommendations in Table 1.
 # Surge by repurposing wards or ICUs into COVID-19 wards and hospitals.
-# Where health facilities can no longer manage patients with mild or moderate disease, isolate patients who are not at high risk for severe disease (< 60 years of age, no co-morbid diseases) either in community facilities (e.g. stadium, gymnasium, hotel, or tent) with access to rapid health advice (i.e. via adjacent dedicated COVID-19 health post, telemedicine) or at home according to WHO guidance.
+# Where health facilities can no longer manage patients with mild or moderate disease, isolate patients who are not at high risk for severe disease (< 60 years of age, no co-morbid diseases) either in community facilities (e.g. stadium, gymnasium, hotel, or tent) with access to rapid health advice (i.e. via adjacent dedicated COVID-19 health post, telemedicine) or at home according to WHO guidance.<Ref name=“5”> World Health Organization. Emergency Medical Teams Initiative: Guidance and Publications.
 # If patient develops symptoms that may correspond to complications, ensure rapid referral to hospital.
 # Plan for new structures to augment the health system based on the assumption that the number of cases will double every 3 to 7 days subject to the effectiveness of public health interventions.
@@ Line 109: / Line 110: @@
+|
 # Undertake a health facility readiness assessment to evaluate established health facilities response capacity.
-# Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.6.
+# Establish or reinforce screening and triage protocols at all points of first access to the health system, including primary health care centres, clinics, and hospital emergency units.<Ref name=“6”> World Health Organization. Infection prevention and control during health care when COVID-19 is suspected.</ref>
 # Ensure that each facility is able to implement basic emergency care (BEC) for seriously ill patients and then activate referral.7.
 # Develop a supply procurement and distribution plan for personal protective equipment (PPE) and biomedical equipment (including oxygen, ventilators), including contingency plan for shortages.
@@ Line 199: / Line 200: @@
 | Expand COVID-19 patient care areas by a factor of 5- 8.
 |}
 =References=

@@ Line 133: / Line 133: @@
 ## COVID-19 treatment areas should be designed to allow implementation of all required IPC interventions.
 ## COVID-19 treatment areas should be designed to deliver life-saving oxygen therapy. Most patients hospitalized with severe disease will need oxygen, and a smaller proportion will require ventilation.
-|-
+# Establish COVID-19 surge plan.
-| Establish COVID-19 surge plan.
+## Plan for repurposing of wards for severely or critically ill patients.
-| Plan for repurposing of wards for severely or critically ill patients. 2. Plan for community facilities for isolation of mild or moderate patients or for self-isolation at home. 3. Re-evaluate COVID-19 discharge criteria and disposition during recovery period.
+## Plan for community facilities for isolation of mild or moderate patients or for self-isolation at home.
 |-
 | Maintain essential health services
-| Establish simplified, purpose-designed, governance, and coordination mechanisms to complement response protocols. The impact of repurposing health system capacities for COVID-19 care should be evaluated on a regular basis. 2. Ensure context-relevant core health services and business continuity are not compromised. 3. Optimize or modify service delivery platforms as per context-relevant core health services. 4. Redistribute health workforce capacity as needed. 4. Develop a consultative and collaborative mechanism to establish non-urgent care priorities.
 |}
 =References=

@@ Line 99: / Line 99: @@
 |-
 |  Community messaging
 |  Messages should include the following:
 # COVID-19 symptoms: distinction between mild symptoms versus severe symptoms. Mild patients should be isolated to reduce transmission and told to self-isolate at home and call COVID informational line for advice on testing and referral. Mild and moderate patients may be isolated either in health facility, community facilities (e.g. stadium, gymnasium, hotel or tent) with access to rapid health advice (i.e. adjacent COVID-19 dedicated health post/EMT-type 1, telemedicine) or self- isolate at home. Severely ill patients should call COVID hotline to seek emergency referral to health facility.