Coronavirus disease (COVID-19) technical guidance by WHO Clinical management of SARI | Page 2

Considerations in the investigation of cases and clusters of COVID-19: Interim guidance
documented for any contacts who become infected with COVID-19. Instructions can be found here:
OpenWHO website
Management of
case(s) and
contacts
COVID-19 case(s)
•
•
All patients with suspected COVID-19 who have severe acute respiratory infection should be
triaged and isolated at the first point of contact with the health care system. Emergency treatment
should be started based on disease severity. 4
For those presenting with mild illness, hospitalization may not be required unless there is concern
about rapid deterioration. If there is only mild illness, providing care at home may be considered,
with strict precautions regarding when to seek care. 5
Contacts
•
•
Collection and
testing of
specimens
For contacts of a suspected COVID-19 case, at a minimum, health authorities need to encourage
respiratory and hand hygiene and may encourage, depending on the epidemiological context and
resources available, self-monitoring for symptoms, social distancing, or quarantine.
For contacts of a laboratory-confirmed COVID-19 case, WHO recommends that such persons be
quarantined for 14 days from the last time they were exposed to a COVID-19 patient. 6
From all confirmed cases and their contacts, a respiratory sample should be collected and tested as soon as
possible, particularly contacts with symptoms. 7 Respiratory samples from quarantined persons, irrespective
of whether they have symptoms, should be sent for laboratory testing at the end of the quarantine period.
Ensure that all those involved in collection and transportation of specimens should be trained in safe
handling practices and spill decontamination procedures. 6
For laboratory-confirmed cases, 2 negative specimens at least 1 day apart indicate recovery from infection.
Based on initial data, this is estimated to be 14 days after the end of illness for mild cases of infection.
Risk
communication
Assess the initial perception of risk among affected and at-risk populations, manage expectations and
communicate uncertainties
Encourage people to adopt protective behaviours: frequent hand hygiene and good respiratory etiquette,
avoiding people with respiratory symptoms
Encourage people to call hotline (if available) or their health care provider if they have concerns/questions
or develop symptoms
Discourage use of medical masks, unless one of the following exists:
•
•
•
Reporting
Individuals with respiratory symptoms
Health care workers
Individuals in close contact (within 1 metre) of a patient with a respiratory infection
National authorities need to report probable and confirmed cases of COVID-19 to WHO within 48 hours
of identification. 8
Report using the Individual Case Reporting Form and consider transitioning to the aggregate
Daily/Weekly Reporting Form if the number of cases increases and resources are no longer available for
individual case reporting. 8
Further
investigations
Standardised epidemiological protocols have been developed for COVID-19 and are available on the WHO
website. 9 These may be initiated in addition to the public health investigation, but should not replace the
investigation:
• First few cases and contacts transmission investigation protocol, which evaluates extent of infection
among cases and their contacts
• Household transmission investigation protocol, which evaluates extent of infection within the
household setting
• Assessment of risk factors for COVID-19 among health care workers working in a health care
setting in which a confirmed COVID-19 patient is receiving care
• Surface sampling of COVID-19 virus: A practical ‘how to’ protocol for health care and public
health professionals to assess surface contamination and the role of environmental contamination
in transmission
• Global COVID-19 Clinical Characterization Case Record Form and data platform for anonymized
COVID-19 clinical data to collect clinical data to better understand the natural history of disease
and describe clinical phenotypes and treatment interventions
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