Coronavirus disease (COVID-19) technical guidance by WHO Infection prevention and control | Page 3

Infection prevention and control during health care when COVID-19 is suspected: interim guidance
4.
Collecting and handling laboratory specimens
from patients with suspected COVID-19.
Implementing administrative controls
2
Administrative controls and policies for the prevention and
control of transmission of COVID-19 within the health care
setting include, but may not be limited to: establishing
sustainable IPC infrastructures and activities; educating
patients’ caregivers; developing policies on the early
recognition of acute respiratory infection potentially caused
by COVID-19 virus; ensuring access to prompt laboratory
testing for identification of the etiologic agent; preventing
overcrowding, especially in emergency departments;
providing dedicated waiting areas for symptomatic patients;
appropriately isolating hospitalized patients; ensuring
adequate supplies of PPE; and ensuring adherence to
IPC policies and procedures for all aspects of health care.
All specimens collected for laboratory investigations should
be regarded as potentially infectious. HCWs who collect,
handle, or transport clinical specimens should adhere
rigorously to the following standard precaution measures and
biosafety practices to minimize the possibility of exposure to
pathogens. 16,17,18

4.1 Administrative measures related to health
care workers.
 provision of adequate training for HCWs;
 ensuring an adequate patient-to-staff ratio;
 establishing a surveillance process for acute
respiratory infections potentially caused by
COVID-19 virus among HCWs;
 ensuring that HCWs and the public understand the
importance of promptly seeking medical care;
 monitoring HCW compliance with standard
precautions and providing mechanisms for
improvement as needed.
5.
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Using environmental and engineering controls

These controls address the basic infrastructure of the health
care facility 14 and aim to ensure adequate ventilation 10 in all
areas in the health care facility, as well as adequate
environmental cleaning.

Additionally, separation of at least 1 metre should be
maintained between all patients. Both spatial separation and
adequate ventilation can help reduce the spread of many
pathogens in the health care setting. 15
ensure that HCWs who collect specimens use
appropriate PPE (i.e. eye protection, a medical mask,
a long-sleeved gown, and gloves). If the specimen is
collected during an aerosol-generating procedure,
personnel should wear a particulate respirator at
least as protective as a NIOSH-certified N95, an
EU standard FFP2, or the equivalent;
ensure that all personnel who transport specimens
are trained in safe handling practices and spill
decontamination procedures; 8
place specimens for transport in leak-proof
specimen bags (secondary containers) that have a
separate sealable pocket for the specimen (a plastic
biohazard specimen bag), with the patient’s label on
the specimen container (the primary container), and
a clearly written laboratory request form;
ensure that laboratories in health care facilities
adhere to appropriate biosafety practices and
transport requirements, according to the type of
organism being handled;
deliver all specimens by hand whenever possible.
DO NOT use pneumatic-tube systems to transport
specimens;
document clearly each patient’s full name, date of
birth and “suspected COVID-19” on the laboratory
request form. Notify the laboratory as soon as
possible that the specimen is being transported.
Recommendation for outpatient care
Ensure that cleaning and disinfection procedures are followed
consistently and correctly. 9 Cleaning environmental surfaces
with water and detergent and applying commonly used
hospital disinfectants (such as sodium hypochlorite) is
effective and sufficient. 8 Manage laundry, food service
utensils and medical waste in accordance with safe routine
procedures.
The basic principles of IPC and standard precautions should
be applied in all health care facilities, including outpatient
care and primary care. For COVID-19, the following
measures should be adopted:


Duration of contact and droplet precautions
for patients with COVID-19.



Standard precautions should be applied at all times.
Additional contact and droplet precautions should continue
until the patient is asymptomatic. More comprehensive
information about the mode of virus transmission is required
to define the duration of additional precautions.

- 3-
triage and early recognition;
emphasis on hand hygiene, respiratory hygiene, and
medical masks to be used by patients with
respiratory symptoms;
appropriate use of contact and droplet precautions
for all suspected cases;
prioritization of care of symptomatic patients;
when symptomatic patients are required to wait,
ensure they have a separate waiting area;
educate patients and families about the early
recognition of symptoms, basic precautions to be
used, and which health care facility they should
go to.