Coronavirus disease (COVID-19) technical guidance by WHO Responding to community spread of COVID-19 | Page 3

Responding to community spread of COVID-19: Interim guidance
Training: OpenWHO Critical Care Severe Acute Respiratory
Infection (SARI).
Module 1: Introduction to nCoV and IPC
Module 2: Clinical syndromes and pathophysiology of sepsis
and ARDs.
Module 3: Triage
Module 4: Monitoring
Module 5: Diagnostics
Module 6: Oxygen therapy
Module 7: Antimicrobials
Module 8: Sepsis
Module 9: Mechanical ventilation
Module 10: Sedation
Module 11: Best practices to prevent complications
Module 12: Liberation from mechanical ventilation
Module 13: Quality in critical care
Module 14: Pandemic preparedness and ethical
considerations.
Available in English.
Case management and health services
Summary
Health care facilities should be prepared for a significant
increase of COVID-19 cases while maintaining provision of
essential health services. Triage systems will be needed to
reduce the risk of exposing other persons or patients to
COVID-19, to prioritise treatment for severe and high-risk
patients and to manage demands on staff, facilities, and
supplies. For many countries, the private sector will be a key
partner in provision of health services.
Recommended actions
Highest priority:
 Set up surge triage, screening areas, treatment and
critical care units (including staffing, space and
supplies, including oxygen) at health facilities.
 Disseminate guidance to health providers for
COVID-19 and severe acute respiratory infections
using international and WHO standards, including
for community care.
 Make guidance available for home care of patients
with mild COVID-19 symptoms and recommend
when referral to healthcare facilities is advised if
symptoms worsen.
 Support comprehensive medical, nutritional, and
psycho-social care for people with COVID-19.
 Maintain routine and emergency health service
provision for the population.
Secondary priority
 Update training of and refresh medical/ambulatory
teams.
 Participate in clinical expert networks to aid in
clinical characterization of COVID-19, address
challenges in clinical care, foster global
collaboration.
Infection prevention and control
Summary
Health care facilities should prepare for a significant increase
of COVID-19 cases. Staff should be able to recognise signs
and symptoms, identify known complications, and administer
appropriate treatment while protecting themselves.
Preventing infection in health workers and avoiding the
spread of COVID-19 amongst patients is key for successful
prevention and response, protects the health work force and
maintains confidence in the health care system. The private
sector should be included in all IPC planning and activities.
Recommended actions
Highest priority:
 Identify and mobilize trained staff with the authority
and technical expertise to implement IPC activities
at vulnerable health facilities.
 Implement triage, early detection, administrative,
environmental and engineering controls, personal
protective equipment. Provide visual alerts
(educational materials in appropriate languages) for
patients and families for triage of respiratory
symptoms and to practice respiratory etiquette.
 Define patient referral pathways and a national plan
for ensuring personal protective equipment (PPE)
supply management and human resource surge
capacity (numbers and competence).
 Implement a plan for monitoring health personnel
exposed to confirmed COVID-19 cases for
respiratory illness and for reporting healthcare-
associated infections.
Secondary priority
 Monitor IPC and WASH implementation in
selected health facilities and public spaces using
the IPC Assessment Framework, the Hand Hygiene
Self-Assessment Framework, hand hygiene
compliance observation tools, and the
WASH Facilities Improvement Tool.
Resources
Clinical management of severe acute respiratory infection
when COVID-19 is suspected.
Intended for clinicians caring for hospitalised adult and
paediatric patients with severe acute respiratory infection
when COVID-19 infection suspected.
Available in English and Russian.
Home care for patients with suspected novel coronavirus
(COVID-19) infection presenting with mild symptoms.
WHO recommendations on safe home care for patients with
suspected novel coronavirus (COVID-19) infection
presenting with mild symptoms.
Available in English and Russian.
Coming soon: Guidance on a safe and adequate blood supply
for COVID-19.
Coming soon: Hospital preparedness for COVID-19
Global guidance in development. Currently, PAHO and
EURO guidance are available.
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