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editorial
. 2020 Feb 25;52(1):105–109. doi: 10.3947/ic.2020.52.1.105

Table 1. Practical suggestions for contingency plans.

Settings Suggestions
Triage • Dedicated triage/walk-in clinic for patients with acute respiratory infections.
• Room/area for specimen collection can be a delicate issue.
• Transport and testing capacities should be provided.
Acute respiratory illness clinics • Test for influenza and consider preemptive oseltamivir.
• Advise to revisit 3–5 days later for further evaluation (SARS-CoV-2 test and chest X-ray) if no improvement seen.
Patient isolation in the healthcare settings • Operate dedicated wards, preferably in a building separated from the rest of the facilities.
• Separate route of movement, preferably with dedicated corridors and elevators.
• Temporary airborne infections isolation rooms (AIIR) using mobile negative-air machines or by adjusting ventilation can be alternatives for fully equipped AIIRs.
Procedures and tests • Avoid unnecessary aerosol-generating procedures (AGP).
• If necessary, perform AGPs in AIIR by trained personnel with proper personal protective equipment (PPE).
• Most radiologic test rooms are not equipped to meet the requirement for AIIR – separate dedicated radiology suites are ideal; if unavailable, consider adjusting ventilation to generate negative pressure. Advance knowledge on air change per hour would be helpful to determine safe interval between tests.
• Avoid futile care.
Personnel • Train medical and non-medical personnel for adequate use of PPE and providing care with PPE donned.
• Healthcare workers (HCW) who provides specialized care (e.g., intensive care, respiratory care, renal replacement) should be trained to perform expected activities with PPE.
• Consider differential level of PPE according to risk.
• Plan contingency work shifts with limited number of HCWs in case of mass isolation after unexpected exposure.
• Vaccination for influenza and pneumococcus, as indicated.
Contact tracing • Prepare effective and easy methods for contact tracing.
• Prioritize effort to clusters and high-risk events.
• Monitor human behavior.
• Home quarantine of close contacts with financial and emotional support.
Healthcare system • Telemedicine and/or electronic subscription for patients at risk.
• Designating hospitals for COVID-19 care.
Public education (nonpharmaceutical interventions) • Personal hygiene: hand hygiene, respiratory etiquette.
• Staying home when feeling ill (voluntary home isolation).
• Wearing facemasks when feeling ill or at crowded places.
• Cancellation of mass gathering.
• Social distancing: increase the distance between persons when possible.
• Cleaning frequently touched surfaces and objects.
• Staying home for people who are old (>65 years) or who have chronic illnesses.
• Vaccination for influenza and pneumococcus, as indicated.