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. |