Table 2.

Roles of CHWs to INTERRUPT the COVID-19 epidemic25

Prevent	Leverage evidence-based behaviour change strategies and widely accessible mobile technologies to educate communities regarding signs, symptoms and transmission routes. Lead skill building for personal preventive measures such as social distancing, hand hygiene, coughing/sneezing into elbows and wash interventions. Organise hand hygiene stations in communities and health facilities and mobilise local residents to use them.26 Support, lead or reinforce community and facility-based infection prevention and control measures, such as construction of triage areas and use of PPE.
Detect*	Follow protocols designed to ensure the physical safety and health of CHWs and, with supervision from nurses, identify signs and symptoms in community members, support safe collection of samples in communities and health facilities, and facilitate rapid transport to laboratories for analysis, thus reducing risks of nosocomial transmission. Where available, conduct COVID-19 rapid tests.27 CHWs should only be tasked with responsibilities if they can be regularly supplied with the key materials necessary to conduct those tasks and protect themselves. Enter alerts into community events-based surveillance systems.26
Respond	Communicate rapidly and effectively to residents in COVID-19 areas, including delivering health information in a tailored, context-specific and relevant way28 while combating the spread of misinformation. Support contact tracing, symptom reporting and monitoring of contacts of patients with COVID-19 to ensure access to testing and treatment for those who develop signs and symptoms.28

*Mobilising CHWs to test, contact-trace and isolate cases is the strategy best placed to control the epidemic. In the absence of PPE and RDTs, however, CHWs should adopt an information provision strategy rather than a testing-focused strategy. Workflows should be modified to allow for the provision of patient care in a safe manner via phone or from a safe distance.

CHW, community health workers; PPE, personal protective equipment; RDT, rapid diagnostic test.