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. 2021 Feb 1;7(2):e41. doi: 10.1192/bjo.2020.167
General measures Out-patient care In-patient care Therapies Staff COVID ward
Phase I
  • Events postponed

  • Teaching cancelled

  • Electroencephalogram (EEG)/

  • electrocardiogram (ECG) ✓

  • ECT ✓

  • Hygienic measures

  • Separate room, wearing of face mask

  • Screening questions about possible SARS-CoV-2 infection at first contact

  • Hygienic measures

  • No therapy restrictions

  • Psychotherapy/occupational therapy/ physical therapy/ social services/ addiction treatment/ supervision: fully available

  • Hygienic measures

  • Staff with risk region contacts: 14-day quarantine

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Phase II
  • Patient contact restricted

  • Visiting ban

  • EEG/EKG ✓

  • ECT ✓

  • Emergencies

  • Cases that prevent in-patient admissions

  • Reduction of therapy group size (2 m distance!)

  • Reduction of therapy content (no sports, cooking and so on)

  • Psychotherapy: groups across wards cancelled, groups within wards reduced (2 m distance!), individual sessions where possible

  • Occupational therapy/physical therapy: 1 session/week

  • Social services: available, 2 m distance, hygienic measures, no bodily contact

  • Addiction therapy limited to detoxification

  • Supervision

  • Protective mask obligatory

  • Back-up rules for doctors

  • Home office options

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Phase III
  • Protective mask obligatory

  • ECT ✓

  • Polymerase chain reaction (PCR) testing for staff and patients

  • Entry controls, screening

  • Isolation measures in suspicious cases

  • Preparation of Psychiatric COVID ward

  • Reduced multimodal therapy programme, see phase II

  • Telemedicine psychotherapy

  • Crisis management via telephone

  • Protective mask obligatory

  • Team-building preparations/

  • emergency

  • Team A: direct patient care;

  • Team B: home office

  • Mobilisation of medical students

  • Crisis intervention for staff via telephone

  • Daily conference calls for staff

  • Close interaction with internal ward

  • Daily testing available

  • Oxygen administration available

Phase IV
  • Consideration of ethical issues

  • Patients provision, healthcare proxy

  • Dealing with fatality/death

See phase III
  • Further reduction of multimodal therapy programme

  • Telemedicine for basic psychotherapy

  • Crisis intervention for staff via telephone

COVID ward:
  • Mental disorder plus positive SARS-CoV-2 diagnosis

  • PCR testing

  • Multimodal therapy programme cancelled

  • Preparation for psychosocial rehabilitation ward

  • Shifting of staff

Mass epidemic:
  • Any disorder plus positive SARS-CoV-2 diagnosis

  • Internal medicine care prioritised

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  • Further shifting of staff

Emergency plan:
  • coping with high numbers of patients

Phase V Phase V is considered as a long-term period (>2 years). Patients with SARS-CoV-2 infection are expected to continuously present at the Psychiatric Hospital