Pillar 7. Case Management
Step		Actions to Be Taken	Responses and Plans
1	1	Map vulnerable populations and public and private health facilities (including traditional healers, pharmacies, and other providers) and identify alternative facilities that may be used to provide treatment	The family health care unit and the environmental health unit of the deputy of health care identified vulnerable populations based on prior health services and programs.
	2	Identify intensive care unit capacity	Available in the MoHb deputy of treatment observatory.
	3	Continuously assess the burden on the local health system, and as the less capacity to safely deliver primary health care services	Patients are directed to 16-hour and 24-hour centers for outpatient assessment and their SIB c profile is updated accordingly, thus a load of patients is observable in real-time.
	4	Ensure that guidance is made available for the self-care of patients with mild COVID‑19 symptoms, including guidance on when referral to health care facilities is recommended	Protocols on patient education are introduced to health care providers by the deputy of health care.
2	5	Disseminate regularly updated information, train, and refresh medical/ambulatory teams in the management of severe acute respiratory infections and COVID‑19-specific protocols based on international standards and WHO clinical guidance; set up triage and screening areas at all health care facilities	All local protocols were published by the MoHb deputy of treatment using expert teams.
	6	Establish dedicated and equipped teams and ambulances to transport suspected and confirmed cases, and referral mechanisms for severe cases with comorbidity	Regional treatment deputies planned this for all 16-hour primary health centers.
	7	Ensure comprehensive medical, nutritional, and psychosocial care for those with COVID‑19	The following was organized by the Imam Khomeini Relief Foundation, the State Welfare Organization of Iran, the Ministry of Education, Farhangian University, Seminaries, and the Ministry of Agriculture: - Phone diet counseling via the 4030 system - Phone diet tips and content via the automated 1569 system - Educational videos on diet and COVID-19 are made and shared on social media for the public. - Form support groups for medical professionals who have COVID-19 and offer them specialized dietary advice - Give food packages for the pregnant population and undernourished children, through charitable fund-raising events - Occupational health and geriatric program experts visit the covered nursing homes, providing diet education for their supervisors - Preserve one-third of the workforce in active duty during the control phase of the pandemic. Use of full capacity should continue after primary control of pandemics Faculty of behavioral sciences, the deputy of treatment, Tehran and Shahid-Beheshti universities of medical sciences,dAkhavan centre (Article 16), edrop-in centers (DIC): - Grief counseling was introduced as of April 15, 2020, for COIVD-19 losses - Screening of DIC patients - Start the “4030” phone grief counselling system by reorganizing the mental health workforce in April 2020 All are monitored by the Iranian Medical Council
	8	Participate in clinical expert networks to aid in the clinical characterization of COVID‑19 infection, address challenges in clinical care, and foster global collaboration (optional based on country capacity)	None
3	9	Prepare to assess diagnostics, therapeutics, and vaccines for compassionate use, clinical trials, regulatory approval, market authorization, and/or post-market surveillance, as appropriate	A national-level regulatory is in progress.
	10	Adopt international R&D blueprint guidance and WHO protocols for special studies (companionate use, monitored emergency use of unregistered and investigational interventions) to investigate additional epidemiological, virologic, and clinical characteristics; designate a clinical trial or study sponsor	The deputy of research and technology is active.
	11	Evaluate implementation and effectiveness of case management procedures and protocols (including for pregnant women, children, and immunocompromised individuals), and adjust guidance and/or address implementation gaps as necessary	Monitored by the Iranian Medical Council - The Special Needs Education Organization, the Sports and Youth Office, the Barracks, universities and the covered faculties, and seminaries all performed the following actions: - In late February as schools were shut down, conditions for safe reopening and possible risks of early reopening were fully explained to the Ministry of Education. - The SALAMAT.IR web portal was introduced to the Ministry of Education, and the Chief Office of Education in Tehran province was asked to register the health records of students. - Arrangements were made with the Chief Office of Education in Tehran for foreign students in Tehran province so that students without a national code could register their health records in the SALAMAT.IR portal. - The MoHb Youth and Adolescent Health Office was asked to propose an expert opinion on the process of restoring target group services and missed cares through the pandemic. - The Youth National Campaign website was launched to involve children and teenagers in public health. - Covered schools were asked to provide a report from student health ambassadors during the pandemic. The following special care services were organized by the State Welfare Organization of Iran, marriage registration offices, midwifery offices, the Iranian Medical Council, and primary health centers: Pregnant women: - Triage order in the health sector in addition to the treatment sector for pregnant women - Reduction of maternal visits from 8 to 4 caused a loss of mental health screening visits in the 16th-20th weeks; therefore, mental health visits were arranged for pregnant women needing them. - Grouping hospitals for deliveries based on whether a woman is COVID-19-infected or healthy. - Proposal of virtual childbirth classes for funding and infrastructure. Newborns, Children, and Breast milk - Report of discrepancy in COVID-19 screening form of the SIBc health system with the MoHb standard service of “Child care” in primary health centers. - Recommendations on separation of general waiting halls in auxiliary primary health centers from patient waiting rooms - Follow-up of MANA (Integrated Care for Ill Children) health form to be uploaded to the SIB c health system for comprehensive patient management and case follow-up - Excel registry forms for pediatric patients were sent to covered primary health centers while the SIB c system was being updated for MANA forms. - Similar factors of the MANA health program were compared to a similar timeline of last year to investigate the pandemic effect on the pediatric population. - Due to the financial burden of the COVID-19 epidemic, subsidies are provided for formula milk to rural infants under the age of 1 to prevent them from being fed livestock milk. - Monitoring the implementation of baby-friendly hospital guidelines. planning for breastfeeding counselling using social media/phone lines.