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Table 1 Proposed COVID-19 case management strategies for African countries

From: COVID-19 case management strategies: what are the options for Africa?

COVID-19 transmission scenario Objective Proposed case management strategy and intervention
No COVID-19 transmission Prepare for a potential outbreak Prepare for case management by:
Defining and reaching consensus on case management strategies, criteria, requirements and package of care
Identify, map and re-purpose health facilities that will be used for case management
Identify and map public venues and facilities that can be re-purposed for case management when health facility capacity is overwhelmed
Develop clinical protocol for case management
Identify, train, equip and deploy staff to designated facilities
Quantify, procure and stock the required essential medicines, medical supplies and equipment
Establish a COVID-19 patient referral system
Establish COVID-19 triage desk in all major healthcare facilities
Define other requirements such as security, food, water, shelter, etc.
Sporadic or clustered transmission of COVID-19 cases Stop transmission and provide appropriate care Implement health facility-based case management strategy as part of outbreak containment measure to prevent further spread of the disease and save lives as follows:
Intensification of COVID-19 triage in all health facilities
Intensified active case search, timely detection and diagnosis of cases
Isolation of all suspected and confirmed cases of COVID-19 in designated health facilities (re-purposed facilities may be used to isolate suspected or asymptomatic cases)
Implementation of clinical protocol; supportive care for mild cases and specialized care for moderate, severe and critical cases where feasible
Ensure continuation of basic health care services for other common ailments
Widespread community transmission of COVID-19 with a huge case load Slow transmission and provide appropriate care Implement a combination of both home and health facility-based case management strategies as follows:
Intensification of COVID-19 triage in all health facilities
Intensified active case search, timely detection and diagnosis of cases
Isolation of all suspected and confirmed, asymptomatic, mild and moderate cases without co-morbidities or high risk in home settings provided all the criteria for home-based care are met
Provide health facility care for all cases with existing co-morbidity, severe and critical cases
Consider re-purposed facilities and community care centers for isolation of suspected, asymptomatic, mild and moderate cases who cannot be isolated at home for various reasons
Implementation of clinical protocol; supportive care for uncomplicated mild and moderate cases and specialized care for complicated moderate, severe and critical cases where feasible
Ensure continuation of basic health care services for other common ailments
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