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 |