Table 2 Criteria and package of care for management of COVID-19 cases in Africa
From: COVID-19 case management strategies: what are the options for Africa?
Strategy | Criteria | Package | Requirements |
|---|---|---|---|
Health facility | Severe and critical cases Mild and moderate cases with risk factors for poor outcomes (co-morbidities, age > 60 years) All confirmed cases if resources allow All suspected cases if resources allow | Medical care as appropriate  Supportive treatment  Treat co-infections and co-morbidities  Oxygen therapy  Mechanical ventilation for critical cases Psychosocial support for patients and health workers Food, water and other necessities | Dedicated trained COVID-19 health workers/teams Adequate Personal Protective Equipment for health workers Oxygen generation plant/cylinders Ventilators and other intensive care supplies/consumables Critical care doctors and nurses Essential medicines |
Re-purposed facility | Mild and moderate cases with no risk factors Asymptomatic cases (if resources allow) All suspected cases (if resources allow) | Basic medical care as appropriate  Supportive treatment  Treat co-infections  Monitor for clinical deterioration to institute referral Psychosocial support for patients and health workers Food, water and other necessities Social engagement activities | Dedicated trained COVID-19 health workers/teams (community health workers can be trained) Basic essential medicines that can be administered by community health workers Adequate Personal Protective Equipment for health workers Access to ambulance services for referral to a health facility in case of clinical deterioration Recreational facilities |
Home-based care | If there is no capacity for isolation in designated facilities, home isolate:  Suspected cases  Asymptomatic cases  Mild and moderate cases with no risk factors | Home based care kit with essential IPC supplies (e.g. soap, disinfectant, medical masks) and medications for supportive treatment such as antipyretics, as adapted for the country context Regular communication with community health workers to monitor for any clinical deterioration (this can be done by phone or physical visits at scheduled intervals) Scheduled visits by community health workers to monitor adherence to IPC measures Psychosocial support for patients and caregivers | Assessment of the home by a health care worker to assess its suitability for home-based care Training of caregivers on infection prevention and control measures Community engagement to address stigma Legal enforcement to ensure adherence to isolation measures Compensation for loss of income e.g. by provision of food or non-food items or cash Access to ambulance services for referral to a health facility in case of clinical deterioration |