COVID-19 Specific Interventions

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Preparing for and Responding with COVID-19 specific interventions

Preparation and response to COVID-19 specific interventions will be essential to containing and mitigating the pandemic. This category refers to interventions that are specific to COVID-19, as opposed to COVID-19-sensitive interventions that are listed in the second category entitled Adapting existing interventions to COVID-19 (COVID-sensitive). The current category includes four sections: 1) Risk assessment & content analysis; 2) Investigation & surveillance; 3) Prevention; and 4) Case management.

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Risk Assessment and Context Analysis

An insightful understanding of the context is essential to inform preparedness and response strategies. This includes identifying high-risk population groups for COVID-19 and non-COVID-19 shocks; recognizing setting-specific constraints (e.g. land availability, remoteness, population density, general health services availability as well as intensive care capacity) and also gauging pragmatic approaches to implement activities. This section focuses on methodologies, tools, measures and challenges related to conducting risk assessments and context analyses in humanitarian setting.

Context Analysis

The decision about which activities to conduct and how to implement them in a given setting will depend on the characteristics of the context. Options and adaptation possibilities will vary in urban or rural settings, high or low densely populated areas, and populations with higher burden of chronic diseases, among other factors.

Different rapid assessment methods exist that have been used both following natural disasters as well as protracted crises. Some are broader in scope and cover multiple aspects of vulnerability, others focus on specific subjects, such as nutritional or health status. This section will focus on whether and how these tools need to be adapted for COVID-19 in order to gather the needed data to inform preparedness and response plans.
Guidance
Updated when available.
Field Context Specific Adaptations and Innovations
Experience: COVID-19 Specific Interventions Risk Assessment & Context Analysis, Context Analysis - Data collection in mixed migration settings in West, North and East Africa, Asia and Latin America
MMC, May 07 2020
Health Facility Assessment
Measuring the level of readiness is essential to ensure all resources and processes at the health facility level are in place to respond to COVID-19. This assessment tool is designed to measure the preparedness and availability of resources for the isolation and treatment of COVID-19 infections in primary healthcare facilities in resource-limited settings.
Guidance
Guidance: COVID-19 Specific Interventions Risk Assessment & Context Analysis Health Facility Assessment - COVID-19 Health Facility Assessment Tools and Guidance for Primary Health Care Facilities
CERAH, May 1 2020

Guidance: COVID-19 Specific Interventions Risk Assessment & Context Analysis Health Facility Assessment - COVID-19 Secondary Care Hospital Preparedness Checklist
CERAH, April 22 2020
Field Context Specific Adaptations and Innovations
Uploaded when available.
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Investigation and Surveillance

A core element of the COVID-19 pandemic response is the rapid investigation of suspected cases or clusters of COVID-19, and robust surveillance of SARS-COV-2 transmission and COVID-19 in the population. Given the novelty of SARS-COV-2, investigation and surveillance are particularly challenging in general, and in crisis-affected settings in particular. This section includes guidance for the planning, implementation and evaluation of COVID-19 investigation and surveillance interventions in crisis-affected populations.

Investigation
This section will focus on the planning and implementation of investigation for suspected cases of covid-19 including case definitions, contact tracing, collection of samples for testing, risk communication to cases and contacts as well as reporting
Guidance
Guidance: COVID-19 Specific Interventions Investigation
Considerations in the investigation of cases and clusters of COVID-19
WHO, May 2 2020
Field Context Specific Adaptations and Innovations
COVID-19 Specific Interventions: Investigation- Field Experience Summary: Border screening in South Sudan IRSS, May 22 2020
Surveillance
Surveillance is a core public health activity and is one of the critical pillars in COVID-19 outbreak preparedness and response strategy. A strong surveillance system will enable to: i) rapidly detect and report new cases in areas where the virus is not circulating and monitor cases where the virus has already started circulating; ii) monitor trends in disease: intensity, geographic spread and severity of COVID-19 in the population at global, national and local levels in order to estimate the burden of disease, assess the direction of recent time trends, and inform appropriate mitigation measures; and iii) monitor epidemic’s impact on health care system and impact on any mitigation measures. Strong surveillance systems require clear case definitions and strong reporting networks while various surveillance methods can be used depending on their intended specific objectives.
Guidance
Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Revealing the toll of COVID-19: A Technical Package for Rapid Mortality Surveillance and Epidemic Response
Bloomberg DHFI & Vital Strategies et al., May 2020

Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Strategies for the surveillance of COVID-19
ECDC, April 9 2020

Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Operational considerations for COVID-19 surveillance using GISRS
WHO, March 26 2020

Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Global surveillance for COVID-19 caused by human infection with COVID-19 virus
WHO, March 20 2020

Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Protocol for Enhanced Severe Acute Respiratory Illness and Influenza-Like Illness Surveillance for COVID-19 in Africa
Africa CDC, March 2020

Guidance: COVID-19 Specific Interventions Investigation & Surveillance, Surveillance – Scaling-up COVID-19 outbreak readiness and response operations in humanitarian situations including camps and camp-like settings
IASC, March 2020
Field Context Specific Adaptations and Innovations
Experience: COVID-19 Specific Interventions Investigation & Surveillance Surveillance Afghanistan Mixed populations (National Level)
May 19 2020
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Prevention

A key tenet for the control of communicable diseases is the prevention of transmission. One arm includes the policies, infrastructure, protocols, and equipment to reduce transmission in health facilities and in the public; the other arm includes consistent and factual health messaging on the risk of disease, the promotion of effective communication, and the engagement of the community in prevention efforts.

Isolation Measures
Preventive isolation measures play a key role in the public health response to control outbreaks. The aim of these mitigation measures is to reduce transmission, thereby controlling the spread of the virus, delaying the epidemic peak and spreading cases over a longer time to relieve pressure on the healthcare system. Depending on the context and the specific objectives, various isolation strategies can be considered. Some imply severe movement and contact restrictions such as mass ‘stay-at-home’ orders or population wide confinement; some are less restrictive and focus on isolating only high-risk individuals to protect them from transmission (‘shielding’); and others target only cases and their contacts, such as self-isolation or quarantine of contacts of suspected or confirmed cases. When designing the response strategy, careful consideration should be given to the potential socio-economic impacts of such isolation measures.
Guidance
Guidance: COVID-19 Specific Interventions Prevention Isolation Measures- Community Physical Distancing during COVID-19 Pandemic Africa CDC, May 12 2020

Guidance: COVID-19 Specific Interventions Prevention Isolation Measures
Prevention of COVID-19 infections among high-risk individuals in urban settings
LSHTM, April 30 2020

Guidance: COVID-19 Specific Interventions Prevention Isolation Measures
Prevention of COVID-19 infections among high-risk individuals in camps and camp-like settings
LSHTM, March 31 2020

Guidance: COVID-19 Specific Interventions Prevention Isolation Measures
Considerations for quarantine of individuals in the context of containment for COVID-19
WHO, March 19 2020
Field Context Specific Adaptations and Innovations
Uploaded when available.
Rumor Management
Rumors and misinformation can cause stigma, undermine trust and social cohesion, and create reluctance to adopt recommended infection control and prevention measures. The rapid spread of rumors about COVID-19, both online and within communities, has been described as an “infodemic” and led to the creation of the EPI-WIN network for timely and trustworthy information. Risk communication and community engagement are essential for rumor management. WHO advises health authorities to convey the latest and most accurate information frequently, and acknowledge uncertainties to maintain credibility and public trust. Responders making information materials for COVID-19 should ensure they are tailored to context, pre-tested with target audiences, and be action-oriented with key instructions to follow, behaviors to adopt and readily shareable factual information.
Guidance
Guidance: COVID-19 Specific Interventions Prevention Rumor Management - Risk communication essentials
WHO, 2017

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - EPI-WIN: WHO information network for epidemics
WHO, 2020

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - Connect: COVID-19 (Internews, Translators without Borders, BBC Media Action, and Evidence Aid, 2020)
Internews & H2H Network, March 19 2020

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response
WHO UNICEF IFRC, March 13 2020

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - Social Stigma associated with COVID-19: A guide to preventing and addressing social stigma
IFRC UNICEF WHO, February 24 2020

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - A WHO Guideline for Emergency Risk Communication (ERC) policy and practice
WHO, January 10 2018

Guidance: COVID-19 Specific Interventions Prevention Rumor Management - Rumour has it: A practice guide to working with rumours
CDAC Network, June 2017
Field Context Specific Adaptations and Innovations
Uploaded when available.
Infection Prevention and Control
Infection prevention and control (IPC) strategies are vital to curb COVID-19 infection rates. The virus is transmitted from person-to-person through droplets, contacts, and through fomites within the immediate environment of the person. According to the WHO, airborne transmission may also be possible in specific circumstances where aerosol-generating procedures or support treatments are performed (e.g., intubation). All staff should know about local IPC protocols and meticulously follow the WHO’s “5 Moments for Hand Hygiene”. Appropriate IPC for COVID-19 includes interventions in four main domains: 1) Personal protective equipment (PPE); 2) Water, sanitation and hygiene (WASH); 3) Environmental IPC; and 4) Safe disposal of a dead body.
Guidance
Guidance: COVID-19 Specific Interventions Prevention IPC Islamic Relief Worldwide IRW, April 2020


Guidance: COVID-19 Specific Interventions Prevention IPC
Infection Prevention and Control
UNHCR, March 31 2020

Guidance: COVID-19 Specific Interventions Prevention IPC
WHO Open Course: Infection Prevention and Control (IPC) for COVID-19
WHO, 2020

Guidance: COVID-19 Specific Interventions Prevention IPC
Interim Guidance for COVID-19 Prevention and Control in Schools
IFRC UNICEF WHO March 24, 2020
Field Context Specific Adaptations and Innovations
Experience: COVID-19 Specific Interventions Prevention IPC
Infection prevention and control in migrant camp (Lesbos)
MSF, May 13 2020
Risk Communication and Community Engagement
Risk communication and community engagement is a critical component of the public health response to any infectious disease outbreak, although it is often overlooked. It is essential to build trust and confidence in response efforts, and it enables community participation and action for the outbreak response. Risk communication aims to address factors that shape risk perception and behavior, and is about giving communities enough contextualized and appropriate information to make informed decisions to protect themselves and mitigate the effects of the threat. It encompasses a mix of strategies covering a wide range of domains, ranging from mass communication to community-level dialogue and community engagement.

Community engagement is the process of supporting communities to consider themselves partners in an outbreak response, and to have ownership in controlling an outbreak. It is a principle rather than a defined set of activities, and the approaches to this vary depending on factors such as local social structures, community coherence, preferred communication methods, and relationships with authority.
Guidance
Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Community Engagement During COVID-19: 13 Practical Tips
OXFAM, April 27 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Community Engagement During COVID-19: A Guide for Community-Facing Staff
OXFAM, April 27 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Community Engagement during COVID-19 Checklist
OXFAM, April 27 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Risk Communication & Community Engagement: Practical Tips on Engaging Adolescents and Youth in the COVID-19 Response UNICEF, April 20 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - COVID-19: Guidance on Risk Communication and Community Engagement
UNHCR, March 21 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - COVID-19: How to include marginalized and vulnerable people in risk communication and community engagement
RCCE Working Group, March 19 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - The COVID-19 risk communication package for healthcare facilities
WHO, March 10 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - New Coronavirus Risk Communication and Community Engagement Strategy (Africa)
IFRC, March 3 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Minimum quality standards and indicators in community engagement
UNICEF, March 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response
WHO, March 16 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Social Stigma associated with COVID-19: A guide to preventing and addressing social stigma
WHO UNICEF IFRC, February 24 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Risk communication and community engagement readiness and response to coronavirus disease (COVID-19)
WHO, January 26 2020

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - Communication and community engagement in humanitarian response
HPN, February 2019

Guidance: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement - The Development of Standard Operating Procedures for Social Mobilization and Community Engagement in Sierra Leone During the West Africa Ebola Outbreak of 2014-2015
JHC, August 13 2017
Field Context Specific Adaptations and Innovations
Experience: COVID-19 Specific Interventions Prevention Risk Communication & Community Expérience de terrain:Communication Multirisques en Haïti Haiti DPC, May 1 2020

Experience: COVID-19 Specific Interventions Prevention Risk Communication & Community Engagement
Risk Communications and Community Engagement in Pakistan
IRC, April 28 2020
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Case Management

The treatment of COVID-19 cases first relies on successful identification of cases to prevent transmission and determination of their clinical severity to make informed decisions about the appropriate level of care. Clinical guidelines for the management of the full spectrum of clinical symptomology, from mild cases to severe cases requiring hospitalization and critical care, are necessary for the efficient allocation of scarce resources. Adapting triage and case management guidelines to specific contexts is imperative for an effective health system response.

Triage
Appropriate triage is imperative in health and other designated facilities to ensure effective management of infected patients as well as to reduce transmission to other patients. Positive COVID-19 patients should be triaged in health facilities according to local algorithms and protocols, based on availability of resources and local context. The WHO advises designated primary and secondary facilities for initial assessment and management, with the referral to tertiary hospitals for very severe COVID-19 patients.
Guidance
Guidance: COVID-19 Specific Interventions Case Management Triage
WHO Algorithm for COVID-19: Patient triage and referral for resource-limited settings during community transmission
WHO, March 22 2020

Guidance: COVID-19 Specific Interventions Case Management Triage
Triage of Suspected COIVD-19 Patients in non-US Healthcare Settings
CDC, April 15 2020
Field Context Specific Adaptations and Innovations
COVID-19 Specific Interventions Case Management Triage
Experience: Triage in South Sudan
IMC, May 05 2020

COVID-19 Specific Interventions Case Management Triage
Experience: Triage in Somalia
ARC, April 29 2020

COVID-19 Specific Interventions Case Management Triage
Experience: Triage Myanmar
IRC, March 20 2020
Management of mild cases
The management of suspected and confirmed cases of COVID-19 who present with mild symptoms will constitute a majority of cases. Mild cases are defined as patients who have mild clinical symptomatology (e.g., fever, cough, headache and malaise) without any of the severe symptoms.
Guidance
Guidance: COVID-19 Specific Interventions Case Management Mild Cases COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community
NICE, April 03 2020

Guidance: COVID-19 Specific Interventions Case Management Mild Cases
Infection prevention and control in the household management of people with suspected or confirmed coronavirus disease (COVID-19)
ECDC, March 30 2020

Guidance: COVID-19 Specific Interventions Case Management Mild Cases
COVID-19: a remote assessment in primary care
BMJ, March 25 2020

Guidance: COVID-19 Specific Interventions Case Management Mild Cases
Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts
WHO, March 17 2020

Guidance: COVID-19 Specific Interventions Case Management Mild Cases
Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19)
CDC, February 12 2020
Field Context Specific Adaptations and Innovations
Uploaded when available.
Management of severe cases (non-ICU)
A small but significant portion of cases will require management of severe cases and will be admitted to hospital, but not in the intensive care unit (ICU). Every health system must adapt its infrastructure and available resources to care for severe COVID-19 cases according to their capacity, which will be quite different according to context. Issues include increased bed capacity, locally adapted clinical protocols, and provision of intensive care outside ICUs. Guidance will also include measures on how to protect staff and other patients at risk from nosocomial transmission.
Guidance
Guidance: COVID-19 Specific Interventions Case Management Severe Cases (non-ICU) - WHO Open Course: Clinical Care Training for Severe Acute Respiratory Infection
WHO, 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (non-ICU) Coronavirus (COVID-19) evidence relevant to critical care
COCHRANE, April 14 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (non-ICU) - Emergency Care of Covid-19 In Adults In Low Resource Settings
African Federation Emergency Medicine, March 25 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (non-ICU) - WHO Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected
WHO, March 13 2020
Field Context Specific Adaptations and Innovations
Uploaded when available.
Management of severe cases (ICU)
An even smaller number of patients will require management of severs cases in an ICU. Every health system must adapt its infrastructure and available resources to care for severe COVID-19 cases according to their capacity, which will be quite different according to context. Issues include increased ICU bed capacity and locally adapted clinical protocols, among others. Guidance will also include measures on how to protect staff and other patients at risk from nosocomial transmission.
Guidance
Guidance: COVID-19 Specific Interventions Case Management Severe Cases (ICU) - WHO Open Course: Clinical Care Training for Severe Acute Respiratory Infection
WHO, 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (ICU)
Emergency Care of Covid-19 In Adults In Low Resource Settings
African Federation for Emergency Medicine, March 25 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (ICU) - WHO Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected
WHO, 2020

Guidance: COVID-19 Specific Interventions Case Management Severe Cases (ICU) - Coronavirus (COVID-19) evidence relevant to critical care
COCHRANE, February 11 2020
Field Context Specific Adaptations and Innovations
Uploaded when available.
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1. Which specific intervention within the specific program area that you chose, do you want to document?

2. How did you specifically implement it (COVID-specific) or adapt it (COVID-sensitive; what changes/modications)? Did you add a new activity in your program, did you change its focus, did you change the way/modality it was implemented?

3. Why did you decide to adapt it this way? Explain the contextual considerations amongst other issues.

4. What challenges did you have in adaptation?

5. Which resources (financial, human, supplies/logistics) did you need?

6. Is it working as intended or not? Please explain regardless of outcome.

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