Equatorial Guinea has committed to contribute 5 billion CFA francs (about $8 million) to a special emergency fund to manage the COVID-19 outbreak
ADDIS ABABA, Ethiopia, March 24, 2020/APO Group/ --
In addition to our weekly brief on the spread of COVID-19 and the actions that Africa CDC is taking to helpmember states, Africa CDC has begun to share a weekly brief detailing the latest changes inscientificknowledgeandpublichealthpolicychanges,aswellasupdates to the latest guidance fromWHO and others. Contents of this document are not intended to serve as recommendations from theAfricaCDC;rather,itisa summary of the factbase to help inform member states. It is important tonotethattheoutbreakisevolvingrapidlyand that the nature of this information will continue tochange.So we will continue to provide regular updates to ensure member states are informed of themost critical developments in these areas.
A Executive Summary
A report on COVID-19 patients in China suggest that prior to the travel restrictions in January 23, 86% of all infections were undocumented and that these infections were the source of 79% of documented cases.
A published study on aerosol and surface stability of SARS-CoV-2 suggests that the virus can remain viable in aerosols for up to 3 hours, copper for up to 4 hours, cardboard for up to 24 hours and plastics and steel for up to 4 days.
An epidemic-modeling report suggests that a combination of case isolation, home quarantine and social distancing of >70-year-olds could reduce peak critical care demand by two-thirds and halve the number of deaths. However, this would still result in an 8-fold higher peak demand then surge capacity on critical care beds in both UK and the US. Leveraging population-wide social distancing, home isolation of cases and school and university closures have the potential to suppress transmission below the threshold of R=1, however, to avoid rebound in transmission, these policies would need to be maintained until large stocks of vaccines are available (which could be in 18 months).
A clinical trial of lopinavir-ritonavir treatment on 199 patients found that intake of the drugs resulted in no benefit beyond standard care. Meanwhile, an observational trial suggests that chloroquine could be a promising treatment based on lower viral loads observed in patients who were administered the drug. However, randomized control trials need to be conducted in order to validate viability of the drug. Multiple trials are underway including a large global trial, SOLIDARITY, launched by WHO.
The US FDA has granted 'emergency use authorization' to Cepheid's COVID-19 test. The test is a molecular, PCR-based test, that can provide accurate results in 45 minutes. The tests are planned to be rolled out on March 30.
As cases in the continent continue to rise over the past week, African countries have imposed tighter travel and public health policies such as full border closures (e.g., Angola, Rwanda, Nigeria), cessation of air traffic (e.g., Kenya, Sierra Leone, Mauritania), entry restrictions for non-citizens / non-residents (e.g., Seychelles), lockdown (e.g., South Africa, Rwanda) and etc.
Similarly, heavily affected countries globally have continued to enforce strict public health and travel policies such as entry restrictions for all foreigners (e.g., EU), closure of schools and non-essential businesses (e.g., Italy, US, UK) etc.
New Guidlines and Resources
Since March 17th, WHO has published new and updated guidance on CriticalPreparedness and Response Actions for COVID-19, Home care for patients with COVID-19 presenting with mild symptoms, Rights, Roles and Responsibilities of health workers, IPC during health care, Guidance for Mental Health and Psychosocial considerations, Guidance for Population-based age-stratified seroepidemiological investigation protocolfor COVID-19, Advice on the use of masks in the community, during home care and inhealthcare settings
US CDC has published new and updated guidance on Preparedness of HealthcareFacilities, Long-term Care Facilities / Nursing Homes, Criteria for Return to Work of aHealthcare Personnel with Confirmed or Suspected COVID-19, IPC for OutpatientHemodialysis Facilities, Interim Guidelines for Collecting, Handling and Testing ClinicalSpecimens, Travel, Protecting and Preparing Home and Family for COVID-19
ECDC has issued new guidance and resources on Safe handling of bodies of deceasedpersons with suspected or confirmed COVID-19, Supply of substances of human origin inthe EU/EEA, Discharge criteria for confirmed COVID-19 cases, IPC in HealthcareSettings, Information for Specific Groups (e.g., Elderly, Chronic Disease Patients,Pregnant Women etc.) and Considerations relating to Social Distancing Measures
The full list of latest guidance and resources from WHO and other public health institutions are listed at the end of this update in section G.
A published study on aerosol and surface stability of SARS-CoV-2 suggests that the viruscan remain viable in aerosols for up to 3 hours, copper for up to 4 hours, cardboard for upto 24 hours and plastics and steel for up to 4 days.
A review of the viral dynamics of mild and severe patients (76) in Nanchang found that severe COVID-19 patients tend to have a high viral load (mean viral load that was 60xhigher than that of mild cases') and a long virus-shedding period (90% of mild cases tested negative after 10 days, while severe cases all still tested positive).
A case report on the kinetics of immune responses in relation to clinical and virologic features of a patient with mild-to-moderate COVID-19 found that increased antibody-secreting cells (ASCs), follicular helper T cells (TFH cells), activated CD4+ T cells andCD8+ T cells and immunoglobulin M (IgM) and IgG antibodies that bound the COVID-19-causing coronavirus SARS-CoV-2 were detected in blood before symptomatic recovery. These immunological changes persisted for at least 7 days following full resolution of symptoms. Further examinations of larger cohort sizes are needed to determine if such immune parameters can be used to predict disease outcomes.
Epidemiology
An estimation of undocumented COVID-19 patients in China suggest that prior to the travel restrictions in January 23, 86% of all infections were undocumented and that these undocumented infections (many of whom were most likely not severely symptomatic) were the source of 79% of documented cases.
A review of 1391 children tested (of which 171 or 12.3% were positive) from Jan 28 to Feb 26 in Wuhan suggests that most children have a milder clinical course and thatasymptomatic cases are not uncommon. Only 42% of the children had fever, only 3 required intensive care (all of whom had coexisting conditions). As of March 8, there was only 1 death (a 10-month-old child with intussusception). 21 patients were in stable condition and 149 have been discharged.
An investigation of 10 pediatric SARS-CoV-2 infection cases found that 8 of 10 childrenpersistently tested positive on rectal swabs even after nasopharyngeal testing wasnegative, suggesting the possibility of fecal–oral transmission and that rectal swab-testing may be more useful than nasopharyngeal swab-testing in judging the effectiveness of treatment and determining the termination of quarantine. However, the report found no evidence of replication-competent virus in fecal swabs, which is required to confirm the potential for fecal–oral transmission.
A single center observational study on 8 severe pediatric COVID-19 patients found that polypnea was the most common symptom, followed by fever and cough. Multiple patch- like shadows and ground-glass opacity in CT scans and a cytokine storm in these patients were observed.
A review of literature describing 38 pregnant women with COVID-19 and their newborns in China reveals that COVID-19 did not lead to maternal deaths. More importantly, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses.
Diagnostics
The US FDA has granted 'emergency use authorization' to Cepheid's COVID-19 test. The test is a molecular, PCR-based test, that can provide accurate results in 45 minutes. The tests are planned to be rolled out on March 30.
An examination of the time kinetics of antibodies produced against SARS-CoV-2 suggests that humoral response to SARS-CoV-2 can aid in its diagnosis. IgM ELISAassay when combined with PCR can increase positive detection rate to 98.6% vs. asingle qPCR test (51.9%). This methodology needs to be replicated further to fully assess effectiveness of IgM ELISA assay in diagnosis.
Care and Treatment
A clinical trial of lopinavir-ritonavir treatment on 199 patients show that intake of the drugsresulted in no benefit i.e., clinical improvement that was one day shorter and no improvement in mortality or detectable viral RNA.
An observational trial suggests that chloroquine could be a promising treatment based on lower viral loads observed in patients who were administered the drug. However, randomized control trials need to be conducted in order to validate viability of the drug.
A network-based methodology for systematic identification of drugs for potential treatment of SARS-CoV-2 has prioritized 16 candidate repurposable drugs and 3potential drug combinations. However, although the majority of predictions have been validated by various literature data, these must be validated in various experimental assays and randomized clinical trials before being used in patients.
WHO announced a large global trial, called SOLIDARITY, focused on the four mostpromising therapies: remdesivir, chloroquine and hydroxychloroquine, lopinavir andritonavir, and lopinavir and ritonavir plus interferon-beta, an immune system messenger that can help cripple viruses. Similarly, INSERM, announced that it will coordinate an add-on trial in Europe, named Discovery, that will follow WHO’s example and will include 3200 patients from at least seven countries, including 800 from France. That trial will test the same drugs, except for chloroquine.
Vaccines
China has authorized clinical trials on its first vaccine developed to combat the new coronavirus, according to a report in the ruling Communist Party's People's Daily.
Moderna is seeking to provide access to the vaccine to a limited group, likely consistingof healthcare workers, by as early as this fall. The company plans to do so under an emergency use authorization from the US FDA.
Non-pharmaceutical interventions, social distancing
The epidemic-modeling report out of Imperial College London suggests that unmitigated, the outbreak would result in approximately 510,000 deaths in the UK and 2.2 million in the US. Implementing an "optimal" mitigation strategy (i.e., reducing R but not to less than 1 through a combination of case isolation, home quarantine and social distancing of >70-year-old) reduces peak critical care demand by two-thirds and halves the number of deaths. However, this scenario would still result in an 8-fold higher peak demand on critical care beds over and above the available surge capacity in both UK and the US. Leveraging population-wide social distancing, home isolation of cases and school anduniversity closures – has the potential to suppress transmission below the threshold ofR=1, however, to avoid rebound in transmission, these policies would need to be maintained until large stocks of vaccines are available (which could be in 18 months).
Related Public Health Policy
Africa
As cases in the continent continue to rise over the past week, African countries have continued to impose tighter travel and public health policies to manage the outbreak: (not exhaustive)
Full border closure(air, land, sea) except for cargo / freight and emergencies:Angola, Burkina Faso, Congo Republic, Gabon, Gambia, Ghana, Niger, Nigeria, Rwanda, Uganda, Zimbabwe
Flight suspensions to/from high risk countries: Mali,South Sudan
Entryrestrictionsfor non-citizens / non- residents coming from high riskcountries: Eswatini, Côte d'Ivoire, Sao Tome and Principe, Seychelles
Mandatoryfacilityquarantine at own expense of traveler: Kenya, Ethiopia, Tanzania
Lock down(limitingof movement outside home) and curfew: Burkina Faso, Côte d'Ivoire, DRC, Gabon, Madagascar, Rwanda, Senegal, South Africa, Tunisia
Shutdownof educational / religious institutions and entertainment venues,banning of mass gatherings: BurkinaFaso, Cote d’Ivoire, DRC, Eswatini, Gabon, Mali, Kenya, Nigeria, Sierra Leone, South Africa, Zambia, Zimbabwe and etc.
Limitationon prison and hospital visits: Eswatini, Gabon, Zimbabwe
Equatorial Guinea has committed to contribute 5 billion CFA francs (about $8 million) to a special emergency fund to manage the COVID-19 outbreak.
Kenya, Uganda, Cameroon and Ghana have asked banks and mobile network operators to promote more efficient, digital forms of payment (e.g., lower or no tariffs on mobile money transfers)
Ethiopian Airlines has started the distribution of coronavirus donation made to Africa by Chinese business mogul Jack Ma, CEO of e-commerce giants Ali Baba. The carrier will start distribution to its neighbors – Eritrea, Djibouti, Egypt and Sudan.
Ethiopian Airlines has suspended flights to 30 affected countries.
Refer to Section E and F for the full summary of travel restrictions and social distancing measures implemented by African countries.
Rest of World
As COVID-19 cases outside China accelerate rapidly, heavily affected countries have continued to impose public health policies to contain the outbreak
The European Union (EU) will impose an entry ban on travelers from outside the bloc for 30 days, only nationals of EFTA countries and Britain are exempt.
Italy has ordered all non-essential businesses to close until April 3. The army wasdeployed to enforce lockdown in the country’s worst-hit region. In addition, thecountry will rush 10,000 student doctors into service, scrapping their final exams.
Multiple states in the US have ordered closures of schools / education institutions and non-essential businesses. The US military will make available up to 5 millionrespirator masks and protective equipment
Germany has expanded entry restrictions to include flights from Italy, Spain, Austria, France, Luxembourg, Denmark and Switzerlan
UK has announced a strict lockdown in the country, restricting public movement to essential activities.
Canada's most populous province Ontario has ordered the closure of bars and restaurants and banned gatherings of more than 50 people.
As cases across multiple countries across all continent grow, countries have increasingly
imposedrestrictive travel and public health policies (not exhaustive)
Fullborder closures: Chile, Colombia, Ecuador, Malaysia, Lithuania, Honduras
Suspension of all international flights: Belgium, UAE, Pakistan, Vietnam, etc.
Entry restrictions to travelers from specific countries or all foreigners: Australia, Russia, Uzbekistan Singapore, Jamaica, Cuba
Suspension of travel to and from high risk areas e.g., Argentina, Bangladesh, Netherlands, Turkey, Jordan
Communityquarantine / lockdown: El Salvador, Bolivia, Ecuador, Venezuela, Peru, Philippines, Iraq
Shutdownof educational institutions, religious institutions, and other publicareas: Afghanistan, Australia, India, Qatar, UAE, Armenia, Thailand, Kazakhstan, Italy, Poland etc.
Banning of mass / public gatherings: Oman, Lebanon, Qatar and etc.
While domestic cases in China have waned, imported cases have risen. As a result, the country has tightened quarantine measures for travelers arriving into the country, requiring all travelers arriving in Beijing and Hong Kong are required to go into centralizedquarantine locations for 14 days.
Summary of Travel Restriction implemented By Member States
Lastupdated
Country
Mandatoryself-quaran-tine
Mandatoryfacilityquarantine for all travelers
Entryrestric-tions (incl. visa limitations)
Flight / travelsuspensions to specific countries
Airtrafficclosure
Fullborderclosure
18-Mar
Algeria
y
21-Mar
Angola
y
17-Mar
Benin
y
y
17-Mar
Botswana
y
21-Mar
Burkina Faso
y
24-Mar
Burundi
y
18-Mar
Cabo Verde
y
y
18-Mar
Cameroon
y
18-Mar
Central African Republic
18-Mar
Chad
y
y
y
17-Mar
Comoros
y
21-Mar
Congo Republic
y
18-Mar
Côte d'Ivoire
y
y
18-Mar
Djibouti
y
18-Mar
DR Congo
y
17-Mar
Egypt
y
18-Mar
Equatorial Guinea
y
17-Mar
Eritrea
y
18-Mar
Eswatini
y
y
23-Mar
Ethiopia
y
y
20-Mar
Gabon
y
y
23-Mar
Gambia
y
22-Mar
Ghana
y
17-Mar
Guinea
y
18-Mar
Guinea- Bissau
y
22-Mar
Kenya
y
y
17-Mar
Lesotho
y
17-Mar
Liberia
y
18-Mar
Libya
y
18-Mar
Madagascar
y
17-Mar
Malawi
y
18-Mar
Mali
y
21-Mar
Mauritania
y
18-Mar
Mauritius
y
y
17-Mar
Morocco
y
17-Mar
Mozambique
y
18-Mar
Namibia
y
y
21-Mar
Niger
y
21-Mar
Nigeria
y
21-Mar
Rwanda
y
19-Mar
Sahrawi Republic
y
18-Mar
Sao Tome and Principe
y
Lastupdated
Country
Mandatoryself-quaran-tine
Mandatoryfacilityquarantine for all travelers
Entryrestric-tions (incl. visa limitations)
Flight / travelsuspensions to specific countries
Airtrafficclosure
Fullborderclosure
18-Mar
Senegal
y
18-Mar
Seychelles
y
23-Mar
Sierra Leone
y
18-Mar
Somalia
y
17-Mar
South Africa
y
y
21-Mar
South Sudan
y
y
17-Mar
Sudan
y
y
23-Mar
Tanzania
y
24-Mar
Togo
y
18-Mar
Tunisia
y
y
22-Mar
Uganda
y
18-Mar
Zambia
y
24-Mar
Zimbabwe
y
Summary of social distancing measures implemented by Member States
Lastupdated
Country
Closureofeducationalinstitutions
Banningofmassgatherings,closure ofpublic spaces
Measuresforspecialpopulationse.g., prison,elder homes
Lockdown(e.g., curfew,stay athome)
12-Mar
Algeria
y
y
19-Mar
Angola
y
18-Mar
Benin
y
19-Mar
Botswana
y
20-Mar
Burkina Faso
y
y
y
19-Mar
Burundi
18-Mar
Cabo Verde
y
17-Mar
Cameroon
y
y
19-Mar
Central African Republic
20-Mar
Chad
y
19-Mar
Comoros
19-Mar
Congo Republic
23-Mar
Côte d'Ivoire
y
y
y
20-Mar
Djibouti
y
23-Mar
DR Congo
y
y
y
16-Mar
Egypt
y
y
19-Mar
Equatorial Guinea
23-Mar
Eritrea
y
17-Mar
Eswatini
y
y
y
16-Mar
Ethiopia
y
y
21-Mar
Gabon
y
y
y
y
17-Mar
Gambia
y
y
16-Mar
Ghana
y
y
19-Mar
Guinea
19-Mar
Guinea-Bissau
15-Mar
Kenya
y
y
19-Mar
Lesotho
y
18-Mar
Liberia
y
y
13-Mar
Libya
y
y
Lastupdated
Country
Closureofeducationalinstitutions
Banningofmassgatherings,closure ofpublic spaces
Measuresforspecialpopulationse.g., prison,elder homes
Lockdown(e.g., curfew,stay athome)
23-Mar
Madagascar
y
29-Mar
Malawi
y
y
18-Mar
Mali
y
y
14-Mar
Mauritania
y
y
y
18-Mar
Mauritius
y
14-Mar
Morocco
y
y
19-Mar
Mozambique
y
y
17-Mar
Namibia
y
y
19-Mar
Niger
y
y
21-Mar
Nigeria
y
21-Mar
Rwanda
y
19-Mar
Sahrawi Republic
19-Mar
Sao Tome and Principe
24-Mar
Senegal
y
y
y
19-Mar
Seychelles
18-Mar
Sierra Leone
y
19-Mar
Somalia
23-Mar
South Africa
y
19-Mar
South Sudan
y
14-Mar
Sudan
y
y
17-Mar
Tanzania
y
y
19-Mar
Togo
20-Mar
Tunisia
y
y
y
18-Mar
Uganda
y
y
17-Mar
Zambia
y
y
23-Mar
Zimbabwe
y
y
y
WHO Guidlines and Resources
Organization
Datepublished
Guidanceor resource name
Countryreadiness
WHO
9-Jan-2020
National capacitiesreviewtoolfor a novel coronavirus
WHO
19-Mar-2020
Critical preparedness, readiness and response actions forCOVID-19
WHO
4-Mar-2020
Operational Planning Guidelines and COVID-19 PartnersPlatform to support country preparedness and response
Surveillance andcasedefinitions
WHO
27-Feb-2020
Global Surveillance for human infection with coronavirusdisease (COVID-19)
WHO
27-Feb-2020
Revised case reporting form for COVID-19 for confirmed casesand their outcome
WHO
n/a
Emerging respiratory viruses, including 2019-nCoV: methodsfordetection, prevention, responseandcontrol
WHO
n/a
Global COVID-19 Clinical Characterization Case Record Formand new data platform for anonymized COVID-19 clinical data
Organization
Datepublished
Guidanceor resource name
WHO
n/a
Case Reporting Form for COVID-19
Laboratoryguidance
WHO
2-Mar-2020
Laboratorytestingfor 2019 novel coronavirus (2019-nCoV) insuspected human cases
WHO
1-Mar-2020
Guidancefor laboratories shipping specimens to WHOreference laboratories that provide confirmatory testing forCOVID-19 virus
Patient management
WHO
13-Mar-2020
Clinical management of severeacuterespiratoryinfectionwhen novel coronavirus (nCoV) infection is suspected
WHO
17-Mar-2020
Homecareforpatients with suspected novel coronavirus(nCoV)infectionpresenting with mild symptoms andmanagementof contacts
WHO
n/a
WHO Critical Care Severe Acute Respiratory Infection TrainingShort Course
WHO
19-Mar-2020
TheRights, Roles and Responsibilities Of Health Workers,Including Key Considerations For Occupational Safety AndHealth
WHO
19-Mar-2020
Mental health and psychosocial considerations during theCOVID-19outbreak
Infectionprevention and control
WHO
19-Mar -2020
Infection prevention and control during health care when novelcoronavirus(nCoV) infection is suspected
WHO
19-Mar-2020
Advice on the use of masks in the community, during homecare and in health care settings in the context of the novelcoronavirus (2019-nCoV) outbreak
WHO
10-Feb-2020
Q&A on infection prevention and control for health careworkers caring for patients with suspected or confirmed 2019-nCoV
WHO
11-Feb-2020
Keyconsiderationsforrepatriation and quarantine of travellersin relation to the outbreak of novel coronavirus 2019-nCoV
WHO
16-Feb-2020
ManagementofilltravellersatPointsofEntry– internationalairports, seaports and ground crossings – in the context ofCOVID-19 outbreak
WHO
18-Feb-2020
Surfacesamplingofcoronavirus disease (COVID-19):
A practical “how to” protocol for health care and public healthprofessionals
WHO
14-Feb-2020
Key planningrecommendations for Mass Gatherings in thecontextof the current COVID-19 outbreak
WHO
n/a
Online course for public health preparedness for massgatheringevents
WHO
n/a
Infection Prevention and Control (IPC) for Novel Coronavirus(COVID-19)
WHO
27-Feb-2020
Rational use of personal protective equipment
Organization
Datepublished
Guidanceor resource name
forcoronavirus disease 2019 (COVID-19)
WHO
1-Mar-2016
Handbookfor the Management of Public Health Events in AirTransport
WHO
1-Jan-2016
Handbookfor management of public health events on boardships
WHO
24-Jan-2011
Handbookfor inspection of ships and issuance of shipsanitation certificates
Earlyinvestigations
WHO
25-Jan-2020
Protocolfor assessmentofpotentialrisk factorsfor 2019-novelcoronavirus (2019-nCoV) infection among health care workersin a health care setting
WHO
25-Jan-2020
Household transmission investigation protocol for 2019-novelcoronavirus (2019-nCoV) infection
WHO recommendations to reduce risk of transmission ofemerging pathogens from animals to humans in live animalmarkets
Traveladvice
WHO
29-Feb-2020
UpdatedWHOrecommendations for international traffic inrelation to COVID-19 outbreak
Others
Organization
Datepublished
Guidanceor resource name
WHO
3-Feb-2020
2019-nCoV StrategicPreparedness and Response Plan
IATA (in
partnership with WHO)
n/a
EmergencyResponse Plan and Action Checklist (for aircarriers)
IATA (in
partnership with WHO)
n/a
AirTransport & Communicable Diseases Guidelines
WHO
12-Feb-2020
2019 Novel Coronavirus: Global Research and InnovationForum: Towards a Research Roadmap/report
WHO
11-Feb-2020
2019 Novel Coronavirus: Global Research and InnovationForum: Towards a Research Roadmap/report - presentation
WHO
18-Feb-2020
COVID-19PhaseIIb/IIIVaccine Trial Synopsis
WHO
19-Feb-2020
Emerging respiratory viruses, including nCoV: methods fordetection, prevention, response and control
WHO
19-Feb-2020
ePROTECT Respiratory Infections (EN)
WHO
24-Feb-2020
Operational considerationsfor managing COVID-19cases/outbreak on board ships
WHO
6-Mar-2020
Q&A on COVID-19 vs. Influenza
Other public health institutions guidance and resources
Organization
Datepublished
Guidanceor resource name
Countryreadiness
ECDC
17-Mar-2020
Guidanceforhealthsystemcontingency planning duringwidespread transmission of SARS-CoV-2 with high impact onhealthcareservices
Surveillance andcasedefinitions
US CDC
2-Feb-2020
Interim Guidancefor Healthcare Professionals
US CDC
2-Feb-2020
Flowchart to Identify and Assess 2019 Novel Coronavirus
US CDC
n/a
Check and Record Everyday Booklet – China
US CDC
21-Mar-2020
Informationfor Health Departments on Reporting Cases ofCOVID-19
US CDC
22-Mar-2020
InterimUSGuidancefor Risk Assessment and Public HealthManagement of Persons with Potential Coronavirus Disease2019 (COVID-19) Exposures: Geographic Risk and Contactsof Laboratory-confirmed Cases
ECDC
n/a
Case definition and European surveillance for humaninfection with novel coronavirus (2019-nCoV)
Laboratoryguidance
Organization
Datepublished
Guidanceor resource name
US CDC
28-Jan-2020
US CDC panel primer and probes– U.S. CDC, USAV – U.S.CDC, USA
US CDC
n/a
Informationfor Laboratories 2019-nCoV Requests forDiagnostic Panels and Virus
Interim Infection Prevention and Control Recommendationsfor Patients with Confirmed Coronavirus Disease 2019(COVID-19) orPersonsUnderInvestigationfor COVID-19 inHealthcare Settings
US CDC
n/a
Healthcare Supply of Personal Protective Equipment
US CDC
22-Mar-2020
InterimUSGuidancefor Risk Assessment and Public HealthManagement of Persons with Potential Coronavirus Disease2019 (COVID-19) Exposures: Geographic Risk and Contactsof Laboratory-confirmed Cases
US CDC
n/a
InterimConsiderations for Infection Prevention and Control ofCoronavirus Disease 2019 (COVID-19) in Inpatient ObstetricHealthcare Settings
US CDC
11-Feb-2020
Interim Guidancefor Discontinuation of In-Home Isolation forPatientswith COVID-19
US CDC
11-Feb-2020
Interim Guidancefor Discontinuation of Transmission-BasedPrecautions and Disposition of Hospitalized Patients withCOVID-19
US CDC
25-Feb-2020
Interim Guidancefor PreventingtheSpreadofCoronavirusDisease 2019 (COVID-19) in Homes and ResidentialCommunities
US CDC
n/a
InterimU.S. Guidancefor Risk Assessment and Public HealthManagement of Healthcare Personnel with Potential
Organization
Datepublished
Guidanceor resource name
Exposure in a Healthcare Setting to Patients with 2019 NovelCoronavirus (2019-nCoV)
US CDC
n/a
Interim Guidancefor Public Health Personnel EvaluatingPersonsUnderInvestigation (PUIs) and Asymptomatic CloseContacts ofConfirmed Cases at Their Home or Non-HomeResidential Setting
US CDC
n/a
HealthcareInfection Prevention and Control FAQs forCOVID-19
US CDC
n/a
Strategiesfor Optimizing the Supply of N95 Respirators
US CDC
28-Feb-2020
Checklistfor Healthcare Facilities: Strategies for Optimizingthe Supply of N95 Respirators during the COVID-19Response
US CDC
28-Feb-2020
Release of Stockpiled N95 Filtering Facepiece RespiratorsBeyond the Manufacturer-Designated Shelf Life:Considerations for the COVID-19 Response
US CDC
n/a
InterimAdditionalGuidance for Infection Prevention andControl Recommendations for Patients with Suspected orConfirmed COVID-19 in Outpatient Hemodialysis Facilities
ECDC
29-Jan-2020
Public health management of persons having had contactwith novel coronavirus cases in the European Union
ECDC
12-Mar-2020
Infection prevention and control for COVID-19 in healthcaresettings
ECDC
7-Feb-2020
Personal protective equipment (PPE) needs in healthcaresettings for the care of patients with suspected or confirmednovel coronavirus (2019-nCoV)
ECDC
18-Feb-2020
Interim guidancefor environmental cleaning in non-healthcarefacilities exposed to SARS-CoV-2
ECDC
2-Mar-2020
Resourceestimation for contact tracing, quarantine andmonitoring activities for COVID-19 cases in the EU/EEA
ECDC
28-Feb-2020
Guidancefor wearingand removing personal protectiveequipment in healthcare settings for the care of patients withsuspected or confirmed COVID-19
ECDC
25-Feb-2020
Public health management of persons, including health careworkers, having had contact with COVID-19 cases in theEuropean Union
ECDC
26-Feb-2020
Checklistfor hospitals preparing for the reception and care ofcoronavirus 2019 (COVID-19) patients
ECDC
23-Mar-2020
Considerations related to the safe handling of bodies ofdeceased persons with suspected or confirmed COVID-19
Earlyinvestigations
US CDC
28-Feb-2020
Recommendations for Reporting,Testing,and SpecimenCollection
US CDC
3-Feb-2020
PatientUnder Investigation form
US CDC
4-Mar-2020
Evaluatingand Reporting Patients Under Investigation (PUI)
Organization
Datepublished
Guidanceor resource name
US CDC
2-Feb-2020
Interim Guidelines for Collecting, Handling, and TestingClinical Specimensfrom Patients Under Investigation (PUIs)for 2019 Novel Coronavirus (2019-nCoV)
US CDC
n/a
Informationfor Health Departments on Reporting a PatientUnder Investigation (PUI) for 2019-nCoV
US CDC
n/a
Case Report Form for 2019 Novel Coronavirus
ECDC
30-Jan-2020
Algorithm formanagementofcontacts of probable orconfirmed2019-nCoV cases
Risk communication& community engagement
US CDC
24-Feb-2020
CDC in Action: Preparing Communities for Potential SpreadofCOVID-19
Interim Guidancefor AdministratorsofUS ChildcarePrograms and K-12 Schools to Plan, Prepare, and Respondto Coronavirus Disease 2019 (COVID-19)
US CDC
8-Mar-2020
Resources forInstitutesofHigher Education
US CDC
8-Mar-2020
COVID-19and Cruise Ship Travel
US CDC
8-Mar-2020
Environmental Cleaning and Disinfection Recommendations
US CDC
8-Mar-2020
People at Risk for Serious Illness from COVID-19
US CDC
8-Mar-2020
What lawenforcement personnel needtoknowabout coronavirus disease 2019 (COVID-19)
US CDC
n/a
Resources for Community-and Faith-Based Leaders
US CDC
n/a
Resourcesfor Homeless Shelters
US CDC
n/a
ProtectYour Home
US CDC
17-Mar-2020
ProtectYour Family
US CDC
n/a
Howto Prepare for COVID-19
US CDC
18-Mar-2020
Howto Protect Yourself
US CDC
21-Mar-2020
OlderAdults
US CDC
17-Mar-2020
People with Asthma and COVID-19
US CDC
22-Mar-2020
Schools,Workplaces& Community Locations
ECDC
13-Feb-2020
Guidance on community engagement for public health eventscaused by communicable disease threats in the EU/EEA
ECDC
12-Mar-2020
Information on COVID-19 for specific groups: the elderly,patients with chronic diseases, people withimmunocompromising condition and pregnant women
ECDC
11-Mar-2020
Considerations relating to social distancing measures inresponse to the COVID-19 epidemic
Disease commoditypackage
Organization
Datepublished
Guidanceor resource name
US CDC
2-Feb-2020
InterimLaboratory Biosafety Guidelines forHandlingandProcessing Specimens Associated with 2019 NovelCoronavirus (2019-nCoV)
Traveladvice
US CDC
n/a
Travelers from China Arriving in the United States
US CDC
n/a
Communication Resources for Travelers
US CDC
22-Mar-2020
Coronavirus Disease 2019 Information for Travel
ECDC
30-Jan-2020
Advice for travellers: outbreak of a novel coronavirus 2019-nCoV
Others
US CDC
13-Feb-2020
Interim Guidancefor Airlines and Airline Crew: CoronavirusDisease 2019 (COVID-19)
US CDC
4-Feb-2020
2019 Novel Coronavirus: Interim Health Guidance from theFederal Aviation Administration and the Centers for DiseaseControl and Prevention for Air Carriers and Crews
US CDC
n/a
PreventingSpread of Disease on Commercial Aircraft:Guidance for Cabin Crew
US CDC
n/a
Interim GuidanceforBusinesses and Employers to Plan andRespond to 2019 Novel Coronavirus (2019-nCoV), February2020
US CDC
n/a
Interim GuidanceforEmergencyMedical Services (EMS)Systems and 911 Public Safety Answering Points (PSAPs) for2019-nCoV in the United States
US CDC
18-Feb-2020
Interim Guidancefor Ships on Managing SuspectedCoronavirus Disease 2019
ECDC
23-Mar-2020
Coronavirus disease 2019 (COVID-19) and supply ofsubstances ofhuman origin in the EU/EEA
Socialdistancing
ECDC
18-Mar-2020
Video on COVID-19: Why social distancing is important
Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).
COVID-19 Scientific and Public Health Policy Update – (March 24, 2020)
African countries have imposed tighter travel and public health policies such as full border closures
ADDIS ABABA, Ethiopia, March 24, 2020/APO Group/ --
In addition to our weekly brief on the spread of COVID-19 and the actions that Africa CDC is taking to helpmember states, Africa CDC has begun to share a weekly brief detailing the latest changes inscientificknowledgeandpublichealthpolicychanges,aswellasupdates to the latest guidance fromWHO and others. Contents of this document are not intended to serve as recommendations from theAfricaCDC;rather,itisa summary of the factbase to help inform member states. It is important tonotethattheoutbreakisevolvingrapidlyand that the nature of this information will continue tochange.So we will continue to provide regular updates to ensure member states are informed of themost critical developments in these areas.A Executive Summary
A report on COVID-19 patients in China suggest that prior to the travel restrictions in January 23, 86% of all infections were undocumented and that these infections were the source of 79% of documented cases.
A published study on aerosol and surface stability of SARS-CoV-2 suggests that the virus can remain viable in aerosols for up to 3 hours, copper for up to 4 hours, cardboard for up to 24 hours and plastics and steel for up to 4 days.
An epidemic-modeling report suggests that a combination of case isolation, home quarantine and social distancing of >70-year-olds could reduce peak critical care demand by two-thirds and halve the number of deaths. However, this would still result in an 8-fold higher peak demand then surge capacity on critical care beds in both UK and the US. Leveraging population-wide social distancing, home isolation of cases and school and university closures have the potential to suppress transmission below the threshold of R=1, however, to avoid rebound in transmission, these policies would need to be maintained until large stocks of vaccines are available (which could be in 18 months).
A clinical trial of lopinavir-ritonavir treatment on 199 patients found that intake of the drugs resulted in no benefit beyond standard care. Meanwhile, an observational trial suggests that chloroquine could be a promising treatment based on lower viral loads observed in patients who were administered the drug. However, randomized control trials need to be conducted in order to validate viability of the drug. Multiple trials are underway including a large global trial, SOLIDARITY, launched by WHO.
The US FDA has granted 'emergency use authorization' to Cepheid's COVID-19 test. The test is a molecular, PCR-based test, that can provide accurate results in 45 minutes. The tests are planned to be rolled out on March 30.
As cases in the continent continue to rise over the past week, African countries have imposed tighter travel and public health policies such as full border closures (e.g., Angola, Rwanda, Nigeria), cessation of air traffic (e.g., Kenya, Sierra Leone, Mauritania), entry restrictions for non-citizens / non-residents (e.g., Seychelles), lockdown (e.g., South Africa, Rwanda) and etc.
Similarly, heavily affected countries globally have continued to enforce strict public health and travel policies such as entry restrictions for all foreigners (e.g., EU), closure of schools and non-essential businesses (e.g., Italy, US, UK) etc.
New Guidlines and Resources
Since March 17th, WHO has published new and updated guidance on CriticalPreparedness and Response Actions for COVID-19, Home care for patients with COVID-19 presenting with mild symptoms, Rights, Roles and Responsibilities of health workers, IPC during health care, Guidance for Mental Health and Psychosocial considerations, Guidance for Population-based age-stratified seroepidemiological investigation protocolfor COVID-19, Advice on the use of masks in the community, during home care and inhealthcare settings
US CDC has published new and updated guidance on Preparedness of HealthcareFacilities, Long-term Care Facilities / Nursing Homes, Criteria for Return to Work of aHealthcare Personnel with Confirmed or Suspected COVID-19, IPC for OutpatientHemodialysis Facilities, Interim Guidelines for Collecting, Handling and Testing ClinicalSpecimens, Travel, Protecting and Preparing Home and Family for COVID-19
ECDC has issued new guidance and resources on Safe handling of bodies of deceasedpersons with suspected or confirmed COVID-19, Supply of substances of human origin inthe EU/EEA, Discharge criteria for confirmed COVID-19 cases, IPC in HealthcareSettings, Information for Specific Groups (e.g., Elderly, Chronic Disease Patients,Pregnant Women etc.) and Considerations relating to Social Distancing Measures
The full list of latest guidance and resources from WHO and other public health institutions are listed at the end of this update in section G.
A published study on aerosol and surface stability of SARS-CoV-2 suggests that the viruscan remain viable in aerosols for up to 3 hours, copper for up to 4 hours, cardboard for upto 24 hours and plastics and steel for up to 4 days.
A review of the viral dynamics of mild and severe patients (76) in Nanchang found that severe COVID-19 patients tend to have a high viral load (mean viral load that was 60xhigher than that of mild cases') and a long virus-shedding period (90% of mild cases tested negative after 10 days, while severe cases all still tested positive).
A case report on the kinetics of immune responses in relation to clinical and virologic features of a patient with mild-to-moderate COVID-19 found that increased antibody-secreting cells (ASCs), follicular helper T cells (TFH cells), activated CD4+ T cells andCD8+ T cells and immunoglobulin M (IgM) and IgG antibodies that bound the COVID-19-causing coronavirus SARS-CoV-2 were detected in blood before symptomatic recovery. These immunological changes persisted for at least 7 days following full resolution of symptoms. Further examinations of larger cohort sizes are needed to determine if such immune parameters can be used to predict disease outcomes.
Epidemiology
An estimation of undocumented COVID-19 patients in China suggest that prior to the travel restrictions in January 23, 86% of all infections were undocumented and that these undocumented infections (many of whom were most likely not severely symptomatic) were the source of 79% of documented cases.
A review of 1391 children tested (of which 171 or 12.3% were positive) from Jan 28 to Feb 26 in Wuhan suggests that most children have a milder clinical course and thatasymptomatic cases are not uncommon. Only 42% of the children had fever, only 3 required intensive care (all of whom had coexisting conditions). As of March 8, there was only 1 death (a 10-month-old child with intussusception). 21 patients were in stable condition and 149 have been discharged.
An investigation of 10 pediatric SARS-CoV-2 infection cases found that 8 of 10 childrenpersistently tested positive on rectal swabs even after nasopharyngeal testing wasnegative, suggesting the possibility of fecal–oral transmission and that rectal swab-testing may be more useful than nasopharyngeal swab-testing in judging the effectiveness of treatment and determining the termination of quarantine. However, the report found no evidence of replication-competent virus in fecal swabs, which is required to confirm the potential for fecal–oral transmission.
A single center observational study on 8 severe pediatric COVID-19 patients found that polypnea was the most common symptom, followed by fever and cough. Multiple patch- like shadows and ground-glass opacity in CT scans and a cytokine storm in these patients were observed.
A review of literature describing 38 pregnant women with COVID-19 and their newborns in China reveals that COVID-19 did not lead to maternal deaths. More importantly, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses.
Diagnostics
The US FDA has granted 'emergency use authorization' to Cepheid's COVID-19 test. The test is a molecular, PCR-based test, that can provide accurate results in 45 minutes. The tests are planned to be rolled out on March 30.
An examination of the time kinetics of antibodies produced against SARS-CoV-2 suggests that humoral response to SARS-CoV-2 can aid in its diagnosis. IgM ELISAassay when combined with PCR can increase positive detection rate to 98.6% vs. asingle qPCR test (51.9%). This methodology needs to be replicated further to fully assess effectiveness of IgM ELISA assay in diagnosis.
Care and Treatment
A clinical trial of lopinavir-ritonavir treatment on 199 patients show that intake of the drugsresulted in no benefit i.e., clinical improvement that was one day shorter and no improvement in mortality or detectable viral RNA.
An observational trial suggests that chloroquine could be a promising treatment based on lower viral loads observed in patients who were administered the drug. However, randomized control trials need to be conducted in order to validate viability of the drug.
A network-based methodology for systematic identification of drugs for potential treatment of SARS-CoV-2 has prioritized 16 candidate repurposable drugs and 3potential drug combinations. However, although the majority of predictions have been validated by various literature data, these must be validated in various experimental assays and randomized clinical trials before being used in patients.
WHO announced a large global trial, called SOLIDARITY, focused on the four mostpromising therapies: remdesivir, chloroquine and hydroxychloroquine, lopinavir andritonavir, and lopinavir and ritonavir plus interferon-beta, an immune system messenger that can help cripple viruses. Similarly, INSERM, announced that it will coordinate an add-on trial in Europe, named Discovery, that will follow WHO’s example and will include 3200 patients from at least seven countries, including 800 from France. That trial will test the same drugs, except for chloroquine.
Vaccines
China has authorized clinical trials on its first vaccine developed to combat the new coronavirus, according to a report in the ruling Communist Party's People's Daily.
Moderna is seeking to provide access to the vaccine to a limited group, likely consistingof healthcare workers, by as early as this fall. The company plans to do so under an emergency use authorization from the US FDA.
Non-pharmaceutical interventions, social distancing
The epidemic-modeling report out of Imperial College London suggests that unmitigated, the outbreak would result in approximately 510,000 deaths in the UK and 2.2 million in the US. Implementing an "optimal" mitigation strategy (i.e., reducing R but not to less than 1 through a combination of case isolation, home quarantine and social distancing of >70-year-old) reduces peak critical care demand by two-thirds and halves the number of deaths. However, this scenario would still result in an 8-fold higher peak demand on critical care beds over and above the available surge capacity in both UK and the US. Leveraging population-wide social distancing, home isolation of cases and school anduniversity closures – has the potential to suppress transmission below the threshold ofR=1, however, to avoid rebound in transmission, these policies would need to be maintained until large stocks of vaccines are available (which could be in 18 months).
Related Public Health Policy
Africa
As cases in the continent continue to rise over the past week, African countries have continued to impose tighter travel and public health policies to manage the outbreak: (not exhaustive)
Full border closure(air, land, sea) except for cargo / freight and emergencies:Angola, Burkina Faso, Congo Republic, Gabon, Gambia, Ghana, Niger, Nigeria, Rwanda, Uganda, Zimbabwe
Flight suspensions to/from high risk countries: Mali,South Sudan
Entryrestrictionsfor non-citizens / non- residents coming from high riskcountries: Eswatini, Côte d'Ivoire, Sao Tome and Principe, Seychelles
Mandatoryfacilityquarantine at own expense of traveler: Kenya, Ethiopia, Tanzania
Lock down(limitingof movement outside home) and curfew: Burkina Faso, Côte d'Ivoire, DRC, Gabon, Madagascar, Rwanda, Senegal, South Africa, Tunisia
Shutdownof educational / religious institutions and entertainment venues,banning of mass gatherings: BurkinaFaso, Cote d’Ivoire, DRC, Eswatini, Gabon, Mali, Kenya, Nigeria, Sierra Leone, South Africa, Zambia, Zimbabwe and etc.
Limitationon prison and hospital visits: Eswatini, Gabon, Zimbabwe
Equatorial Guinea has committed to contribute 5 billion CFA francs (about $8 million) to a special emergency fund to manage the COVID-19 outbreak.
Kenya, Uganda, Cameroon and Ghana have asked banks and mobile network operators to promote more efficient, digital forms of payment (e.g., lower or no tariffs on mobile money transfers)
Ethiopian Airlines has started the distribution of coronavirus donation made to Africa by Chinese business mogul Jack Ma, CEO of e-commerce giants Ali Baba. The carrier will start distribution to its neighbors – Eritrea, Djibouti, Egypt and Sudan.
Ethiopian Airlines has suspended flights to 30 affected countries.
Refer to Section E and F for the full summary of travel restrictions and social distancing measures implemented by African countries.
Rest of World
As COVID-19 cases outside China accelerate rapidly, heavily affected countries have continued to impose public health policies to contain the outbreak
The European Union (EU) will impose an entry ban on travelers from outside the bloc for 30 days, only nationals of EFTA countries and Britain are exempt.
Italy has ordered all non-essential businesses to close until April 3. The army wasdeployed to enforce lockdown in the country’s worst-hit region. In addition, thecountry will rush 10,000 student doctors into service, scrapping their final exams.
Multiple states in the US have ordered closures of schools / education institutions and non-essential businesses. The US military will make available up to 5 millionrespirator masks and protective equipment
Germany has expanded entry restrictions to include flights from Italy, Spain, Austria, France, Luxembourg, Denmark and Switzerlan
UK has announced a strict lockdown in the country, restricting public movement to essential activities.
Canada's most populous province Ontario has ordered the closure of bars and restaurants and banned gatherings of more than 50 people.
As cases across multiple countries across all continent grow, countries have increasingly
imposedrestrictive travel and public health policies (not exhaustive)
Fullborder closures: Chile, Colombia, Ecuador, Malaysia, Lithuania, Honduras
Suspension of all international flights: Belgium, UAE, Pakistan, Vietnam, etc.
Entry restrictions to travelers from specific countries or all foreigners: Australia, Russia, Uzbekistan Singapore, Jamaica, Cuba
Suspension of travel to and from high risk areas e.g., Argentina, Bangladesh, Netherlands, Turkey, Jordan
Communityquarantine / lockdown: El Salvador, Bolivia, Ecuador, Venezuela, Peru, Philippines, Iraq
Shutdownof educational institutions, religious institutions, and other publicareas: Afghanistan, Australia, India, Qatar, UAE, Armenia, Thailand, Kazakhstan, Italy, Poland etc.
Banning of mass / public gatherings: Oman, Lebanon, Qatar and etc.
While domestic cases in China have waned, imported cases have risen. As a result, the country has tightened quarantine measures for travelers arriving into the country, requiring all travelers arriving in Beijing and Hong Kong are required to go into centralizedquarantine locations for 14 days.
Summary of Travel Restriction implemented By Member States
Lastupdated
Country
Mandatoryself-quaran-tine
Mandatoryfacilityquarantine for all travelers
Entryrestric-tions (incl. visa limitations)
Flight / travelsuspensions to specific countries
Airtrafficclosure
Fullborderclosure
18-Mar
Algeria
y
21-Mar
Angola
y
17-Mar
Benin
y
y
17-Mar
Botswana
y
21-Mar
Burkina Faso
y
24-Mar
Burundi
y
18-Mar
Cabo Verde
y
y
18-Mar
Cameroon
y
18-Mar
Central African Republic
18-Mar
Chad
y
y
y
17-Mar
Comoros
y
21-Mar
Congo Republic
y
18-Mar
Côte d'Ivoire
y
y
18-Mar
Djibouti
y
18-Mar
DR Congo
y
17-Mar
Egypt
y
18-Mar
Equatorial Guinea
y
17-Mar
Eritrea
y
18-Mar
Eswatini
y
y
23-Mar
Ethiopia
y
y
20-Mar
Gabon
y
y
23-Mar
Gambia
y
22-Mar
Ghana
y
17-Mar
Guinea
y
18-Mar
Guinea- Bissau
y
22-Mar
Kenya
y
y
17-Mar
Lesotho
y
17-Mar
Liberia
y
18-Mar
Libya
y
18-Mar
Madagascar
y
17-Mar
Malawi
y
18-Mar
Mali
y
21-Mar
Mauritania
y
18-Mar
Mauritius
y
y
17-Mar
Morocco
y
17-Mar
Mozambique
y
18-Mar
Namibia
y
y
21-Mar
Niger
y
21-Mar
Nigeria
y
21-Mar
Rwanda
y
19-Mar
Sahrawi Republic
y
18-Mar
Sao Tome and Principe
y
Lastupdated
Country
Mandatoryself-quaran-tine
Mandatoryfacilityquarantine for all travelers
Entryrestric-tions (incl. visa limitations)
Flight / travelsuspensions to specific countries
Airtrafficclosure
Fullborderclosure
18-Mar
Senegal
y
18-Mar
Seychelles
y
23-Mar
Sierra Leone
y
18-Mar
Somalia
y
17-Mar
South Africa
y
y
21-Mar
South Sudan
y
y
17-Mar
Sudan
y
y
23-Mar
Tanzania
y
24-Mar
Togo
y
18-Mar
Tunisia
y
y
22-Mar
Uganda
y
18-Mar
Zambia
y
24-Mar
Zimbabwe
y
Summary of social distancing measures implemented by Member States
Lastupdated
Country
Closureofeducationalinstitutions
Banningofmassgatherings,closure ofpublic spaces
Measuresforspecialpopulationse.g., prison,elder homes
Lockdown(e.g., curfew,stay athome)
12-Mar
Algeria
y
y
19-Mar
Angola
y
18-Mar
Benin
y
19-Mar
Botswana
y
20-Mar
Burkina Faso
y
y
y
19-Mar
Burundi
18-Mar
Cabo Verde
y
17-Mar
Cameroon
y
y
19-Mar
Central African Republic
20-Mar
Chad
y
19-Mar
Comoros
19-Mar
Congo Republic
23-Mar
Côte d'Ivoire
y
y
y
20-Mar
Djibouti
y
23-Mar
DR Congo
y
y
y
16-Mar
Egypt
y
y
19-Mar
Equatorial Guinea
23-Mar
Eritrea
y
17-Mar
Eswatini
y
y
y
16-Mar
Ethiopia
y
y
21-Mar
Gabon
y
y
y
y
17-Mar
Gambia
y
y
16-Mar
Ghana
y
y
19-Mar
Guinea
19-Mar
Guinea-Bissau
15-Mar
Kenya
y
y
19-Mar
Lesotho
y
18-Mar
Liberia
y
y
13-Mar
Libya
y
y
Lastupdated
Country
Closureofeducationalinstitutions
Banningofmassgatherings,closure ofpublic spaces
Measuresforspecialpopulationse.g., prison,elder homes
Lockdown(e.g., curfew,stay athome)
23-Mar
Madagascar
y
29-Mar
Malawi
y
y
18-Mar
Mali
y
y
14-Mar
Mauritania
y
y
y
18-Mar
Mauritius
y
14-Mar
Morocco
y
y
19-Mar
Mozambique
y
y
17-Mar
Namibia
y
y
19-Mar
Niger
y
y
21-Mar
Nigeria
y
21-Mar
Rwanda
y
19-Mar
Sahrawi Republic
19-Mar
Sao Tome and Principe
24-Mar
Senegal
y
y
y
19-Mar
Seychelles
18-Mar
Sierra Leone
y
19-Mar
Somalia
23-Mar
South Africa
y
19-Mar
South Sudan
y
14-Mar
Sudan
y
y
17-Mar
Tanzania
y
y
19-Mar
Togo
20-Mar
Tunisia
y
y
y
18-Mar
Uganda
y
y
17-Mar
Zambia
y
y
23-Mar
Zimbabwe
y
y
y
WHO Guidlines and Resources
Organization
Datepublished
Guidanceor resource name
Countryreadiness
WHO
9-Jan-2020
National capacitiesreviewtoolfor a novel coronavirus
WHO
19-Mar-2020
Critical preparedness, readiness and response actions forCOVID-19
WHO
4-Mar-2020
Operational Planning Guidelines and COVID-19 PartnersPlatform to support country preparedness and response
Surveillance andcasedefinitions
WHO
27-Feb-2020
Global Surveillance for human infection with coronavirusdisease (COVID-19)
WHO
27-Feb-2020
Revised case reporting form for COVID-19 for confirmed casesand their outcome
WHO
n/a
Emerging respiratory viruses, including 2019-nCoV: methodsfordetection, prevention, responseandcontrol
WHO
n/a
Global COVID-19 Clinical Characterization Case Record Formand new data platform for anonymized COVID-19 clinical data
Organization
Datepublished
Guidanceor resource name
WHO
n/a
Case Reporting Form for COVID-19
Laboratoryguidance
WHO
2-Mar-2020
Laboratorytestingfor 2019 novel coronavirus (2019-nCoV) insuspected human cases
WHO
1-Mar-2020
Guidancefor laboratories shipping specimens to WHOreference laboratories that provide confirmatory testing forCOVID-19 virus
Patient management
WHO
13-Mar-2020
Clinical management of severeacuterespiratoryinfectionwhen novel coronavirus (nCoV) infection is suspected
WHO
17-Mar-2020
Homecareforpatients with suspected novel coronavirus(nCoV)infectionpresenting with mild symptoms andmanagementof contacts
WHO
n/a
WHO Critical Care Severe Acute Respiratory Infection TrainingShort Course
WHO
19-Mar-2020
TheRights, Roles and Responsibilities Of Health Workers,Including Key Considerations For Occupational Safety AndHealth
WHO
19-Mar-2020
Mental health and psychosocial considerations during theCOVID-19outbreak
Infectionprevention and control
WHO
19-Mar -2020
Infection prevention and control during health care when novelcoronavirus(nCoV) infection is suspected
WHO
19-Mar-2020
Advice on the use of masks in the community, during homecare and in health care settings in the context of the novelcoronavirus (2019-nCoV) outbreak
WHO
10-Feb-2020
Q&A on infection prevention and control for health careworkers caring for patients with suspected or confirmed 2019-nCoV
WHO
11-Feb-2020
Keyconsiderationsforrepatriation and quarantine of travellersin relation to the outbreak of novel coronavirus 2019-nCoV
WHO
16-Feb-2020
ManagementofilltravellersatPointsofEntry– internationalairports, seaports and ground crossings – in the context ofCOVID-19 outbreak
WHO
18-Feb-2020
Surfacesamplingofcoronavirus disease (COVID-19):
A practical “how to” protocol for health care and public healthprofessionals
WHO
14-Feb-2020
Key planningrecommendations for Mass Gatherings in thecontextof the current COVID-19 outbreak
WHO
n/a
Online course for public health preparedness for massgatheringevents
WHO
n/a
Infection Prevention and Control (IPC) for Novel Coronavirus(COVID-19)
WHO
27-Feb-2020
Rational use of personal protective equipment
Organization
Datepublished
Guidanceor resource name
forcoronavirus disease 2019 (COVID-19)
WHO
1-Mar-2016
Handbookfor the Management of Public Health Events in AirTransport
WHO
1-Jan-2016
Handbookfor management of public health events on boardships
WHO
24-Jan-2011
Handbookfor inspection of ships and issuance of shipsanitation certificates
Earlyinvestigations
WHO
25-Jan-2020
Protocolfor assessmentofpotentialrisk factorsfor 2019-novelcoronavirus (2019-nCoV) infection among health care workersin a health care setting
WHO
25-Jan-2020
Household transmission investigation protocol for 2019-novelcoronavirus (2019-nCoV) infection
WHO recommendations to reduce risk of transmission ofemerging pathogens from animals to humans in live animalmarkets
Traveladvice
WHO
29-Feb-2020
UpdatedWHOrecommendations for international traffic inrelation to COVID-19 outbreak
Others
Organization
Datepublished
Guidanceor resource name
WHO
3-Feb-2020
2019-nCoV StrategicPreparedness and Response Plan
IATA (in
partnership with WHO)
n/a
EmergencyResponse Plan and Action Checklist (for aircarriers)
IATA (in
partnership with WHO)
n/a
AirTransport & Communicable Diseases Guidelines
WHO
12-Feb-2020
2019 Novel Coronavirus: Global Research and InnovationForum: Towards a Research Roadmap/report
WHO
11-Feb-2020
2019 Novel Coronavirus: Global Research and InnovationForum: Towards a Research Roadmap/report - presentation
WHO
18-Feb-2020
COVID-19PhaseIIb/IIIVaccine Trial Synopsis
WHO
19-Feb-2020
Emerging respiratory viruses, including nCoV: methods fordetection, prevention, response and control
WHO
19-Feb-2020
ePROTECT Respiratory Infections (EN)
WHO
24-Feb-2020
Operational considerationsfor managing COVID-19cases/outbreak on board ships
WHO
6-Mar-2020
Q&A on COVID-19 vs. Influenza
Other public health institutions guidance and resources
Organization
Datepublished
Guidanceor resource name
Countryreadiness
ECDC
17-Mar-2020
Guidanceforhealthsystemcontingency planning duringwidespread transmission of SARS-CoV-2 with high impact onhealthcareservices
Surveillance andcasedefinitions
US CDC
2-Feb-2020
Interim Guidancefor Healthcare Professionals
US CDC
2-Feb-2020
Flowchart to Identify and Assess 2019 Novel Coronavirus
US CDC
n/a
Check and Record Everyday Booklet – China
US CDC
21-Mar-2020
Informationfor Health Departments on Reporting Cases ofCOVID-19
US CDC
22-Mar-2020
InterimUSGuidancefor Risk Assessment and Public HealthManagement of Persons with Potential Coronavirus Disease2019 (COVID-19) Exposures: Geographic Risk and Contactsof Laboratory-confirmed Cases
ECDC
n/a
Case definition and European surveillance for humaninfection with novel coronavirus (2019-nCoV)
Laboratoryguidance
Organization
Datepublished
Guidanceor resource name
US CDC
28-Jan-2020
US CDC panel primer and probes– U.S. CDC, USAV – U.S.CDC, USA
US CDC
n/a
Informationfor Laboratories 2019-nCoV Requests forDiagnostic Panels and Virus
Interim Infection Prevention and Control Recommendationsfor Patients with Confirmed Coronavirus Disease 2019(COVID-19) orPersonsUnderInvestigationfor COVID-19 inHealthcare Settings
US CDC
n/a
Healthcare Supply of Personal Protective Equipment
US CDC
22-Mar-2020
InterimUSGuidancefor Risk Assessment and Public HealthManagement of Persons with Potential Coronavirus Disease2019 (COVID-19) Exposures: Geographic Risk and Contactsof Laboratory-confirmed Cases
US CDC
n/a
InterimConsiderations for Infection Prevention and Control ofCoronavirus Disease 2019 (COVID-19) in Inpatient ObstetricHealthcare Settings
US CDC
11-Feb-2020
Interim Guidancefor Discontinuation of In-Home Isolation forPatientswith COVID-19
US CDC
11-Feb-2020
Interim Guidancefor Discontinuation of Transmission-BasedPrecautions and Disposition of Hospitalized Patients withCOVID-19
US CDC
25-Feb-2020
Interim Guidancefor PreventingtheSpreadofCoronavirusDisease 2019 (COVID-19) in Homes and ResidentialCommunities
US CDC
n/a
InterimU.S. Guidancefor Risk Assessment and Public HealthManagement of Healthcare Personnel with Potential
Organization
Datepublished
Guidanceor resource name
Exposure in a Healthcare Setting to Patients with 2019 NovelCoronavirus (2019-nCoV)
US CDC
n/a
Interim Guidancefor Public Health Personnel EvaluatingPersonsUnderInvestigation (PUIs) and Asymptomatic CloseContacts ofConfirmed Cases at Their Home or Non-HomeResidential Setting
US CDC
n/a
HealthcareInfection Prevention and Control FAQs forCOVID-19
US CDC
n/a
Strategiesfor Optimizing the Supply of N95 Respirators
US CDC
28-Feb-2020
Checklistfor Healthcare Facilities: Strategies for Optimizingthe Supply of N95 Respirators during the COVID-19Response
US CDC
28-Feb-2020
Release of Stockpiled N95 Filtering Facepiece RespiratorsBeyond the Manufacturer-Designated Shelf Life:Considerations for the COVID-19 Response
US CDC
n/a
InterimAdditionalGuidance for Infection Prevention andControl Recommendations for Patients with Suspected orConfirmed COVID-19 in Outpatient Hemodialysis Facilities
ECDC
29-Jan-2020
Public health management of persons having had contactwith novel coronavirus cases in the European Union
ECDC
12-Mar-2020
Infection prevention and control for COVID-19 in healthcaresettings
ECDC
7-Feb-2020
Personal protective equipment (PPE) needs in healthcaresettings for the care of patients with suspected or confirmednovel coronavirus (2019-nCoV)
ECDC
18-Feb-2020
Interim guidancefor environmental cleaning in non-healthcarefacilities exposed to SARS-CoV-2
ECDC
2-Mar-2020
Resourceestimation for contact tracing, quarantine andmonitoring activities for COVID-19 cases in the EU/EEA
ECDC
28-Feb-2020
Guidancefor wearingand removing personal protectiveequipment in healthcare settings for the care of patients withsuspected or confirmed COVID-19
ECDC
25-Feb-2020
Public health management of persons, including health careworkers, having had contact with COVID-19 cases in theEuropean Union
ECDC
26-Feb-2020
Checklistfor hospitals preparing for the reception and care ofcoronavirus 2019 (COVID-19) patients
ECDC
23-Mar-2020
Considerations related to the safe handling of bodies ofdeceased persons with suspected or confirmed COVID-19
Earlyinvestigations
US CDC
28-Feb-2020
Recommendations for Reporting,Testing,and SpecimenCollection
US CDC
3-Feb-2020
PatientUnder Investigation form
US CDC
4-Mar-2020
Evaluatingand Reporting Patients Under Investigation (PUI)
Organization
Datepublished
Guidanceor resource name
US CDC
2-Feb-2020
Interim Guidelines for Collecting, Handling, and TestingClinical Specimensfrom Patients Under Investigation (PUIs)for 2019 Novel Coronavirus (2019-nCoV)
US CDC
n/a
Informationfor Health Departments on Reporting a PatientUnder Investigation (PUI) for 2019-nCoV
US CDC
n/a
Case Report Form for 2019 Novel Coronavirus
ECDC
30-Jan-2020
Algorithm formanagementofcontacts of probable orconfirmed2019-nCoV cases
Risk communication& community engagement
US CDC
24-Feb-2020
CDC in Action: Preparing Communities for Potential SpreadofCOVID-19
Interim Guidancefor AdministratorsofUS ChildcarePrograms and K-12 Schools to Plan, Prepare, and Respondto Coronavirus Disease 2019 (COVID-19)
US CDC
8-Mar-2020
Resources forInstitutesofHigher Education
US CDC
8-Mar-2020
COVID-19and Cruise Ship Travel
US CDC
8-Mar-2020
Environmental Cleaning and Disinfection Recommendations
US CDC
8-Mar-2020
People at Risk for Serious Illness from COVID-19
US CDC
8-Mar-2020
What lawenforcement personnel needtoknowabout coronavirus disease 2019 (COVID-19)
US CDC
n/a
Resources for Community-and Faith-Based Leaders
US CDC
n/a
Resourcesfor Homeless Shelters
US CDC
n/a
ProtectYour Home
US CDC
17-Mar-2020
ProtectYour Family
US CDC
n/a
Howto Prepare for COVID-19
US CDC
18-Mar-2020
Howto Protect Yourself
US CDC
21-Mar-2020
OlderAdults
US CDC
17-Mar-2020
People with Asthma and COVID-19
US CDC
22-Mar-2020
Schools,Workplaces& Community Locations
ECDC
13-Feb-2020
Guidance on community engagement for public health eventscaused by communicable disease threats in the EU/EEA
ECDC
12-Mar-2020
Information on COVID-19 for specific groups: the elderly,patients with chronic diseases, people withimmunocompromising condition and pregnant women
ECDC
11-Mar-2020
Considerations relating to social distancing measures inresponse to the COVID-19 epidemic
Disease commoditypackage
Organization
Datepublished
Guidanceor resource name
US CDC
2-Feb-2020
InterimLaboratory Biosafety Guidelines forHandlingandProcessing Specimens Associated with 2019 NovelCoronavirus (2019-nCoV)
Traveladvice
US CDC
n/a
Travelers from China Arriving in the United States
US CDC
n/a
Communication Resources for Travelers
US CDC
22-Mar-2020
Coronavirus Disease 2019 Information for Travel
ECDC
30-Jan-2020
Advice for travellers: outbreak of a novel coronavirus 2019-nCoV
Others
US CDC
13-Feb-2020
Interim Guidancefor Airlines and Airline Crew: CoronavirusDisease 2019 (COVID-19)
US CDC
4-Feb-2020
2019 Novel Coronavirus: Interim Health Guidance from theFederal Aviation Administration and the Centers for DiseaseControl and Prevention for Air Carriers and Crews
US CDC
n/a
PreventingSpread of Disease on Commercial Aircraft:Guidance for Cabin Crew
US CDC
n/a
Interim GuidanceforBusinesses and Employers to Plan andRespond to 2019 Novel Coronavirus (2019-nCoV), February2020
US CDC
n/a
Interim GuidanceforEmergencyMedical Services (EMS)Systems and 911 Public Safety Answering Points (PSAPs) for2019-nCoV in the United States
US CDC
18-Feb-2020
Interim Guidancefor Ships on Managing SuspectedCoronavirus Disease 2019
ECDC
23-Mar-2020
Coronavirus disease 2019 (COVID-19) and supply ofsubstances ofhuman origin in the EU/EEA
Socialdistancing
ECDC
18-Mar-2020
Video on COVID-19: Why social distancing is important
Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).
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