Why Have We Developed This Guide? x To update IPPF occupational health and safety mechanisms in

response to the risk posed by COVID-19, to ensure we can

protect our staff and clients. This brief refresher has been

compiled to support (not replace) current Infection Prevention

and Control Measures.

Infection Prevention and Control (IPC) is crucial to managing this risk. IPC programmes support the prevention of avoidable infections and save lives. Effective IPC programmes have led to a 30%+ reduction in hospital-acquired infection rates and prevent morbidity and mortality.

KEY POINTS

Coronavirus disease 2019 (COVID-19) is a

respiratory tract infection caused by a newly

emergent coronavirus

The best way to prevent illness is to avoid

being exposed to this virus.

The virus is thought to spread mainly from

person-to-person. Social distancing and

practicing good hand hygiene are key to

stopping the spread of the virus.

BEWARE FAKE NEWS! This guide has been developed using resources from the World Health Organisation, the Centre for Disease

Control and other reputable sources. Before sharing news or information, check the source and make sure it is accurate.

What is Coronavirus? x

Coronavirus disease 2019 (COVID-19) is a respiratory tract

infection caused by a newly emergent coronavirus, SARS-CoV-2,

that was first recognized in Wuhan, China, in December 2019.

What are the Symptoms of Coronavirus?

Fever Cough Shortness of Breath

(less common: weakness, malaise, runny nose, diarrhoea, vomiting)

Early recognition of suspected patients allows for timely

initiation of appropriate IPC measures.

Most people with COVID-19 develop mild or uncomplicated

illness. Approximately 14% develop severe disease requiring

hospitalization and oxygen support and 5% require admission to

an intensive care unit. In severe cases, COVID-19 can be

complicated by acute respiratory disease syndrome (ARDS),

sepsis and septic shock, multiorgan failure, including acute

kidney injury and cardiac injury. Older age and co-morbid

disease have been reported as risk factors for death.

HOW IS COVID-19 SPREAD?

PREVENTATIVE MEASURES

SCREENING

In an SRH outpatient clinic

setting, the simplest

screening tool is to use the

three most common

symptoms:

Fever

Shortness of

breath

Cough

If a client or person

accompanying is

suspected/ displaying any

COVID-19 symptoms, they

must be isolated and

referred to the appropriate

health facility.

IN THIS GUIDE: This guide includes the information you need to keep clinic staff and clients safe during the COVID-19 outbreak.

1) Hand Washing 2) Personal Protective Equipment 3) Triage & Setting Up Your Clinic

This information was compiled using the best available evidence (as of 01/04/2020). For the most up to date information go to www.who.int/emergencies/diseases/novel-coronavirus-2019

Modes of Transmission

Coronavirus is thought to spread mainly from

person-to-person, between people who are in

close contact with one another (within about 6

feet).

Respiratory droplets produced when an

infected person coughs or sneezes can land in

the mouths or noses of people who are nearby

or possibly be inhaled into the lungs. These

droplets can also land on and contaminate

surfaces and equipment. These droplets are

then transferred when someone touches the

infected surface.

There is currently no vaccine to prevent COVID-19.

The best way to prevent illness is to avoid being exposed to

the virus. The most effective preventative measures include:

Performing hand hygiene frequently (with alcohol-based hand rub or soap

and water)

Avoid touching your eyes, mouth and nose

Maintain social distance (1 metre) from individuals (particularly those with

respiratory symptoms)

Practice respiratory hygiene by coughing and sneezing into a tissue or bent

elbow, then immediately disposing of the tissue and washing your hands

Wear a medical mask, if you have respiratory symptoms.

Hand Hygiene

Practicing hand hygiene is the

best way to prevent the

spread of germs in the

healthcare setting and the

community.

Our hands are our main tool

for work as healthcare workers

– and they are the key link in

the chain of transmission

SUGGESTION: Set up a handwashing station at the entrance to your clinic (before the triage area). Check out an idea

for a low cost & quick assembly handwashing station from the WHO Africa Regional Office

When to Wash Your Hands

WATCH THE VIDEO AT https://www.youtube.com/watch?v=y7e8nM0JAz0

What is Personal Protective

Equipment (PPE)?

Personal Protective Equipment (PPE)

is specialized clothing or equipment

worn by an employee for protection

against infectious materials.

When to use PPE

The use of masks across contexts

varies, the WHO guidance is:

For healthy people, wear a mask

only if you are taking care of a

person with suspected COVID-19

infection

Wear a mask if you are coughing

or sneezing

Masks are effective only when

used in combination with

frequent hand-cleaning with

alcohol-based hand rub or soap

and water

If you wear a mask, you must

know how to use it and dispose of

it properly. Most masks are single

use only.

IPPF recommends masks are available for all clinicians.

Always assess PPE according to the procedure. For PPE in the SRH setting, see infographic to the right.

DONNING PPE How to Apply PPE

Key Points

PPE should be

available (in the

right condition and

size) when and

where indicated

Always put PPE on

before contact with

the patient

NEVER touch your

face while wearing

PPE https://photos.google.com/share/AF1QipNdOp0UbDcpS-D5AHxbsvGlmlvKMma6KKJRkeyqEjnYVjXs2u8LdbjTWTUCh_5C8g/photo/AF1QipPTdLOgDCZktBafwlpJsWMxVep18P_zuUIiHZjX?key=dGdiekRaUWlTMGtOaExUZllqNFlrbUZZVVh2NzdR

SUGGESTION: Triage is used to screen and refer all patients with COVID- 19 symptoms. PPE should be used according to

the risk of exposure to bodily fluids. PPE is not required in areas of client transit (e.g. corridors, waiting areas).

DOFFING PPE How to Remove PPE

Key Points

Proper removal of PPE is

key to ensuring that you

do not contaminate

yourself

Always remove from

dirtiest to cleanest.

1. Gloves

2. (if wearing a

gown) Wash your

hands before

touching you face

3. (if wearing goggles

remove)

4. Remove the mask

from behind your

head.

5. Hand hygiene

REMEMBER:

The most effective preventative measures against COVID-19 (both in the community and healthcare settings) include:

Performing hand hygiene frequently (with

alcohol-based hand rub or soap and water)

Avoid touching your eyes, mouth and nose

Maintain social distance (1 metre) from

individuals (particularly those with

respiratory symptoms)

Practice respiratory hygiene by coughing and

sneezing into a tissue or bent elbow, then

immediately disposing of the tissue and

washing your hands

Wear a medical mask, if you have respiratory

symptoms.

All health care settings operating in this environment must:

Establish a handwashing station and triage area at the

entrance of the facility. All people entering must wash their

hands.

In the triage area, assess every person entering the facility for

COVID-19 symptoms using a screening questionnaire. It can be

as simple as the three symptoms in graphic to the right.

Post signs around the clinic reminding clients of COVID-19

symptoms and the importance of hand hygiene.

How do I set up the clinic?

In the triage area:

DISTANCE: Ensure that there is at least 1-metre (3- 6 feet) between the triage worker and the client and anyone accompanying. An easy way to do this: rotate your desk so there is maximum distance between the triage worker and the client. Do not share pens or other items with clients.

PPE & HAND HYGIENE: The triage worker should have access to gloves and a mask and hand hygiene (extra PPE may be required based on the risk). Ensure that the clients have access to handwashing and tissues.

ISOLATION & REFERRAL: If a client or person accompanying is suspected/ displaying any COVID-19 symptoms, they must be isolated and referred to the appropriate health facility. Plan an isolation area, where people who are displaying symptoms can wait (for transfer to COVID-19 facility). It must be away from the other clients.

What is a Triage?

Clinical triage includes a system for assessing all clients at the entrance of the facility. This allows

early recognition of possible COVID-19 cases and immediate isolation from others..

SETTING UP YOUR CLINIC

In the Waiting Room

Ensure all chairs are at least 1

metre apart.

Display posters with symptoms

and directions.

Have tissues available.

If a patient develops

symptoms, ask them to wear a

medical mask and refer to

COVID-19 health care facility.

Increase environmental

cleaning and disinfection

procedures.

Thoroughly cleaning

environmental surfaces with

water and detergent and

applying commonly used

hospital level disinfectants

(such as sodium hypochlorite)

are effective and sufficient

procedures.

HAND WASHING STATIONS

If alcohol-based hand gel is not available in your context, consider other hand washing opportunities. See low cost alternatives below

More information on

how to set up your

Tippy Tap available

from the WHO

RESOURCES:

Introduction

1. CDC. COVID-19 Symptoms. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-symptoms.pdf

2. WHO Global surveillance for COVID-19 disease caused by human infection with the 2019 novel coronavirus https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected

Hand Washing

1. World Health Organisation. Responding to COVID- 19. This can be accessed at https://openwho.org/channels/covid-19 2. World Health Organisation. When to Wash Your Hands. This can be accessed at

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public 3. World Health Organisation. The five moments of hand hygiene. This can be accessed at

https://www.who.int/gpsc/5may/background/5moments/en/ 4. World Health Organisation. How to Wash Your Hands. This can be accessed at

https://www.who.int/gpsc/5may/How_To_HandWash_Poster.pdf?ua=1 5. World Health Organisation. Hand Hygiene in Healthcare Guidelines. This can be accessed at

https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf?sequence=1&isAllowed=y 6. Centre for Disease Control. Handwashing. This can be accessed at https://www.cdc.gov/handwashing/ 7. Centre for Disease Control. Answering Your Handwashing Questions. This can be accessed at

https://youtu.be/d914EnpU4Fo

PPE

1. The United States of America, Department of Labour. Occupational Health and Safety Administration. This This can be accessed at https://www.osha.gov

2. World Health Organisation. Rationale use of personal protective equipment for coronavirus (COVID-19) Interim guidance 27/o2/2020. This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf

3. World Health Organisation. Responding to COVID- 19 This can be accessed at https://openwho.org/channels/covid-19 4. Modified based on recommendations made in: World Health Organisation. Rationale use of personal protective

equipment for coronavirus (COVID-19) Interim guidance 27/o2/2020. This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf

5. The World Health Organisation. The COVID-19 Risk Communication Package for Health Care Facilities. 10/03/2020 This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf

6. World Health Organisation. When to use a mask. This can be accessed at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

7. Centre for Disease Control. PPE Sequence. This can be accessed at https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf 8. World Health Organisation. How to remove PPE. This can be accessed at

https://www.who.int/csr/resources/publications/ebola/ppe-steps/en/

Triage

1. Handwashing stations. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126916 2. CDC. Get Your Clinic Ready for Coronavirus. https://www.cdc.gov/coronavirus/2019-ncov/downloads/Clinic.pdf 3. http://www.washplus.org/sites/default/files/How%20to%20Make%20Other%20Types%20of%20Tippy%20Taps.pdf 4. WHO. Tippy Tap. https://www.afro.who.int/node/12469 5. WHO. The COVID-19 risk communication package for healthcare facilities.

https://iris.wpro.who.int/handle/10665.1/14482

6. WHO. Infection Prevention & Control When Coronavirus Infection is Suspected. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125