COVID-19

HIGHLIGHTS •

Five new Member States (Azerbaijan, Ecuador, Ireland, Monaco and Qatar) reported cases of COVID-19 in the past 24 hours.

• Working with clinicians is crucial to understanding the clinical presentation, natural history and treatment interventions for COVID-19. WHO has published interim clinical guidance, clinical training materials and has launched a global clinical data platform to gather data and improve care for COVID-19 patients. This information is critical to inform the public health response. More information can be found in the Subject in Focus.

 • The number of confirmed cases in Hubei province, China, has increased for two successive days after a period of decline. WHO is monitoring the situation and working to understand its possible significance.

• WHO has published updated recommendations for international traffic in relation to COVID
 outbreak.

SUBJECT IN FOCUS:  CLINICAL MANAGEMENT OF PATIENTS WITH COVID-19

WHO is working closely with clinicians caring for patients with COVID-19, in China and across the globe and international experts on infectious disease to better understand, in real time, the clinical presentation, natural history and treatment interventions for COVID-19.

A majority of patients with COVID-19 are adults. Among 44 672 patients in China with confirmed infection, 2.1% were below the age of 201 . The most commonly reported symptoms included fever, dry cough, and shortness of breath, and most patients (80%) experienced mild illness. Approximately 14% experienced severe disease and 5% were critically ill. Early reports suggest that illness severity is associated with age (>60 years old) and co-morbid disease.

Clinical care of patients with COVID-19 focuses on early recognition, immediate isolation and implementation of appropriate infection prevention and control (IPC) measures; provision of symptomatic care for those with mild illness; and optimized supportive care for those with severe disease. WHO has published patient management guidance, including interim clinical care guidance for hospitalized patients and home care guidance for those with mild disease that may be treated at home in isolation when the health system is strained.

Oxygen therapy is the major treatment intervention for patients with severe COVID-19. All countries should work to optimize the availability of pulse oximeters and medical oxygen systems. Mortality in those with critical illness has been reported as over 50%, thus implementation of proven critical care interventions such as lung protective ventilation should be optimized. COVID-19 critical care clinical training materials are available on https://openwho.org/courses/severe-acute-respiratory-infection. The first regional COVID-19 Clinical Case Management training was conducted in Brazzaville from 25-28 February 2020 with representatives from 18 countries of the WHO African region. WHO will continue to conduct such trainings to increase global knowledge on the management and care of patients with COVID-19. WHO launched the Global COVID-19 Clinical Data Platform to aggregate and report on clinical severity to inform the public health response. Member States are encouraged to contribute by contacting [email protected] for log-in information. As there is currently no known effective antiviral therapy for COVID-19, the WHO R&D Blueprint has prioritized investigational therapeutics and developed a master randomized clinical trial protocol that can be used and adapted at the national level. There are many ongoing ethics-approved clinical trials evaluating a number of different therapeutic interventions globally including priority agents such as ritonavir/lopinavir and remdesivir.

STRATEGIC OBJECTIVES :

WHO’s strategic objectives for this response are to:

• Interrupt human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread*;

• Identify, isolate and care for patients early, including providing optimized care for infected patients; • Identify and reduce transmission from the animal source;

• Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines;

 • Communicate critical risk and event information to all communities and counter misinformation;

 • Minimize social and economic impact through multisectoral partnerships.

 *This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and control in health care settings, implementation of health measures for travelers, awareness-raising in the population and risk communication.

Source:https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200301-sitrep-41-covid-19.pdf?sfvrsn=6768306d_2

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