BMJ has created a free resource on SARS-CoV-2 and covid-19 to inform diagnosis and treatment, and to promote the wellbeing and safety of staff and patients during this extremely stressful and challenging period.
BMJ’s dedicated covid-19 hub not only draws on the latest peer reviewed research, n...ews and opinion from The BMJ and BMJ’s 70 + specialist journals. It also provides online CPD from BMJ Learning and guidance on the evidence-based management of covid-19 from BMJ Best Practice.
The content is updated daily so that healthcare professionals on the frontline of care can readily keep abreast of the latest developments in thinking and practice
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Refugees and migrants face similar health threats from COVID-19 as their host populations. However, inadequate access to essential services and exclusion may makes early detection, testing, diagnosis, contact tracing and seeking care for COVID-19 difficult for refugees and migrants thus increasing t...he risk of outbreaks in these population and presenting an additional threat to public health. This document offers guidance to Member States and partners for the inclusion of refugees and migrants, as part of holistic efforts to respond to COVID-19 epidemics in the general populations.
17 April 2020
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Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung function; − Physical deconditioning and muscle weakness; − Delirium and other cognitive impairment...s; − Impaired swallow and communication; and − Mental health disorders and psychosocial support needs. − Rehabilitation needs may be amplified by underlying health conditions and decrements in health associated with ageing, − Rehabilitation professionals play an important role in facilitating early discharge, which is especially critical in the context of hospital bed shortages. − Rehabilitation needs of people with severe COVID-19 exist during the acute, sub-acute and long-term phases of care; rehabilitation professionals should be positioned in ICUs, hospital wards, stepdown facilities and in the community. − Particularly in the acute phase, rehabilitation interventions for patients with severe COVID-19 requiring ventilatory support generally require a particular skill-set acquired through specialist training.
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A comprehensive briefing by Half of Syria
April 2020
A comprehensive briefing on the critical challenges of the COVID-19 pandemic to Syrians, as reported by Syrian civil society organisations. These challenges have been collated following extensive interviews with the teams of member and partner... organisations working in the field in various sectors: health, child care, education, women’s empowerment, media and culture, research, human rights and accountability, relief and social services, and local governance.
This comprehensive briefing also include concrete recommendations formulated by the Syrian civil society.
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MEDBOX Issue Brief No.2.
The main route of transmission of the Sars-CoV-2 virus are small respiratory droplets. Therefore, thoroughly cleaning of hands with either alcohol-based hand rub or soap and water is one of the corner stones of basic protective measures against COVID-19 for everyone. A part...icular focus of this Issue Brief are documents for the health care sector, but also multilingual material for the public.
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Internally displaced persons (IDPs), refugees, migrants and returnees constitute a sizeable population in the WHO Eastern Mediterranean Region. There were 12 million refugees (half are Palestinians) and 13 million IDPs in the Region as of 2018. These populations are often vul...nerable to poor health due to the conditions they live in and limited access to needed quality health care. In addition, those who can access care, are often faced with financial hardship. There are also 46 million professionals and low-income labour migrants in the Region (of which 22 million are from the Region), with differential access to health services and varied health coverage schemes
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The COVID-19 pandemic is causing untold fear and suffering for older people across the world. As of 26 April, the virus itself has already taken the lives of some 193,710 people, and fatality rates for those over 80 years of age is five times the global average. As the virus spreads rapidly to devel...oping countries, likely overwhelming health and social protection systems, the mortality rate for older persons could climb even higher.
Less visible but no less worrisome are the broader effects: health care denied for conditions unrelated to COVID-19; neglect and abuse in institutions and care facilities; an increase in poverty and unemployment; the dramatic impact on well-being and mental health; and the trauma of stigma and discrimination.
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For over a decade, Senegalese and international journalists, human rights advocates, and child protection experts have documented and denounced the ongoing exploitation, abuse and neglect of children living in many of Senegal’s traditional Quranic schools, or daaras. Thousands of these children, k...nown as talibés, continue to live in conditions of extreme squalor, deprived of adequate food and medical care.
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The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from ...Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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Nested case-control study of health workers exposed to confirmed COVID-19 patients.
Similar objectives to the cohort study but case-control studies may be cheaper and provide robust evidence to characterize and assess the risk factors for SARS-CoV-2 infection in health workers exposed to COVID-19 p...atients.
Health workers with confirmed COVID-19 will be recruited as cases and other health workers in the same health care setting without infection will be recruited as controls (incidence density sampling).
Secondary objectives are similar to the cohort study.
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a systematic review and meta-analysis Derek K Chu et al. on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors.
Published: The Lancet June 01, 2020 DOI: https://doi.org/10.1016S0140-6736(20)31142-9
'We did a systematic review of 172 observational studies in health-...care and non-health-care settings across 16 countries and six continents... Physical distancing of 1 m or more was associated with a much lower risk of infection, as was use of face masks (including N95 respirators or similar and surgical or similar masks [eg, 12–16-layer cotton or gauze masks]) and eye protection (eg, goggles or face shields)...'
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This is the first version of the INEE technical guideline to support education during the Covid-19 pandemic. It is a living document that will be regularly updated to meet the learning and well-being needs of children, adolescents, youth, teachers, caregivers and other education personnel affected b...y Covid-19.
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR) as identified in the Global Action Plan to combat AMR. Yet, at present, WASH and wastewater management... actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
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The Toolkit for Child Friendly Spaces in Humanitarian Settings was developed by
the International Federation of the Red Cross and Red Crescent Societies Reference
Centre for Psychosocial Support and World Vision International. The toolkit provides
a set of materials to assist managers and facilit...ators/animators in setting up and
implementing quality Child Friendly Spaces (CFS). These resources have at their core
the protection of children from harm; the promotion of psychosocial well-being; and
the engagement of community and caregiver capacities. The CFS Toolkit includes:
• Activity Catalogue for Child Friendly Spaces in Humanitarian Settings
• Operational Guidance for Child Friendly Spaces in Humanitarian Settings
• Training for Implementers of Child Friendly Spaces in Humanitarian Settings.
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Several countries affected by COVID-19, have seen increases in levels of violence occurring in the home, including violence against children, intimate partner violence and violence against older people. Countries also face increasing challenges in maintaining support and care for survivors of violen...ce. This brief compiles key actions that the health sector can undertake within a multisectoral response to prevent or mitigate interpersonal violence based on existing WHO guidance.
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This evaluation is the fifth in a series of structured evaluations of CFS and was completed as part of three-year collaboration with World Vision and Columbia University. It was conducted with Syrian refugees in an urban setting in Zarqa, Jordan during the months of February to August 2014. The CFS ...was implemented through partners and supported and monitored by World Vision Jordan. Interviews were conducted during a one-week registration period hosted by partner staff and preceded by awareness campaigns in the community. Measurement tools were selected to assess impact in three areas in line with the programme’s key objectives: (a) the protection of children from risk, (b) supporting caregivers and communities in strengthening systems of child protection, and (c) the promotion of children’s psychosocial wellbeing (including the acquisition of skills and knowledge).
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and challenges, maps existing international commitments and... frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas..., the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
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Infection prevention and control practices need to be implemented to guarantee the safety of healthcare workers and patients in healthcare settings, it is fundamental to prevent cross contamination and containment of spread of COVID 19. As of the day of this publication, the following precautions ar...e recommended for the care of patients with suspected or confirmed cases of COVID-19: - For any suspected or confirmed cases of COVID-19: standard + contact + droplet precautions. -For any suspected or confirmed cases of COVID-19 and Aerosol Generated Procedure: standard + contact + airborne precautions. - The results of the application of this evaluation tool, in addition to other tools, will provide an overview regarding compliance with the activities of prevention and control of infections associated with provision of care in acute healthcare services in a health setting, without making judgments about the individual risk of patients, nor on particular cases. By its nature, this tool is only an external diagnostic to support IPC professionals and managers to assess the gaps and take corrective measures. To provide a tool for assessment of infection prevention and control practices in isolation areas in acute healthcare settings in the context of the novel coronavirus (COVID-19). These recommendations are preliminary and subject to review as new evidence becomes available.
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