This document aims to provide guidance to healthcare facilities and healthcare providers in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK) on preparedness and infection prevention and control (IPC) measures for the management of possible and confirmed cases of COVID-1
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9 in healthcare settings, including long-term care facilities (LTCFs). In addition, this document addresses the management of clinical diagnostic specimens at laboratories in the EU/EEA. This is the sixth update of the ECDC guidance on ‘Infection prevention and control and preparedness for COVID-19 in healthcare settings’, and replaces the document dated 6 October 2020.
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
coun
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tries across all six WHO Regions and was rapidly replacing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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Les pays du monde entier sont confrontés à des situations épidémiologiques diverses, et disposent de capacités de réaction différentes et d’un accès inégal aux outils permettant de sauver des vies. L’Organisation mondiale de la Santé (OMS) recommande aux autorités nationales de contin
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uer à appliquer une approche fondée sur les risques lorsqu’elles mettent en œuvre des mesures relatives aux voyages internationaux dans le contexte de la COVID-19, tout en respectant la dignité, les droits humains et les libertés fondamentales des voyageurs. Cette approche doit prendre en compte le risque d’importation et d’exportation de cas posé par les voyages dans le cadre de l’évolution de la situation épidémiologique, y compris de l’émergence et de la circulation de variants préoccupants du SARS-CoV-2, du déploiement de la vaccination contre la COVID-19 et des enseignements tirés de la riposte à la pandémie, notamment en ce qui concerne la détection précoce et la prise en charge des cas, ainsi que l’application de mesures sociales et de santé publique.
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O Informe Semanal de Evidências sobre Variantes de Atenção do SARS-CoV-2 é uma produção organizada pelo Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde do Ministério da Saúde (DECIT/SCTIE/MS). O documento tem o objetiv
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o de acompanhar e relatar as mais recentes evidências descritas em publicações científicas e
na literatura cinzenta sobre as principais variantes de SARS-CoV-2 circulantes no Brasil e no mundo, bem como as implicações destas para a saúde. Para tanto, são realizadas buscas estruturadas em bases de dados de indexação de periódicos científicos revisados pelos pares, de artigos no formato pré-print e de literatura cinzenta. Este informe tem caráter unicamente informativo e não representa
uma recomendação oficial do MS sobre a temática. Os trechos destacados em itálico no corpo do texto consistem em novas informações publicadas no período de 11 a 17 de outubro de 2021. Os demais trechos são referentes a informações já fornecidas em Informes anteriores.
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Interim guidanceAnnex to: Policy considerations for implementing a risk-based approach to international travel in the context of COVID-19, 2 July 2021
Countries across the world are facing diverse epidemiological situations with varying response
capacities and access to life saving tools. The World Health Organization (WHO) recommends that national authorities continue to apply a risk-based approach when implementing measures related to COVID-19
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and international travel while respecting the dignity, human rights and fundamental freedoms of travellers. This approach should consider the risk posed by travel for the importation and exportation of cases in the context of the evolving epidemiology, including the emergence and circulation of virus variants of concern; the expansion of the COVID-19 vaccination roll-out; and lessons learned while responding to the pandemic, including on the early detection and management of cases and the application of public health and social measures.
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As of 12 December 2022, over 645 million people worldwide have been diagnosed with COVID-19, with over 6.6 million deaths (4).
The Omicron variant, which emerged in late November 2021, and its subvariants, are now the dominant circulating viruses, contributing to the ongoing surge in several countr
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ies (4). Vaccination has substantially reduced case numbers and hospitalizations in many countries,but limitations in global access to vaccines mean that many populations, including those in low- and middle-income countries, remain vulnerable. Even in vaccinated individuals, uncertainties remain about duration of protection and efficacy, and the degree of crossprotection with new variants.
There remains a need for more effective treatment and management for those affected by COVID-19. The pandemic – and the
explosion of both research and misinformation – has highlighted the need for trustworthy, accessible and regularly updated living
guidelines to place emerging findings into context and provide clear recommendations for clinical practice
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for
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hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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What do we know about Omicron variant so far? WHO's Dr Maria Van Kerkhove updates on the transmissibility, severity, symptoms and ways to protect yourself in Science in 5.
If Omicron is less severe, why are people ending up in the hospital and dying from it? Is it true that everyone will eventually get Omicron? Why is it important to reduce transmission? WHO's Dr Maria Van Kerkhove explains in Science in 5.
Sequencing SARS-CoV-2 in the Americas
The COVID-19 Genomic Surveillance Regional Network was created in 2020 not only to strengthen the sequencing capacity in the participating laboratories, but also for them to establish a routine SARS-CoV-2 genomic sequencing, as a strategy to increase the amoun
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t of genetic sequence data available to the global community, which is critical to support the development of diagnostic protocols, the information for vaccine development and to better understand the evolution and molecular epidemiology of the SARS-CoV-2.
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Вариант вируса, названный «SARSCoV-2, вариант202012/01»,впервые был выявлен в Соединенном Королевстве, и сейчас его циркуляция подтверждена в ряде стран Европейского ре
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иона ВОЗ. Он помечен как «вариант, вызывающий обеспокоенность» (VOC), поскольку, по имеющимся данным, он более активнопередается от человека к человеку.
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Why does WHO recommend at this time, in June 2021, that vaccinating children is not a priority? When would their vaccination be prioritized? How is safety of these vaccines ensured? WHO’s Chief Scientist Dr Soumya Swaminathan explains in Science in 5.
If you are fully vaccinated can you still get COVID-19? How frequent are breakthrough infections and what does COVID-19 look like if you are fully vaccinated. WHO’s Dr Kate O’Brien explains in Science in 5.
No matter whether you are vaccinated against #COVID19 or are still waiting, keep followi
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ng these precautions to protect yourself and others:
- Avoid crowds
- Keep physical distance
- Open windows
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What have we learned about COVID-19 and antibiotics so far? What happens when antibiotics are not taken according to prescription or are used irrationally? When are antibiotics prescribed in the course of COVID-19 treatment? Professor Hanan H. Balkhy explains in Science in 5 this week.
How has the pandemic impacted the fight against Polio? How has the polio infrastructure helped the fight against COVID-19? Why is it important that the world doesn’t take its eyes off polio? Sona Bari explains in Science in 5 this week.
The aim of this article is to identify the elements behind the country’s successful COVID-19 rollout as well as lessons and chal lenges derived from this process. The analysis is relevant to many countries today—as they keep searching for strategies to cope with the second year of the COVID-19 p
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andemic and the challenge of implementing a large-scale vaccine rollout—and in the coming years—as new variants develop and unceertainty about the vaccination strategy increases.
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