WHO Information Network for

Epidemics

Dr Andy Ramsay
Infectious Hazards Management
WHO Health Emergencies Programme

www.who.int/epi-win
Scenario Health system priorities Public health measures/ social distancing
1. No reported cases • Do active case finding • Communicate, communicate, communicate
• Prepare all health facilities to screen and
assess/triage • Quarantine and isolation of cases and contacts
• Prepare designated COVID facilities/wards • Individual and family measures - clean hands and cough etiquette, protect the vulnerable
• Set up a COVID hotline
• Voluntary physical distancing (>1m), staying away from crowded places
• Conduct risk assessment for large events/gatherings (large sporting events, festivals,
2. Sporadic cases • Do testing and contact tracing conferences, faith-based events) and implement measures to reduce risks
Countries with one or • Screen and triage at all health facilities
more cases, imported or • Isolate and treat patients in designated • Protection measures for special populations/ institutions
locally acquired facilities/wards • Adapt and implement stay-at-home measures for:
• schools & tele-study,
• workplaces & tele-working, flexible leave policies, staggered shifts
3. Clusters of cases • Screen, triage and treat as above • public spaces, restaurants, cultural events & entertainment
Countries experiencing • Expand designated treatment areas/hospitals
cases clustered in time, • Manage mild/moderate/low risk cases in community • places of worship
geographic location or settings or at home to avoid over-burdening the • Adapt or cancel public and private events
common exposure health system
• Cordon sanitaire/movement restrictions
• Cross-border travel measures
4. Community • In addition to the above, consider new or temporary
transmission structures for treating patients ➢ Protect food supply and access to care
Countries experiencing • Implement a “hub and spoke” referral strategy
larger outbreaks of local • Continue testing as long as possible particularly if ➢ Implement community resilience, mental health strategies
transmission cases emerge in new areas. ➢ Mitigate economic impact
• If capacity is limited, consider not testing
mild/moderate patients who can self-isolate at
home

02/04/2020
 “Flatten the curve”

The steep curve represents exponential spread of the virus – the local health system will quickly become overloaded
beyond its capacity to treat people.

The flatter curve assumes the same number of people get

infected but over a longer period of time – a less stressed
health system and potentially less deaths
# cases
Without
measures to
slow
transmission Health system capacity

With
measures to
slow
transmission

Time since first case

Adapted from CDC

02/04/2020