Please Download Clinical Approach to COVID-19 and distribute to all health professionals in your clinic, hospitals for best practice in Nepal. We also recommend to be updated with COVID-19 technical guidance from WHO.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/patient-management

The guidance for healthcare workers covers those who have travelled or have come into contact with a known case. However, if primary care providers come into contact (using the definition of close contact here) with a suspected case they should continue to practise as normal. Should the case then be confirmed, PHE will undertake contact tracing which may include the practitioner.

For more information for primary care providers in England, read the full NHS England guidance.

An unwell patient with a relevant travel history should be identified when they book in at reception and immediately placed in a room away from other patients and staff.

If COVID-19 becomes a possible diagnosis once a consultation is already in progress, you should:

• Withdraw from the room, sensitively explaining to the patient why this is necessary.

• Leave the patient in the room with the door closed.

• Wash your hands thoroughly with soap and water.

• Belongings and waste should remain in the room.

• Advise others not to enter the room.

• If entry to the room or contact with the patient is unavoidable in an emergency, wear PPE (personal protective equipment) in line with the standard infection control precautions, such as gloves apron and FRSM (fluid resistant surgical mask) and keep exposure to a minimum. All PPE should be disposed of as clinical waste.

• Should the patient need to use the toilet, they should be allocated a WC for their sole use. Instruct the patient to wash their hands thoroughly after toileting, and return directly to the room they have been isolated in and close the door. The toilet should be taken out of use until cleaned and disinfected following the decontamination guidance.

• Ask the patient to call appropriate emergency numbers.

When a telephone interview is being conducted with a patient located elsewhere (for example at home) and it is determined that Covid-19 is possible, then a face to face assessment in the hospital must be avoided.

Instead call the local Sukraraj Tropical & Infectious Disease Hospital Teku, Kathmandu, Nepal977-1-4253395, 977-1-4253396 to discuss safe assessment, if hospital care is being considered.

Immediately report to the authority in your clinic or hospital to take the extra-precaution to contain the virus. Follow "Clinical Approach to COVID-19 in Nepal"

• How to assess risk, monitor for symptoms and understand work restriction decisions for health care professionals with potential exposure to COVID-19: Interim U.S. guidance

• Who should be tested for COVID-19 and how to get them tested: COVID-19 clinical criteria

• Health care professionals should immediately notify their local or state health department in the event of a PUI for COVID-19: Find your state and local health department contacts

• How to manage patients diagnosed with COVID-19: Clinical guidance from the CDC

• Precautions to take for vulnerable patients:

  • The immunocompromised

  • Infants and pregnant women

  • Long-term care residents

• COVID-19 facts to share with concerned or anxious patients: CDC fact sheets

• Common myths that you should be ready to debunk: The biggest misconceptions

• Advice to give patients who have suspected or confirmed COVID-19: Top advice from CDC

• Notices to inform travelers and clinicians about current health issues that impact travelers’ health: CDC travel notices

• Getting your workplace ready for COVID-19 from WHO

• Prevent the spread of COVID-19 in your practice or health care facility: Guides from WHO

• Steps health care facilities can take now to prepare: CDC steps to prepare

• How to minimize exposure and implement standard, contact and airborne precautions: Interim infection prevention and control recommendations

• How to manage your supply of personal protective equipment (PPE): CDC supply chain advice

Responding to community spread of COVID-19 - WHO

This is a draft document on COVID19 suggested by NSCCM to manage crisis. We encourage our experts to provide feedback to NSCCM to make it more robust and useful according to our setup.

NMA is working with Ministry of Health and Population, Department of Health Services, EDCD, Sukraraj Tropical & Infectious Disease Hospital Teku and WHO to produce more information across Nepal, to help them support in responding to Covid-19.