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vulnerable groups please see section above “Disease background”. Patients with a mild clinical presentation (mainly with fever, cough, headache and malaise) may not initially require hospitalisation and can be safely managed at home. However, as clinical signs and symptoms may worsen with progressive dyspnoea due to lower respiratory tract disease in the second week of illness; all patients should be monitored closely. An estimated 10-15% of mild cases will progress to severe and 15-20% of severe cases will become critical according to the Chinese data [16]. Average progression times include the following: · For mild cases: from onset of symptoms to recovery almost 2 weeks · For severe cases: from onset of symptoms to recovery 3-6 weeks, and from onset of symptoms to death 2-8 weeks. Designated facilities for caring for COVID-19 patients with mild symptoms should be considered in scenarios 3 and 4 in order to cohort confirmed cases and limit further transmission in the household. However, in scenario 3, and especially in scenario 4, home health care can be considered for those presenting with mild symptoms, unless there is concern for rapid deterioration. Home health care could also be considered for symptomatic patients no longer requiring hospitalisation, where inpatient care is unavailable or unsafe (i.e. limited capacity and resources unable to meet demand for healthcare services) or in a case of informed refusal of hospitalisation [63]. Rigorous education for cases and their household members is needed for appropriate IPC practices to limit secondary transmission. Criteria to be considered when deciding whether a confirmed COVID-19 case can be safely discharged (i.e. without being infectious) from hospital have been proposed by ECDC [74]. Clinical criteria such as resolution of symptoms or absence of fever and laboratory evidence of SARS-CoV-2 clearance from upper respiratory tract should be considered but also adapted to the local context i.e. existing capacity of the healthcare system, laboratory diagnosis resources and the current epidemiology situation. After discharge, 14 days of further isolation at home or in other community care settings is advised, provided that regular health monitoring is ensured (e.g. follow-up visits, phone calls) and conditions to protect family members and the community from infection and further spread of SARS-CoV-2 exist. Patients with severe illness should be cared for in a designated treatment hospital and should be placed in an airborne infection isolation room if available, or in a single room with private bathroom. Guidance for clinical care of severe cases is available from WHO [75] and from the US CDC [76]. In scenarios 3 and 4, solutions to increase hospital surge capacity can be explored as discussed above in the options for preparedness. No antiviral or other pharmaceutical is currently recommended for the treatment of COVID-19 cases, although clinical trials with the combination lopinavir/ritonavir and the orphan drug redemsivir are ongoing in Asian countries and the USA. Compassionate use of remdesivir has been used for severe cases in EU countries. The evidence for the potential effectiveness of chloroquine is from in vitro trials and unpublished single arm studies in China at this point. Inhalational interferon beta 1a is also among potentially interesting candidates for treatment or prophylaxis [77]. Recruiting patients in Europe into multinational clinical trials to ensure rapid data collection and assessment of the safety and effectiveness of treatment options is an immediate priority in countries in the early phases of the outbreak. Health authorities are encouraged to monitor the treatment modalities used in their countries, and physicians treating COVID-19 cases are also invited to join WHO’s clinical network where new therapeutic options and experiences are exchanged. Community measures ECDC guidelines for the use of non-pharmaceutical countermeasures to delay and mitigate the impact of the COVID-19 pandemic include a description of the measures that can be applied in the community: infection prevention and control, social distancing, travel-related and screenings of travellers [55]. Infection prevention and control in the community The use of personal protective measures (i.e. rigorous hand hygiene, cough etiquette, and face masks) may contribute to reducing the risk of transmitting or acquiring COVID-19 infections. · Rigorous hand-washing schemes, including washing of hands with soap and water for at least 20 seconds, or cleaning hands with alcohol-based solutions, gels or tissues is recommended in all community settings in all possible scenarios. Organisations should ensure availability of sufficiently and suitably located washbasins and taps, as well as hand gels, to encourage washing. Proper hand hygiene will also reduce the transmission of other communicable diseases. · Covering the mouth and nose when coughing and sneezing (e.g. by using a paper tissue, and sneezing or coughing into the elbow) may mechanically block the droplet transmission that is believed to be the principal transmission mode for COVID-19. The proper disposal of used tissues is