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arrangements and stagger staff dining, look at split shifts in the laboratories especially where there is no external contingency in place with no crossover to minimise the risk of passing on the virus, have as many of the critical staff work from home if that is possible, retrain staff to provide extra cover, bring back recently retired staff if necessary to fill essential roles, cease non-essential travel etc. - Communicate regularly with staff so that they feel assured that the situation is being managed and that you will inform them as the situation changes. Staff should be clearly informed about procedures after a direct contact with staff who tested positive for COVID-19 as well as need for self-isolation and social distancing. - Minimise social disruptions and the economic impact of the outbreak. · Communication between SoHO establishments, NCA, national health authorities, ECDC and European Commission is essential to facilitate adequate and proportional response to COVID-19 outbreak at local, national and EU/EEA level. The alert platforms hosted by the European Commission for communication between Member States’ SoHO authorities, Rapid Alert Blood (RAB) and Rapid Alert Tissues and Cells (RATC) platforms may be used for the communication between NCAs, EU commission and ECDC in order to share data on implemented measures and difficulties in supply. According to the previous ECDC risk assessment and in the absence of evidence of COVID-19 transmission through organ transplantation, precautionary measures should be applied to prevent possible transmission to recipients, organ procurement and patient treating personnel. Deceased donors who have died with COVID-19 are not eligible for organ donation. Living organ donors potentially exposed to risk of being infected due to travel to area or being in contact with COVID-19 case should be tested for the presence of the virus or deferred from donation for 14 days after exposure. After recovery form COVID-19 disease, living donors are eligible for donation if tested negative or 14 days after recovery. Additionally, organ transplantation authorities should develop measures for management of organ recipients with COVID-19, procedures when the transplant centre is temporarily closed, isolation of recipients if transplanted during a potential incubation period or in an area with sustained community transmission country in order to protect the patient, family and hospital personnel. It is also important to keep uninterrupted national and international transportation of organs and other cells and tissues intended for transplantation. 6 Research needs In the current situation of the outbreak it is crucial to investigate the availability and impact of countermeasures for public health actions and clinical management. Research on most affected populations or risk groups are also required to improve case management for the prevention of severe and fatal outcomes. It is important to understand the relative efficiency and relevance of the different modes of transmissions (e.g. droplets versus airborne, surfaces, or faecal-oral). Molecular studies could shed more light on disease dynamics and COVID-19 evolution and spread. Prevention and control measures include the development of vaccines and antiviral treatment options, which also have an implication on the management of cases and clinical measures. Several clinical trials for different products and pharmaceutical substances are currently conducted, which require continuous funding and harmonised approaches. To boost global preparedness, prevention and containment of the virus, new funding worth €232 million will be allocated to different sectors from the European Commission [97]. The European Commission funds the EU research and innovation programme up to €45 million of the Innovative Medicines Initiative fast track call for research proposals in response to the COVID-19 outbreak [98]. ECDC is in collaboration or will establish collaboration with projects such as Rapid European COVID-19 Emergency research Response (ReCoVer), and IMove. Available study protocols to conduct ‘First few hundred’, household transmission or other studies are available from WHO and should be applied. Results should be made available as soon as possible. Engagement and efforts should also include serological studies to analyse the impact on a population level and compare with potential pre-existing immunity in the population. Such studies require sensitive and reliable serological tests, which are currently under development requiring validation. Study protocols are currently being developed and should be conducted in a harmonised way across the EU/EEA. The assessment of the effectiveness of PPE in various settings will help provide more evidence regarding the prevention of transmission in healthcare settings and in particular how to protect healthcare workers. Finally, modelling studies assessing effectiveness of interventions and policies aimed at delaying disease transmission could be of key importance to support decision-making and spare hospital capacity. 7 Limitations This assessment is undertaken based on facts known to ECDC at the time of publication. There is substantial uncertainty regarding the epidemiological characteristics of the COVID-19. There is limited epidemiological
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