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... 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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Review
published: 12 August 2016 doi: 10.3389/fpubh.2016.00166
Frontiers in Public Health | www.frontiersin.org 1 August 2016 | Volume 4 | Article 166
Recommendations for a Public Health approach and considerations for policy-makers and managers
The World Health Organization (WHO) recognizes the challenges countries face for maintaining their COVID-19 response while addressing competing public health challenges, conflicts, climate change and economic crises.
It remains critical for national programmes to continue to offer testing for COVI...D-19 in line with three main objectives: reduce morbidity and mortality through linkage to prompt care and treatment, reduce onward transmission and track the evolution of the epidemic and the virus
itself.
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Communities can play a critical role in suicide prevention. Facilitating community engagement in suicide prevention is an important task. The toolkit is a step-by-step guide for communities to engage in suicide prevention activities and have ownership of the process and keep efforts sustained. It is... hoped that the pilot version will be used, after necessary adaptation, in many countries and contexts, so that the final product can be strengthened and become more effective and user-friendly.
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Consolidated Guidelines
Updated 2016
WHO/HIV/2017.05
Tackling Tuberculosis in Under-Served Populations: A Resource for TB Control Boards and their partners
PLOS ONE | https://doi.org/10.1371/journal.pone.0192765 February 23, 2018
This twelfth version of the WHO living guideline now contains 19 recommendations. This latest update provides updated recommendations for remdesivir, addresses the use of combination therapy with corticosteroids, interleukin-6 (IL-6) receptor blockers and Janus kinase (JAK) inhibitors in patients wi...th severe or critical COVID-19, and modifies previous recommendations for the neutralizing monoclonal antibodies sotrovimab and casirivimab-imdevimab in patients with non-severe COVID-19.
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For the Assesor's Guide Vol 1 and 2 see: nrhm.gov.in/images/pdf/programmes/maternal-health/guidelines/Operational_Guidelines_for_Quality_Assurance_in_Public_Health_Facilities_and_checklists-3_books.zip
The objectives of the scheme is to promote cleanliness, hygiene and infection control practices in public health care facilities, to incentivize and recognize such public healthcare facilities that show exemplary performance in adhering to standard protocols of cleanliness and infection control, to... inculcate a culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation, to create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes.
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PlosOne Published: July 14, 2021
https://doi.org/10.1371/journal.pone.0254339