|Name of document||Reference to older people||Last updated|
|Clinical management of COVID-19||**62 pg document; several references to older people with specific focus in Chapter 20: Caring for older people with COVID-19||27 May 2020|
|Technical specifications for invasive and non-invasive ventilators for COVID-19||No specific reference to older people||15 Apr 2020|
|Clinical care of severe acute respiratory infections – Tool kit||*200 pg document; some clinical guidelines around older people diagnosis for various respiratory illnesses (COVID-19, influenza etc)||11 Apr 2020|
|Oxygen sources and distribution for COVID-19 treatment centres||No specific reference to older people||4 Apr 2020|
|Severe Acute Respiratory Infections Treatment Centre||*120 pg document; no specific reference of older people||28 Mar 2020|
|Maintaining a safe and adequate blood supply during the pandemic outbreak of coronavirus disease (COVID-19)||No specific reference to older people||20 Mar 2020|
|Operational considerations for case management of COVID-19 in health facility and community||Scenario and strategic priorities|
- Known risk factors for severe COVID-19: age over 60 years, hypertension, diabetes, cardiovascular disease, chronic respiratory disease, immunocompromising conditions.
|18 Mar 2020|
|Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts||Where to manage COVID19 patients|
- In situations where isolation in a health care facility of all cases is not possible, WHO emphasizes the prioritization of those with highest probability of poor outcomes: patients with severe and critical illness and those with mild disease and risk for poor outcome (age >60 years, cases with underlying co-morbidities, e.g., chronic cardiovascular disease, chronic respiratory disease, diabetes, cancer)
Home care for patients with suspected COVID19, mild symptoms
- patients with mild symptoms and without underlying chronic conditions − such as lung or heart disease, renal failure, or immunocompromising conditions that place the patient at increased risk of developing complications − may be cared for at home.
- a trained HCW should conduct an assessment to verify whether the residential setting is suitable for providing care
- a communication link with health care provider or public health personnel, or both, should be established for the duration of the home care period – that is, until the patient’s symptoms have completely resolved
- Patients and household members should be educated about personal hygiene, basic IPC measures, and how to care as safely as possible for the person suspected of having COVID19 to prevent the infection from spreading to household contacts
|17 Mar 2020|
|Informal consultation on prioritization of candidate therapeutic agents for use in novel coronavirus 2019 infection||No specific reference to older people||24 Jan 2020|
|Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected||Background|
- Older age and co-morbid disease have been reported as risk factors for death, and recent multivariable analysis confirmed older age, higher SOFA score and d-dimer > 1 µg/L on admission were associated with higher mortality.
Caring for older persons with COVID-19
- older people are at highest risk for fatality and one of the most vulnerable populations. It is important to recognize that older people have the same rights as others to receive high-quality health care including intensive care. Refer to ICOPE
- For older people with probable or suspected COVID-19, provide person-centred assessment, including not only conventional history taking, but a thorough understanding of the person’s life, values, priorities and preferences for health management.
- Ensure multidisciplinary collaboration among physicians, nurses, pharmacists, other health care professionals in the decision-making process to address multimorbidity and functional decline.
- Remark 1: Physiological changes with age lead to declines in intrinsic capacity such as malnutrition, cognitive decline, depressive symptoms, and those conditions should be managed comprehensively.
- Early detection of inappropriate medication prescriptions is recommended to prevent adverse drug events and drug interactions for those being treated with COVID-19.
- Remark 2: Older people are at greater risk of polypharmacy, due to newly prescribed medications, inadequate medication reconciliation and a lack of care coordination which increases the risk of negative health consequences.
- Involve caregivers and family members in decision-making and goal-setting throughout the management of COVID-19.
|12 Jan 2020|
|Recommendations: Prehospital Emergency Medical Services (EMS) COVID-19||Geriatric considerations|
- Elderly populations often have special needs which could affect COVID-19 pre-hospital protocol. Potential needs may include:
• Hearing deficits – patients with partial or complete hearing loss may require a provider to be in close proximity in order to communicate. This would preclude a provider from maintaining adequate distance precautions.
• Neurological or mobility disorders (e.g. Parkinson’s, hand tremors, strokes) - patients may have difficulty applying masks to their own faces, accessing the ambulance or complying with provider requests.
• Cognitive impairment (e.g. dementia, Alzheimer’s Disease) - patients may have difficulty providing reliable and accurate information regarding exposure. If caregiver is present, providers may consider including them in the assessment.
• Co-morbidity - patients may have multiple health concerns that need to be addressed during transport in conjunction with COVID-19 signs and symptoms.
|Use of chest imaging in COVID-19. A rapid advice guide||No specific reference to older people|