|Name of document||Reference to older people||Last updated|
|Maintaining essential health services: operational guidance for the COVID-19 context||Section 2: Identify context-relevant essential services |
- Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery. High-priority categories include:
• Care of vulnerable populations, such as young infants and older adults;
- The selection of priorities will be guided by health system context and the local burden of disease, but should initially be oriented to preventing communicable disease, averting maternal and child morbidity and mortality, preventing acute exacerbations of chronic conditions by maintaining established treatment regimens, and managing emergency conditions that require time-sensitive intervention.
[updated document: 62 pg with reference to older people throughout]
Part 2: Life course and disease considerations - Chapter on older people
- Older people, particularly those with underlying health conditions, are at higher risk of serious health outcomes and death from COVID-19 and are more vulnerable to many of the indirect consequences of the pandemic. They are more likely to have ongoing needs for medication and care, including home-based visits and community care, so movement restrictions may disproportionately affect them
- Specific WHO technical guidance is available about caring for older people with COVID-19, providing home care and community-based health care, and implementing IPC in long-term care facilities.
- WHO recommends that older people, their households and caregivers are informed about preventive measures and the importance of promoting physical and mental health in the COVID-19 context. Older people should be proactively engaged in adapting their care plans, and specific mechanisms should be put in place to ensure that they have safe access to integrated health and social care, including support, monitoring and follow up
Table recommending programme activities and service delivery.
|1 Jun 2020|
|Framework for decision-making: implementation of mass vaccination campaigns in the context of COVID-19||No specific reference to older people||20 May 2020|
|Immunization in the context of COVID-19 pandemic||Is adult vaccination recommended during the COVID-19 pandemic?|
- Countries with existing pneumococcal, influenza, or pertussis vaccination programmes for older adults and individuals with high-risk conditions should maintain those programs while implementing measures to avoid the spread of COVID19, especially for those at higher risk of severe disease such as older adults, Preventing respiratory illness and hospitalization from pneumococcus, influenza, and pertussis through vaccination will allow respiratory medical equipment, medications, and health care workers to be more available to support patients with COVID-19, While there is currently limited information on whether COVID-19 is associated with an increased risk of pneumococcal infection, pneumococcal vaccination can prevent both primary and secondary bacterial infections and the unnecessary use of antibacterial medications (antibiotics),
Are there ways to organize the immunization service site to minimize the risk of COVID-19 virus transmission?
- Establishing immunization sessions exclusively for vaccination of older persons and those with pre-existing medical conditions (such as high blood pressure, heart disease, respiratory illness, or diabetes).
|15 May 2020|
|Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic||**43 pg document with reference to older people throughout|
Part 2: Older people
- Recognize non-specific signs and symptoms of COVID-19 in older people, including fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium and the absence of fever (42).
- Reach out (for example, by phone or telehealth connection) to older people who have additional risk factors (6) for developing severe illness from COVID-19, such as those with chronic lung disease, cardiovascular disease including hypertension, immunodeficiency including HIV, diabetes, renal disease, liver disease, chronic neurological or neuromuscular disease, malignancy, or undernutrition.
- Advise older people to have at home, if possible, at least 2 weeks of critical medicines and supplies. Provide repeat prescriptions and mechanisms for delivering refills.
- Discuss advanced care planning and the possibilities of palliative care, including end-of-life care, to allow informed, inclusive and autonomous decisions, if appropriate.
- Follow up (for example, by phone or with a home visit) if the older person fails to attend appointments.
- Recognize that older people, particularly those in isolation and with impairments (such as visual impairment, hearing loss, cognitive decline or dementia), may become more anxious, angry and stressed (18).
• Adapt communication (verbal and written) to older people with impairments so that information is accessible and clearly understood (5).
• Provide practical advice in a clear, concise, respectful and calm way, and repeat simple facts as frequently as needed.
• Be mindful that wearing a mask prevents lip reading and decreases vocal clarity for those with hearing loss (43).
- Ensure that assistive devices are provided, such as wheelchairs and walkers, to those older people who need them, and communicate the importance of ensuring that these are disinfected before and after use.
- Ensure that older people who live alone or are institutionalized have access to nutritious food. Consider individual preferences and underlying physical limitations when ensuring this access (such as problems with chewing, swallowing or digestion) (44).
- Engage the community health workforce to help older persons who depend on care (45).
- Discuss with the older person and their household an alternative plan to ensure continuity of care in case the main caregiver is unavailable (46):
• identify alternative caregivers and prepare a readily available care plan for handover;
• identify possible facilities (such as long-term care facilities, community centres) for short-term admissions.
|5 May 2020|
|Recommendations to Member States to improve hand hygiene practices to help prevent the transmission of the COVID-19 virus||WHO recommendations|
- The quantity and usability of the hand hygiene stations should be adapted to the type (e.g. young children, elderly, those with limited mobility) and number of users to better encourage use and reduce waiting time.
|1 Apr 2020|
|Guiding principles for immunization activities during the COVID-19 pandemic: interim guidance||Guiding principles: “Where feasible, influenza vaccination of health workers, older adults, and pregnant women is advised”||26 Mar 2020|
|Guide to local production: WHO-recommended handrub formulations||No specific reference to older people||7 May 2020|