Overview of public health and social measures in the context of COVID-19: interim guidance, 18 May 2020

-1- Overview of public health and social measures in the context of COVID-19 Interim guidance 18 May 2020 Background The overarching goal for all countries is to control COVID-19 by slowing down transmission of the virus and preventing associated illness and death. In response to COVID-19, every country should be implementing a comprehensive set of measures, calibrated to the local context and epidemiology of the disease.1 Central to this comprehensive strategy are time-tested, core public health measures that break chains of person-to-person transmission, including (i) identification, isolation, testing, and clinical care for all cases, and (ii) tracing and quarantine of all contacts,2-6 which should be a part of all national COVID-19 responses. A comprehensive strategy to control COVID-19 will also include other public health and social measures, which are actions by individuals, institutions, communities, local and national governments, and international bodies to suppress or stop community spread of COVID-19.1 Public health and social measures contribute to stopping individual chains of transmission and preventing outbreaks, and are therefore critical in limiting further spread of COVID-19, particularly while vaccines and therapeutics are not yet available. These measures include the following: • Personal measures aim to limit person-to-person spread, protect individuals and their contacts, and reduce contamination of frequently touched surfaces.6,7 Personal measures include frequent hand hygiene, physical distancing, respiratory etiquette, use of masks if ill or attending to someone who is ill, and environmental cleaning and disinfection at home. • Physical and social distancing measures in public spaces prevent transmission between infected individuals and those who are not infected, and shield those at risk of developing serious illness. These measures include physical distancing, reduction or cancellation of mass gatherings,8 and avoiding crowded spaces in different settings (e.g. public transport, restaurants, bars, theatres), working from home, staying at home, and supporting adaptations for workplaces9 and educational institutions.10 For physical distancing, WHO recommends a minimum distance of at least one metrea between people to limit the risk of interpersonal transmission. • Movement measures aim to prevent introduction and limit movement of the virus from one area to another. Measures include limiting movement of persons locally or nationally, offering guidance regarding travel, arranging orderly travel in advance to avoid congestion at travel hubs, including train stations, bus terminals and airports, and considering a cordon sanitaire or other selected measures when justified by the local epidemiology of COVID-19. • Special protection measures aim to protect special populations and vulnerable groups: • Persons at risk for more serious illness from COVID-19 (e.g. older people, persons with underlying medical conditions) • Persons or groups with social vulnerabilities (e.g. migrant workers, refugees, displaced populations, the homeless) • Persons or groups living in closed settings (e.g. long-term living facilities,11 places of detention, camps/camp-like settings) • Persons or groups with higher occupational risk of exposure to the virus (e.g. staff of institutional settings, health workers and frontline responders). Protecting health and care workers also prevents outbreaks in health facilities and residences for seniors. Public health and social measures provide a toolkit of interventions that countries can select and calibrate based on their local context. National and local authorities must, however, balance interventions to address the direct health impact of COVID-19 with strategies to limit short- and long-term consequences on health and socioeconomic wellbeing, such as arise from loss of income or access to services, that may result from putting in place certain measures.1 Advance planning and preparedness are also critical to avert the indirect health impact that may result when health systems are overwhelmed or other essential health and social services are interrupted. a One metre is equivalent to three feet and 3.4 inches. WHO is monitoring ongoing research on risks of COVID-19 transmission. Overview of public health and social measures in the context of COVID-19: Interim guidance -2- Purpose The purpose of this document is to provide an overview of public health and social measures that can be implemented to slow or stop the spread of COVID-19, and to propose strategies to limit any possible harm resulting from these interventions.b The document is intended to inform national and local authorities and other decision-makers, who must balance public health interventions to control COVID-19 while seeking to minimize their social and economic impact. Applying public health and social measures according to level of disease transmission Each category of public health and social measures—including personal, physical distancing, movement and special protection measures—contains a range of interventions that should be selected, calibrated, and implemented based on the local intensity of COVID-19 transmission (no cases reported, sporadic cases, clusters of cases, community transmission).6 Public health interventions should be commensurate with the intensity of COVID-19 transmission, and any measures that countries seek to implement should be safely adapted to ensure they are feasible, sustainable, and acceptable in the local context. National authorities should recommend or apply measures nationally and sub-nationally based on their specific context, risk, or level of spread, and review the situation regularly as the pandemic evolves. Communities might also adapt measures as needed, bearing in mind local culture, living environments, and access to resources and services. The intensity of COVID-19 transmission is typically not homogenous within a country, so national authorities should ensure that measures that are applied are based on sub-national epidemiology and with time limits on their length of implementation. Any adjustments to public health and social measures, and the reasons for the adjustments, should be clearly communicated to the public.12 WHO has issued guidance to national authorities and decision makers on considerations for adjusting public health and social measures in a gradual and phased manner as the local epidemiology of the disease changes.12,13 Table 1 outlines a range of public health and social measures countries can consider, to reduce transmission of COVID-19. Balancing the benefits and risks of public health and social measures The primary goal of public health and social measures is to protect health; however, the use of certain measures, including stringent physical and social distancing and movement measures, may have harmful effects on the health and socioeconomic wellbeing of individuals and communities. Potentially harmful consequences that may result from implementing the measures selected14 need to be identified and managed, along with policies to maintain essential health services; protect access to food, water, and essential goods and services; protect incomes; support families and communities; and ensure human rights for all,15 including gender considerations.16 Addressing these concerns at both national policy and local levels will help alleviate potential burdens associated with implementing public health and social measures and support adherence to the measures. It is also critical to adapt measures to the local context and consider how long they can be in place. Close coordination of public health and social services is also needed to ensure everyone knows how to seek testing or medical attention, to find and test suspected cases quickly, isolate and treat patients effectively, trace and quarantine contacts timely, and to ensure safe discharge and appropriate post-hospital care to protect others in the community setting. To be effective, public health and social measures require the engagement of all members of society. Policies and interventions should be accompanied by regular dialogue through trusted channels to provide the right information at the right time to enable people to make informed decisions to protect themselves. Decision-makers should engage with communities and communicate openly and regularly with people about how to implement public health and social measures throughout all phases of the emergency response and recovery. There is no single formula for which measures to include or how to implement them given the wide range of epidemiological situations and social and economic contexts in which the pandemic is occurring. Mindful attention to the dual objectives of controlling COVID-19 and protecting communities from unintended consequences of response measures will help to safeguard health and protect well-being through all phases of response and recovery. Table 2 suggests considerations for successful implementation of public health and social measures. Table 3 provides an overview of policies to implement alongside public health and social measures to limit harm and support community resilience and social cohesion. Further considerations for measures in low-income settings are available.17 b Guidance for personal and environmental measures, infection prevention and control, case finding and management, mass gatherings, international travel, use of masks, schools and other topics is available at www.who.int/emergencies/diseases/novel- coronavirus-2019. Overview of public health and social measures in the context of COVID-19: Interim guidance -3- Table 1. Selected public health and social measures for consideration in the context of COVID-19* Personal measures Physical and social distancing Movement measures Special protection measures Aim: limit person-to-person spread, protect individuals and their contacts, and reduce contamination of frequently touched surfaces Encourage the public to practice18 • Frequent hand hygiene • Physical distancing • Respiratory etiquette • Proper use of masks if unwell or attending to someone who is ill • Environmental cleaning at home Aim: ensure safe physical distancing through reduced crowding Workplaces 9 • Support businesses and workplaces to put in place hand hygiene, physical distancing, and environmental cleaning • Plan for business continuity and minimum services • Where feasible, encourage teleworking, staggered shifts, flexible leave policies, teleconferences, virtual meetings, and protection for front-line workers and service personnel • Conduct risk assessment by workstation or function according to the environment, expected tasks, possibility of exposure, and available resources • Close non-essential businesses as transmission intensifies Schools 10 • Support schools to put in place hand hygiene and distancing measures, as well as environmental cleaning • Consider distance learning, suspension of classes, rotation in attendance, or closing school buildings for a limited time • Hygiene and distancing measures in canteens and buses Mass gatherings8,19 • Conduct risk assessment 20 for high visibility events, sporting 21 and faith-based events,22 festivals, conferences • Adapt, postpone, or cancel public and private events • Limit size of public and private events • Adapt wedding, funeral and burial23 customs Public spaces and transportation – • Reduce crowding, limit access to, or close public spaces, restaurants, sporting events,24 sports clubs, entertainment venues, places of worship,25 or venues with limited ventilation Aim: prevent introduction of virus from infected areas to non-infected areas • Offer advice regarding travel19 appropriate to circumstances, such as reducing non-essential travel or how to protect oneself while travelling • Limit movement locally, regionally, or nationally as necessary to interrupt transmission or prevent reintroduction • Arrange travel in advance as needed (students, workers, repatriation) • Consider a cordon sanitaire or border measures when justified by local epidemiology • Consider isolation or quarantine for arriving travellers, in line with national screening and testing policy Aim: reduce the risk of exposure of vulnerable groups Persons at risk, vulnerable persons, and others • Shelter-in-place advice for older age groups • Protect closed settings - seniors’ residences, long-term11 or psychiatric care, prisons27 • Limit visitors or allow visits only with safe distancing • Plan for migrants, refugees,28 displaced29 or homeless • Separation from others if appropriate to context and can be done safely and voluntarily • In special settings, identify and plan for those at higher risk, e.g. in shops, public transport, hospitals Plan to safely maintain essential health services including immunization, prenatal care, maternity care, cancer care and disease control efforts30 Health workers,31 frontline responders, caregivers, and the health system • Coordinate community services, phone hotlines, health facilities, and emergency response units to support testing, isolation, quarantine, and referral • Support telemedicine and remote health services • Reschedule non-urgent health and medical care • Organize services to reduce risk and frequency of contact, ensure physical distancing in all areas • Ensure availability of personal protective equipment32 • Implement surge plans for community clinics, isolation units where preferred, hospitals, and palliative care 33 Overview of public health and social measures in the context of COVID-19: Interim guidance -4- *WHO has developed a series of guidance on critical preparedness, readiness and response; clinical care; infection prevention and control; essential health services; essential resource planning; laboratory and diagnosis; risk communication and community engagement; surveillance and case investigations; travel and mass gatherings, vulnerable populations; schools and institutions, and other topics, which are all available at www.who.int. Table 2. Considerations for successful implementation of public health and social measures in the context of COVID-19 For individuals and the community Collective action and support at higher levels of government Communicate effectively, engage communities • Communicate risk clearly34 with information on how to protect oneself and others18 • Demystify science, simplify messages, encourage sharing of information • Focus on what individuals and communities can do rather than on what not to do • Offer tips on actions people can take to help others who need assistance • Underline personal responsibility and the role each person plays in preventing disease and saving lives • Prevent stigma by emphasizing respect for human rights35 • Ccommunicate risk, policy and plans, regularly and often • Develop strategies and products to counter mis-information and myths • Engage with communities in decision-making and to strengthen engagement for public health measures • Identify local networks and engage communities, businesses, religious leaders, and local influencers; • Support police and security forces to ensure clear role and avoid mishaps Enable adherence to measures • Ensure access to affordable hygiene products and multiply wash points in public spaces,36 transport hubs, taxi stands; deploy water cisterns or other water services where needed • Facilitate access to essential services such as food shopping, essential travel, exercise, emergencies • Provide support to persons in isolation or quarantine • Establish residential units for migrants and the homeless • Establish one-way flow for services, shops and markets, to reduce crowds and limit the number of contacts • Apply simple measures such as markings at > 1 metre intervals in shops, clinics, other queues, or for desk spacing in schools • Schedule appointments for essential services to reduce waiting time, offer online alternatives • Provide information on proper use, care, and disposal of masks, where used • Train local workers or volunteers in case-finding, home visits,3 contact tracing,2 and communication • Encourage innovation (e.g. hands-free or pedal-activated water or hand gel dispensers) • Strengthen cleaning in offices, shops, transport, buildings, and restrooms • Maintain transport options for essential travel (e.g. for work, access to services and health care) • Plan early for student housing or repatriation of visitors as needed • Consider voluntary use of phone apps to support measures, while respecting human rights • Plan iterative assessment of response to adapt measures and communicate about changes • Encourage physical distancing in public places and transportation (e.g. in queues and in waiting areas) • Reduce mixing between individuals and households • Communicate policy on wearing masks in public26 • Coordinate health care, rehabilitation centres, and community services to ensure hospital discharge planning and safe step-down care Overview of public health and social measures in the context of COVID-19: Interim guidance -5- Table 3. Sample strategies and policies for limiting secondary effects of implementing public health and social measures For individuals and the community Collective action and support at higher levels of governance Support family and community • Propose alternatives for education10 (e.g. distance learning, coaching by library staff or older siblings, or buddy systems with phone support) • Care for children of essential personnel, e.g. keeping schools open for them with strict hygiene and physical distancing • Deploy alternatives to school meals for those in need • Encourage communities to support the elderly, sick, or vulnerable • Encourage social interaction by virtual means • Orient social and community services to enhance resilience of communities • Keep pharmacies open, protect access to essential medicines30 • Establish mental health strategies and crisis hotline • Ensure services and protection for migrant workers • Develop social services to reduce risk and respond to domestic violence • Innovate for emergencies, e.g. establishing safe codes for victims of abuse/interpersonal violence • Establish or advocate for suspension of health care user fees Protect incomes and the economy • Pilot or support teleworking, shift changes, and physical distancing9 • Initiate flexible leave and payment policies at work • Encourage part-time work or adapted services (e.g. home delivery) • Implement business continuity plans for essential services and business • Engage occupational health and safety services • Ensure access to health and social care for employees • Promote employee income maintenance, flexible leave policies9 • Plan for income support by employers, communities, government • Offer social, economic, unemployment, and tax relief packages • Develop an integrated all-of-society approach across sectors to ensure essential services and supplies reach when and where they are needed • Devise strategies and approaches, such as public health corridors, to safely deliver supplies and services Protect access to food and water • Keep food shops and supply routes open37 • Establish priority access to shops, markets for those who need it, e.g. early morning hours reserved for the elderly and the vulnerable • Encourage home preparedness for quarantine or isolation, and support access to food and supplies • Facilitate protection for store personnel – screens, distancing, masks • Engage food producers, suppliers, and sellers to prepare, and to protect safe and efficient food supply37 • Pre-position and deploy food supplies to priority groups and populations in special circumstances, including the displaced • Ensure food distribution in special settings and repeat as required, in humanitarian corridors where needed • Protect harvest and food services workers; arrange safe travel as needed Maintain essential health services • Schedule appointments for essential health services to reduce time in open waiting areas • Pilot telemedicine and strengthen and protect access to care • Facilitate protection for pharmacy staff – screens, distancing, masks • Maintain elective surgeries and procedures in safe environment where possible, reschedule where necessary • Guide safe care-seeking behaviours by disseminating information to the public, including new pathways for services, opening hours, precautions • Establish effective patient flow (screening, triage and targeted referral) at all levels • Ensure adequate capacity for testing and contact-tracing including reassignment and training of non-public health staff from national or municipal levels • Establish mechanisms to govern delivery of core and community essential health services,30 in coordination with response protocols, while scaling surge capacity as needed • Identify context-relevant list of essential services and medicines • Optimize essential service delivery settings and platforms • Re-distribute health workforce capacity as needed, including re-assignment and task sharing Identify mechanisms to maintain availability of and access to essential medication and supplies Overview of public health and social measures in the context of COVID-19: Interim guidance -6- References 1. World Health Organization. COVID-19 Strategy Update (Interim Guidance) (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/strategies-plans-and-operations, accessed 14 April 2020) 2. World Health Organization. Contact tracing in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/contact-tracing-in-the-context-of-covid-19 , accessed 10 May 2020) 3. World Health Organization. Surveillance strategies for COVID-19 human infection (Interim Guidance) (https://www.who.int/publications-detail/surveillance-strategies-for-covid-19-human-infection, accessed 10 May 2020) 4. World Health Organization. Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19) (Interim guidance) (https://www.who.int/publications-detail/considerations-for- quarantine-of-individuals-in-the-context-of-containment-for-coronavirus-disease-(covid-19, accessed 19 March 2020) 5. World Health Organization. Operational considerations for case management of COVID-19 in health facility and community. (https://www.who.int/publications-detail/operational-considerations-for-case-management-of-covid- 19-in-health-facility-and-community, accessed 16 May 2020) 6. World Health Organization. Critical preparedness, readiness, and response actions for COVID-19. (https://www.who.int/publications-detail/critical-preparedness-readiness-and-response-actions-for-covid-19, accessed 16 May 2020) 7. World Health Organization. Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza. October 2019. (https://www.who.int/influenza/publications/public_health_measures/publication/en/, accessed 19 March 2020) 8. Key planning recommendations for mass gatherings in the context of the current COVID-19 outbreak (https://www.who.int/publications-detail/key-planning-recommendations-for-mass-gatherings-in-the-context-of- the-current-covid-19-outbreak) 9. World Health Organization. Considerations for public health and social measures in the workplace (Interim Guidance) (https://www.who.int/publications-detail/considerations-for-public-health-and-social-measures-in-the-workplace-in- the-context-of-covid-19, accessed 10 May 2020) 10. World Health Organization. Considerations for school-related public health measures in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/considerations-for-school-related-public-health-measures- in-the-context-of-covid-19, accessed 10 May 2020) 11. World Health Organization. Infection prevention and control for long-term care facilities in the context of COVID-19 (https://apps.who.int/iris/bitstream/handle/10665/331508/WHO-2019-nCoV-IPC_long_term_care-2020.1-eng.pdf, accessed 10 May 2020) 12. World Health Organization. Considerations in adjusting public health and social measures in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/considerations-in-adjusting-public-health-and-social- measures-in-the-context-of-covid-19-interim-guidance, accessed 15 April 2020) 13. World Health Organization. Public health criteria to adjust public health and social measures in the context of COVID-19 (https://www.who.int/publications-detail/public-health-criteria-to-adjust-public-health-and-social- measures-in-the-context-of-covid-19, accessed 16 May 2020) 14. Brooks S, Webster R, Smith L, Woodland L, Wessely S, Greenberg N. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext 15. World Health Organization. Addressing human rights as key to the COVID response. (https://www.who.int/publications-detail/addressing-human-rights-as-key-to-the-covid-19-response, accessed 21 April 2020) 16. World Health Organization. Gender and COVID-19. (Advocacy Brief) (https://apps.who.int/iris/bitstream/handle/10665/332080/WHO-2019-nCoV-Advocacy_brief-Gender-2020.1- eng.pdf?sequence=1&isAllowed=y, accessed 14 May 2020) 17. IASC (2020). Public health and social measures for COVID-19 preparedness and response operations in low capacity and humanitarian settings. (Interim Guidance, March 2020). https://interagencystandingcommittee.org/health/interim-guidance-public-health-and-social-measures-covid-19- preparedness-and-response 18. World Health Organization. Coronavirus disease (COVID-19) advice for the public (Website) (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public, accessed 29 April 2020) 19. World Health Organization. Coronavirus disease (COVID-19) technical guidance: points of entry and mass gatherings (Website) (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/points-of-entry-and- mass-gatherings, accessed 16 May 2020) 20. World Health Organization. How to use WHO risk assessment and mitigation checklist for Mass Gatherings in the context of COVID-19 (Tool) (https://www.who.int/publications-detail/how-to-use-who-risk-assessment-and- mitigation-checklist-for-mass-gatherings-in-the-context-of-covid-19, accessed 19 March 2020) Overview of public health and social measures in the context of COVID-19: Interim guidance -7- 21. World Health Organization. Guidance for the use of the WHO Mass Gatherings sports addendum risk assessment tools in the context of COVID-19 (Tool) (https://www.who.int/who-documents-detail/guidance-for-the-use-of-the-who- mass-gatherings-sports-addendum-risk-assessment-tools-in-the-context-of-covid-19, accessed 30 April 2020) 22. World Health Organization. How to use the WHO Mass Gathering religious addendum risk assessment tool in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/how-to-use-the-who-mass- gathering-religious-addendum-risk-assessment-tool-in-the-context-of-covid-19, accessed 20 March 2020) 23. World Health Organization. Infection prevention and control for the safe management of a dead body in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/infection-prevention-and-control-for-the-safe- management-of-a-dead-body-in-the-context-of-covid-19-interim-guidance, accessed 24 March 2020) 24. World Health Organization. Considerations for sports federations/ sports event organizers when planning mass gatherings in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/considerations- for-sports-federations-sports-event-organizers-when-planning-mass-gatherings-in-the-context-of-covid-19-interim- guidance, accessed 14 April 2020) 25. World Health Organization. Practical considerations and recommendations for religious leaders and faith-based communities in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/practical- considerations-and-recommendations-for-religious-leaders-and-faith-based-communities-in-the-context-of-covid-19, accessed 07 April 2020) 26. World Health Organization. Advice on the use of masks in the context of COVID-19 (Interim Guidance) (https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in- healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak, accessed 06 April 2020) 27. World Health Organization. Preparedness, prevention and control of COVID-19 in prisons and other places of detention (Interim Guidance) (http://www.euro.who.int/en/health-topics/health-determinants/prisons-and- health/publications/2020/preparedness,-prevention-and-control-of-covid-19-in-prisons-and-other-places-of-detention,- 15-march-2020, accessed 15 March 2020) 28. World Health Organization. Preparedness, prevention and control of coronavirus disease (COVID-19) for refugees and migrants in non-camp settings (Interim Guidance) (https://www.who.int/publications-detail/preparedness-prevention- and-control-of-coronavirus-disease-(covid-19)-for-refugees-and-migrants-in-non-camp-settings, accessed 17 April 2020) 29. Interagency Standing Committee. Scaling-up COVID-19 outbreak in readiness and response operations in camps and camp-like situations (Interim Guidance) (https://interagencystandingcommittee.org/other/interim-guidance-scaling- covid-19-outbreak-readiness-and-response-operations-camps-and-camp, accessed 17 March 2020) 30. World Health Organization. COVID-19: Operational guidance for maintaining essential health services during an outbreak. (Interim Guidance) (https://www.who.int/publications-detail/covid-19-operational-guidance-for-maintaining- essential-health-services-during-an-outbreak, accessed 25 March 2020). 31. World Health Organization. Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers including key considerations for occupational safety and health (Interim Guidance) (https://www.who.int/publications-detail/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilities-of- health-workers-including-key-considerations-for-occupational-safety-and-health, accessed 18 March 2020) 32. World Health Organization. Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages. (Interim Guidance) (https://www.who.int/publications-detail/rational-use-of- personal-protective-equipment-for-coronavirus-disease-(covid-19)-and-considerations-during-severe-shortages , accessed 06 April 2020). 33. World Health Organization. Coronavirus disease (COVID-19) technical guidance: essential resource planning. (Website) (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/covid-19-critical- items) 34. World Health Organization. Risk communication and community engagement readiness and response to coronavirus disease (COVID-19) (Interim Guidance) (https://www.who.int/publications-detail/risk-communication-and- community-engagement-readiness-and-initial-response-for-novel-coronaviruses-(-ncov), accessed 19 March 2020) 35. World Health Organization, UNICEF, International Federation of Red Cross and Red Crescent. A guide to preventing and addressing social stigma associated with COVID-19 (Interim Guidance) (https://www.who.int/who-documents- detail/a-guide-to-preventing-and-addressing-social-stigma-associated-with-covid-19, accessed 24 February 2020) 36. World Health Organization. Recommendations to Member States to improve hand hygiene practices to help prevent the transmission of the COVID-19 virus (Interim Guidance) (https://www.who.int/publications- detail/recommendations-to-member-states-to-improve-hand-hygiene-practices-to-help-prevent-the-transmission-of-the- covid-19-virus, 01 April 2020) 37. World Health Organization. COVID-19 and food safety: guidance for food businesses. (Interim Guidance) (https://www.who.int/publications-detail/covid-19-and-food-safety-guidance-for-food-businesses, 07 April 2020) Overview of public health and social measures in the context of COVID-19: Interim guidance -8- Additional resources Africa Centres for Disease Control and Prevention Guidance on Community Social Distancing During COVID-19 Outbreak; 2020. (https://africacdc.org/download/guidance-on-community-social-distancing-during-covid-19-outbreak/) European Centre for Disease Prevention and Control. Considerations relating to social distancing measures in response to COVID-19. Stockholm: ECDC; 2020. (https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-social- distancing-measuresg-guide-second-update.pdf) Imperial College COVID-19 Response Team. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand. 16 March 2020. London: Imperial College; 2020. (https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI- modelling-16-03-2020.pdf) IFRC, IOM, UNHCR and WHO. Interim guidance on scaling-up COVID-19 outbreak readiness and response operations in camps and camp-like settings. (https://interagencystandingcommittee.org/other/interim-guidance-scaling-covid-19- outbreak-readiness-and-response-operations-camps-and-camp) International Labour Organization (ILO) Note. COVID-19 and world of work: Impacts and responses 18 March 2020; (https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/documents/briefingnote/wcms_738753.pdf) New Zealand Government. COVID-19 Alert System. (https://covid19.govt.nz/alert-system/covid-19-alert-system/). 6 April 2020. UNICEF, WHO, IFRC. Key Messages and Actions for COVID-19 Prevention and Control in Schools. 2020 (https://www.unicef.org/media/65716/file/Key%20Messages%20and%20Actions%20for%20COVID- 19%20Prevention%20and%20Control%20in%20Schools_March%202020.pdf) World Health Organization. Getting your workplace ready for COVID-19, 19 March 2020 Geneva; 2020 (https://www.who.int/docs/default-source/coronaviruse/advice-for-workplace-clean-19-03-2020.pdf) World Health Organization. Q & A. Considerations for the cleaning and disinfection of environmental surfaces in the context of covid-19 in non-health-care settings. (https://www.who.int/news-room/q-a-detail/q-a-considerations-for-the- cleaning-and-disinfection-of-environmental-surfaces-in-the-context-of-covid-19-in-non-health-care-settings) World Health Organization. Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response (https://www.who.int/publications-detail/risk-communication-and-community-engagement- (rcce)-action-plan-guidance) World Health Organization. guidance for maintaining essential health services and systems. (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health- services-and-systems, accessed 16 May 2020) Acknowledgements This document was developed in collaboration with WHO Regional Offices, in reference to documents developed with UNICEF and IFRC. WHO continues to monitor the situation closely for any changes that may affect this interim guidance. Should any factors change, WHO will issue a further update. Otherwise, this interim guidance document will expire 2 years after the date of publication © World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. WHO reference number: WHO/2019-nCoV/PHSM_Overview/2020.1