Pan American Health Organization · Interim recommendations, 14 April 2020
Checklist tool for assessing IPC standards in COVID-19 isolation areas, for IPC professionals and healthcare facility managers.
- Issuer
- Pan American Health Organization
- Edition
- Interim recommendations, 14 April 2020
- Audience
- Infection prevention and control professionals, healthcare facility managers, clinicians and public health professionals
- Evidence
- Expert consensus based on existing IPC standards
- Reviewed
- 20 Oct 2026 · GMJ
What this guideline says
GMJ summary
This interim guidance from the Pan American Health Organization provides a comprehensive assessment tool for evaluating infection prevention and control (IPC) practices in COVID-19 isolation areas within healthcare facilities. The document was released on 14 April 2020 to support IPC professionals and managers in identifying gaps in compliance with standards and implementing corrective measures.
The checklist is structured around four main components: human resources (workforce, training, health status follow-up), administrative strategies (IPC activities, patient containment, environmental cleaning policies), hospital environment and sanitation (hand hygiene, isolation area specifications, waste management, environmental cleaning), and cleaning/sterilization/high-level disinfection of medical devices. The tool emphasizes that as of 14 April 2020, standard + contact + droplet precautions are recommended for suspected or confirmed COVID-19 cases, with standard + contact + airborne precautions added for aerosol-generating procedures.
The assessment is designed to be performed weekly by the same professional or group, with results plotted on an automated radar graph to visualize key performance metrics. All indicators carry equal weighting, with an expected result of 100% compliance. Any ‘absent/no’ response should trigger immediate corrective action.
Key points
For clinicians — doses and thresholds as stated in the guideline
- For suspected or confirmed COVID-19 cases: standard + contact + droplet precautions required
- For suspected or confirmed COVID-19 cases with aerosol-generating procedures: standard + contact + airborne precautions required
- Natural ventilation: 160 L/min/person or mechanical ventilation with 12 air changes per hour (ACH) for aerosol-generating procedure areas; 60 L/min/person in rooms under droplet precautions
- Separation of one metre or more between beds in cohort areas or multiple-patient rooms
- Potable water must be available on an ongoing basis with a minimum of 8 hours supply
- Alcohol hand rub solution and accessible, operational washbasins with soap must be available in all patient care areas
- At least one dedicated cleaner per shift required for isolation areas
- Weekly assessment recommended, performed by the same professional or group, with 100% compliance as the expected result
Precautions recommended for COVID-19 patient care (as of 14 April 2020)
Table extracted from the guideline
| Clinical scenario | Precautions required |
|---|---|
| Suspected or confirmed COVID-19 cases | Standard + contact + droplet precautions |
| Suspected or confirmed COVID-19 cases with aerosol-generating procedures | Standard + contact + airborne precautions |
Source: Pan American Health Organization, Assessment of infection prevention and control practices for COVID-19 isolation areas in healthcare facilities. Reproduced in summary form.
From the guideline
Verbatim
“As of 14 April 2020, the following precautions are recommended for the care of patients with suspected or confirmed cases of COVID-19: For any suspected or confirmed cases of COVID-19: standard + contact + droplet precautions”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As Chair of the Public Health Institute of Georgia and WHO consultant, I recognize this assessment tool as essential for strengthening infection prevention and control systems in Georgian healthcare facilities, particularly as we continue managing COVID-19 alongside other respiratory pathogens. The structured weekly assessment approach with objective indicators aligns well with Georgia's ongoing efforts to improve healthcare quality standards under our Universal Health Coverage programme introduced in 2013. I would stress to Georgian clinicians the specific ventilation requirements—160 L/min/person for aerosol-generating procedures and 60 L/min/person for droplet precautions—as these infrastructure standards require careful evaluation in many of our facilities. The realistic implementation caveat for Georgia is that achieving 100% compliance across all indicators will require sustained investment in infrastructure upgrades, particularly for ventilation systems and hand hygiene facilities, which may be challenging in older healthcare facilities across the region without dedicated capital funding and phased implementation plans.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 20 Oct 2026
Applicability
Georgia and the South Caucasus
This assessment tool remains highly relevant for healthcare facilities across Georgia and the South Caucasus region as COVID-19 continues to circulate and healthcare-associated infections remain a persistent challenge. Georgian healthcare facilities implementing COVID-19 isolation areas or preparing for future respiratory pathogen outbreaks would benefit from this systematic evaluation framework. National infection prevention and control programmes in Georgia, Armenia and Azerbaijan should consider adapting this tool to local contexts, ensuring that infrastructure requirements (particularly ventilation standards of 160 L/min/person for aerosol-generating procedures and 60 L/min/person for droplet precautions) align with existing building stock and climate conditions. The emphasis on weekly assessment and 100% compliance targets provides a realistic quality improvement framework that can be integrated into existing healthcare quality assurance systems across the region.
Questions this guideline answers
Quick answers
What precautions are required for patients with suspected or confirmed COVID-19?
Standard + contact + droplet precautions are required for all suspected or confirmed COVID-19 cases. If aerosol-generating procedures are performed, standard + contact + airborne precautions are required instead.
What ventilation is needed in COVID-19 isolation areas?
Natural ventilation of 160 L/min/person or mechanical ventilation with 12 air changes per hour (ACH) is required for aerosol-generating procedure areas. Rooms for patients under droplet precautions require 60 L/min/person.
How often should this assessment be performed?
Ideally, the evaluation should be performed weekly by the same professional or group on a regular basis to track compliance and identify areas needing improvement.
What is the minimum distance between beds in cohort areas?
A separation of one metre or more is required between beds in cohort areas or multiple-patient rooms to reduce transmission risk.
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- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Edition
- Interim recommendations, 14 April 2020
- Status
- Current
- Published
- 2020-01-01
- Scope
- Healthcare facilities with COVID-19 isolation areas
- Audience
- Infection prevention and control professionals, healthcare facility managers, clinicians and public health professionals
- Licence
- CC BY-NC-SA 3.0 IGO
- Evidence
- Expert consensus based on existing IPC standards
- Record history
- Created 20 Oct 2026 · updated 20 Oct 2026 · next check Apr 2027
Pan American Health Organization. Assessment of infection prevention and control practices for COVID-19 isolation areas in healthcare facilities: interim recommendations, 14 April 2020. Washington, DC: PAHO; 2020. (PAHO/PHE/IM/Covid-19/20-006).GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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