Pan American Health Organization · 2020
Risk communication toolkit for healthcare facility management and workers to prepare for, manage and protect themselves from COVID-19.
- Issuer
- Pan American Health Organization
- Edition
- 2020
- Audience
- Healthcare workers and healthcare facility management
- Evidence
- Simplified messages based on WHO technical guidance
- Reviewed
- 19 Oct 2026 · GMJ
What this guideline says
GMJ summary
This risk communication package was developed by WHO’s Western Pacific Regional Office and adapted by PAHO to provide healthcare facilities with practical guidance on protecting healthcare workers and preventing COVID-19 transmission within healthcare settings. Released on 20 March 2020 during the early phase of the COVID-19 pandemic, when WHO had declared the outbreak a Public Health Emergency of International Concern on 30 January 2020, the package recognizes that healthcare workers face higher risks of infection whilst serving as the backbone of a country’s disease containment efforts.
The package contains eight ready-to-print products including posters and flyers covering: facility preparation with triage stations, management of suspected/confirmed cases with at least 1-metre distancing between patients, personal protective equipment (PPE) requirements for different healthcare activities, patient communication strategies, hand hygiene practices, and staff stress management. It emphasizes prompt isolation of suspected cases, appropriate use of surgical masks for routine care and N95 respirators for aerosol-generating procedures, and the critical importance of hand hygiene at five key moments.
The toolkit is designed to be easily edited, printed and shared in healthcare facilities as visual reminders. It translates WHO’s comprehensive technical guidance on infection prevention and control into simplified, actionable messages suitable for display at triage stations, isolation ward entrances, lunchrooms and other staff areas.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Establish triage stations at healthcare facility entrance, prior to waiting areas, to screen patients for COVID-19 symptoms (cough, fever, shortness of breath, difficulty breathing) before they enter the facility
- Immediately isolate suspected and confirmed cases, keeping them separate from each other; place patients in single rooms if possible and maintain at least 1-metre distance between all patients
- For routine care of suspected/confirmed COVID-19 cases without aerosol-generating procedures: wear disposable gloves, clean long-sleeve gown, surgical mask covering mouth and nose, and eye protection (goggles or face shield)
- For aerosol-generating procedures (such as intubation): use particulate respirator (N95 or similar) with seal check, along with goggles or face shield, gown and gloves
- Perform hand hygiene with alcohol-based hand rub or soap and water at five key moments: before touching a patient, before clean/aseptic procedures, after body fluid exposure risk, after touching a patient, and after touching patient surroundings
- Change PPE between each patient; single-use PPE (masks, gloves, face shields) must be disposed of in lidded waste bins and cannot be reused or sterilized
- Limit visitor numbers per patient; all visitors must wear required PPE and visits should be recorded; if patient is a child, admit one family member or guardian with appropriate PPE
- Healthcare workers who develop coughing, sneezing or fever after providing care must report illness immediately to the concerned authority
Personal Protective Equipment According to Healthcare Activities
Table extracted from the guideline
| Healthcare Activity | Surgical Mask | N95 Respirator | Goggles/Face Shield | Gown | Gloves |
|---|---|---|---|---|---|
| Triage/point of entry screening | Yes | No | No | No | Yes |
| Collecting respiratory specimens | Yes | No | Yes | Yes | Yes |
| Caring for suspected/confirmed case WITHOUT aerosol-generating procedure | Yes | No | Yes | Yes | Yes |
| Caring for suspected/confirmed case WITH aerosol-generating procedure | No | Yes (N95 or similar) | Yes | Yes | Yes |
| Transport of suspected/confirmed case | Yes | No | Yes | Yes | Yes |
Source: Pan American Health Organization, The COVID-19 Risk Communication Package for Healthcare Facilities. Reproduced in summary form.
From the guideline
Verbatim
“HCWs are playing a critical role in the COVID-19 outbreak response and are the backbone of a country's defenses to limit or contain the spread of disease.”
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 someone who has worked extensively with WHO on health systems strengthening in Georgia, I recognize that this March 2020 toolkit provided essential early pandemic guidance when healthcare facilities worldwide were scrambling to protect their workforce. For Georgian healthcare facilities, the most critical recommendation is the immediate establishment of triage stations before any waiting area—this single intervention prevents wholesale contamination of healthcare settings and protects vulnerable patients seeking care for other conditions. The 1-metre distancing requirement and clear PPE specifications gave our facilities concrete, actionable standards when evidence was still emerging. However, Georgian healthcare administrators must acknowledge that sustained implementation depends on reliable PPE supply chains and regular competency-based training, both of which remain challenging in rural areas of Georgia and neighbouring Armenia and Azerbaijan where healthcare worker density is low and turnover is high.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 19 Oct 2026
Applicability
Georgia and the South Caucasus
This guidance remains highly relevant for Georgia and the South Caucasus region as COVID-19 continues to circulate and healthcare facilities must maintain infection prevention and control protocols. Georgian healthcare facilities implementing these recommendations would need to ensure adequate supplies of PPE (particularly N95 respirators and surgical masks), establish alcohol-based hand rub stations throughout facilities, and adapt the visual materials into Georgian, Armenian and Azerbaijani languages for widespread dissemination. The emphasis on triage stations and spatial separation is particularly important for smaller rural healthcare facilities in the region where space constraints may require creative solutions. National programmes should integrate this guidance with existing infection prevention and control frameworks and ensure regular training and competency assessment for healthcare workers, especially in settings where PPE supply chains may be interrupted.
Questions this guideline answers
Quick answers
What PPE should healthcare workers wear when caring for a COVID-19 patient during routine (non-aerosol) care?
Disposable gloves, a clean long-sleeve gown, a surgical mask covering mouth and nose, and eye protection such as goggles or a face shield. Boots and coverall suits are not required.
When should healthcare workers use an N95 respirator instead of a surgical mask?
When performing aerosol-generating procedures such as intubation. The N95 respirator (or similar particulate respirator) must be properly fitted with a seal check performed.
How far apart should patients be placed in healthcare facilities?
Maintain at least 1-metre distance between all patients. Suspected and confirmed cases should be kept separate from each other. If possible, place patients in single rooms, and never put more than one patient in a single hospital bed.
What are the five key moments for hand hygiene in COVID-19 care?
Before touching a patient, before engaging in clean/aseptic procedures, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. Use alcohol-based hand rub or wash hands with soap and water.
Related on GMJ
Interconnected resources
Dictionary of Public Health
GMJ News coverage
Quality & accreditation
- ASF Hospital — Standard 7 — Governance & Management
- ASF Hospital — Standard 5 — Safety & Emergency Preparedness
- ASF Hospital — Standard 4 — Care & Treatment
- ASF Medical Transport — Standard 5 — Infection Prevention & Control
- ASF Laboratory — Standard 7 — Examination: Process & Safety
- ASF Hospital — Standard 11 — Critical Care
- ASF Medical Transport — Standard 6 — Emergency Response During Transport
Other guidelines on this topic
- How Can Research Transparency Be Promoted? Actions for National Health Authorities During the COVID-19 Pandemic
- COVID-19 Recommended Interventions in Mental Health and Psychosocial Support (MHPSS) during the Pandemic
- Ongoing Living Update of Potential COVID-19 Therapeutics: summary of rapid systematic reviews
- Reorganization and Progressive Expansion of Health Services for the Response to the COVID-19 Pandemic
- Influenza at the Human-Animal Interface: PAHO Recommendations to Strengthen Intersectoral Work for Surveillance, Early Detection, and Investigation
- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Status
- Current
- Published
- 2020-01-01
- Scope
- Healthcare facility infection prevention and control
- Audience
- Healthcare workers and healthcare facility management
- Licence
- CC BY-NC-SA 3.0 IGO
- Evidence
- Simplified messages based on WHO technical guidance
- Record history
- Created 19 Oct 2026 · updated 19 Oct 2026 · next check Apr 2027
Pan American Health Organization. The COVID-19 Risk Communication Package for Healthcare Facilities, 20 March 2020. Washington, D.C.: PAHO; 2020. Licence: CC BY-NC-SA 3.0 IGO.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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