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We recommend that EDs develop clear processes to identify and isolate patients who may be a source of disease transmission (see also triage section below). The likelihood of a positive diagnosis is increased in patients with clinically compatible symptoms (e.g. fever and cough) and/or epidemiological risk factors (e.g. contact with a confirmed case). Patients with severe acute respiratory illness are likely to have a higher viral load and pose a higher risk of disease transmission. An example of a simple risk stratification system linked to infection prevention and control procedures is provided below in Figure 1.
 
As a general principle, all patients should be considered as potentially infectious. Some will present with atypical symptoms (especially children and older persons), such that they fall outside of case definition criteria. For this reason, clinicians should exercise a high degree of suspicion and vigilance at all times.

Figure 1. Example of a simple risk stratification system
Note that risk stratification may change as the pandemic progresses

  • Waiting areas
  • Zoning
  • Selection of specific treatment spaces
  • Prioritisation of treatment spaces based on infection prevention and control needs
  • Patient cohorting
  • Temporary treatment spaces
  • References
  • Section disclaimer

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