Isolate personnel from exposure

Modify work processes to reduce exposure

Directly protect the exposed worker

Collective

Individual

Prioritise implementation by category:

• Category 1. Urgent or essential (needed for life-threatening treatment)

• Category 2. Life-limiting (needed to initiate treatments that improve quality of life)

• Category 3. Routine

• Category 4. Vulnerable patients

Categories 3 and 4 should be reserved for the post-pandemic phase

Infrastructure:

• Ventilation rates of at least 6 air changes/HR

• HEPA filters with adequate maintenance

• Negative pressure room for active TB patients

Consumables:

• Disposable mouthpieces (do not reuse)

• Mandatory use of high efficiency filters

Screening for active respiratory infections:

• Signs and symptoms questionnaire (re-agendize for active infection data)

• Immunocompetent do not need negative PCR vs. SARS-CoV-2 30 days after infection

• Immunocompromised 2 PCRs recommended versus SARS-CoV-2 (-) after illness

Organisation of schedule and patient flow:

Earmarking first shifts or specific areas for vulnerable patients

Physical distance (at least 2 metres) in waiting area

Minimise patient exposure time during testing

Mandatory mouth cover on patient between manoeuvres

Cough or sneeze etiquette when

performing the manoeuvre

Mandatory handwashing of staff and patient

Aerosol break

Cleaning and disinfection between patient and patient

Eye protection:

• Goggles or face shield

Respiratory protection:

• Respirators with more than 95% particulate filtering

(FFP2 or N95)

• Seal test

• The use of fabric, surgical or other masks is not recommended when testing