Ministry of Health COVID-19 Preparedness and Response Plan 2020 (TONGA) 1 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 Table of Contents 1 Acronyms ....................................................................................................................... 5 2 FOREWORD FROM THE MINISTER OF HEALTH ........................................................ 6 3 MESSAGE FROM THE CHIEF EXECUTIVE OFFICER ................................................. 7 4 Authority for Planning ..................................................................................................... 7 5 Acknowledgements / Consultations................................................................................ 8 6 Country profile ............................................................................................................... 8 6.1 Geographic location ................................................................................................ 8 6.2 Population ............................................................................................................... 8 6.3 Government ............................................................................................................ 8 6.3.1 The Executive .................................................................................................. 9 6.3.2 The Parliament ................................................................................................ 9 6.3.3 Judiciary .......................................................................................................... 9 6.4 Emergency Services ............................................................................................... 9 7 Ministry of Health Sector Plan linkages .......................................................................... 9 7.1 Acts 9 7.2 Tonga Strategic Development Framework (TSDF) II, 2015-2025 .......................... 10 7.3 Sustainable Development Goals ........................................................................... 11 8 Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) ............ 11 9 COVID-19: The Novel Coronavirus .............................................................................. 12 10 Health Sector Strategic Directions ............................................................................ 12 11 Strategic Outcomes .................................................................................................. 12 11.1 Outcome 1: Community Engagement and Mobilization ......................................... 12 11.2 Outcome 2: Establish adequate Quarantine Facilities ........................................... 13 11.3 Outcome 3: Strengthened Health System Capacity .............................................. 13 12 Objective(s) .............................................................................................................. 14 12.1 Strategic Objectives .............................................................................................. 14 12.2 Operational Objectives .......................................................................................... 14 13 Opportunities and Challenges .................................................................................. 15 14 PHASED APPROACH to COVID-19 ........................................................................ 18 14.1 Phase 1: Preparedness and Prevention ................................................................ 20 14.2 Phase 2: Virus detected - early response & Phase 3: Containment ...................... 23 14.3 Phase 4: Outbreak /Pandemic .............................................................................. 24 14.4 Phase 5: Post outbreak stand down and recovery ................................................ 25 15 WHO Preparedness and Response Pillars ............................................................... 25 2 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 16 Case Definition ......................................................................................................... 27 17 Governance Structure .............................................................................................. 27 18 Governing Principles ................................................................................................ 28 18.1 Whole of Society Approach ................................................................................... 28 18.1.1 Community Engagement, Empowerment, Participation and Mobilization ....... 28 18.2 Whole of Government Approach ........................................................................... 28 18.2.1 High level approaches ................................................................................... 28 18.2.2 National Emergency Management ................................................................. 29 18.2.3 Inter-agency coordination or Clusters ............................................................ 29 18.2.4 Initiatives that are embedded in the Tongan Cultural Context ........................ 29 19 Coordinating Mechanism .......................................................................................... 30 19.1 Approval Process for COVID-19 requests ............................................................. 30 20 References ............................................................................................................... 31 21 Annex ....................................................................................................................... 34 21.1 Annex A: Stage 1 Preparedness Checklist ............................................................ 34 21.2 Annex B: Procurement Implementation Arrangements .......................................... 40 21.3 Annex C: COVID-19 BUDGET Costing by Pillars .................................................. 44 21.4 Annex D: Monitoring & Evaluation Framework ..................................................... 84 21.4.1 Pillar 1: Country-level Coordination, Planning and Monitoring ........................ 84 21.4.2 Pillar 8: Operational Support and Logistics .................................................... 95 21.4.3 Pillar 2: Risk Communication and Community Engagement ......................... 108 21.4.4 Pillar 3: Surveillance, Rapid Response Teams and Case Investigation ........ 121 21.4.5 Pillar 4: Point of Entry .................................................................................. 130 21.4.6 Pillar 5: National Laboratories ...................................................................... 138 21.4.7 Pillar 6: Infection Prevention and Control ..................................................... 145 21.4.8 Pillar 7: Case Management .......................................................................... 157 21.4.9 Pillar 9: Maintaining essential health services and systems ......................... 165 21.5 Annex E: PPE Request ....................................................................................... 166 21.6 Annex F: IPC Detailed Items ............................................................................... 168 21.7 Annex G: Case Management Detailed Items ...................................................... 176 21.8 Annex H: Public Health Sectional Plans .............................................................. 186 21.9 Annex I: Fever Clinic Screening Form ................................................................. 198 21.10 Annex J: Community Health Flow-Chart .......................................................... 199 21.11 Annex K: ED Flow Diagram CODE BLACK ..................................................... 200 21.12 Annex L: Laboratory Plan: Laboratory Sample Management, Testing, Referral and Reporting of Laboratory Results, Lab COVID-19 team ............................................ 201 3 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 21.13 Annex M: Radiology Department Tonga.COVID-19 Plan ................................. 206 21.14 Annex N: Ultrasound Transducer and Equipment Cleaning and Disinfection ... 207 21.15 Annex O: The role of ultrasound for patients with suspected or proven COVID-19 209 21.16 Annex P: Paediatric Section Management Plan For Moderate/Severe/Critical Paediatric Suspected/Confirmed Covid19 Cases ........................................................... 217 21.17 Annex Q: Assess Covid-19 Risk In Maternity Ward ......................................... 226 21.18 Annex R: Clinical Procedures / Mental Health Referral Pathway ...................... 227 21.19 Annex S: COVID-19 CONTAINMENT PLAN ................................................... 228 21.20 Annex T: Surge Capacity Plan ......................................................................... 232 4 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 1 Acronyms Acronym Definition 1 CDU Communicable Disease Unit 2 CEO Chief Executive Officer 3 Comm Community Health 4 COVID-19 Novel Coronavirus 5 EH Environmental Health 6 HPU Health Promotion Unit 7 MOH Ministry of Health 8 NEMC National Emergency Management Committee 9 PoE Point of Entry 10 WHO World Health Organization 5 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 6 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan 2020 (TONGA) (June 2020 7 | P a g e Ministry of Health COVID-19 Preparedness & Response Plan