Plan De Acción Ante Un Brote O Epidemia De COVID-19 En El Territorio Nacional

Objectives

Panama’s COVID-19 health action plan aims to contain transmission and mitigate harm nationally while preventing health services from being overwhelmed by COVID-19 and seasonal acute respiratory infections. It seeks to provide accessible, timely, safe and continuous care across community, primary, ambulatory, pre-hospital and hospital settings.[1][2][3]

• Strengthen active epidemiological surveillance, early detection, laboratory diagnosis, isolation, contact tracing and prompt notification of suspected and confirmed cases.[1][3]
• Organise care by clinical severity and service complexity, directing clinically stable mild cases towards safe home or community care and reserving hospital and intensive-care capacity for severe and complex cases.[4][5]
• Apply respiratory triage in all health facilities to identify, separate and classify people with acute respiratory infection, reduce transmission within facilities and regulate demand for care.[2][6]
• Strengthen capacity at points of entry, first-level facilities, referral hospitals and complementary care sites, including management of beds, staff, supplies, transport and critical resources.[7][8][5]
• Prevent healthcare-associated transmission through standard, contact, droplet and aerosol precautions, hand hygiene, appropriate personal protective equipment, environmental cleaning and safe handling of equipment and waste.[9][10][11]
• Improve population knowledge of prevention, home-based initial care and warning signs requiring health-service consultation, while countering misinformation with technically validated information.[12][3]

Implementation

The plan uses a primary-health-care-based, regionally organised response linking the Ministry of Health, the Social Security Fund, regional and institutional directorates, first-level facilities, provincial referral hospitals, the Gorgas Memorial Institute for Health Studies and international partners. It combines surveillance and border-health measures with tiered clinical pathways, home follow-up, referral networks and hospital surge arrangements.[13][11][12]

• Reinforce surveillance at airports, maritime ports and land borders through traveller screening, health declarations, advance risk assessment, monitoring of potentially exposed travellers for 14 days, and referral of suspected cases to designated regional hospitals.[7][14][15]
• Coordinate airport International Health teams, national and regional epidemiology departments, the National Focal Point, migration and border authorities, and maritime institutions to share information, investigate cases and continue contact follow-up.[14][15]
• Establish respiratory-triage areas with trained personnel, ventilation, signage, hand-hygiene facilities, physical separation where possible, clinical records and links to transport, referral and counter-referral systems.[6][16]
• Deliver home-based care through rapid-response teams comprising a doctor and nurse, supported by transport, communications, clinical supplies, personal protective equipment and waste-management materials. Assess clinical stability, comorbidities and household safety; collect diagnostic samples where needed; provide prevention advice; and arrange escalation, transfer or shelter referral when appropriate.[17][18][19]
• Maintain patient and household follow-up through home visits, telephone contact, provincial or regional response teams and Ministry of Health call centre 169, including psychological support where available and surveillance of household contacts.[20][21][18]
• Provide safe pre-hospital and inter-hospital transport by coordinating identification, documentation, ambulance selection, trained staff, protective equipment, receiving-facility acceptance, isolation capacity and ambulance decontamination between transfers.[22][23]
• Manage ambulatory cases at first-level Ministry of Health and Social Security Fund facilities where available, using designated respiratory areas, temporary isolation, infection precautions and decisions on home management or hospital referral.[8]
• Prepare hospitals for surge demand by auditing beds, establishing isolation capacity, suspending elective surgery where necessary, converting or expanding bed areas, using complementary facilities, reorganising staffing and estimating requirements and costs for personal protective equipment, medicines and medical devices.[5][9]
• Apply infection-prevention procedures through risk-based selection and correct use of personal protective equipment, hand hygiene before and after equipment use, safe waste disposal, and enhanced respiratory protection for aerosol-generating procedures.[10][24][11]
• Record care and notify cases through the relevant information and epidemiological surveillance systems, identify and trace contacts, and update regional operational plans in response to epidemiological developments, alerts and observed rates exceeding expected limits.[12][3]

Monitoring & Evaluation

The plan relies principally on epidemiological surveillance, case investigation, contact tracing, notification, follow-up and operational checks to identify COVID-19 cases early, interrupt transmission and manage demand across entry points, communities, primary care and hospitals.[13][1][3]It does not establish a consolidated formal monitoring and evaluation framework with a defined indicator set, reporting calendar, evaluation methodology or performance-accountability system in the supplied extracts.[13][1][15][5][3]

• Strengthen active surveillance of cases and contacts, including detection, isolation, traceability and follow-up at airports, ports, land borders and health facilities.[1][7][14]
• Manage surveillance information through monitoring, supervision and evaluation intended to ensure data reliability and support decision-making.[13]
• Monitor potentially exposed travellers for 14 days, use telephone contact where required, locate non-responders, and grant epidemiological clearance when the observation period ends without acute respiratory symptoms.[14][15]
• Notify the national Epidemiology Department after flight assessments and enable regional epidemiology teams to continue follow-up, including cross-border notification of relevant transit contacts through the destination country’s National Focal Point.[15]
• Use advance airport information received four hours before arrival, passenger screening and traveller health questionnaires to undertake risk analysis and identify people requiring follow-up.[7][14]
• Use information on vessels and crews, including the Maritime Single Window platform, to assess risk before authorising entry and to inform management of suspected cases.[7][14]
• Investigate suspected cases against the applicable case definition and update identification criteria as information and transmission patterns change.[4]
• Record and notify suspected or confirmed cases immediately through the Ministry of Health epidemiological surveillance system, while using health information systems, including SEIS and SIS, for care records and case registration.[3]
• Apply the case framework for suspected, confirmed, discarded and imported cases; confirm infection through a positive SARS-CoV-2 laboratory result endorsed by the National Reference Laboratory for Public Health at the Gorgas Memorial Institute for Health Studies and its Virology Department.[25][26]
• Maintain follow-up of people in home isolation, monitor household safety and contacts, undertake testing where needed, and retain patients’ addresses and telephone details to support communication with provincial or regional rapid-response teams.[20][21]
• Use respiratory triage to collect information supporting subsequent patient identification and location, classify cases by severity and determine disposition according to clinical condition and available resources.[6]
• Complete epidemiological reports, records and notifications, including contact identification and management, across ambulatory-care services.[8][27]
• Use bed audits and admission triage to oversee hospital capacity and allocate patients between intensive care and inpatient wards.[5]
• Monitor observed against predicted respiratory-event rates, identify unusual patterns and issue alerts where observations exceed the upper limit; revise regional and provincial operational plans in response to epidemiological developments and national or international alerts.[12]
• Maintain home-visit records covering public-health event notification, influenza and influenza-like illness surveillance, contact monitoring and social or environmental risks.[19]
• Monitor household contacts and use the stated laboratory criterion for ending isolation, namely two negative RT-PCR tests at least 24 hours apart after clinical improvement or normalisation of laboratory results.[28]

Costing & Financing

The supplied extracts identify substantial operational resource requirements, including workforce, transport, beds, personal protective equipment, medicines, devices, diagnostics, communications and supplies.[6][18][5][19]However, they do not provide a quantified budget, expenditure total, financing source, allocation, funding gap, resource-mobilisation target or economic assumption.[29][30][15][22][3]

• Manage critical human resources, supplies, beds and other scarce resources as central operational priorities, including reinforcement of personnel, materials, equipment and service capacity.[30][1][7]
• Use medicines, medical and surgical supplies, personal protective equipment and other resources rationally because indiscriminate use may make costly items difficult to replace.[1]
• Provide rapid-response teams for home-based care with a doctor, nurse, vehicle, communications equipment, clinical supplies, personal protective equipment and waste-management materials.[18]
• Maintain transport capacity through trained personnel, appropriate ambulances, personal protective equipment, communication with receiving facilities, and cleaning, disinfection and decontamination between transfers.[22]
• Equip respiratory-triage services with adequate staff, protective equipment, clinical assessment devices, record-keeping materials, ventilation, signage, hand-hygiene facilities, basic services and waste-management capacity.[6][16]
• Expand hospital capacity by preparing isolation rooms and designated beds, auditing capacity, converting elective-surgery beds, expanding care areas and establishing complementary facilities where needed.[5]
• Estimate requirements and costs for personal protective equipment, medicines and medical devices for acute and severe acute respiratory infection care, and manage procurement according to demand.[5][9]
• Support home visits with authorised vehicles, drivers, fuel, mobile phones or radios, sampling materials, hygiene supplies and personal protective equipment, without monetary values assigned.[31][19]