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

Objectives

The national COVID-19 plan seeks to contain transmission and mitigate its impact throughout Panama by identifying cases and contacts early, ensuring timely treatment, and organising safe care across homes, community settings and public and private health services.[1][2]It positions primary health care, public co-responsibility and integrated service networks as central to preventing avoidable pressure on emergency, hospital and critical-care capacity.[3][4]

• Intensify active surveillance of cases and contacts at airports, ports, land borders and within communities, including early detection, isolation, tracing and prompt notification.[1][5][6]
• Organise care by level of complexity within each province and health region, linking home care, first-level services, pre-hospital response, ambulatory care, hospitals and critical care through referral and counter-referral systems.[1][7][6]
• Establish respiratory triage to identify acute infectious respiratory illness, apply case definitions, determine the immediate care destination and assess critical-care priorities where needed.[8][9]
• Provide safe home-based care for clinically stable patients with mild disease who can isolate safely, while referring people with deterioration, severe disease or elevated complication risk to higher-level care.[10][11][12]
• Strengthen diagnostic capacity from nasopharyngeal sampling to results, and ensure case confirmation through testing validated by the National Reference Laboratory for Public Health at the Gorgas Memorial Institute for Health Studies.[1][13]
• Expand hospital surge capacity, isolation beds and supplementary care facilities, while reserving hospitals for complicated cases requiring specialised, inpatient or critical care.[14][12]
• Protect patients, health workers, caregivers and communities through biosafety, respiratory hygiene, environmental cleaning, equipment reprocessing and precautions against contact, droplet and aerosol transmission.[15][16]
• Promote public knowledge of prevention, home management of mild illness and warning signs requiring consultation, using technically validated information and measures to counter misinformation.[6]

Implementation

Implementation combines surveillance and information management with a decentralised delivery model in which hospitals are not the sole response setting.[2][1]The Ministry of Health leads coordination with the Social Security Fund, the Gorgas Memorial Institute for Health Studies, provincial and regional health authorities, and collaborating Pan American Health Organization and World Health Organization partners.[2][4]Regional and institutional directorates are expected to activate local operational and contingency plans, disseminate technical guidance and coordinate first-level facilities with designated referral hospitals.[4]

• Operate entry-point surveillance through updated contingency protocols, trained personnel, health advice, passenger screening and questionnaires, risk analysis, maritime coordination and referral of suspected cases under applicable protocols.[5][17]Airport teams operate continuously through three shifts, receive advance passenger information, monitor aircraft declarations and activate the International Health Contingency Plan when illness is reported.[17]
• Notify the National Epidemiology Department through the national liaison mechanism following relevant flight assessments, enabling regional epidemiology departments to conduct follow-up and monitor suspected cases.[17][18]Contact travellers from areas with active transmission for up to 14 days and initiate tracing if they do not respond.[17]
• Require respiratory triage in all health facilities, using dedicated ventilated and restricted-access assessment areas where feasible, with hand-hygiene facilities, waste-management capacity, clinical devices, records and trained staff.[19][9]Link triage to communications, transport, referral, counter-referral, route signage, information-sharing and security arrangements.[20]
• Deploy Ministry of Health rapid response teams comprising a doctor and nurse for home visits, patient assessment, sample collection, household safety assessment, isolation advice and activation of pre-hospital transport where required.[21][22]Maintain public access to information, follow-up and team referral through Call Centre 169.[11][21]
• Support home isolation through education for patients and caregivers, written guidance, telephone and in-person follow-up, household contact surveillance, infection prevention, safe waste handling and escalation when clinical assessment indicates that home care is no longer appropriate.[10][11][23]
• Coordinate safe pre-hospital and inter-hospital transfer by confirming receiving-facility acceptance and bed availability, using trained personnel and appropriate personal protective equipment, communicating clinical changes, and cleaning, disinfecting and decontaminating ambulances between transfers.[7][24]
• Prepare first-level facilities with laboratory and X-ray capacity and extended opening hours to manage mild or moderate cases, and designate isolation wards or intensive-care admission according to severity.[24][12]Plan capacity on the assumption that around 15% of confirmed cases may require hospital care and around 5% critical or intensive care.[12]
• Manage surge resources by auditing bed availability, suspending elective activity where necessary, converting beds, expanding care areas and using supplementary facilities such as rural hospitals, health centres, hotels, schools, temples and fairground spaces.[14]Reorganise staffing, estimate requirements and costs for personal protective equipment, medicines and medical devices, and procure or mobilise resources in line with demand.[14]
• Apply standard precautions for all patients and additional contact, droplet and aerosol precautions for suspected or confirmed cases, including risk-based selection, correct donning and doffing, hand hygiene and safe disposal of single-use protective equipment.[25][26]Use respiratory protection, eye protection and fluid-resistant gowns for relevant care, with N95 respirators for aerosol-generating procedures.[15][4]
• Monitor respiratory-event rates against predicted levels, investigate unusual patterns, issue alerts when rates exceed upper limits and adapt operational plans to changing viral circulation and national or international alerts.[4]The plan does not specify a comprehensive indicator set, reporting timetable, formal evaluation methodology, budget allocation or accountability framework beyond surveillance, notification, supervision and operational follow-up procedures.[1][14][6]

Monitoring & Evaluation

The plan establishes a surveillance-led response intended to identify cases and contacts promptly, support reliable information for decision-making, and sustain follow-up from entry points and households through to ambulatory, hospital and community care.[1][6]Surveillance includes case detection, isolation, contact tracing, notification, clinical reassessment and adaptation of case definitions as epidemiological conditions change.[1][19][8]

• Conduct active surveillance at airports, ports and land borders through passenger screening, traveller questionnaires, risk analysis, alert activation, passenger follow-up and contact identification.[27][5][17]
• Follow travellers from countries with active transmission by telephone for up to 14 days and initiate tracing when they cannot be reached; discontinue follow-up after 14 symptom-free days and issue epidemiological clearance.[17][18]
• Notify the National Epidemiology Department through the National Liaison Centre or National Focal Point Centre after relevant airport assessments, enabling regional epidemiology departments to follow suspected cases and monitor their health condition.[17][18]
• Notify every suspected or confirmed COVID-19 case immediately to the Ministry of Health epidemiological surveillance system, record care in relevant information systems, and complete surveillance reports, records, notifications and contact-management documentation.[6][24][12]
• Classify suspected cases using respiratory illness, exposure or travel history, hospitalisation criteria, healthcare-worker exposure or unusual clinical deterioration; confirm cases through positive SARS-CoV-2 results validated by the National Reference Laboratory for Public Health at the Gorgas Memorial Institute for Health Studies.[28][13]
• Review case definitions as evidence and epidemiological behaviour change, including during local transmission, and base early suspected-case identification on travel in the 14 days before symptom onset.[19][8]
• Use respiratory triage records and clinical and epidemiological documentation to support subsequent patient identification, location and tracing.[8][9]
• Monitor patients in home isolation through home visits, diagnostic testing where required and telephone follow-up until recovery; maintain surveillance of household contacts and trigger transfer alerts when clinical escalation is needed.[11][21]
• Use maritime health declarations and aircraft general declarations to report illness during travel to port-entry health authorities, and identify relevant aircraft contacts for follow-up.[18]
• Monitor observed respiratory-event rates against predicted rates, identify unusual patterns, issue alerts when observations exceed the upper limit, track viral circulation and adjust operational plans in response to national or international alerts.[4]
• Verify activation of facility contingency plans and preparedness of health professionals and other workers to manage cases promptly and appropriately.[4]
• Audit bed availability and apply admission triage for hospital wards and intensive care to support capacity management.[14]

Monitoring, supervision and evaluation are intended to help ensure data reliability for decision-making.[1]However, the plan does not specify a comprehensive formal indicator set, indicator targets, reporting frequency, evaluation timetable or methodology, or a wider accountability framework beyond the notification, surveillance, follow-up, contingency-plan verification and bed-audit procedures described.[1][17][24][14][4][6]

Costing & Financing

The plan focuses on securing and managing the human, material and logistical resources needed for COVID-19 care, rather than presenting a quantified financing framework. It identifies medicines, medical and surgical supplies, personal protective equipment, beds, trained personnel, transport, communications, diagnostic equipment and referral systems as critical inputs across entry-point, home, ambulatory and hospital services.[1][9][20][21][14]

• Use medicines, medical and surgical supplies and personal protective equipment rationally, recognising that these are high-cost resources that may become scarce if used indiscriminately.[1]
• Manage beds and critical resources, expand isolation and hospital capacity where needed, and estimate demand for personal protective equipment, medicines and medical devices for acute respiratory infection cases.[5][14]
• Estimate the costs of required supplies before procurement or mobilisation, with resource management aligned to the pace of demand.[14]
• Ensure adequate human resources, supplies and equipment during increased demand, including through staff redeployment, task reorganisation, extended working hours and additional personnel where necessary.[14]
• Equip rapid response teams and home-visit services with transport, communications, sampling and monitoring equipment, protective equipment, disinfection materials, biohazard waste bags and oxygen supplies where required.[21][22]
• Provide first-level facilities with medicines and supplies required to prevent transmission and protect patients and health professionals.[6]

No budget allocation, total cost, unit cost, financing source, resource-mobilisation mechanism, funding gap, allocation amount or economic assumption is specified.[7][14][15][6]