The World Health Organization issued the following guidelines on Saturday about ways to prevent and fight flu, especially in poor areas where medical facilities may lack staff, beds and drugs:

SOCIAL DISTANCING

-- Social distancing, respiratory etiquette, hand hygiene, and household ventilation, are at present the most feasible measures available to reduce or delay disease (morbidity) caused by pandemic influenza.

-- This includes keeping at least an arm's length distance from other people, minimizing public gatherings, and covering coughs and sneezes.

-- Once pandemic flu becomes widespread in a community, however, the WHO said that interventions to isolate patients and quarantine contacts would probably be ineffective, not a good use of limited health resources, and socially disruptive.

-- Routine mask use in public places should be permitted but is not expected to have an impact on disease prevention.

MILD CASES TREATED AT HOME

-- During a pandemic, very high numbers of patients presenting to the health-care facility will necessitate home treatment, the WHO said.

-- In the case of mild illness, patients should be provided with supportive care at home by a designated caregiver and only referred to health care facilities if they deteriorate or develop danger signs.

-- Such danger signs may include: weakness or inability to stand, lethargy, unconsciousness, convulsions, very difficult or obstructed breathing or shortness of breath, inability to drink fluids, high fever.

-- Treatment at home should entail rest, fluids, medication for fever, and good nutrition, with patients kept separate from other people except one designated carer who should wash their hands and household surfaces frequently.

-- It is more important in the home that the patient wears a mask than the caregiver. The mask need not be worn all day and only when close contact with the caregiver is anticipated.

-- If enough masks are available, caregivers should also use them to cover their mouth and nose during close contact.

-- Windows should be kept open to allow good ventilation.

IN HEALTH CLINICS:

-- Medical facilities with limited resources and beds should aggressively triage patients and ensure those with respiratory symptoms are kept separately from other patients

-- Essential medical services should be continued, while elective medical services should be temporarily suspended.

-- Admission criteria may change depending on bed availability, but should be reserved for severe cases most likely to benefit from treatment.

-- Health facilities should anticipate a very high demand for treatment, the WHO said. Based on current estimates, agencies should anticipate that up to 10 percent of those who fall ill may require inpatient treatment.

-- The WHO recommends this order of priority for antiviral drugs: a) treatment of sick health-care and other essential staff, b) treatment of sick individuals from the community, c) post-exposure treatment for essential staff at high risk, d) pre-exposure prophylaxis for critical staff with anticipated high-risk exposure

Medicine