Table 2

Anticipated risks and mitigation plans

Anticipated risk	Underlying causes of risk	Anticipated impact	Mitigation strategy
Reduced materials and supplies	Disruption of the supply chain	Increased infection exposure to staff Inability to care for patients	Stocking 6-month worth of supplies (calculated on an ongoing consumption basis)
Staff infections while on duty	Inadequate information Inadequate or inappropriate PPE	Low staff morale Clinical duty abandonment	Peer training of staff Training of trainers at department level. Guidelines and training on use of PPE. Provision of PPE.
Staff anxiety and panic	Inadequate information Inadequate process of knowledge assimilation in high-risk situation	Low staff output and morale Suboptimal patient care	Staff and immediate dependants with full COVID medical cover Reserved staff COVID-19 treatment facility Clear guidelines and handbook to staff and families of admitted patients
Staff shortage	Patient surge Infected staff under treatment or quarantine Multiple unplanned staff absenteeism due to infection Low staff morale	Increased infection exposure to staff Inability to care for patients	Adequate PPE provision Staff training Staff treatment
Exceeding internal hospital capacity and the national health system capacity	Patient upsurge	Ethical dilemmas—of ‘who lives?’ and ‘who gets priority for treatment?’ Multiple fatalities Increased infection spread	Ensure mass patient influx plans are in place Conduct mass patient influx drills Establishment of field hospital Treatment innovations Establish ethical guidelines
Internal and community transmission	High number of admitted patients Hospital contamination Failure to follow guidelines	Increased infections and fatalities Potential to drive community spread of infection	Implement IPC procedures at all levels Personal protection guidelines Decontamination protocols
Misinformation, disinformation and myths	Communication breakdown Unverified sources of information	Confusion Lack of community support Loss of trust	Timely communication leaving room for questions Share only verified information Familiarise with existing WHO and MoH guidelines

IPC, infection prevention and control; MoH, Ministry of Health; PPE, personal protective equipment.