Table 2

Anticipated risks and mitigation plans

Anticipated riskUnderlying causes of riskAnticipated impactMitigation strategy
Reduced materials and suppliesDisruption 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 capacityPatient 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.