Any changes needed to Public Health Response tools due to WHO COVID Guidance Changes?

Hi COVID Squad & Community Experts,

The WHO has been updating published guidelines on a variety of different sub-topics about COVID care and treatment. Directory: (Looking through this list based on publication date is helpful. Is there another, better source for WHO COVID medical guidance?)

My questions are: Based on this updated guidance, should we (the COVID squad) update anything in the COVID Public Health Response toolkit (e.g. the covid data dictionary or any forms in the form bank)? If the answer is yes, do we really want to try to maintain this work going forward?

Examples of recently updated guidelines I thought might possibly apply to us from a quick skim:

  • Antigen detection
  • Corticosteroids for COVID-19
  • WHO COVID-19 Case definition

I’ve held off on doing an extensive review of what specifically changed; seemed better to start by hearing peoples’ responses here. I also imagine we’re still expecting the onus to be on implementers to adapt the forms to their regional needs & regional guidelines; and, the forms listed are probably ultimately owned by the implementing org that led their creation. But if there’s a more meaningful review that needs to happen, we could bring that clinical review activity under the COVID squad umbrella.

Maybe a can of worms but seemed like a worthwhile thing to clarify :slight_smile:

@ball @akanter @jteich @ibacher @hamish


cc @ssmusoke

This does remind me that the forms I initially built were never properly tested and probably need to be adjusted.

The WHO Case Definition has definitely changed from last I saw it, but I don’t think that it materially effects any of the work done so far. I notice that the updated WHO Case Definition doesn’t match the inclusion criteria in the RAPID CORE form; I suppose this is because the RAPID CORE form has not been updated since the update to the WHO Case Definition. (The changes to the case definition are the addition of unexplained anosmia and ageusia and the definition of a suspect chest x-ray; the previous case definition we had been working from was from February when neither anosmia nor ageusia were associated with COVID-19 and there was not enough data on chest x-rays).

That said, I don’t think that anywhere we had made specific reference to case definitions and by the time the concept work was actually done, anosmia and aguesia were known symptoms, so they’re already in the CIEL COVID-19 Starter Set.

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Thanks Ian, sounds reasonable.

@jteich @akanter anything to add? We’d appreciate your medical opinion here.

I have been trying to track changes in testing and therapeutics and these have been added to the starter set. I don’t know if anyone has built specific form lists that needed additional concepts. I would definitely want to know if CIEL is missing anything. The recent WHO work on eCRF for COVID is moving away from using CIEL concepts to only using standard codes… although they are adding additional standard codes (LOINC, for example) which can then be added to existing CIEL concepts.

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I would assume people would reach out to you/CIEL with specific requests if this came up, right?

By standard codes does this mean SNOMED/LOINC/ICD/etc?

Overall, it sounds like your takeaway @akanter is that no action is required by the squad at this point?

I am not sure people would request terms from me if they are building their own forms. Standard codes do refer to SNOMED CT, LOINC, RxNORM, ICD, etc. yes.