Table 2 Standard of care for COVID-19 at study sites

Supplemental oxygen therapy immediately to patients with severe acute respiratory infection (SARI) and respiratory distress, hypoxaemia or shock.

• Commence oxygen therapy at 5 L/min and titrate flow rates to reach target SpO₂ ≥ 90% in non-pregnant adults and SpO₂ ≥ 92–95% in pregnant patients.

• Children with emergency signs, such as breathing difficulty, obstruction or apnea, severe respiratory distress, central cyanosis, shock, coma or convulsions, should receive oxygen therapy during resuscitation to target SpO₂ ≥ 94%; otherwise, the target SpO₂ is ≥ 90%.

• Wards and outpatients where patients with SARI are cared for are equipped with pulse oximeters, functioning oxygen systems and disposable, single-use, oxygen-delivering interfaces (nasal cannula, simple face mask and mask with reservoir bag).

• Contact precautions will be taken when handling contaminated oxygen interfaces of patients with SARS-COV-2 infection.

Conservative fluid management in patients with SARI when there is no evidence of shock.

• Patients with SARI will be treated cautiously with intravenous fluids, because aggressive fluid resuscitation may worsen oxygenation.

Empiric antimicrobials to treat all likely pathogens causing SARI.

Antimicrobials (Augmentin 650mg tablets 12hhrly for 24h or Augmentin IV 1g q 24 h) within 1 h of initial patient assessment for patients with evidence of URTI or sepsis.

• The clinicians will administer appropriate empiric antimicrobials within 1 h of identification of sepsis or URTI.

• Empiric antibiotic treatment will be based on the clinical diagnosis (community-acquired pneumonia, healthcare-associated pneumonia [if infection was acquired in healthcare setting] or sepsis). Empiric therapy will be de-escalated on the basis of microbiology results and clinical judgment.

• Zinc sulphate tablets 100mg daily

• Calcium tablets 300mg daily

• Vitamin C tablets 1g daily

• Vitamin D tablets 50mcg daily

• Given to all individuals with COVID-19