Dr Rui Moreno

• Unidade de Cuidados Intensivos Polivalente
• Hospital de St. Ant?nio dos Capuchos
• Centro Hospitalar de Lisboa Central, E.P.E.
• Lisboa Portugal

An interdisciplinary It is best if the process of planning begins at least nine process is encouraged metabolic disease goat buy actoplus met online now. In small and large family child care homes where required representation at the various meetings diabetes type 2 and honey buy actoplus met uk. Each an interdisciplinary team is not present diabetes type 1 population cheap 500mg actoplus met visa, the caregivers/ agency can adapt the format to its own needs diabetes signs and symptoms poster order 500mg actoplus met with mastercard. However, teachers should participate in the planning and preparation consistent formats for planning and information exchange, along with other care or treatment providers, with parent/ requiring written parental/guardian consent, would be use guardian written consent. Examples of appropriate clothing/footwear include: When several staf shifs are involved, information about a. Children can learn math, science, and language concepts through games involving movement (3,4). The policy can make clear that outdoor Policies and Practices that Promote activity may require special clothing in colder weather or Physical Activity arrangements for cooling of when it is warm. Caregivers/ day outdoors depending on their age, weather permit teachers can be helpful by having extra clean clothing on ting. Type: Structured (caregiver/teacher-initiated) versus sun-protective clothing, and insect repellent, if necessary unstructured activity. A procedure to obtain and maintain updated individual Vector-Borne Diseases care plans for children and staf with special health 3. The fact that adults may be on staf with known health problems or may develop health problems while at work;. Following the infection Red Book: 2015 Report of the committee on infectious diseases. All notifable diseases should be reported to the Facilities may comply by adopting a model policy and health department. Caregivers/teachers can check for other caregivers/teachers may not be a mandatory reporter. Health record information should be reviewed and other children whom the unimmunized child would by the staf of the facility and information sharing between expose to increased risk of vaccine-preventable disease. When age-appropriate health assessments and should receive immunizations on admission or provide use of health insurance benefts are promoted by caregivers/ evidence of an immunization plan to prevent an increased teachers, children enrolled in child care will have increased exposure to vaccine-preventable diseases. Special clinics the child may attend, including sessions Immunizations should be required for all children in child with medical specialists and registered dietitians; care and early education settings. In addition to print versions child care and health care professionals is inadequate of the recommended childhood immunization schedule, communication (1,2). Every child should have a medical home and those enus/advocacy-and-policy/aap-health-initiatives/ with special health care needs may have additional special immunization/Pages/Immunization-Schedule. The primary care provider and a child who has a medical exemption from immunization is needed specialists will create the Care Plan which will be included in child care, reasonable accommodation of that the blueprint for healthy and safe inclusion into child care child requires planning to exclude such a child in the event for the child with special health care needs. They also release an The facility must have accurate, current information regard information form at ucsfchildcarehealth. Not administering a new medication for the frst Information on family health can be gathered by asking time to a child while he or she is in child care; parents/guardians to tell the caregiver/teacher about any 4. Verifying the consent form; The facility should have a written policy for the adminis 2. How the medication is to be administered; cations are in their original container and include the 6. The proper handling and storage of medications, creams, insect repellants, and sun screens; including: 2. Emergency medications?totally inaccessible to chil and ibuprofen; dren but readily available to supervising caregivers/ 3. The procedures to follow when administering medica Because children twenty-four months of age and younger tions. Assigning administration only to an adequately nerable to the possible side efects of medications, extra trained, designated staf; care should be given to the circumstances under which 2. Documenting and reporting any medication errors; aware of each of the medications a child received at child 5. Information about the medication including warnings medication by documenting the process. It The facility should consult with the State Board of Nursing, may assist a health professional in determining whether the other interested organizations and their child care health child is actually getting the medicine, especially when the consultant about required training and documentation for child is not getting better from treatment. Caregivers/teachers must be diligent in efect on the environment if not disposed of properly. Maintaining sanitation for food preparation and Center, Large Family Child Care Home food service. Regular and thorough cleaning of toys, equipment, and rooms helps to prevent References 1. Human waste (such as urine and feces); associated with cough and cold medications: Two states. Medication adminis a routine basis, standard precautions and sanitation pro tration in day care centers for children. Food procurement and storage; A policy about infant feeding should be developed with d. Age-appropriate eating utensils and tableware; mechanical food preparation and feeding devices, l. Promotion of breastfeeding and provision of including blenders, feeding bottles, and food warmers; community resources to support mothers. Whether expressed human milk, formula, or infant A nutritionist/registered dietitian and a food service expert food should be provided from home, and if so, how should provide input for and facilitate the development and much food preparation and use of feeding devices, implementation of a written nutrition plan for the early including blenders, feeding bottles, and food warmers, care and education facility. Prohibiting bottle propping during feeding or encompasses the pertinent nutrition elements will promote prolonging feeding; the optimal health of children and staf in early care and i. Implementation of daily tooth brushing or rinsing the breastfeeding on future overweight explained by decreased maternal mouth with water afer eating; feeding restriction? Age-appropriate oral health educational activities; sleep equipment including their sanitation and disinfection. Alcohol, Illegal Drugs, and Toxic Substances Educational material such as handouts could include infor Facilities should have written policies addressing the mation on the health risks and dangers of these prohibited use and possession of tobacco and electronic cigarette substances and referrals to services for counseling or (e-cigarette) products, alcohol, illegal drugs, legal drugs rehabilitation programs. Any when caregivers/teachers are responsible for the supervision legal edible marijuana products in a family child care home of children, including times when children are transported, should be held in a locked and child-resistant storage device. Secondhand tobacco smoke and The hazards of second-hand and third-hand smoke expo smoke-free homes. Excerpts from the health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Residual National Center for Chronic Disease Prevention and Health Promotion, Ofce on Smoking and Health. Alcohol and drug use, including the misuse of prescrip Secondhand Smoke What It Means to You. Outcomes in children and young adults who are hospitalized for frearms-related injuries. Changes in health information may require changes in the Centers for Disease Control and Prevention. Assurance that the frst aid kits are resupplied following Urgent Medical Care or Threatening each frst aid incident, and that required contents are Incidents maintained in a serviceable condition, by a monthly The facility should have a written plan for reporting and review of the contents; managing what they assess to be an incident or unusual h. Policy for staf supervision following an incident when The management, documentation, and reporting of the a child is lost, missing, or seriously injured. Death of a child or staf member, including a death that an approach requires written plans, policies, procedures, was the result of serious illness or injury that occurred and record-keeping so that there is consistency over time on the premises of the child care facility, even if the and across staf and an understanding between parents/ death occurred outside of child care hours; guardians and caregivers/teachers about concerns for, i. The presence of a threatening individual who attempts and attention to , the safety of children. Facilities must have a plan for records with other service providers; what to do in such situations (1-3). Notifcation of parent/guardian(s); Medical Services for Children National Resource Center. This site also lists internet The care plan for a child with special health care needs links to emergency plans for specifc health needs such as should cover emergency care needs and be shared with diabetes, asthma, seizures, and allergic reactions. Resources and discussed between parents/guardians and caregivers/ for emergency response to non-medical incidents can be teachers prior to an emergency situation (1). Parents/guardians should be notifed, vent poor judgments made under the stress of an emergency. Such an approach requires written access of a threatening individual to the facility and the plans, policies, procedures, and record-keeping so that means of alerting others in the facility as well as summon there is consistency over time and across staf and an un ing the police if such an event occurs.

They want to make trained to assess pregnant women you feel happy with all aspects of the and their developing baby blood glucose and triglycerides order actoplus met 500mg with amex, plan their care you receive labile diabetes definition order actoplus met 500mg on-line, both while you are care and to carry out all appointments pregnant and when you have your as long as there are no problems baby diabetes blood sugar levels buy actoplus met amex. If you Medical or Health Centres alongside have had problems in this or a General Practitioners diabete and exercise discount 500 mg actoplus met overnight delivery, Health Visitors previous pregnancy a more detailed and Dieticians. If you deliver are based in locations within the city your baby in hospital your community close to the women and families to midwife team will visit you following whom they provide care. The community every day and also provide an on call midwives and healthcare assistants service for home births wherever also provide support and information possible. Community midwives on preparing for labour and birth, 24 feeding your baby and preparing to become parents alongside our parent education team. A midwife will look after you during labour and, if everything is straightforward, will deliver your baby. If any complications develop during your pregnancy or delivery, you will also see a doctor. After the birth, you and your baby will be cared for by midwives and maternity support workers. If you have questions or concerns regarding your care then you can always ask to speak one of our supervisor of An anaesthetist is a doctor who midwives who is a senior midwife with specialises in providing pain relief and responsibility for the safety and anaesthesia. You may be referred if you are experiencing back or pelvic pain, bladder or bowel problems. Individual appointments An obstetrician is a doctor offer advice and safe an effective specialising in the care of women exercises to help you manage during during pregnancy. You obstetrician if you have any particular may meet your health visitor before concerns. If your many tasks on the wards, in clinic, in baby is born at home or your stay in theatre, on the Delivery Suite and hospital is short, you may not see a Birthing Centre. A domestic assistant helps to maintain a safe environment for everyone in the A researcher may ask if you will hospital. Such projects are vital to example if you develop gestational improve maternity care. The A paediatrician is a doctor students will be at various stages of specialising in the care of babies and their training but will always be children. You can say no, but if you your baby after the birth to make sure let a student be present it will help all is well and will be present when their education and may even add to your baby is born if you have had a your experience of pregnancy and dif? Your booking appointment What should happen the earlier you make your booking Your midwife or doctor should: appointment the better. Measure your blood pressure and acid and vitamin D supplements, test your urine for protein. Photo shows the top to bottom measurement (crown rump length) used to date the pregnancy. Please ask at the beginning of the scan if you would like to know the sex of your baby. Use a tape to measure the size of results of any screening tests from your uterus and plot this on your the last appointment. Use a tape to measure the size of 36 weeks your uterus and plot this on your Your midwife or doctor should discuss: graph. They are completely painless, have no known serious side effects and may be carried out for medical need at any stage of pregnancy. At the 11-14 week scan we offer the First a dating scan at 11-14 weeks to combined screening test for Downs determine when the baby is due; then Syndrome. Details of the test are in the a scan between 18 and 21 weeks to National Screening booklet which is check for any problems with the given to you as a separate lea? The anomalies that are At these scans it is helpful if you have screened for at the 18-21 week scan a full bladder which pushes your are also discussed in the booklet. Check whether you are carrying scans are medical procedures, many more than one baby couples feel that they help to make the. Image from the National Screening Committee booklet Screening tests for you and your baby (2012) A screening test Some tests look at the risk that your baby could be affected by certain disabilities or health conditions. The results of these optional tests will not tell you for sure if your baby has a particular condition but they can show if there is an increased risk. A diagnostic test A diagnostic test is offered if a screening test indicates that there is a high risk of a particular condition. Examples of a diagnostic test are an amniocentesis which examines cells in some of the? It helps us to collect valuable information to improve our services and the care that we provide to pregnant women, their babies and their families. You may be approached by one of our research team to see if you would like to take part in one or more of our studies at some point during your pregnancy. It is completely up to you if you would like to take part in research and we will give you as much information as you need to make that choice. The Last year more than 2800 women results improve the maternity care and agreed to take part in our studies. Our experienced team includes senior doctors, research midwives and Each study is different and you may nurses, research sonographers, be offered information at various times support staff and scientists. You may receive leaflets about research at We aim to give you the opportunity to home or you may be given information take part in research studies by by your community or hospital providing all the information you need midwife. Some studies collect to help decide if you want to be information about the care you receive involved. Every research study is co so you would not be asked to do ordinated by a research midwife who anything different. There are other will be able to answer any questions studies where you may be asked to do and help you to decide if participating something more that may include: in research is right for you. Giving samples of urine, blood or kept confidential (in the same way as small pieces of tissue, (which may your other medical records), and that require extra visits to the hospital) the health and well-being of you and. Having extra visits or procedures your baby will always be our top (such as ultrasound scans) priority. The Where possible we try to fit research studies focus on important issues in around your normal care to make it as pregnancy and childbirth, for easy as it can be for you to be example, high blood pressure, involved. Everyone can reduce In pregnancy and for six weeks afterwards, 2 in every 1000 women will their risk by being as develop a clot a venous thrombosis. Written in your Varicose veins lie under the surface of personal maternity record this the skin and are different from the assessment is then updated if your deep veins that may develop clots situation changes. Occasionally compression stocking may be recommended to give some this assessment score helps to symptomatic relief. Varicose veins in decide whether you would benefit the leg and groin will often improve in from preventative treatment with the days and weeks following the Heparin. Wearing special stockings (graduated Sudden unexplained difficulty in breathing elastic compression stockings) helps Tightness in the chest or chest pain to prevent blood clots Coughing up blood. Keeping hydrated by drinking normal Feeling very unwell or collapsing amounts of fluids. If prescribed Heparin & after pregnancy A daily Heparin injections work as an anticoagulant to ?thin the blood it is very important to making clots less likely. Heparin cannot be given as a tablet so you will be shown how and where in your body to give the injections. There may be some bruising where Heparin is given into the fat layer you inject this will usually fade in a underneath the skin of the outer part few days. One or two women in every of the upper arm, thigh or abdomen 100 will have an allergic reaction. The injection should inform your doctor so that the is very safe to give but change the site type of heparin can be changed. If the injection site becomes painful, red or What should I do when labour starts? Keep the needle in place for a few seconds the remove If you were on heparin before the the needle in one go. Even if you weren?t Use a different site each day and having injections in pregnancy, you dispose of the needleand syringe in may need to start having injections for the sharps box straight away.

Safe actoplus met 500 mg. + Q MAGAZINE 25 DIABETES.

The whole day is flled with moments ripe for planned and spontaneous teaching and learning moments metabolic brain disease journal impact factor buy actoplus met 500 mg online. Back-and-forth conversations can be incorporated into many aspects of the daily schedule even during routines such as hand washing blood glucose 200 level 500mg actoplus met with amex, lining up blood glucose 60 cheap actoplus met amex, and gathering belongings diabetes mellitus patient handout actoplus met 500 mg otc. For example, educators might provide daily questions for children to think about as they engage in a tran sition for example, lining up to go down the hall and then have children share their responses with a partner when they reach their destination. Interactive readings of a variety of books related to the content under study increases the quality of the language environment in at least two ways. First, the written language often stands in contrast to conversational, and even instructional, language. Second, classroom read-alouds are foundational for spurring content-rich classroom discussions. In their free play, almost all preschoolers engage in sub stantial amounts of pre-mathematical activity. They count objects; compare magnitudes; and explore patterns, shapes, and spatial relations. Mathematical thinking reaches beyond competence with numbers and shapes to form a foundation for general cognition and learning. Given its importance, children need a robust foundation in mathematics knowledge in their earliest years. Preschool educators tend not to support mathematics learning and when they do it is often of a low quality. Most early childhood educa tors in the United States receive weak preparation for teaching mathematics, which may in part be due to their having a low level of mathematics knowledge prior to their choosing to pursue teaching as a profes sion. Because content knowledge is a prerequisite for knowing how to teach the content, increasing the mathematics knowledge of early childhood educators needs to be a priority. Mathematical learning trajectories Children generally follow certain developmental paths in learning mathematics. As they learn about a mathematical topic, they progress through increasingly sophisticated levels of thinking. These activities help children understand the concept of ?how many and ultimately grasp the mathematical principle of cardinality that the num ber of elements in a grouping is a property of that grouping. Efective educators understand both the mathematics and the progression of levels of thinking along these paths and are able to sequence and individualize activities accordingly. For example, they must understand how counting involves much more than simple verbal recitation of number words. Please see Chapter 6, Educational Practices, in Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation to learn more about supporting subject-area learning and educational practices. Social and emotional competence means the ability to understand and manage emotions and behavior, to make decisions and achieve goals, and to establish and maintain positive rela tionships, including feeling and showing empathy for others. Social and emo tional competence give children the capacity to engage in academic tasks by increasing their ability to interact constructively with teachers, work efectively with peers, and dedicate sustained attention to learning. Aspects of social and emotional development Relationships and emotional well-being. For example, children who have secure relationships with their parents develop greater social skills with adults and peers and greater social and emotional understanding of others, show more advanced moral development, and have a more positive self-concept. Securely attached children also have been found to be more advanced in cognitive and language development and to show greater achievement in school. A smaller but signifcant body of research has looked at attachments between children and educators. As with their parents and other caregivers, children who receive strong emotional and instructional support from their educators can approach learning opportunities more positively and confdently, and the quality of those relationships has a signifcant and potentially enduring infuence on their classroom success. In one study, preschoolers identifed as academically at risk based on demographic characteristics and re ports of problems by their kindergarten teachers were followed to the end of frst grade. The children with frst-grade teachers who provided high amounts of instructional and emotional support had achievement scores comparable to their low-risk peers. Children who lack efective self-regulation do not participate in a productive way in learning activities. They may act disruptively and aggressively; they then receive less support from their peers, which in turn may undermine their learning. Young children are better able to exercise self-regulation in the company of educators who have develop mentally appropriate expectations for their self-control, provide predictable routines, and ofer guidance that scafolds their developing skills of self-management especially in the context of carefully designed daily practices in a well-organized setting. Starting with a straightforward awareness that people act inten tionally and are goal directed, have positive and negative feelings in response to things around them, and diferent feelings and goals, young children develop an increasingly sophisticated understanding of the mental experiences that cause people to act as they do. They also begin to appreciate how personality dif ferences among people can cause diferent individuals to act in the same situation in very diferent ways. How young children think of themselves as learners infuences their academic success. Young children become increasingly sensitive to positive and negative evaluations of their behavior, which serve as the basis for their self-evaluations. In one study, 4-year-old children were represented by puppets whose performance was praised by a teacher using either feedback that implied trait-based, ability-centered success ?You are a good draw er. A substantial body of evidence now shows that adversity and stress in early life are associated with higher rates of childhood mental and physical problems, more frequent disturbances in development and educational achievement, and lifelong risks of chronic disorders that compromise health and well-being. Circumstances that con tribute to this chronic stress include poverty and abuse, as well as less severe but persistent circumstanc es such as parents chronic marital confict. Individuals in adversity show less behavioral reactivity and better-regulated cortisol (a stress hormone) when in the company of people who provide them with emotional support. These supports in the learning environment can also be a bufer for the negative efects children expe rience as a result of chronic stress and adversity. However, such children, as well as other children facing challenges with their social and emotional development, may have other specifc needs for support. Consultants can provide educators with guidance on classroom management and instructional practices for all children, as well as individualized consultation for particular children based on classroom observations. The adults who provide for their care and education bear a great respon sibility. Care and education professionals are best able to support children from birth through age 8 when they have a shared foundation of knowledge and competencies related to development and early learn ing across this age span. This foundation needs to be augmented by specialized knowledge and compe tencies depending on the specifc age groups with which they work or for specifc professional roles such as early intervention specialists, mental health consultants, or language development specialists. Foundational knowledge and competencies for all adults with professional responsibilities for young children All adults with professional responsibilities for young children need to know about. How a child develops and learns, including cognitive development, specifc content knowledge and skills, general learning competencies, socioemotional development, and physical development and health. All adults with professional responsibilities for young children need to use this knowledge and develop the skills to . Strengthening the competen cies of the workforce is challenging because those who care for and educate young children work in a variety of settings such as homes, childcare centers, preschools, educational programs, and elementary schools. Oversight and infuence are complicated because the care and education of young children take place in so many diferent contexts: with diferent practitioner traditions and cultures, funded through multiple government and nongovernment sources, and operating under the management or regulatory oversight of diverse agencies. Care and education professionals across settings and professional roles need access to high-quality pro fessional learning that supports them in acquiring and applying the competencies they need. High-qual ity professional learning systems encompass a coherent series of activities to prepare professionals for practice, assess and ensure their competency to practice, and continuously enhance the quality of their ongoing practice. Please see Chapter 7, Knowledge and Competencies, in Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation for more information about the foundational knowledge and competencies for all adults with professional responsibilities for young children as well as for knowledge and competencies for educators and leaders. As with multiple sets of complex gears, many interconnected elements need to move together to sup port a convergent approach to caring for and teaching young children one that allows for continuity across settings from birth through elementary school, driven by the shared core of the science of child development and early learning (see Figure 1 below). Interacting elements of supporting quality professional practice for the care and education of children from birth through age 8. A blueprint for action A blueprint for action to strengthen the care and education workforce is based on the unifying founda tion of the science of child development and early learning and the principles for supporting high-qual ity professional practice. At the core of this blueprint are interrelated recommendations to improve professional learning systems in the areas of qualifcation requirements, higher education, professional learning during ongoing practice, and continuous quality improvement. Success will require coordinated actions by multiple stakeholders, often working in diferent systems and sectors and at diferent levels. Please see Chapter 12, A Blueprint for Action, in Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation for more information as well as implementation considerations for each recommendation. Recommendation 3: Strengthen practice-based qualifcation requirements for all lead educators working with children from birth through age 8. Support for Implementation Recommendation 10: Support workforce devel Higher Education and Ongoing Professional opment with coherent funding, oversight, and Learning policies. Recommendation 4: Build an interdisciplinary Recommendation 11: Collaboratively develop foundation in higher education for child develop and periodically update coherent guidance that ment.

Hogan issued an executive order directing that effective April 18 jelaskan diabetes insipidus buy discount actoplus met 500 mg online, all Marylanders are required to wear face coverings when inside retail establishments or when riding any form of public transportation in the state blood glucose 50 order 500 mg actoplus met otc. People with disabilities who are unable to wear a mask are provided reasonable accommodations per the Americans with Disabilities Act diabetes type 2 guidelines buy generic actoplus met 500mg. On May 6 diabetes diet fruit juice buy actoplus met 500 mg line, the Maryland State Department of Education announced that schools will remain closed for the remainder of the school year. Can I still get food from take-out places and restaurants providing take out service? Please confer with your lawn service and make a good faith determination about whether it is ?essential or non-essential. Please confer with your cleaning service about their willingness to keep delivering the service safely. Also, if you are ill or in any elevated risk category, limit all outside visitors to your home. It is good to get exercise and fresh air, and to take a pet on a walk, but stay at least six feet away from others. Many, but not all, food and drink establishments which offer carry-out are still serving. Grocery stores, big box retailers like Walmart, pharmacies and drug stores are also open, although some have limited hours. If you are well and your business is closed, you will need to continue to stay at home. If you test positive, you should self-isolate at home for at least 7 days after your symptoms started or 3 days after your last fever, whichever is longer - if your symptoms improve. Continue to practice good hygiene, including frequent and thorough hand washing, disinfecting ?high-touch surfaces and frequently washing clothing and bedding. Practice social distancing within the home if you live with family members or other people. That means keep to one room or suite of rooms and keep away from family members, particularly older adults and young children, as much as possible. Most people will have mild to moderate symptoms and will be advised to recover at home and isolate themselves from others. These individuals should call their physicians or healthcare practitioners if their symptoms get worse. Do not go to an urgent care facility or emergency department without calling first. If you are experiencing emergency symptoms such as inability to breathe, confusion, or blue lips, call 911. You will need to have access to necessary resources, food and medications while you recover. Depending on the severity of your symptoms, you may need a caregiver available to provide support. Caregivers should practice good hygiene, including frequent and thorough handwashing, avoiding touching their face, and frequently disinfecting ?high touch surfaces. You should self-isolate at home for at least 7 days after your symptoms started or 3 days after your last fever, whichever is longer, and if your symptoms are improved. Ask the healthcare provider to call the local or state health department for additional guidance. If the patient is not able to wear a facemask (for example, because it causes trouble breathing), you, as the caregiver, should wear a mask when you are in the same room as the patient. Then, immediately clean your hands with soap and water or alcohol-based hand sanitizer. Next, remove and dispose of facemask, and immediately clean your hands again with soap and water or alcohol-based hand sanitizer. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product. Wear disposable gloves while handling soiled items and keep soiled items away from your body. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after removing your gloves. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these items. But this right away to meet urgent needs and the surge in is much more than a health crisis. Scientifc collaboration in the search match the unique nature of the crisis and the for a vaccine and effective therapeutics must be magnitude of the response must match its scale. Universal access to vaccines and treatment must be assured, with this report is a call to action, for the immediate full respect for human rights, gender equality and health response required to suppress transmission without stigma. That medium enterprises, the informal sector and on means the direct provision of resources to support vulnerable groups who are already at risk. Every country protection, and support to businesses to prevent must step up with public, private and civic sectors bankruptcies and massive job losses. But on their own, means designing fscal and monetary responses national-level actions will not match the global scale to ensure that the burden does not fall on those and complexity of the crisis. Had we been further advanced the United Nations family and our global network in meeting the Sustainable Development Goals of regional, sub-regional and country ofces and the Paris Agreement on Climate Change, we working for peace, human rights, sustainable could better face this challenge with stronger development and humanitarian action, will support health systems, fewer people living in extreme all governments, working with our partners, to poverty, less gender inequality, a healthier natural ensure frst and foremost that lives are saved, environment, and more resilient societies. We livelihoods are restored, and that the global must seize the opportunity of this crisis to economy and the people we serve emerge stronger strengthen our commitment to implement the from this crisis. By making progress on our global roadmap for a more inclusive and sustainable future, we can we need solidarity, hope and the political will and better respond to future crises. Once an China, a broadly available vaccine is not expected outbreak has entered the community transmission for the next 12 to 18 months. On average, 20 per cent of those infected no cases; sporadic cases; clusters; or community develop severe or critical symptoms with case transmission. It is the Test and detect all suspected cases as most effective way to save lives and protect the global rapidly as possible. However, many countries do not have the possibility of suppressing transmission and resources to prepare themselves for the crisis. Decisive, urgent and coordinated action by Introduce measures such as quarantine, all leaders of nations, businesses, fnance, strictly restricting the movement of people, science and communities is needed to suppress reducing person-to-person contact overall transmission of the virus as quickly as possible via work and school closures and physical and stop the pandemic. Act decisively and early to prevent the further spread or quickly Share knowledge and develop and distribute suppress the transmission of new diagnostics, drugs and vaccines. Provide urgent support to developing impacts on segments of the population, countries with weaker health systems: incorporate disadvantaged groups across all the most vulnerable in the face of this crisis are societies and adhere to the highest human those who are already at risk: those caught up in rights standards. Countries with large populations and signifcant There is a need to shore up the movement of informal sectors are especially vulnerable. New for the disease to take a deep foothold in fragile restrictions on national and international contexts and in poor and densely populated urban movement for response-critical people and areas and slums, unable to self-isolate, would leave goods are a unacceptable. Manufacturing and us all at risk as the virus continues to spread across distribution of essential medical equipment such the globe. Urgently strengthen the resilience basic and effective prevention measure against of health systems. Here again, the All countries should implement with the greatest poorest and more vulnerable are at a disadvantage. Without global solidarity There needs to be immediate scaled-up development, availability, production and distribution of:? Laboratory testing kits, reagents and supporting materials and infrastructure to ensure all who need testing get it to drive down transmission and enable a tailored national response. Otherwise, key resources will languish unused where they are not Sustain humanitarian fnancing to ensure needed, and not be available at critical moments humanitarian assistance continues to reach where and when they are. Businesses and Corporations: Step up agencies, which will assist 51 or more of to the challenge the most vulnerable and confict-affected Many corporations have been helping to shore countries in the Middle East, Asia, Africa and up the health system response. Pharmaceutical Latin America where the impact on people companies are working with governments to will be particularly severe in the absence of increase testing capability, while manufacturers assistance, and where health systems will be are offering to shift or add new production lines most unable to cope.