mteb/FeedbackQARetrieval huggingface dataset:
Q&A: Contraception/Family planning and COVID-19
I want to avoid getting pregnant during the COVID-19 pandemic. What can I do?
If you do not want to become pregnant, you should start or continue to use
your contraceptive method of choice. You may be able to access information and
contraceptive services from a healthcare provider by phone or online.
If you cannot access these services you may opt for a method that is available
without a prescription (such as condoms, spermicides, pills, or emergency
contraceptive pills) from a nearby pharmacy or drug shop.
Q&A: Contraception/Family planning and COVID-19
I am a programme manager. What can I do to help people access contraception and family planning information and services?


Increase use of telehealth for counselling and sharing of messages related to safe and effective use of contraception and for selection and initiation of contraceptives. 


Ensure adequate inventory to avoid potential stock outs at all levels of the health system. 


Prepare advisories for users on how they can access contraceptive information, services and supplies. 


Monitor contraceptive consumption in your area to identify any potential pitfall and shortage.


Increase availability and access to the contraceptives which can be used by the client without service provider support.
Q&A: Contraception/Family planning and COVID-19
I want to change my contraceptive method – is this possible?
Yes. It may be difficult however, to access all the methods of contraception
that are normally available in your country due to restrictions on movement,
lack of supply, as well as increased demands on health providers and services.
If you have a pre-existing health condition, consult a provider to find out
what options suit you best, and which are available and feasible. Seek advice
and information from your health provider and consider using methods that do
not have medical restrictions like minipills, condoms, fertility awareness-
based methods, diaphragm, spermicides or lactational amenorrhea if you are
exclusively breastfeeding.
Q&A: Ethics and COVID-19: resource allocation and priority setting
What conclusions can we draw about the fair allocation of scarce resources within countries during the COVID-19 outbreak?

Health care workers (caring for patients) and first responders can justifiably be prioritized when allocating some resources because of their contribution to the health and well-being of the community. Their health helps preserve the health of others.
Participants of research aimed at developing vaccines, therapies or other critical resources should receive some priority in receiving those resources because they have also helped save others by their participation. This is not an absolute priority – for example, it should not take precedence over giving priority to those most at risk in the case of resources such as vaccines.
While the principle of first come, first served is often applied when allocating resources in health care settings, it is rarely appropriate in an emergency. In practice, it is very likely to favour certain groups, such as those closest to a distribution centre, those with access to better information, or those who are most well-off.
Younger populations appear to be at lower risk in the COVID-19 context. Consequently, the principle of youngest first should have low priority for vaccine, but perhaps may have more weight if they do become sick and need critical care resources.
The allocation of different resources may find ethical justification in different principles or values. For instance, if a novel vaccine is found to be safe and effective, a lottery-based allocation may be justified among those as highest risk, the old and those with co-morbidities, if they outnumber available vaccines.
Maximizing utility should be balanced with the principle of priority to the worst-off: centralizing the availability of resources in larger centres may extend their benefits to more people, but may exclude isolated populations and challenge our concern for those at highest risk.
Q&A: Ethics and COVID-19: resource allocation and priority setting
What are the key ethical considerations that governments, vaccine manufacturers and funders should take into account to ensure a fair distribution of vaccines globally?
Countries are equally vulnerable to COVID-19 and have a shared responsibility,
grounded in solidarity, to collaborate globally to mitigate the outbreak. Each
government has special obligations to its own citizens, but the fair
allocation of vaccines globally requires us not to simply appeal to self-
interest, claims of resource ownership and the prioritization of compatriots.
Vaccines should be allocated in a way that prioritizes those who fall into the
categories presented in the below table. (Where individuals or populations
fall into multiple categories, they should receive even higher priority.)
Priority populations, and rationale for prioritization
Priority population|  Rationale for prioritization
---|---  
Those at greatest risk of becoming infected and seriously ill
| Maximize benefit of vaccine  
Those who, if vaccinated, would prevent the greatest spread of the virus
| Maximize benefit of vaccine  
Those who have volunteered to participate in research aimed at developing the
vaccine
|
Reciprocal obligation to those who were voluntarily put at risk to aid in this
effort  
Those falling into each category may change over time.
Q&A: Ethics and COVID-19: resource allocation and priority setting
Are the ethical considerations the same for all medical countermeasures, including therapeutics, vaccines and personal protective equipment (PPE)?
Generally, the considerations may be different. The allocation of different
resources may find ethical justifications in different principles or values.
For instance, once a novel vaccine is found to be safe and effective, to
prioritize those at highest risk, as well as populations like health care
workers who may be more likely to serve as vectors for transmission, is
justified.
Within those subgroups, some suggest that a lottery-based (i.e., random)
allocation may be justified, given that resources will be limited and we can
assume nearly equal benefits will be derived from any recipient within that
group. This is not the case, however, for other resources such as ventilators,
where some individuals may derive significantly more benefit than others.
Q&A: Ethics and COVID-19: resource allocation and priority setting
Can I adapt previous frameworks for pandemic influenza to guide resource allocation for COVID-19?
Many ethical frameworks have been produced for resource allocation, some of
which have been included in pandemic plans. Those frameworks provide useful
guidance in the current scenario. Yet, when applying them, we must take into
account the type of health care resource, the context, and the stage of the
pandemic. That is, while the ethical principles that apply to resource
allocation might be the same in different pandemics, they can lead to
different decisions, given contextual circumstances. For example, this
pandemic appears to significantly impact older adults (those 60 years of age
or older), and such characteristics are relevant to shaping priorities for the
allocation of resources during COVID-19. As a result, it may be inappropriate
to use critical care triage guidelines that have age cut-offs that
deprioritize or exclude those aged over 60 years.
When applying ethical guidelines for resource allocation, we should consider
the extent to which resources are overwhelmed in the current context. It would
be inappropriate, for instance, to exclude population groups from being
allocated a resource (for example, ventilators) at the outset of a pandemic
when capacity remains. When resources are scarce, though – when there is an
insufficient supply to meet everyone’s needs – resource allocation should be
guided by well established, broadly applicable ethical principles, unless
there are characteristics of the outbreak that justify different courses of
action. Irrelevant characteristics of populations within countries, such as
ethnicity, race or creed, should play no role in any resource allocation in
any pandemic. This reflects our commitment to treating people with equal
respect.
Q&A: Ethics and COVID-19: resource allocation and priority setting
How should decision-makers make considered ethical judgements about these matters, given the likelihood that there will not be enough of a resource? Who should be involved in decision-making on scarce resources?
For most decisions, multiple ethical values and principles will be relevant to
deliberations about how to allocate resources. This is likely to generate some
disagreement, because different people may weigh the values differently. Some
may prioritize equality while others might put more emphasis on best outcomes
or prioritization of the worst-off. For this reason, it is imperative that the
different values be weighed and applied to specific allocation issues using a
fair process.
A fair process for allocating scarce resources must promote certain ethical
values:

Transparency. In a transparent process, the decisions and their justifications should be made public. This means that the population should be informed about the criteria guiding the decisions.
Inclusiveness. Those affected by allocation decisions – including individuals, communities or countries – should be able to exert at least some influence over the decision-making process as well as the decision itself. This also means that decisions 4 should be open to challenge and potentially revisable, perhaps through an appeal process. 
Consistency. Decisions should be consistent so that all persons in the same categories are treated in the same way. This means that favouritism towards one’s own family, religious or political compatriots, or otherwise, is not appropriate. All forms of corruption that are at variance with this principle should be challenged and condemned. 
Accountability. Those making decisions about allocation must be accountable for those decisions – that is, they should justify their decisions and be held responsible for them. A fair process means that allocation decisions should not be made by individuals, by individual pharmaceutical companies, or, in the case of allocation between countries, by a single country. Resources such as vaccines and therapies should not be stockpiled outside the system of fair allocation.

The fair allocation of resources is one that is valuable in itself precisely
because it is fair. However, it may also be valuable because a fair system
engenders solidarity and trust, which are vital to the successful and
sustained collective response necessary for dealing effectively with any
outbreak.
Q&A: HIV, antiretrovirals and COVID-19
How can programmes assure continued access to HIV services?
It is important to assure continuous access to essential HIV prevention,
testing and treatment services also where measurements of confinement are
implemented within the public health response to the COVID-19 pandemic. While
access to essential services should be maintained, adapted and evidence-based
measures to reduce possible transmission should be considered and implemented.
These include[12]:

Applying standard precautions for all patients (including ensuring that all patients cover their nose and mouth with a tissue or elbow when coughing or sneezing, offering a medical mask to patients with suspected COVID-19 infection while they are in waiting in the service, perform hand hygiene etc.) 
Health care and outreach workers, as well as peer educators and clients should apply adapted hand hygiene measures
Ensuring triage, early recognition, and source control (isolating patients with suspected COVID-19 infection)
Ensure there is adequate ventilation in all areas in the healthcare facility
Spatial separation of at least 1 metre should ideally be maintained between all patients within all types of services
Cleaning and disinfection procedures should be followed consistently and correctly
Dispensing medicines (for treatment of HIV, TB and other chronic conditions such as opioid dependence) for longer periods allowing reduced frequency of patient visits 
Consider reduction of services to the most critical ones (provision of essential treatment and prevention services; services such as counselling sessions may be reduced or adapted)

Generally, vulnerable populations, including members of key populations, as
well as homeless and/or displaced people may be at increased risk of infection
– because of additional comorbidities impacting on their immune system,
reduced ability to apply measures of confinement and social distancing, as
well as generally limited access to health services. It is critical that
services that reach these populations such as community-based services, drop-
in centres and outreach services can continue providing life-saving prevention
(distribution of condoms, needles and syringes), testing and treatment while
securing safety of staff and clients. Services can be adapted according to
above considerations where applicable.
Q&A: HIV, antiretrovirals and COVID-19
Can pregnant or postpartum women living with HIV transmit the COVID-19 virus to their unborn child or infant?
There are few data on the clinical presentation of COVID-19 in specific
populations, such as children and pregnant women[13] but findings from a small
published study suggest that there is currently no evidence for intrauterine
infection caused by vertical transmission in women who develop COVID-19
pneumonia in late pregnancy[14]. **** Although no vertical transmission has
been documented, transmission after birth via contact with infectious
respiratory secretions is a concern. Infants born to mothers with suspected,
probable, or confirmed COVID-19 should be fed according to standard infant
feeding guidelines[15], while applying necessary precautions for infection
prevention and control (IPC). As with all confirmed or suspected COVID-19
cases, symptomatic mothers who are breastfeeding or practicing skin-to-skin
contact or kangaroo mother care should practice respiratory hygiene, including
during feeding (for example, use of a medical mask when near a child if the
mother has respiratory symptoms), perform hand hygiene before and after
contact with the child, and routinely clean and disinfect surfaces with which
the symptomatic mother has been in contact[16].

Q&A on COVID-19, pregnancy, childbirth and breastfeeding
Q&A: HIV, antiretrovirals and COVID-19
What is WHO’s position on use of corticosteroids for the treatment of COVID-19?
The current interim guidance from WHO on clinical management of severe acute
respiratory infection when COVID-19 infection is suspected advises against the
use of corticosteroids unless indicated for another reason.[8]
This guidance is based on several systematic reviews that cite lack of
effectiveness and possible harm from routine treatment with corticosteroids
for viral pneumonia or acute respiratory distress syndrome.[9]
Q&A: HIV, antiretrovirals and COVID-19
Are people living with HIV at increased risk of being infected with the virus that causes COVID-19?
People living with HIV with advanced disease, those with low CD4 and high
viral load and those who are not taking antiretroviral treatment have an
increased risk of infections and related complications in general. It is
unknown if the immunosuppression of HIV will put a person at greater risk for
COVID-19, thus, until more is known, additional precautions for all people
with advanced HIV or poorly controlled HIV, should be employed[1],[2]. __
At present there is no evidence that the risk of infection or complications of
COVID-19 is different among people living with HIV who are clinically and
immunologically stable on antiretroviral treatment when compared with the
general population. Some people living with HIV may have known risk factors
for COVID-19 complications, such as diabetes, hypertension and other
noncommunicable diseases and as such may have increased risk of COVID-19
unrelated to HIV. We know that during the SARS and MERS outbreaks there were
only a few case reports of mild disease among people living with HIV.
To date, there is a case report of a person living with HIV who had COVID-19
and recovered[3] and a small study on risk factors and antiretrovirals used
among people living with HIV with COVID-19 from China. This study reported
similar rates of COVID-19 disease as compared to the entire population and
increased risk with older age, but not with low CD4, high viral load level or
antiretroviral regimen[4]. Current clinical data suggest the main mortality
risk factors are linked to older age and other comorbidities including
cardiovascular disease, diabetes, chronic respiratory disease, and
hypertension. Some very healthy people have also developed severe disease from
the coronavirus infection[5].
PLHIV are advised to take the same precautions as the general
population[6],[7]:


wash hands often


cough etiquette 


physical distancing


seek medical care if symptomatic


self-isolation if in contact with someone with COVID-19 and 


other actions per the government response 


People living with HIV who are taking antiretroviral drugs should ensure that
they have at least 30 days and up to 6-month supply of medicines and ensure
that their vaccinations are up to date (influenza and pneumococcal vaccines).
Adequate supplies of medicines to treat co-infections and comorbidities and
addiction should also be ensured.
Q&A: HIV, antiretrovirals and COVID-19
What is WHO’s position on the use of antiretrovirals for the treatment of COVID-19?
Currently, there is insufficient data to assess the effectiveness of LPV/r or
other antivirals for treating COVID-19. Several countries are evaluating the
use of LPV/r and other antivirals and we welcome the results of these
investigations.
Again, as part of WHO’s response to the outbreak, the
WHO R&D Blueprint
has been activated to accelerate evaluation of diagnostics,
vaccines and therapeutics for this novel coronavirus. WHO has also designed a
set of procedures to assess the performance, quality and safety of medical
technologies during emergency situations.
Q&A: HIV, antiretrovirals and COVID-19
How do we ensure human rights and reduce stigma and discrimination?
As the world scales up public health responses to the COVID19 pandemic,
countries are being urged to take decisive action to control the epidemic. WHO
has urged all countries to ensure an appropriate balance between protecting
health, preventing economic and social disruption, and respecting human
rights.
WHO is working with partners including the UNAIDS Joint Programme and the
Global Network of People Living with HIV to ensure that human rights are not
eroded in the response to COVID-19 and to ensure that people living with or
affected by HIV are offered the same access to services as others and to
ensure HIV-related services continue without disruption.
To mitigate potential prison outbreaks of COVID19 and reduce morbidity and
mortality among people in prisons and other closed settings, it is crucial
that prisons and immigration detention centres are embedded within the broader
public health response. This requires close collaboration between health and
justice ministries and includes protocols for entry screening, personal
protection measures, physical distancing, environmental cleaning and
disinfection, and restriction of movement, including limitation of transfers
and access for non-essential staff and visitors. In the current context it is
of critical importance that countries work toward developing non-custodial
strategies to prevent overcrowding in closed settings[10]. Governance of
prison health by a ministry of health, rather than a ministry of justice or
similar, is likely to facilitate this[11]. __
Q&A: HIV, antiretrovirals and COVID-19
If countries use antiretrovirals for COVID-19, are there concerns about treatment shortages for people living with HIV?
Antiretrovirals are an efficacious and highly tolerable treatment for people
living with HIV. The antiretroviral LPV/r is currently being investigated as a
possible treatment for COVID-19.  
If they are to be used for the treatment of COVID-19, a plan should be in
place to ensure there is adequate and continuous supply to cover the needs of
all people living with HIV already using LPV/r and those who will need to
begin treatment. However, a relatively small proportion of people are on
regimens which include LPV/r, since it is used as a second-line regimen
according to WHO’s HIV treatment guidelines. Any country that allows the use
of HIV medicines for the treatment of COVID-19 must ensure that an adequate
and sustainable supply is in place.
Q&A: HIV, antiretrovirals and COVID-19
Can antiretrovirals be used to treat COVID-19?
Several studies have suggested that patients infected with the virus causing
COVID-19, and the related coronavirus infections (SARS-CoV and MERS-CoV) had
good clinical outcomes, with almost all cases recovering fully. In some cases,
patients were given an antiretroviral drug: lopinavir boosted with ritonavir
(LPV/r). These studies were mostly carried out in HIV-negative individuals.
It is important to note that these studies using LPV/r had important
limitations. The studies were small, timing, duration and dosing for treatment
were varied and most patients received co-interventions/co-treatments which
may have contributed to the reported outcomes.
While the evidence of benefit of using antiretrovirals to treat coronavirus
infections is of very low certainty, serious side effects were rare. Among
people living with HIV, the routine use of LPV/r as treatment for HIV is
associated with several side effects of moderate severity. However, as the
duration of treatment in patients with coronavirus infections was generally
limited to a few weeks, these occurrences can be expected to be low or less
than that reported from routine use.
Q&A: HIV, antiretrovirals and COVID-19
Can antiretrovirals be used to prevent COVID-19 infection?
Two studies have reported the use of LPV/r as post-exposure prophylaxis for
SARS-CoV and MERS-CoV. One of these studies suggested that the occurrence of
MERS-CoV infection was lower among health workers receiving LPV/r compared to
those who did not receive any drugs; the other study found no cases of SARS-
CoV infection among 19 people living with HIV hospitalized in the same ward of
SARS patients, of whom 11 were on antiretroviral therapy. Again, the certainty
of the evidence is very low due to small sample size, variability in drugs
provided, and uncertainty regarding intensity of exposure.