· The specimen should be double-bagged. The specimen should be placed in the first bag in the isolation room by a staff member wearing recommended PPE.

Specimens should be hand-delivered to the laboratory by someone who understands the nature of the specimens. Pneumatic tube systems must not be used to transport specimens.

Saline Nebulisation


Do not use saline nebulisation.

Manual hyperinflation


As it involves disconnection/opening of a ventilator circuit, avoid manual hyperinflation and utilise ventilator hyperinflation if indicated (e.g., for suppurative presentations in ICU and if local procedures are in place).

Positioning, including gravity-assisted drainage


Physiotherapists can continue to advice on positioning requirements for patients.

Prone Positioning


Physiotherapists may have a role in the implementation of prone positioning in the ICU. This may include leadership within ICU ‘prone teams’, providing staff education on prone positioning (e.g., simulation-based education sessions) or assisting in turns as part of the ICU team.

Tracheostomy Management


The presence of a tracheostomy and related procedures that are potentially aerosol generating.

· Cuff deflation trials and inner tube changes/cleaning can be aerosol generating.

· Closed, in-line suction is recommended.

· Inspiratory muscle training, speaking valves and leak speech should not be attempted until patients are over the acute infection and the risk of transmission is reduced.

· Airborne precautions are recommended with infectious patients with COVID-19 with a tracheostomy.